|
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
|
|
|
HC 5FR SOLO POWER PICC
|
Facility
|
IP
|
$957.12
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$421.13 |
| Max. Negotiated Rate |
$861.41 |
| Rate for Payer: Aetna American Axle |
$622.13
|
| Rate for Payer: Aetna Commercial |
$813.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$622.13
|
| Rate for Payer: Cash Price |
$765.70
|
| Rate for Payer: Cofinity Commercial |
$669.98
|
| Rate for Payer: Cofinity Commercial |
$823.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.70
|
| Rate for Payer: Healthscope Commercial |
$861.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$669.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$813.55
|
| Rate for Payer: PHP Commercial |
$813.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.98
|
| Rate for Payer: Priority Health SBD |
$602.99
|
| Rate for Payer: UMR Bronson Commercial |
$421.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.84
|
|
|
HC 5FR SOLO POWER PICC
|
Facility
|
OP
|
$957.12
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$354.13 |
| Max. Negotiated Rate |
$861.41 |
| Rate for Payer: Aetna American Axle |
$622.13
|
| Rate for Payer: Aetna Commercial |
$813.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$622.13
|
| Rate for Payer: BCBS Complete |
$382.85
|
| Rate for Payer: Cash Price |
$765.70
|
| Rate for Payer: Cofinity Commercial |
$669.98
|
| Rate for Payer: Cofinity Commercial |
$823.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.70
|
| Rate for Payer: Healthscope Commercial |
$861.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$669.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$813.55
|
| Rate for Payer: PHP Commercial |
$813.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.98
|
| Rate for Payer: Priority Health SBD |
$602.99
|
| Rate for Payer: UMR Bronson Commercial |
$354.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.84
|
|
|
HC 5 FR TL 3CG MAX POWER PICC
|
Facility
|
OP
|
$1,204.90
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$445.81 |
| Max. Negotiated Rate |
$1,084.41 |
| Rate for Payer: Aetna American Axle |
$783.18
|
| Rate for Payer: Aetna Commercial |
$1,024.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.18
|
| Rate for Payer: BCBS Complete |
$481.96
|
| Rate for Payer: Cash Price |
$963.92
|
| Rate for Payer: Cofinity Commercial |
$1,036.21
|
| Rate for Payer: Cofinity Commercial |
$843.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.92
|
| Rate for Payer: Healthscope Commercial |
$1,084.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$843.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,024.16
|
| Rate for Payer: PHP Commercial |
$1,024.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.43
|
| Rate for Payer: Priority Health SBD |
$759.09
|
| Rate for Payer: UMR Bronson Commercial |
$445.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.68
|
|
|
HC 5 FR TL 3CG MAX POWER PICC
|
Facility
|
IP
|
$1,204.90
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$530.16 |
| Max. Negotiated Rate |
$1,084.41 |
| Rate for Payer: Aetna American Axle |
$783.18
|
| Rate for Payer: Aetna Commercial |
$1,024.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.18
|
| Rate for Payer: Cash Price |
$963.92
|
| Rate for Payer: Cofinity Commercial |
$1,036.21
|
| Rate for Payer: Cofinity Commercial |
$843.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.92
|
| Rate for Payer: Healthscope Commercial |
$1,084.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$843.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,024.16
|
| Rate for Payer: PHP Commercial |
$1,024.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.43
|
| Rate for Payer: Priority Health SBD |
$759.09
|
| Rate for Payer: UMR Bronson Commercial |
$530.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.68
|
|
|
HC 5 FR TL SOLO MAX POWER PICC
|
Facility
|
OP
|
$1,044.13
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$386.33 |
| Max. Negotiated Rate |
$939.72 |
| Rate for Payer: Aetna American Axle |
$678.68
|
| Rate for Payer: Aetna Commercial |
$887.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$678.68
|
| Rate for Payer: BCBS Complete |
$417.65
|
| Rate for Payer: Cash Price |
$835.30
|
| Rate for Payer: Cofinity Commercial |
$730.89
|
| Rate for Payer: Cofinity Commercial |
$897.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.30
|
| Rate for Payer: Healthscope Commercial |
$939.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$730.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$783.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$887.51
|
| Rate for Payer: PHP Commercial |
$887.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.89
|
| Rate for Payer: Priority Health SBD |
$657.80
|
| Rate for Payer: UMR Bronson Commercial |
$386.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$783.10
|
|
|
HC 5 FR TL SOLO MAX POWER PICC
|
Facility
|
IP
|
$1,044.13
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$459.42 |
| Max. Negotiated Rate |
$939.72 |
| Rate for Payer: Aetna American Axle |
$678.68
|
| Rate for Payer: Aetna Commercial |
$887.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$678.68
|
| Rate for Payer: Cash Price |
$835.30
|
| Rate for Payer: Cofinity Commercial |
$730.89
|
| Rate for Payer: Cofinity Commercial |
$897.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.30
|
| Rate for Payer: Healthscope Commercial |
$939.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$730.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$783.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$887.51
|
| Rate for Payer: PHP Commercial |
$887.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.89
|
| Rate for Payer: Priority Health SBD |
$657.80
|
| Rate for Payer: UMR Bronson Commercial |
$459.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$783.10
|
|
|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
IP
|
$1,204.90
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$530.16 |
| Max. Negotiated Rate |
$1,084.41 |
| Rate for Payer: Aetna American Axle |
$783.18
|
| Rate for Payer: Aetna Commercial |
$1,024.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.18
|
| Rate for Payer: Cash Price |
$963.92
|
| Rate for Payer: Cofinity Commercial |
$1,036.21
|
| Rate for Payer: Cofinity Commercial |
$843.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.92
|
| Rate for Payer: Healthscope Commercial |
$1,084.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$843.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,024.16
|
| Rate for Payer: PHP Commercial |
$1,024.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.43
|
| Rate for Payer: Priority Health SBD |
$759.09
|
| Rate for Payer: UMR Bronson Commercial |
$530.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.68
|
|
|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
OP
|
$1,204.90
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$445.81 |
| Max. Negotiated Rate |
$1,084.41 |
| Rate for Payer: Aetna American Axle |
$783.18
|
| Rate for Payer: Aetna Commercial |
$1,024.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.18
|
| Rate for Payer: BCBS Complete |
$481.96
|
| Rate for Payer: Cash Price |
$963.92
|
| Rate for Payer: Cofinity Commercial |
$1,036.21
|
| Rate for Payer: Cofinity Commercial |
$843.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.92
|
| Rate for Payer: Healthscope Commercial |
$1,084.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$843.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,024.16
|
| Rate for Payer: PHP Commercial |
$1,024.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$843.43
|
| Rate for Payer: Priority Health SBD |
$759.09
|
| Rate for Payer: UMR Bronson Commercial |
$445.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.68
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
OP
|
$1,044.13
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$386.33 |
| Max. Negotiated Rate |
$939.72 |
| Rate for Payer: Aetna American Axle |
$678.68
|
| Rate for Payer: Aetna Commercial |
$887.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$678.68
|
| Rate for Payer: BCBS Complete |
$417.65
|
| Rate for Payer: Cash Price |
$835.30
|
| Rate for Payer: Cofinity Commercial |
$730.89
|
| Rate for Payer: Cofinity Commercial |
$897.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.30
|
| Rate for Payer: Healthscope Commercial |
$939.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$730.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$783.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$887.51
|
| Rate for Payer: PHP Commercial |
$887.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.89
|
| Rate for Payer: Priority Health SBD |
$657.80
|
| Rate for Payer: UMR Bronson Commercial |
$386.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$783.10
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
IP
|
$1,044.13
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$459.42 |
| Max. Negotiated Rate |
$939.72 |
| Rate for Payer: Aetna American Axle |
$678.68
|
| Rate for Payer: Aetna Commercial |
$887.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$678.68
|
| Rate for Payer: Cash Price |
$835.30
|
| Rate for Payer: Cofinity Commercial |
$730.89
|
| Rate for Payer: Cofinity Commercial |
$897.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$835.30
|
| Rate for Payer: Healthscope Commercial |
$939.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$730.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$783.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$887.51
|
| Rate for Payer: PHP Commercial |
$887.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$730.89
|
| Rate for Payer: Priority Health SBD |
$657.80
|
| Rate for Payer: UMR Bronson Commercial |
$459.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$783.10
|
|
|
HC 8X8 WAFER
|
Facility
|
OP
|
$72.59
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.86 |
| Max. Negotiated Rate |
$65.33 |
| Rate for Payer: Aetna American Axle |
$47.18
|
| Rate for Payer: Aetna Commercial |
$61.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.18
|
| Rate for Payer: BCBS Complete |
$29.04
|
| Rate for Payer: Cash Price |
$58.07
|
| Rate for Payer: Cofinity Commercial |
$50.81
|
| Rate for Payer: Cofinity Commercial |
$62.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.07
|
| Rate for Payer: Healthscope Commercial |
$65.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.70
|
| Rate for Payer: PHP Commercial |
$61.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.81
|
| Rate for Payer: Priority Health SBD |
$45.73
|
| Rate for Payer: UMR Bronson Commercial |
$26.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.44
|
|
|
HC 8X8 WAFER
|
Facility
|
IP
|
$72.59
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.94 |
| Max. Negotiated Rate |
$65.33 |
| Rate for Payer: Aetna American Axle |
$47.18
|
| Rate for Payer: Aetna Commercial |
$61.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.18
|
| Rate for Payer: Cash Price |
$58.07
|
| Rate for Payer: Cofinity Commercial |
$50.81
|
| Rate for Payer: Cofinity Commercial |
$62.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.07
|
| Rate for Payer: Healthscope Commercial |
$65.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.70
|
| Rate for Payer: PHP Commercial |
$61.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.81
|
| Rate for Payer: Priority Health SBD |
$45.73
|
| Rate for Payer: UMR Bronson Commercial |
$31.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.44
|
|
|
HC A1AT PROTEOTYPE
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100610
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.78 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna American Axle |
$31.16
|
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: Aetna Medicare |
$25.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.11
|
| Rate for Payer: BCBS Complete |
$13.84
|
| Rate for Payer: BCBS MAPPO |
$24.09
|
| Rate for Payer: BCBS Trust/PPO |
$21.67
|
| Rate for Payer: BCN Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.96
|
| Rate for Payer: Mclaren Medicaid |
$13.18
|
| Rate for Payer: Mclaren Medicare |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$13.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.75
|
| Rate for Payer: PACE Medicare |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.09
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: PHP Medicare Advantage |
$24.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.98
|
| Rate for Payer: Priority Health Medicare |
$24.09
|
| Rate for Payer: Priority Health Narrow Network |
$12.78
|
| Rate for Payer: Priority Health SBD |
$30.20
|
| Rate for Payer: Railroad Medicare Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.91
|
| Rate for Payer: UHC Core |
$29.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.09
|
| Rate for Payer: UHC Exchange |
$24.09
|
| Rate for Payer: UHC Medicare Advantage |
$24.81
|
| Rate for Payer: UMR Bronson Commercial |
$17.74
|
| Rate for Payer: VA VA |
$24.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.96
|
|
|
HC A1AT PROTEOTYPE
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100610
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna American Axle |
$31.16
|
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.16
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.75
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.56
|
| Rate for Payer: Priority Health SBD |
$30.20
|
| Rate for Payer: UMR Bronson Commercial |
$21.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.96
|
|
|
HC A1AT PROTEOTYPE CMPT
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.24 |
| Max. Negotiated Rate |
$18.90 |
| Rate for Payer: Aetna American Axle |
$13.65
|
| Rate for Payer: Aetna Commercial |
$17.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.65
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$18.06
|
| Rate for Payer: Cofinity Commercial |
$14.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.80
|
| Rate for Payer: Healthscope Commercial |
$18.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.85
|
| Rate for Payer: PHP Commercial |
$17.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.70
|
| Rate for Payer: Priority Health SBD |
$13.23
|
| Rate for Payer: UMR Bronson Commercial |
$9.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.75
|
|
|
HC A1AT PROTEOTYPE CMPT
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.35 |
| Max. Negotiated Rate |
$22.16 |
| Rate for Payer: Aetna American Axle |
$13.65
|
| Rate for Payer: Aetna Commercial |
$17.85
|
| Rate for Payer: Aetna Medicare |
$13.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.80
|
| Rate for Payer: BCBS Complete |
$7.72
|
| Rate for Payer: BCBS MAPPO |
$13.44
|
| Rate for Payer: BCBS Trust/PPO |
$12.09
|
| Rate for Payer: BCN Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$14.70
|
| Rate for Payer: Cofinity Commercial |
$18.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.44
|
| Rate for Payer: Healthscope Commercial |
$18.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.75
|
| Rate for Payer: Mclaren Medicaid |
$7.35
|
| Rate for Payer: Mclaren Medicare |
$13.44
|
| Rate for Payer: Meridian Medicaid |
$7.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.85
|
| Rate for Payer: PACE Medicare |
$12.77
|
| Rate for Payer: PACE SWMI |
$13.44
|
| Rate for Payer: PHP Commercial |
$17.85
|
| Rate for Payer: PHP Medicare Advantage |
$13.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.43
|
| Rate for Payer: Priority Health Medicare |
$13.44
|
| Rate for Payer: Priority Health Narrow Network |
$14.74
|
| Rate for Payer: Priority Health SBD |
$13.23
|
| Rate for Payer: Railroad Medicare Medicare |
$13.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.13
|
| Rate for Payer: UHC Core |
$22.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.44
|
| Rate for Payer: UHC Exchange |
$13.44
|
| Rate for Payer: UHC Medicare Advantage |
$13.84
|
| Rate for Payer: UMR Bronson Commercial |
$7.77
|
| Rate for Payer: VA VA |
$13.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.75
|
|
|
HC ABBY RETRACTOR
|
Facility
|
OP
|
$259.95
|
|
| Hospital Charge Code |
27000643
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$96.18 |
| Max. Negotiated Rate |
$233.96 |
| Rate for Payer: Aetna American Axle |
$168.97
|
| Rate for Payer: Aetna Commercial |
$220.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.97
|
| Rate for Payer: BCBS Complete |
$103.98
|
| Rate for Payer: Cash Price |
$207.96
|
| Rate for Payer: Cofinity Commercial |
$181.96
|
| Rate for Payer: Cofinity Commercial |
$223.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.96
|
| Rate for Payer: Healthscope Commercial |
$233.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$220.96
|
| Rate for Payer: PHP Commercial |
$220.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.96
|
| Rate for Payer: Priority Health SBD |
$163.77
|
| Rate for Payer: UMR Bronson Commercial |
$96.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.96
|
|
|
HC ABBY RETRACTOR
|
Facility
|
IP
|
$259.95
|
|
| Hospital Charge Code |
27000643
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$114.38 |
| Max. Negotiated Rate |
$233.96 |
| Rate for Payer: Aetna American Axle |
$168.97
|
| Rate for Payer: Aetna Commercial |
$220.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.97
|
| Rate for Payer: Cash Price |
$207.96
|
| Rate for Payer: Cofinity Commercial |
$181.96
|
| Rate for Payer: Cofinity Commercial |
$223.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.96
|
| Rate for Payer: Healthscope Commercial |
$233.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$220.96
|
| Rate for Payer: PHP Commercial |
$220.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.96
|
| Rate for Payer: Priority Health SBD |
$163.77
|
| Rate for Payer: UMR Bronson Commercial |
$114.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.96
|
|
|
HC ABDOMINAL HYSTERECT (OB SURGER
|
Facility
|
IP
|
$2,515.07
|
|
| Hospital Charge Code |
36000002
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,106.63 |
| Max. Negotiated Rate |
$2,263.56 |
| Rate for Payer: Aetna American Axle |
$1,634.80
|
| Rate for Payer: Aetna Commercial |
$2,137.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,634.80
|
| Rate for Payer: Cash Price |
$2,012.06
|
| Rate for Payer: Cofinity Commercial |
$1,760.55
|
| Rate for Payer: Cofinity Commercial |
$2,162.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,012.06
|
| Rate for Payer: Healthscope Commercial |
$2,263.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,760.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,886.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,137.81
|
| Rate for Payer: PHP Commercial |
$2,137.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,760.55
|
| Rate for Payer: Priority Health SBD |
$1,584.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,106.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,886.30
|
|
|
HC ABDOMINAL HYSTERECT (OB SURGER
|
Facility
|
OP
|
$2,515.07
|
|
| Hospital Charge Code |
36000002
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$930.58 |
| Max. Negotiated Rate |
$2,263.56 |
| Rate for Payer: Aetna American Axle |
$1,634.80
|
| Rate for Payer: Aetna Commercial |
$2,137.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,634.80
|
| Rate for Payer: BCBS Complete |
$1,006.03
|
| Rate for Payer: Cash Price |
$2,012.06
|
| Rate for Payer: Cofinity Commercial |
$1,760.55
|
| Rate for Payer: Cofinity Commercial |
$2,162.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,012.06
|
| Rate for Payer: Healthscope Commercial |
$2,263.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,760.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,886.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,137.81
|
| Rate for Payer: PHP Commercial |
$2,137.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,760.55
|
| Rate for Payer: Priority Health SBD |
$1,584.49
|
| Rate for Payer: UMR Bronson Commercial |
$930.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,886.30
|
|
|
HC ABDOMINAL STERILIZE (OB SURGER
|
Facility
|
IP
|
$1,546.02
|
|
| Hospital Charge Code |
36000003
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$680.25 |
| Max. Negotiated Rate |
$1,391.42 |
| Rate for Payer: Aetna American Axle |
$1,004.91
|
| Rate for Payer: Aetna Commercial |
$1,314.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,004.91
|
| Rate for Payer: Cash Price |
$1,236.82
|
| Rate for Payer: Cofinity Commercial |
$1,082.21
|
| Rate for Payer: Cofinity Commercial |
$1,329.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,236.82
|
| Rate for Payer: Healthscope Commercial |
$1,391.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,082.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,159.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,314.12
|
| Rate for Payer: PHP Commercial |
$1,314.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.21
|
| Rate for Payer: Priority Health SBD |
$973.99
|
| Rate for Payer: UMR Bronson Commercial |
$680.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,159.52
|
|
|
HC ABDOMINAL STERILIZE (OB SURGER
|
Facility
|
OP
|
$1,546.02
|
|
| Hospital Charge Code |
36000003
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$572.03 |
| Max. Negotiated Rate |
$1,391.42 |
| Rate for Payer: Aetna American Axle |
$1,004.91
|
| Rate for Payer: Aetna Commercial |
$1,314.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,004.91
|
| Rate for Payer: BCBS Complete |
$618.41
|
| Rate for Payer: Cash Price |
$1,236.82
|
| Rate for Payer: Cofinity Commercial |
$1,082.21
|
| Rate for Payer: Cofinity Commercial |
$1,329.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,236.82
|
| Rate for Payer: Healthscope Commercial |
$1,391.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,082.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,159.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,314.12
|
| Rate for Payer: PHP Commercial |
$1,314.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,082.21
|
| Rate for Payer: Priority Health SBD |
$973.99
|
| Rate for Payer: UMR Bronson Commercial |
$572.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,159.52
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV BIL KNEE 3 OR MORE NRVS
|
Facility
|
IP
|
$3,945.36
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100603
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,735.96 |
| Max. Negotiated Rate |
$3,550.82 |
| Rate for Payer: Aetna American Axle |
$2,564.48
|
| Rate for Payer: Aetna Commercial |
$3,353.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,564.48
|
| Rate for Payer: Cash Price |
$3,156.29
|
| Rate for Payer: Cofinity Commercial |
$2,761.75
|
| Rate for Payer: Cofinity Commercial |
$3,393.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,156.29
|
| Rate for Payer: Healthscope Commercial |
$3,550.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,761.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,959.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,353.56
|
| Rate for Payer: PHP Commercial |
$3,353.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,761.75
|
| Rate for Payer: Priority Health SBD |
$2,485.58
|
| Rate for Payer: UMR Bronson Commercial |
$1,735.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,959.02
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV BIL KNEE 3 OR MORE NRVS
|
Facility
|
OP
|
$3,945.36
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100603
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$142.76 |
| Max. Negotiated Rate |
$5,402.75 |
| Rate for Payer: Aetna American Axle |
$2,564.48
|
| Rate for Payer: Aetna Commercial |
$3,353.56
|
| Rate for Payer: Aetna Medicare |
$1,784.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,564.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,145.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,145.29
|
| Rate for Payer: BCBS Complete |
$985.80
|
| Rate for Payer: BCBS MAPPO |
$1,716.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,716.23
|
| Rate for Payer: Cash Price |
$3,156.29
|
| Rate for Payer: Cash Price |
$3,156.29
|
| Rate for Payer: Cofinity Commercial |
$2,761.75
|
| Rate for Payer: Cofinity Commercial |
$3,393.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,156.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,716.23
|
| Rate for Payer: Healthscope Commercial |
$3,550.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,761.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,959.02
|
| Rate for Payer: Mclaren Medicaid |
$938.78
|
| Rate for Payer: Mclaren Medicare |
$1,716.23
|
| Rate for Payer: Meridian Medicaid |
$985.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,802.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,973.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,353.56
|
| Rate for Payer: PACE Medicare |
$1,630.42
|
| Rate for Payer: PACE SWMI |
$1,716.23
|
| Rate for Payer: PHP Commercial |
$3,353.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,716.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$938.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,761.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,402.75
|
| Rate for Payer: Priority Health Medicare |
$1,716.23
|
| Rate for Payer: Priority Health Narrow Network |
$4,322.20
|
| Rate for Payer: Priority Health SBD |
$2,485.58
|
| Rate for Payer: Railroad Medicare Medicare |
$1,716.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.04
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,716.23
|
| Rate for Payer: UHC Exchange |
$142.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,767.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,459.78
|
| Rate for Payer: VA VA |
$1,716.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,959.02
|
|
