|
EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBCUTANEOUS; LESS THAN 3 CM
|
Facility
|
OP
|
$4,536.73
|
|
|
Service Code
|
CPT 27327
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$315.00 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,320.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.50
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$315.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER
|
Facility
|
OP
|
$7,951.14
|
|
|
Service Code
|
CPT 27339
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$748.86 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,787.02
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$823.75
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$748.86
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF THIGH OR KNEE AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM
|
Facility
|
OP
|
$7,951.14
|
|
|
Service Code
|
CPT 27328
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$620.18 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,531.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$682.20
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$620.18
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBCUTANEOUS; 3 CM OR GREATER
|
Facility
|
OP
|
$7,951.14
|
|
|
Service Code
|
CPT 24071
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$403.41 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,277.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$443.75
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$403.41
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER
|
Facility
|
OP
|
$7,951.14
|
|
|
Service Code
|
CPT 24073
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$686.97 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,787.02
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$755.67
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$686.97
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM
|
Facility
|
OP
|
$7,951.14
|
|
|
Service Code
|
CPT 24076
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$544.86 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,531.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$599.35
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$544.86
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: VA VA |
$2,525.74
|
|
|
EXCISION, TUMOR, SOFT TISSUE, OR VASCULAR MALFORMATION, OF HAND OR FINGER, SUBFASCIAL (EG, INTRAMUSCULAR); 1.5 CM OR GREATER
|
Facility
|
OP
|
$4,536.73
|
|
|
Service Code
|
CPT 26113
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$547.16 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,452.53
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$601.88
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$547.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
EXCISION, TUMOR, SOFT TISSUE, OR VASCULAR MALFORMATION, OF HAND OR FINGER, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 1.5 CM
|
Facility
|
OP
|
$4,536.73
|
|
|
Service Code
|
CPT 26116
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$525.54 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,232.47
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$578.09
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$525.54
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
EXEMESTANE 25 MG TABLET
|
Facility
|
IP
|
$346.10
|
|
|
Service Code
|
NDC 47781-108-30
|
| Hospital Charge Code |
26551
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$152.28 |
| Max. Negotiated Rate |
$311.49 |
| Rate for Payer: Aetna American Axle |
$224.96
|
| Rate for Payer: Aetna Commercial |
$294.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.96
|
| Rate for Payer: Cash Price |
$276.88
|
| Rate for Payer: Cofinity Commercial |
$242.27
|
| Rate for Payer: Cofinity Commercial |
$297.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.88
|
| Rate for Payer: Healthscope Commercial |
$311.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$242.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$294.18
|
| Rate for Payer: PHP Commercial |
$294.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.27
|
| Rate for Payer: Priority Health SBD |
$218.04
|
| Rate for Payer: UMR Bronson Commercial |
$152.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.58
|
|
|
EXEMESTANE 25 MG TABLET
|
Facility
|
IP
|
$1,120.99
|
|
|
Service Code
|
NDC 0054-0080-13
|
| Hospital Charge Code |
26551
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$493.24 |
| Max. Negotiated Rate |
$1,008.89 |
| Rate for Payer: Aetna American Axle |
$728.64
|
| Rate for Payer: Aetna Commercial |
$952.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$728.64
|
| Rate for Payer: Cash Price |
$896.79
|
| Rate for Payer: Cofinity Commercial |
$784.69
|
| Rate for Payer: Cofinity Commercial |
$964.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$896.79
|
| Rate for Payer: Healthscope Commercial |
$1,008.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$784.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$840.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$952.84
|
| Rate for Payer: PHP Commercial |
$952.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$784.69
|
| Rate for Payer: Priority Health SBD |
$706.22
|
| Rate for Payer: UMR Bronson Commercial |
$493.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$840.74
|
|
|
EXEMESTANE 25 MG TABLET
|
Facility
|
IP
|
$110.60
|
|
|
Service Code
|
NDC 68382-383-06
|
| Hospital Charge Code |
26551
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.66 |
| Max. Negotiated Rate |
$99.54 |
| Rate for Payer: Aetna American Axle |
$71.89
|
| Rate for Payer: Aetna Commercial |
$94.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.89
|
| Rate for Payer: Cash Price |
$88.48
|
| Rate for Payer: Cofinity Commercial |
$77.42
|
| Rate for Payer: Cofinity Commercial |
$95.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.48
|
| Rate for Payer: Healthscope Commercial |
$99.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.01
|
| Rate for Payer: PHP Commercial |
$94.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.42
|
| Rate for Payer: Priority Health SBD |
$69.68
|
| Rate for Payer: UMR Bronson Commercial |
$48.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.95
|
|
|
EXEMESTANE 25 MG TABLET
|
Facility
|
IP
|
$4,152.85
|
|
|
Service Code
|
NDC 0009-7663-04
|
| Hospital Charge Code |
26551
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,827.25 |
| Max. Negotiated Rate |
$3,737.56 |
| Rate for Payer: Aetna American Axle |
$2,699.35
|
| Rate for Payer: Aetna Commercial |
$3,529.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,699.35
|
| Rate for Payer: Cash Price |
$3,322.28
|
| Rate for Payer: Cofinity Commercial |
$2,907.00
|
| Rate for Payer: Cofinity Commercial |
$3,571.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,322.28
|
| Rate for Payer: Healthscope Commercial |
$3,737.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,907.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,114.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,529.92
|
| Rate for Payer: PHP Commercial |
$3,529.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,907.00
|
| Rate for Payer: Priority Health SBD |
$2,616.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,827.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,114.64
|
|
|
EXENATIDE 10 MCG/DOSE(250 MCG/ML)2.4 ML SUBCUTANEOUS PEN INJECTOR
|
Facility
|
IP
|
$2,453.57
|
|
|
Service Code
|
NDC 0310-6524-01
|
| Hospital Charge Code |
105629
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1,079.57 |
| Max. Negotiated Rate |
$2,208.21 |
| Rate for Payer: Aetna American Axle |
$1,594.82
|
| Rate for Payer: Aetna Commercial |
$2,085.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,594.82
|
| Rate for Payer: Cash Price |
$1,962.86
|
| Rate for Payer: Cofinity Commercial |
$1,717.50
|
| Rate for Payer: Cofinity Commercial |
$2,110.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,962.86
|
| Rate for Payer: Healthscope Commercial |
$2,208.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,717.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,840.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,085.53
|
| Rate for Payer: PHP Commercial |
$2,085.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,717.50
|
| Rate for Payer: Priority Health SBD |
$1,545.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,079.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,840.18
|
|
|
EXENATIDE 5 MCG/DOSE (250 MCG/ML)1.2 ML SUBCUTANEOUS PEN INJECTOR
|
Facility
|
IP
|
$2,453.57
|
|
|
Service Code
|
NDC 0310-6512-01
|
| Hospital Charge Code |
41283
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1,079.57 |
| Max. Negotiated Rate |
$2,208.21 |
| Rate for Payer: Aetna American Axle |
$1,594.82
|
| Rate for Payer: Aetna Commercial |
$2,085.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,594.82
|
| Rate for Payer: Cash Price |
$1,962.86
|
| Rate for Payer: Cofinity Commercial |
$1,717.50
|
| Rate for Payer: Cofinity Commercial |
$2,110.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,962.86
|
| Rate for Payer: Healthscope Commercial |
$2,208.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,717.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,840.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,085.53
|
| Rate for Payer: PHP Commercial |
$2,085.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,717.50
|
| Rate for Payer: Priority Health SBD |
$1,545.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,079.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,840.18
|
|
|
EXPLORATION FOR POSTOPERATIVE HEMORRHAGE, THROMBOSIS OR INFECTION; EXTREMITY
|
Facility
|
OP
|
$8,919.33
|
|
|
Service Code
|
CPT 35860
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$812.06 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,102.14
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$893.27
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$812.06
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: VA VA |
$2,833.29
|
|
|
EXPLORATION FOR UNDESCENDED TESTIS (INGUINAL OR SCROTAL AREA)
|
Facility
|
OP
|
$9,680.93
|
|
|
Service Code
|
CPT 54550
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$483.63 |
| Max. Negotiated Rate |
$9,680.93 |
| Rate for Payer: Aetna Medicare |
$3,198.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,844.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,844.02
|
| Rate for Payer: BCBS Complete |
$1,766.41
|
| Rate for Payer: BCBS MAPPO |
$3,075.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,519.12
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Mclaren Medicaid |
$1,682.15
|
| Rate for Payer: Mclaren Medicare |
$3,075.22
|
| Rate for Payer: Meridian Medicaid |
$1,766.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,228.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,536.50
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Medicare Advantage |
$3,075.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,682.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,680.93
|
| Rate for Payer: Priority Health Medicare |
$3,075.22
|
| Rate for Payer: Priority Health Narrow Network |
$7,744.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$531.99
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,075.22
|
| Rate for Payer: UHC Exchange |
$483.63
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: VA VA |
$3,075.22
|
|
|
EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE); CHEST
|
Facility
|
OP
|
$5,102.91
|
|
|
Service Code
|
CPT 20101
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$206.29 |
| Max. Negotiated Rate |
$5,102.91 |
| Rate for Payer: Aetna Medicare |
$1,685.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,271.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,102.91
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$4,082.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.92
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,620.98
|
| Rate for Payer: UHC Exchange |
$206.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: VA VA |
$1,620.98
|
|
|
EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE); EXTREMITY
|
Facility
|
OP
|
$4,536.73
|
|
|
Service Code
|
CPT 20103
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$339.88 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$762.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$373.87
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$339.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE); NECK
|
Facility
|
OP
|
$1,539.60
|
|
|
Service Code
|
CPT 20100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$267.52 |
| Max. Negotiated Rate |
$1,539.60 |
| Rate for Payer: Aetna Medicare |
$508.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$611.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$611.32
|
| Rate for Payer: BCBS Complete |
$280.92
|
| Rate for Payer: BCBS MAPPO |
$489.06
|
| Rate for Payer: BCBS Trust/PPO |
$394.16
|
| Rate for Payer: BCN Medicare Advantage |
$489.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.06
|
| Rate for Payer: Mclaren Medicaid |
$267.52
|
| Rate for Payer: Mclaren Medicare |
$489.06
|
| Rate for Payer: Meridian Medicaid |
$280.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$513.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.42
|
| Rate for Payer: PACE Medicare |
$464.61
|
| Rate for Payer: PACE SWMI |
$489.06
|
| Rate for Payer: PHP Medicare Advantage |
$489.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,539.60
|
| Rate for Payer: Priority Health Medicare |
$489.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,231.68
|
| Rate for Payer: Railroad Medicare Medicare |
$489.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.98
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$489.06
|
| Rate for Payer: UHC Exchange |
$589.07
|
| Rate for Payer: UHC Medicare Advantage |
$503.73
|
| Rate for Payer: VA VA |
$489.06
|
|
|
EXPLORATION WITH REMOVAL OF DEEP FOREIGN BODY, FOREARM OR WRIST
|
Facility
|
OP
|
$4,497.31
|
|
|
Service Code
|
CPT 25248
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$426.33 |
| Max. Negotiated Rate |
$4,497.31 |
| Rate for Payer: Aetna Medicare |
$1,485.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.76
|
| Rate for Payer: BCBS Complete |
$820.59
|
| Rate for Payer: BCBS MAPPO |
$1,428.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,810.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.61
|
| Rate for Payer: Mclaren Medicaid |
$781.45
|
| Rate for Payer: Mclaren Medicare |
$1,428.61
|
| Rate for Payer: Meridian Medicaid |
$820.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,500.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.90
|
| Rate for Payer: PACE Medicare |
$1,357.18
|
| Rate for Payer: PACE SWMI |
$1,428.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,497.31
|
| Rate for Payer: Priority Health Medicare |
$1,428.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,597.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$468.96
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,428.61
|
| Rate for Payer: UHC Exchange |
$426.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: VA VA |
$1,428.61
|
|
|
EXPLORATORY LAPAROTOMY, EXPLORATORY CELIOTOMY WITH OR WITHOUT BIOPSY(S) (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$5,042.00
|
|
|
Service Code
|
CPT 49000
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$756.39 |
| Max. Negotiated Rate |
$5,042.00 |
| Rate for Payer: BCBS Trust/PPO |
$2,685.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$832.03
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Exchange |
$756.39
|
|
|
EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT
|
Facility
|
IP
|
$48,363.27
|
|
|
Service Code
|
MS-DRG 933
|
| Min. Negotiated Rate |
$22,683.20 |
| Max. Negotiated Rate |
$48,363.27 |
| Rate for Payer: Aetna Medicare |
$24,832.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29,846.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29,846.31
|
| Rate for Payer: BCBS MAPPO |
$23,877.05
|
| Rate for Payer: BCBS Trust/PPO |
$48,363.27
|
| Rate for Payer: BCN Medicare Advantage |
$23,877.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23,877.05
|
| Rate for Payer: Mclaren Medicare |
$23,877.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25,070.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27,458.61
|
| Rate for Payer: PACE Medicare |
$22,683.20
|
| Rate for Payer: PACE SWMI |
$23,877.05
|
| Rate for Payer: PHP Medicare Advantage |
$23,877.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43,508.96
|
| Rate for Payer: Priority Health Medicare |
$23,877.05
|
| Rate for Payer: Priority Health Narrow Network |
$34,807.17
|
| Rate for Payer: Railroad Medicare Medicare |
$23,877.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46,250.13
|
| Rate for Payer: UHC Core |
$37,924.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$23,877.05
|
| Rate for Payer: UHC Exchange |
$30,150.21
|
| Rate for Payer: UHC Medicare Advantage |
$24,593.36
|
| Rate for Payer: VA VA |
$23,877.05
|
|
|
EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT
|
Facility
|
IP
|
$420,453.40
|
|
|
Service Code
|
MS-DRG 927
|
| Min. Negotiated Rate |
$193,451.74 |
| Max. Negotiated Rate |
$420,453.40 |
| Rate for Payer: Aetna Medicare |
$211,778.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$254,541.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$254,541.76
|
| Rate for Payer: BCBS MAPPO |
$203,633.41
|
| Rate for Payer: BCBS Trust/PPO |
$420,453.40
|
| Rate for Payer: BCN Medicare Advantage |
$203,633.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203,633.41
|
| Rate for Payer: Mclaren Medicare |
$203,633.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$213,815.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$234,178.42
|
| Rate for Payer: PACE Medicare |
$193,451.74
|
| Rate for Payer: PACE SWMI |
$203,633.41
|
| Rate for Payer: PHP Medicare Advantage |
$203,633.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$378,245.24
|
| Rate for Payer: Priority Health Medicare |
$203,633.41
|
| Rate for Payer: Priority Health Narrow Network |
$302,596.19
|
| Rate for Payer: Railroad Medicare Medicare |
$203,633.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$402,075.61
|
| Rate for Payer: UHC Core |
$329,694.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$203,633.41
|
| Rate for Payer: UHC Exchange |
$262,110.91
|
| Rate for Payer: UHC Medicare Advantage |
$209,742.41
|
| Rate for Payer: VA VA |
$203,633.41
|
|
|
EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC
|
Facility
|
IP
|
$46,443.42
|
|
|
Service Code
|
MS-DRG 982
|
| Min. Negotiated Rate |
$18,686.07 |
| Max. Negotiated Rate |
$46,443.42 |
| Rate for Payer: Aetna Medicare |
$20,456.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24,586.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24,586.94
|
| Rate for Payer: BCBS MAPPO |
$19,669.55
|
| Rate for Payer: BCBS Trust/PPO |
$46,443.42
|
| Rate for Payer: BCN Medicare Advantage |
$19,669.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,669.55
|
| Rate for Payer: Mclaren Medicare |
$19,669.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$20,653.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,619.98
|
| Rate for Payer: PACE Medicare |
$18,686.07
|
| Rate for Payer: PACE SWMI |
$19,669.55
|
| Rate for Payer: PHP Medicare Advantage |
$19,669.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35,673.90
|
| Rate for Payer: Priority Health Medicare |
$19,669.55
|
| Rate for Payer: Priority Health Narrow Network |
$28,539.12
|
| Rate for Payer: Railroad Medicare Medicare |
$19,669.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37,921.44
|
| Rate for Payer: UHC Core |
$31,094.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,669.55
|
| Rate for Payer: UHC Exchange |
$24,720.78
|
| Rate for Payer: UHC Medicare Advantage |
$20,259.64
|
| Rate for Payer: VA VA |
$19,669.55
|
|
|
EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC
|
Facility
|
IP
|
$110,668.12
|
|
|
Service Code
|
MS-DRG 981
|
| Min. Negotiated Rate |
$35,189.95 |
| Max. Negotiated Rate |
$110,668.12 |
| Rate for Payer: Aetna Medicare |
$38,523.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46,302.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46,302.56
|
| Rate for Payer: BCBS MAPPO |
$37,042.05
|
| Rate for Payer: BCBS Trust/PPO |
$110,668.12
|
| Rate for Payer: BCN Medicare Advantage |
$37,042.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37,042.05
|
| Rate for Payer: Mclaren Medicare |
$37,042.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38,894.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42,598.36
|
| Rate for Payer: PACE Medicare |
$35,189.95
|
| Rate for Payer: PACE SWMI |
$37,042.05
|
| Rate for Payer: PHP Medicare Advantage |
$37,042.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68,024.36
|
| Rate for Payer: Priority Health Medicare |
$37,042.05
|
| Rate for Payer: Priority Health Narrow Network |
$54,419.49
|
| Rate for Payer: Railroad Medicare Medicare |
$37,042.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72,310.06
|
| Rate for Payer: UHC Core |
$59,292.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$37,042.05
|
| Rate for Payer: UHC Exchange |
$47,138.54
|
| Rate for Payer: UHC Medicare Advantage |
$38,153.31
|
| Rate for Payer: VA VA |
$37,042.05
|
|
