|
HAND PROCEDURES FOR INJURIES
|
Facility
|
IP
|
$39,723.92
|
|
|
Service Code
|
MS-DRG 906
|
| Min. Negotiated Rate |
$14,261.42 |
| Max. Negotiated Rate |
$39,723.92 |
| Rate for Payer: Aetna Medicare |
$15,612.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18,765.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18,765.02
|
| Rate for Payer: BCBS MAPPO |
$15,012.02
|
| Rate for Payer: BCBS Trust/PPO |
$39,723.92
|
| Rate for Payer: BCN Medicare Advantage |
$15,012.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,012.02
|
| Rate for Payer: Mclaren Medicare |
$15,012.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15,762.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,263.82
|
| Rate for Payer: PACE Medicare |
$14,261.42
|
| Rate for Payer: PACE SWMI |
$15,012.02
|
| Rate for Payer: PHP Medicare Advantage |
$15,012.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27,000.81
|
| Rate for Payer: Priority Health Medicare |
$15,012.02
|
| Rate for Payer: Priority Health Narrow Network |
$21,600.65
|
| Rate for Payer: Railroad Medicare Medicare |
$15,012.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,701.93
|
| Rate for Payer: UHC Core |
$23,535.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,012.02
|
| Rate for Payer: UHC Exchange |
$18,710.63
|
| Rate for Payer: UHC Medicare Advantage |
$15,462.38
|
| Rate for Payer: VA VA |
$15,012.02
|
|
|
HARVEST OF FEMOROPOPLITEAL VEIN, 1 SEGMENT, FOR VASCULAR RECONSTRUCTION PROCEDURE (EG, AORTIC, VENA CAVAL, CORONARY, PERIPHERAL ARTERY) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$1,221.53
|
|
|
Service Code
|
CPT 35572
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$327.77 |
| Max. Negotiated Rate |
$1,221.53 |
| Rate for Payer: BCBS Trust/PPO |
$1,221.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.55
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$327.77
|
|
|
HC 11 DEOXYCORTISOL
|
Facility
|
IP
|
$64.26
|
|
|
Service Code
|
CPT 82634
|
| Hospital Charge Code |
30100189
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.27 |
| Max. Negotiated Rate |
$57.83 |
| Rate for Payer: Aetna American Axle |
$41.77
|
| Rate for Payer: Aetna Commercial |
$54.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.77
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$44.98
|
| Rate for Payer: Cofinity Commercial |
$55.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.41
|
| Rate for Payer: Healthscope Commercial |
$57.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.62
|
| Rate for Payer: PHP Commercial |
$54.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.98
|
| Rate for Payer: Priority Health SBD |
$40.48
|
| Rate for Payer: UMR Bronson Commercial |
$28.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.20
|
|
|
HC 11 DEOXYCORTISOL
|
Facility
|
OP
|
$64.26
|
|
|
Service Code
|
CPT 82634
|
| Hospital Charge Code |
30100189
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.02 |
| Max. Negotiated Rate |
$57.83 |
| Rate for Payer: Aetna American Axle |
$41.77
|
| Rate for Payer: Aetna Commercial |
$54.62
|
| Rate for Payer: Aetna Medicare |
$30.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.60
|
| Rate for Payer: BCBS Complete |
$16.82
|
| Rate for Payer: BCBS MAPPO |
$29.28
|
| Rate for Payer: BCBS Trust/PPO |
$26.33
|
| Rate for Payer: BCN Medicare Advantage |
$29.28
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$44.98
|
| Rate for Payer: Cofinity Commercial |
$55.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.28
|
| Rate for Payer: Healthscope Commercial |
$57.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.20
|
| Rate for Payer: Mclaren Medicaid |
$16.02
|
| Rate for Payer: Mclaren Medicare |
$29.28
|
| Rate for Payer: Meridian Medicaid |
$16.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$30.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.62
|
| Rate for Payer: PACE Medicare |
$27.82
|
| Rate for Payer: PACE SWMI |
$29.28
|
| Rate for Payer: PHP Commercial |
$54.62
|
| Rate for Payer: PHP Medicare Advantage |
$29.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.16
|
| Rate for Payer: Priority Health Medicare |
$29.28
|
| Rate for Payer: Priority Health Narrow Network |
$32.13
|
| Rate for Payer: Priority Health SBD |
$40.48
|
| Rate for Payer: Railroad Medicare Medicare |
$29.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.14
|
| Rate for Payer: UHC Core |
$48.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.28
|
| Rate for Payer: UHC Exchange |
$29.28
|
| Rate for Payer: UHC Medicare Advantage |
$30.16
|
| Rate for Payer: UMR Bronson Commercial |
$23.78
|
| Rate for Payer: VA VA |
$29.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.20
|
|
|
HC 1/2 X 1/2 STERILE W/LL
|
Facility
|
OP
|
$6.75
|
|
| Hospital Charge Code |
27000680
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.50 |
| Max. Negotiated Rate |
$6.08 |
| Rate for Payer: Aetna American Axle |
$4.39
|
| Rate for Payer: Aetna Commercial |
$5.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.39
|
| Rate for Payer: BCBS Complete |
$2.70
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cofinity Commercial |
$4.72
|
| Rate for Payer: Cofinity Commercial |
$5.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.40
|
| Rate for Payer: Healthscope Commercial |
$6.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5.74
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.72
|
| Rate for Payer: Priority Health SBD |
$4.25
|
| Rate for Payer: UMR Bronson Commercial |
$2.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.06
|
|
|
HC 1/2 X 1/2 STERILE W/LL
|
Facility
|
IP
|
$6.75
|
|
| Hospital Charge Code |
27000680
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.97 |
| Max. Negotiated Rate |
$6.08 |
| Rate for Payer: Aetna American Axle |
$4.39
|
| Rate for Payer: Aetna Commercial |
$5.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.39
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cofinity Commercial |
$4.72
|
| Rate for Payer: Cofinity Commercial |
$5.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.40
|
| Rate for Payer: Healthscope Commercial |
$6.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5.74
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.72
|
| Rate for Payer: Priority Health SBD |
$4.25
|
| Rate for Payer: UMR Bronson Commercial |
$2.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.06
|
|
|
HC 20CM TL CATHETER
|
Facility
|
IP
|
$272.95
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200007
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.10 |
| Max. Negotiated Rate |
$245.66 |
| Rate for Payer: Aetna American Axle |
$177.42
|
| Rate for Payer: Aetna Commercial |
$232.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.42
|
| Rate for Payer: Cash Price |
$218.36
|
| Rate for Payer: Cofinity Commercial |
$191.06
|
| Rate for Payer: Cofinity Commercial |
$234.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.36
|
| Rate for Payer: Healthscope Commercial |
$245.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$191.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$232.01
|
| Rate for Payer: PHP Commercial |
$232.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.06
|
| Rate for Payer: Priority Health SBD |
$171.96
|
| Rate for Payer: UMR Bronson Commercial |
$120.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.71
|
|
|
HC 20CM TL CATHETER
|
Facility
|
OP
|
$272.95
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200007
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.99 |
| Max. Negotiated Rate |
$245.66 |
| Rate for Payer: Aetna American Axle |
$177.42
|
| Rate for Payer: Aetna Commercial |
$232.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.42
|
| Rate for Payer: BCBS Complete |
$109.18
|
| Rate for Payer: Cash Price |
$218.36
|
| Rate for Payer: Cofinity Commercial |
$191.06
|
| Rate for Payer: Cofinity Commercial |
$234.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.36
|
| Rate for Payer: Healthscope Commercial |
$245.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$191.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$232.01
|
| Rate for Payer: PHP Commercial |
$232.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.06
|
| Rate for Payer: Priority Health SBD |
$171.96
|
| Rate for Payer: UMR Bronson Commercial |
$100.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.71
|
|
|
HC 23BPG, U
|
Facility
|
IP
|
$73.44
|
|
|
Service Code
|
CPT 84150
|
| Hospital Charge Code |
30100714
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.31 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna American Axle |
$47.74
|
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.74
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.42
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.41
|
| Rate for Payer: Priority Health SBD |
$46.27
|
| Rate for Payer: UMR Bronson Commercial |
$32.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.08
|
|
|
HC 23BPG, U
|
Facility
|
OP
|
$73.44
|
|
|
Service Code
|
CPT 84150
|
| Hospital Charge Code |
30100714
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.85 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna American Axle |
$47.74
|
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: Aetna Medicare |
$43.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.21
|
| Rate for Payer: BCBS Complete |
$23.99
|
| Rate for Payer: BCBS MAPPO |
$41.77
|
| Rate for Payer: BCBS Trust/PPO |
$37.57
|
| Rate for Payer: BCN Medicare Advantage |
$41.77
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Cofinity Commercial |
$51.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.77
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.08
|
| Rate for Payer: Mclaren Medicaid |
$22.85
|
| Rate for Payer: Mclaren Medicare |
$41.77
|
| Rate for Payer: Meridian Medicaid |
$23.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.42
|
| Rate for Payer: PACE Medicare |
$39.68
|
| Rate for Payer: PACE SWMI |
$41.77
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: PHP Medicare Advantage |
$41.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.23
|
| Rate for Payer: Priority Health Medicare |
$41.77
|
| Rate for Payer: Priority Health Narrow Network |
$27.38
|
| Rate for Payer: Priority Health SBD |
$46.27
|
| Rate for Payer: Railroad Medicare Medicare |
$41.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.12
|
| Rate for Payer: UHC Core |
$41.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.77
|
| Rate for Payer: UHC Exchange |
$41.77
|
| Rate for Payer: UHC Medicare Advantage |
$43.02
|
| Rate for Payer: UMR Bronson Commercial |
$27.17
|
| Rate for Payer: VA VA |
$41.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.08
|
|
|
HC 23BPR URINE
|
Facility
|
OP
|
$85.21
|
|
|
Service Code
|
CPT 84150
|
| Hospital Charge Code |
30100735
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.85 |
| Max. Negotiated Rate |
$76.69 |
| Rate for Payer: Aetna American Axle |
$55.39
|
| Rate for Payer: Aetna Commercial |
$72.43
|
| Rate for Payer: Aetna Medicare |
$43.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.21
|
| Rate for Payer: BCBS Complete |
$23.99
|
| Rate for Payer: BCBS MAPPO |
$41.77
|
| Rate for Payer: BCBS Trust/PPO |
$37.57
|
| Rate for Payer: BCN Medicare Advantage |
$41.77
|
| Rate for Payer: Cash Price |
$68.17
|
| Rate for Payer: Cash Price |
$68.17
|
| Rate for Payer: Cofinity Commercial |
$73.28
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.77
|
| Rate for Payer: Healthscope Commercial |
$76.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.91
|
| Rate for Payer: Mclaren Medicaid |
$22.85
|
| Rate for Payer: Mclaren Medicare |
$41.77
|
| Rate for Payer: Meridian Medicaid |
$23.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.43
|
| Rate for Payer: PACE Medicare |
$39.68
|
| Rate for Payer: PACE SWMI |
$41.77
|
| Rate for Payer: PHP Commercial |
$72.43
|
| Rate for Payer: PHP Medicare Advantage |
$41.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.23
|
| Rate for Payer: Priority Health Medicare |
$41.77
|
| Rate for Payer: Priority Health Narrow Network |
$27.38
|
| Rate for Payer: Priority Health SBD |
$53.68
|
| Rate for Payer: Railroad Medicare Medicare |
$41.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.12
|
| Rate for Payer: UHC Core |
$41.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.77
|
| Rate for Payer: UHC Exchange |
$41.77
|
| Rate for Payer: UHC Medicare Advantage |
$43.02
|
| Rate for Payer: UMR Bronson Commercial |
$31.53
|
| Rate for Payer: VA VA |
$41.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.91
|
|
|
HC 23BPR URINE
|
Facility
|
IP
|
$85.21
|
|
|
Service Code
|
CPT 84150
|
| Hospital Charge Code |
30100735
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$76.69 |
| Rate for Payer: Aetna American Axle |
$55.39
|
| Rate for Payer: Aetna Commercial |
$72.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.39
|
| Rate for Payer: Cash Price |
$68.17
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Cofinity Commercial |
$73.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.17
|
| Rate for Payer: Healthscope Commercial |
$76.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$72.43
|
| Rate for Payer: PHP Commercial |
$72.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.65
|
| Rate for Payer: Priority Health SBD |
$53.68
|
| Rate for Payer: UMR Bronson Commercial |
$37.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.91
|
|
|
HC 24 HOUR PH MONITOR
|
Facility
|
IP
|
$1,521.71
|
|
|
Service Code
|
CPT 91034
|
| Hospital Charge Code |
75000001
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$669.55 |
| Max. Negotiated Rate |
$1,369.54 |
| Rate for Payer: Aetna American Axle |
$989.11
|
| Rate for Payer: Aetna Commercial |
$1,293.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$989.11
|
| Rate for Payer: Cash Price |
$1,217.37
|
| Rate for Payer: Cofinity Commercial |
$1,065.20
|
| Rate for Payer: Cofinity Commercial |
$1,308.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,217.37
|
| Rate for Payer: Healthscope Commercial |
$1,369.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,065.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,141.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,293.45
|
| Rate for Payer: PHP Commercial |
$1,293.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,065.20
|
| Rate for Payer: Priority Health SBD |
$958.68
|
| Rate for Payer: UMR Bronson Commercial |
$669.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,141.28
|
|
|
HC 24 HOUR PH MONITOR
|
Facility
|
OP
|
$1,521.71
|
|
|
Service Code
|
CPT 91034
|
| Hospital Charge Code |
75000001
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$187.95 |
| Max. Negotiated Rate |
$1,499.80 |
| Rate for Payer: Aetna American Axle |
$989.11
|
| Rate for Payer: Aetna Commercial |
$1,293.45
|
| Rate for Payer: Aetna Medicare |
$495.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$989.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$595.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$595.52
|
| Rate for Payer: BCBS Complete |
$273.66
|
| Rate for Payer: BCBS MAPPO |
$476.42
|
| Rate for Payer: BCBS Trust/PPO |
$722.20
|
| Rate for Payer: BCN Medicare Advantage |
$476.42
|
| Rate for Payer: Cash Price |
$1,217.37
|
| Rate for Payer: Cash Price |
$1,217.37
|
| Rate for Payer: Cofinity Commercial |
$1,308.67
|
| Rate for Payer: Cofinity Commercial |
$1,065.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,217.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.42
|
| Rate for Payer: Healthscope Commercial |
$1,369.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,065.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,141.28
|
| Rate for Payer: Mclaren Medicaid |
$260.60
|
| Rate for Payer: Mclaren Medicare |
$476.42
|
| Rate for Payer: Meridian Medicaid |
$273.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$500.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,293.45
|
| Rate for Payer: PACE Medicare |
$452.60
|
| Rate for Payer: PACE SWMI |
$476.42
|
| Rate for Payer: PHP Commercial |
$1,293.45
|
| Rate for Payer: PHP Medicare Advantage |
$476.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,065.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,499.80
|
| Rate for Payer: Priority Health Medicare |
$476.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,199.84
|
| Rate for Payer: Priority Health SBD |
$958.68
|
| Rate for Payer: Railroad Medicare Medicare |
$476.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.74
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$476.42
|
| Rate for Payer: UHC Exchange |
$187.95
|
| Rate for Payer: UHC Medicare Advantage |
$490.71
|
| Rate for Payer: UMR Bronson Commercial |
$563.03
|
| Rate for Payer: VA VA |
$476.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,141.28
|
|
|
HC 2D ECHOCARDIOGRAM LIMITED STUDY
|
Facility
|
OP
|
$809.36
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
48300002
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$96.92 |
| Max. Negotiated Rate |
$816.00 |
| Rate for Payer: Aetna American Axle |
$526.08
|
| Rate for Payer: Aetna Commercial |
$687.96
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$526.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$370.30
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$647.49
|
| Rate for Payer: Cash Price |
$647.49
|
| Rate for Payer: Cash Price |
$647.49
|
| Rate for Payer: Cofinity Commercial |
$566.55
|
| Rate for Payer: Cofinity Commercial |
$696.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$647.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$728.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$566.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$607.02
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$687.96
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$687.96
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$509.90
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.61
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$96.92
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$299.46
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$607.02
|
|
|
HC 2D ECHOCARDIOGRAM LIMITED STUDY
|
Facility
|
IP
|
$809.36
|
|
|
Service Code
|
CPT 93308
|
| Hospital Charge Code |
48300002
|
|
Hospital Revenue Code
|
483
|
| Min. Negotiated Rate |
$356.12 |
| Max. Negotiated Rate |
$728.42 |
| Rate for Payer: Aetna American Axle |
$526.08
|
| Rate for Payer: Aetna Commercial |
$687.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$526.08
|
| Rate for Payer: Cash Price |
$647.49
|
| Rate for Payer: Cofinity Commercial |
$566.55
|
| Rate for Payer: Cofinity Commercial |
$696.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$647.49
|
| Rate for Payer: Healthscope Commercial |
$728.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$566.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$607.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$687.96
|
| Rate for Payer: PHP Commercial |
$687.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.55
|
| Rate for Payer: Priority Health SBD |
$509.90
|
| Rate for Payer: UMR Bronson Commercial |
$356.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$607.02
|
|
|
HC 2 PIECE WAFER
|
Facility
|
IP
|
$13.16
|
|
| Hospital Charge Code |
27100001
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$11.84 |
| Rate for Payer: Aetna American Axle |
$8.55
|
| Rate for Payer: Aetna Commercial |
$11.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.55
|
| Rate for Payer: Cash Price |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$9.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.53
|
| Rate for Payer: Healthscope Commercial |
$11.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.19
|
| Rate for Payer: PHP Commercial |
$11.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.21
|
| Rate for Payer: Priority Health SBD |
$8.29
|
| Rate for Payer: UMR Bronson Commercial |
$5.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.87
|
|
|
HC 2 PIECE WAFER
|
Facility
|
OP
|
$13.16
|
|
| Hospital Charge Code |
27100001
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.87 |
| Max. Negotiated Rate |
$11.84 |
| Rate for Payer: Aetna American Axle |
$8.55
|
| Rate for Payer: Aetna Commercial |
$11.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.55
|
| Rate for Payer: BCBS Complete |
$5.26
|
| Rate for Payer: Cash Price |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$9.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.53
|
| Rate for Payer: Healthscope Commercial |
$11.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11.19
|
| Rate for Payer: PHP Commercial |
$11.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.21
|
| Rate for Payer: Priority Health SBD |
$8.29
|
| Rate for Payer: UMR Bronson Commercial |
$4.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.87
|
|
|
HC 3D ECHO RENDERING
|
Facility
|
OP
|
$656.07
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
32000282
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$590.46 |
| Rate for Payer: Aetna American Axle |
$426.45
|
| Rate for Payer: Aetna Commercial |
$557.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.45
|
| Rate for Payer: BCBS Complete |
$262.43
|
| Rate for Payer: BCBS Trust/PPO |
$27.88
|
| Rate for Payer: Cash Price |
$524.86
|
| Rate for Payer: Cash Price |
$524.86
|
| Rate for Payer: Cofinity Commercial |
$459.25
|
| Rate for Payer: Cofinity Commercial |
$564.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.86
|
| Rate for Payer: Healthscope Commercial |
$590.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$459.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$492.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$557.66
|
| Rate for Payer: PHP Commercial |
$557.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$459.25
|
| Rate for Payer: Priority Health SBD |
$413.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.02
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Exchange |
$24.56
|
| Rate for Payer: UMR Bronson Commercial |
$242.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$492.05
|
|
|
HC 3D ECHO RENDERING
|
Facility
|
IP
|
$656.07
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
32000282
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$288.67 |
| Max. Negotiated Rate |
$590.46 |
| Rate for Payer: Aetna American Axle |
$426.45
|
| Rate for Payer: Aetna Commercial |
$557.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.45
|
| Rate for Payer: Cash Price |
$524.86
|
| Rate for Payer: Cofinity Commercial |
$459.25
|
| Rate for Payer: Cofinity Commercial |
$564.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$524.86
|
| Rate for Payer: Healthscope Commercial |
$590.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$459.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$492.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$557.66
|
| Rate for Payer: PHP Commercial |
$557.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$459.25
|
| Rate for Payer: Priority Health SBD |
$413.32
|
| Rate for Payer: UMR Bronson Commercial |
$288.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$492.05
|
|
|
HC 3D ECHO REND W/WORKSTATION
|
Facility
|
IP
|
$625.36
|
|
|
Service Code
|
CPT 76377
|
| Hospital Charge Code |
32000283
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$275.16 |
| Max. Negotiated Rate |
$562.82 |
| Rate for Payer: Aetna American Axle |
$406.48
|
| Rate for Payer: Aetna Commercial |
$531.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.48
|
| Rate for Payer: Cash Price |
$500.29
|
| Rate for Payer: Cofinity Commercial |
$537.81
|
| Rate for Payer: Cofinity Commercial |
$437.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$500.29
|
| Rate for Payer: Healthscope Commercial |
$562.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$437.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$469.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$531.56
|
| Rate for Payer: PHP Commercial |
$531.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.75
|
| Rate for Payer: Priority Health SBD |
$393.98
|
| Rate for Payer: UMR Bronson Commercial |
$275.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$469.02
|
|
|
HC 3D ECHO REND W/WORKSTATION
|
Facility
|
OP
|
$625.36
|
|
|
Service Code
|
CPT 76377
|
| Hospital Charge Code |
32000283
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$72.85 |
| Max. Negotiated Rate |
$562.82 |
| Rate for Payer: Aetna American Axle |
$406.48
|
| Rate for Payer: Aetna Commercial |
$531.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$406.48
|
| Rate for Payer: BCBS Complete |
$250.14
|
| Rate for Payer: BCBS Trust/PPO |
$72.85
|
| Rate for Payer: Cash Price |
$500.29
|
| Rate for Payer: Cash Price |
$500.29
|
| Rate for Payer: Cofinity Commercial |
$437.75
|
| Rate for Payer: Cofinity Commercial |
$537.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$500.29
|
| Rate for Payer: Healthscope Commercial |
$562.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$437.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$469.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$531.56
|
| Rate for Payer: PHP Commercial |
$531.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.75
|
| Rate for Payer: Priority Health SBD |
$393.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.28
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Exchange |
$76.62
|
| Rate for Payer: UMR Bronson Commercial |
$231.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$469.02
|
|
|
HC 4X4 WAFER
|
Facility
|
OP
|
$24.03
|
|
| Hospital Charge Code |
27000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$21.63 |
| Rate for Payer: Aetna American Axle |
$15.62
|
| Rate for Payer: Aetna Commercial |
$20.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.62
|
| Rate for Payer: BCBS Complete |
$9.61
|
| Rate for Payer: Cash Price |
$19.22
|
| Rate for Payer: Cofinity Commercial |
$16.82
|
| Rate for Payer: Cofinity Commercial |
$20.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.22
|
| Rate for Payer: Healthscope Commercial |
$21.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.43
|
| Rate for Payer: PHP Commercial |
$20.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.82
|
| Rate for Payer: Priority Health SBD |
$15.14
|
| Rate for Payer: UMR Bronson Commercial |
$8.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.02
|
|
|
HC 4X4 WAFER
|
Facility
|
IP
|
$24.03
|
|
| Hospital Charge Code |
27000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.57 |
| Max. Negotiated Rate |
$21.63 |
| Rate for Payer: Aetna American Axle |
$15.62
|
| Rate for Payer: Aetna Commercial |
$20.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.62
|
| Rate for Payer: Cash Price |
$19.22
|
| Rate for Payer: Cofinity Commercial |
$16.82
|
| Rate for Payer: Cofinity Commercial |
$20.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.22
|
| Rate for Payer: Healthscope Commercial |
$21.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.43
|
| Rate for Payer: PHP Commercial |
$20.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.82
|
| Rate for Payer: Priority Health SBD |
$15.14
|
| Rate for Payer: UMR Bronson Commercial |
$10.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.02
|
|
|
HC 5 FR SOLO 3CG POWER PICC
|
Facility
|
IP
|
$1,104.48
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$485.97 |
| Max. Negotiated Rate |
$994.03 |
| Rate for Payer: Aetna American Axle |
$717.91
|
| Rate for Payer: Aetna Commercial |
$938.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$717.91
|
| Rate for Payer: Cash Price |
$883.58
|
| Rate for Payer: Cofinity Commercial |
$773.14
|
| Rate for Payer: Cofinity Commercial |
$949.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$883.58
|
| Rate for Payer: Healthscope Commercial |
$994.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$773.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$828.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$938.81
|
| Rate for Payer: PHP Commercial |
$938.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$773.14
|
| Rate for Payer: Priority Health SBD |
$695.82
|
| Rate for Payer: UMR Bronson Commercial |
$485.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$828.36
|
|
