HC ABLATION CATHETER (8/10 MM TIP
|
Facility
|
IP
|
$5,796.29
|
|
Service Code
|
HCPCS C1733
|
Hospital Charge Code |
27200009
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$2,550.37 |
Max. Negotiated Rate |
$5,216.66 |
Rate for Payer: Aetna American Axle |
$3,767.59
|
Rate for Payer: Aetna Commercial |
$4,926.85
|
Rate for Payer: Aetna New Business (MI Preferred) |
$3,767.59
|
Rate for Payer: Cash Price |
$4,637.03
|
Rate for Payer: Cofinity Commercial |
$4,057.40
|
Rate for Payer: Cofinity Commercial |
$4,984.81
|
Rate for Payer: Encore Health Key Benefits Commercial |
$4,637.03
|
Rate for Payer: Healthscope Commercial |
$5,216.66
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,057.40
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,347.22
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,926.85
|
Rate for Payer: PHP Commercial |
$4,926.85
|
Rate for Payer: Priority Health Cigna Priority Health |
$4,057.40
|
Rate for Payer: Priority Health SBD |
$3,651.66
|
Rate for Payer: UMR Bronson Commercial |
$2,550.37
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,347.22
|
|
HC ABLATION CATH EXTRAVASC TISSUE
|
Facility
|
IP
|
$7,080.84
|
|
Service Code
|
HCPCS C1886
|
Hospital Charge Code |
27000645
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$3,115.57 |
Max. Negotiated Rate |
$6,372.76 |
Rate for Payer: Aetna American Axle |
$4,602.55
|
Rate for Payer: Aetna Commercial |
$6,018.71
|
Rate for Payer: Aetna New Business (MI Preferred) |
$4,602.55
|
Rate for Payer: Cash Price |
$5,664.67
|
Rate for Payer: Cofinity Commercial |
$4,956.59
|
Rate for Payer: Cofinity Commercial |
$6,089.52
|
Rate for Payer: Encore Health Key Benefits Commercial |
$5,664.67
|
Rate for Payer: Healthscope Commercial |
$6,372.76
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,956.59
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,310.63
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,018.71
|
Rate for Payer: PHP Commercial |
$6,018.71
|
Rate for Payer: Priority Health Cigna Priority Health |
$4,956.59
|
Rate for Payer: Priority Health SBD |
$4,460.93
|
Rate for Payer: UMR Bronson Commercial |
$3,115.57
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,310.63
|
|
HC ABLATION CATH EXTRAVASC TISSUE
|
Facility
|
OP
|
$7,080.84
|
|
Service Code
|
HCPCS C1886
|
Hospital Charge Code |
27000645
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$0.03 |
Max. Negotiated Rate |
$6,372.76 |
Rate for Payer: Aetna American Axle |
$4,602.55
|
Rate for Payer: Aetna Commercial |
$6,018.71
|
Rate for Payer: Aetna New Business (MI Preferred) |
$4,602.55
|
Rate for Payer: BCBS Complete |
$2,832.34
|
Rate for Payer: BCBS Trust/PPO |
$0.03
|
Rate for Payer: Cash Price |
$5,664.67
|
Rate for Payer: Cash Price |
$5,664.67
|
Rate for Payer: Cofinity Commercial |
$6,089.52
|
Rate for Payer: Cofinity Commercial |
$4,956.59
|
Rate for Payer: Encore Health Key Benefits Commercial |
$5,664.67
|
Rate for Payer: Healthscope Commercial |
$6,372.76
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,956.59
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,310.63
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,018.71
|
Rate for Payer: PHP Commercial |
$6,018.71
|
Rate for Payer: Priority Health Cigna Priority Health |
$4,956.59
|
Rate for Payer: Priority Health SBD |
$4,460.93
|
Rate for Payer: UMR Bronson Commercial |
$2,619.91
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,310.63
|
|
HC ABLATION CATH NON-CARD ENDOVASC IMPLANT
|
Facility
|
IP
|
$1,275.00
|
|
Service Code
|
HCPCS C1888
|
Hospital Charge Code |
27200324
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$561.00 |
Max. Negotiated Rate |
$1,147.50 |
Rate for Payer: Aetna American Axle |
$828.75
|
Rate for Payer: Aetna Commercial |
$1,083.75
|
Rate for Payer: Aetna New Business (MI Preferred) |
$828.75
|
Rate for Payer: Cash Price |
$1,020.00
|
Rate for Payer: Cofinity Commercial |
$1,096.50
|
Rate for Payer: Cofinity Commercial |
$892.50
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.00
|
Rate for Payer: Healthscope Commercial |
$1,147.50
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$892.50
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$956.25
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,083.75
|
Rate for Payer: PHP Commercial |
$1,083.75
|
Rate for Payer: Priority Health Cigna Priority Health |
$892.50
|
Rate for Payer: Priority Health SBD |
$803.25
|
Rate for Payer: UMR Bronson Commercial |
$561.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$956.25
|
|
HC ABLATION CATH NON-CARD ENDOVASC IMPLANT
|
Facility
|
OP
|
$1,275.00
|
|
Service Code
|
HCPCS C1888
|
Hospital Charge Code |
27200324
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$471.75 |
Max. Negotiated Rate |
$1,147.50 |
Rate for Payer: Aetna American Axle |
$828.75
|
Rate for Payer: Aetna Commercial |
$1,083.75
|
Rate for Payer: Aetna New Business (MI Preferred) |
$828.75
|
Rate for Payer: BCBS Complete |
$510.00
|
Rate for Payer: Cash Price |
$1,020.00
|
Rate for Payer: Cofinity Commercial |
$1,096.50
|
Rate for Payer: Cofinity Commercial |
$892.50
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,020.00
|
Rate for Payer: Healthscope Commercial |
$1,147.50
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$892.50
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$956.25
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,083.75
|
Rate for Payer: PHP Commercial |
$1,083.75
|
Rate for Payer: Priority Health Cigna Priority Health |
$892.50
|
Rate for Payer: Priority Health SBD |
$803.25
|
Rate for Payer: UMR Bronson Commercial |
$471.75
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$956.25
|
|
HC ABLATION RF LUNG
|
Facility
|
IP
|
$5,899.37
|
|
Service Code
|
CPT 32998
|
Hospital Charge Code |
36100055
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$2,595.72 |
Max. Negotiated Rate |
$5,309.43 |
Rate for Payer: Aetna American Axle |
$3,834.59
|
Rate for Payer: Aetna Commercial |
$5,014.46
|
Rate for Payer: Aetna New Business (MI Preferred) |
$3,834.59
|
Rate for Payer: Cash Price |
$4,719.50
|
Rate for Payer: Cofinity Commercial |
$4,129.56
|
Rate for Payer: Cofinity Commercial |
$5,073.46
|
Rate for Payer: Encore Health Key Benefits Commercial |
$4,719.50
|
Rate for Payer: Healthscope Commercial |
$5,309.43
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,129.56
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,424.53
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,014.46
|
Rate for Payer: PHP Commercial |
$5,014.46
|
Rate for Payer: Priority Health Cigna Priority Health |
$4,129.56
|
Rate for Payer: Priority Health SBD |
$3,716.60
|
Rate for Payer: UMR Bronson Commercial |
$2,595.72
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,424.53
|
|
HC ABLATION RF LUNG
|
Facility
|
OP
|
$5,899.37
|
|
Service Code
|
CPT 32998
|
Hospital Charge Code |
36100055
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$418.80 |
Max. Negotiated Rate |
$16,145.72 |
Rate for Payer: Aetna American Axle |
$3,834.59
|
Rate for Payer: Aetna Commercial |
$5,014.46
|
Rate for Payer: Aetna Medicare |
$5,333.96
|
Rate for Payer: Aetna New Business (MI Preferred) |
$3,834.59
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,411.01
|
Rate for Payer: Amish Plain Church Group Commercial |
$6,411.01
|
Rate for Payer: BCBS Complete |
$2,945.99
|
Rate for Payer: BCBS MAPPO |
$5,128.81
|
Rate for Payer: BCBS Trust/PPO |
$3,910.93
|
Rate for Payer: BCN Medicare Advantage |
$5,128.81
|
Rate for Payer: Cash Price |
$4,719.50
|
Rate for Payer: Cash Price |
$4,719.50
|
Rate for Payer: Cofinity Commercial |
$5,073.46
|
Rate for Payer: Cofinity Commercial |
$4,129.56
|
Rate for Payer: Encore Health Key Benefits Commercial |
$4,719.50
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,128.81
|
Rate for Payer: Healthscope Commercial |
$5,309.43
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,129.56
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,424.53
|
Rate for Payer: Mclaren Medicaid |
$2,805.46
|
Rate for Payer: Mclaren Medicare |
$5,128.81
|
Rate for Payer: Meridian Medicaid |
$2,945.99
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,385.25
|
Rate for Payer: MI Amish Medical Board Commercial |
$5,898.13
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,014.46
|
Rate for Payer: PACE Medicare |
$4,872.37
|
Rate for Payer: PACE SWMI |
$5,128.81
|
Rate for Payer: PHP Commercial |
$5,014.46
|
Rate for Payer: PHP Medicare Advantage |
$5,128.81
|
Rate for Payer: Priority Health Choice Medicaid |
$2,805.46
|
Rate for Payer: Priority Health Cigna Priority Health |
$4,129.56
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,145.72
|
Rate for Payer: Priority Health Medicare |
$5,128.81
|
Rate for Payer: Priority Health Narrow Network |
$12,916.58
|
Rate for Payer: Priority Health SBD |
$3,716.60
|
Rate for Payer: Railroad Medicare Medicare |
$5,128.81
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$460.68
|
Rate for Payer: UHC Core |
$8,596.00
|
Rate for Payer: UHC Dual Complete DSNP |
$5,128.81
|
Rate for Payer: UHC Exchange |
$418.80
|
Rate for Payer: UHC Medicare Advantage |
$5,282.67
|
Rate for Payer: UMR Bronson Commercial |
$2,182.77
|
Rate for Payer: VA VA |
$5,128.81
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,424.53
|
|
HC ABLATION VEIN OF MARSHALL
|
Facility
|
IP
|
$8,725.45
|
|
Service Code
|
CPT 93799
|
Hospital Charge Code |
48100122
|
Hospital Revenue Code
|
481
|
Min. Negotiated Rate |
$3,839.20 |
Max. Negotiated Rate |
$7,852.90 |
Rate for Payer: Aetna American Axle |
$5,671.54
|
Rate for Payer: Aetna Commercial |
$7,416.63
|
Rate for Payer: Aetna New Business (MI Preferred) |
$5,671.54
|
Rate for Payer: Cash Price |
$6,980.36
|
Rate for Payer: Cofinity Commercial |
$6,107.82
|
Rate for Payer: Cofinity Commercial |
$7,503.89
|
Rate for Payer: Encore Health Key Benefits Commercial |
$6,980.36
|
Rate for Payer: Healthscope Commercial |
$7,852.90
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,107.82
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,544.09
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,416.63
|
Rate for Payer: PHP Commercial |
$7,416.63
|
Rate for Payer: Priority Health Cigna Priority Health |
$6,107.82
|
Rate for Payer: Priority Health SBD |
$5,497.03
|
Rate for Payer: UMR Bronson Commercial |
$3,839.20
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,544.09
|
|
HC ABLATION VEIN OF MARSHALL
|
Facility
|
OP
|
$8,725.45
|
|
Service Code
|
CPT 93799
|
Hospital Charge Code |
48100122
|
Hospital Revenue Code
|
481
|
Min. Negotiated Rate |
$75.95 |
Max. Negotiated Rate |
$7,852.90 |
Rate for Payer: Aetna American Axle |
$5,671.54
|
Rate for Payer: Aetna Commercial |
$7,416.63
|
Rate for Payer: Aetna Medicare |
$144.40
|
Rate for Payer: Aetna New Business (MI Preferred) |
$5,671.54
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
Rate for Payer: BCBS Complete |
$79.76
|
Rate for Payer: BCBS MAPPO |
$138.85
|
Rate for Payer: BCBS Trust/PPO |
$461.26
|
Rate for Payer: BCN Medicare Advantage |
$138.85
|
Rate for Payer: Cash Price |
$6,980.36
|
Rate for Payer: Cash Price |
$6,980.36
|
Rate for Payer: Cofinity Commercial |
$6,107.82
|
Rate for Payer: Cofinity Commercial |
$7,503.89
|
Rate for Payer: Encore Health Key Benefits Commercial |
$6,980.36
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
Rate for Payer: Healthscope Commercial |
$7,852.90
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,107.82
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,544.09
|
Rate for Payer: Mclaren Medicaid |
$75.95
|
Rate for Payer: Mclaren Medicare |
$138.85
|
Rate for Payer: Meridian Medicaid |
$79.76
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,416.63
|
Rate for Payer: PACE Medicare |
$131.91
|
Rate for Payer: PACE SWMI |
$138.85
|
Rate for Payer: PHP Commercial |
$7,416.63
|
Rate for Payer: PHP Medicare Advantage |
$138.85
|
Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
Rate for Payer: Priority Health Cigna Priority Health |
$6,107.82
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.09
|
Rate for Payer: Priority Health Medicare |
$138.85
|
Rate for Payer: Priority Health Narrow Network |
$349.67
|
Rate for Payer: Priority Health SBD |
$5,497.03
|
Rate for Payer: Railroad Medicare Medicare |
$138.85
|
Rate for Payer: UHC Core |
$700.00
|
Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
Rate for Payer: UHC Medicare Advantage |
$143.02
|
Rate for Payer: UMR Bronson Commercial |
$3,228.42
|
Rate for Payer: VA VA |
$138.85
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,544.09
|
|
HC ABLAVAR
|
Facility
|
OP
|
$26.00
|
|
Service Code
|
HCPCS A9583
|
Hospital Charge Code |
63600007
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$9.62 |
Max. Negotiated Rate |
$23.40 |
Rate for Payer: Aetna American Axle |
$16.90
|
Rate for Payer: Aetna Commercial |
$22.10
|
Rate for Payer: Aetna New Business (MI Preferred) |
$16.90
|
Rate for Payer: BCBS Complete |
$10.40
|
Rate for Payer: BCBS Trust/PPO |
$22.67
|
Rate for Payer: Cash Price |
$20.80
|
Rate for Payer: Cash Price |
$20.80
|
Rate for Payer: Cofinity Commercial |
$18.20
|
Rate for Payer: Cofinity Commercial |
$22.36
|
Rate for Payer: Encore Health Key Benefits Commercial |
$20.80
|
Rate for Payer: Healthscope Commercial |
$23.40
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.20
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.50
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.10
|
Rate for Payer: PHP Commercial |
$22.10
|
Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
Rate for Payer: Priority Health SBD |
$16.38
|
Rate for Payer: UMR Bronson Commercial |
$9.62
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.50
|
|
HC ABLAVAR
|
Facility
|
IP
|
$26.00
|
|
Service Code
|
HCPCS A9583
|
Hospital Charge Code |
63600007
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$11.44 |
Max. Negotiated Rate |
$23.40 |
Rate for Payer: Aetna American Axle |
$16.90
|
Rate for Payer: Aetna Commercial |
$22.10
|
Rate for Payer: Aetna New Business (MI Preferred) |
$16.90
|
Rate for Payer: Cash Price |
$20.80
|
Rate for Payer: Cofinity Commercial |
$18.20
|
Rate for Payer: Cofinity Commercial |
$22.36
|
Rate for Payer: Encore Health Key Benefits Commercial |
$20.80
|
Rate for Payer: Healthscope Commercial |
$23.40
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.20
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.50
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.10
|
Rate for Payer: PHP Commercial |
$22.10
|
Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
Rate for Payer: Priority Health SBD |
$16.38
|
Rate for Payer: UMR Bronson Commercial |
$11.44
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.50
|
|
HC ABSCESS DRAINAGE COMPLICATED
|
Facility
|
OP
|
$488.86
|
|
Service Code
|
CPT 10061
|
Hospital Charge Code |
76100037
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$180.88 |
Max. Negotiated Rate |
$1,115.78 |
Rate for Payer: Aetna American Axle |
$317.76
|
Rate for Payer: Aetna Commercial |
$415.53
|
Rate for Payer: Aetna Medicare |
$368.61
|
Rate for Payer: Aetna New Business (MI Preferred) |
$317.76
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
Rate for Payer: BCBS Complete |
$203.58
|
Rate for Payer: BCBS MAPPO |
$354.43
|
Rate for Payer: BCBS Trust/PPO |
$398.96
|
Rate for Payer: BCN Medicare Advantage |
$354.43
|
Rate for Payer: Cash Price |
$391.09
|
Rate for Payer: Cash Price |
$391.09
|
Rate for Payer: Cofinity Commercial |
$342.20
|
Rate for Payer: Cofinity Commercial |
$420.42
|
Rate for Payer: Encore Health Key Benefits Commercial |
$391.09
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
Rate for Payer: Healthscope Commercial |
$439.97
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$342.20
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$366.64
|
Rate for Payer: Mclaren Medicaid |
$193.87
|
Rate for Payer: Mclaren Medicare |
$354.43
|
Rate for Payer: Meridian Medicaid |
$203.58
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$415.53
|
Rate for Payer: PACE Medicare |
$336.71
|
Rate for Payer: PACE SWMI |
$354.43
|
Rate for Payer: PHP Commercial |
$415.53
|
Rate for Payer: PHP Medicare Advantage |
$354.43
|
Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
Rate for Payer: Priority Health Cigna Priority Health |
$342.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.78
|
Rate for Payer: Priority Health Medicare |
$354.43
|
Rate for Payer: Priority Health Narrow Network |
$892.62
|
Rate for Payer: Priority Health SBD |
$307.98
|
Rate for Payer: Railroad Medicare Medicare |
$354.43
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$200.27
|
Rate for Payer: UHC Dual Complete DSNP |
$354.43
|
Rate for Payer: UHC Exchange |
$182.06
|
Rate for Payer: UHC Medicare Advantage |
$365.06
|
Rate for Payer: UMR Bronson Commercial |
$180.88
|
Rate for Payer: VA VA |
$354.43
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$366.64
|
|
HC ABSCESS DRAINAGE COMPLICATED
|
Facility
|
IP
|
$488.86
|
|
Service Code
|
CPT 10061
|
Hospital Charge Code |
76100037
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$215.10 |
Max. Negotiated Rate |
$439.97 |
Rate for Payer: Aetna American Axle |
$317.76
|
Rate for Payer: Aetna Commercial |
$415.53
|
Rate for Payer: Aetna New Business (MI Preferred) |
$317.76
|
Rate for Payer: Cash Price |
$391.09
|
Rate for Payer: Cofinity Commercial |
$342.20
|
Rate for Payer: Cofinity Commercial |
$420.42
|
Rate for Payer: Encore Health Key Benefits Commercial |
$391.09
|
Rate for Payer: Healthscope Commercial |
$439.97
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$342.20
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$366.64
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$415.53
|
Rate for Payer: PHP Commercial |
$415.53
|
Rate for Payer: Priority Health Cigna Priority Health |
$342.20
|
Rate for Payer: Priority Health SBD |
$307.98
|
Rate for Payer: UMR Bronson Commercial |
$215.10
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$366.64
|
|
HC ABSCESS DRAINAGE SIMPLE
|
Facility
|
OP
|
$391.99
|
|
Service Code
|
CPT 10060
|
Hospital Charge Code |
36100002
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$97.34 |
Max. Negotiated Rate |
$560.20 |
Rate for Payer: Aetna American Axle |
$254.79
|
Rate for Payer: Aetna Commercial |
$333.19
|
Rate for Payer: Aetna Medicare |
$185.07
|
Rate for Payer: Aetna New Business (MI Preferred) |
$254.79
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
Rate for Payer: BCBS Complete |
$102.21
|
Rate for Payer: BCBS MAPPO |
$177.95
|
Rate for Payer: BCBS Trust/PPO |
$250.36
|
Rate for Payer: BCN Medicare Advantage |
$177.95
|
Rate for Payer: Cash Price |
$313.59
|
Rate for Payer: Cash Price |
$313.59
|
Rate for Payer: Cofinity Commercial |
$337.11
|
Rate for Payer: Cofinity Commercial |
$274.39
|
Rate for Payer: Encore Health Key Benefits Commercial |
$313.59
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
Rate for Payer: Healthscope Commercial |
$352.79
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$274.39
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$293.99
|
Rate for Payer: Mclaren Medicaid |
$97.34
|
Rate for Payer: Mclaren Medicare |
$177.95
|
Rate for Payer: Meridian Medicaid |
$102.21
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$333.19
|
Rate for Payer: PACE Medicare |
$169.05
|
Rate for Payer: PACE SWMI |
$177.95
|
Rate for Payer: PHP Commercial |
$333.19
|
Rate for Payer: PHP Medicare Advantage |
$177.95
|
Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
Rate for Payer: Priority Health Cigna Priority Health |
$274.39
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.20
|
Rate for Payer: Priority Health Medicare |
$177.95
|
Rate for Payer: Priority Health Narrow Network |
$448.16
|
Rate for Payer: Priority Health SBD |
$246.95
|
Rate for Payer: Railroad Medicare Medicare |
$177.95
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$115.98
|
Rate for Payer: UHC Dual Complete DSNP |
$177.95
|
Rate for Payer: UHC Exchange |
$105.44
|
Rate for Payer: UHC Medicare Advantage |
$183.29
|
Rate for Payer: UMR Bronson Commercial |
$145.04
|
Rate for Payer: VA VA |
$177.95
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$293.99
|
|
HC ABSCESS DRAINAGE SIMPLE
|
Facility
|
IP
|
$391.99
|
|
Service Code
|
CPT 10060
|
Hospital Charge Code |
36100002
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$172.48 |
Max. Negotiated Rate |
$352.79 |
Rate for Payer: Aetna American Axle |
$254.79
|
Rate for Payer: Aetna Commercial |
$333.19
|
Rate for Payer: Aetna New Business (MI Preferred) |
$254.79
|
Rate for Payer: Cash Price |
$313.59
|
Rate for Payer: Cofinity Commercial |
$337.11
|
Rate for Payer: Cofinity Commercial |
$274.39
|
Rate for Payer: Encore Health Key Benefits Commercial |
$313.59
|
Rate for Payer: Healthscope Commercial |
$352.79
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$274.39
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$293.99
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$333.19
|
Rate for Payer: PHP Commercial |
$333.19
|
Rate for Payer: Priority Health Cigna Priority Health |
$274.39
|
Rate for Payer: Priority Health SBD |
$246.95
|
Rate for Payer: UMR Bronson Commercial |
$172.48
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$293.99
|
|
HC ABSCESS ISHIO/PERIRECTAL
|
Facility
|
IP
|
$1,754.30
|
|
Service Code
|
CPT 46040
|
Hospital Charge Code |
36100196
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$771.89 |
Max. Negotiated Rate |
$1,578.87 |
Rate for Payer: Aetna American Axle |
$1,140.30
|
Rate for Payer: Aetna Commercial |
$1,491.16
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,140.30
|
Rate for Payer: Cash Price |
$1,403.44
|
Rate for Payer: Cofinity Commercial |
$1,228.01
|
Rate for Payer: Cofinity Commercial |
$1,508.70
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,403.44
|
Rate for Payer: Healthscope Commercial |
$1,578.87
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,228.01
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,315.72
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,491.16
|
Rate for Payer: PHP Commercial |
$1,491.16
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,228.01
|
Rate for Payer: Priority Health SBD |
$1,105.21
|
Rate for Payer: UMR Bronson Commercial |
$771.89
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,315.72
|
|
HC ABSCESS ISHIO/PERIRECTAL
|
Facility
|
OP
|
$1,754.30
|
|
Service Code
|
CPT 46040
|
Hospital Charge Code |
36100196
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$422.40 |
Max. Negotiated Rate |
$3,302.11 |
Rate for Payer: Aetna American Axle |
$1,140.30
|
Rate for Payer: Aetna Commercial |
$1,491.16
|
Rate for Payer: Aetna Medicare |
$1,090.90
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,140.30
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,311.18
|
Rate for Payer: Amish Plain Church Group Commercial |
$1,311.18
|
Rate for Payer: BCBS Complete |
$602.51
|
Rate for Payer: BCBS MAPPO |
$1,048.94
|
Rate for Payer: BCBS Trust/PPO |
$1,987.93
|
Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
Rate for Payer: Cash Price |
$1,403.44
|
Rate for Payer: Cash Price |
$1,403.44
|
Rate for Payer: Cofinity Commercial |
$1,508.70
|
Rate for Payer: Cofinity Commercial |
$1,228.01
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,403.44
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
Rate for Payer: Healthscope Commercial |
$1,578.87
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,228.01
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,315.72
|
Rate for Payer: Mclaren Medicaid |
$573.77
|
Rate for Payer: Mclaren Medicare |
$1,048.94
|
Rate for Payer: Meridian Medicaid |
$602.51
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.39
|
Rate for Payer: MI Amish Medical Board Commercial |
$1,206.28
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,491.16
|
Rate for Payer: PACE Medicare |
$996.49
|
Rate for Payer: PACE SWMI |
$1,048.94
|
Rate for Payer: PHP Commercial |
$1,491.16
|
Rate for Payer: PHP Medicare Advantage |
$1,048.94
|
Rate for Payer: Priority Health Choice Medicaid |
$573.77
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,228.01
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,302.11
|
Rate for Payer: Priority Health Medicare |
$1,048.94
|
Rate for Payer: Priority Health Narrow Network |
$2,641.69
|
Rate for Payer: Priority Health SBD |
$1,105.21
|
Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$464.64
|
Rate for Payer: UHC Dual Complete DSNP |
$1,048.94
|
Rate for Payer: UHC Exchange |
$422.40
|
Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
Rate for Payer: UMR Bronson Commercial |
$649.09
|
Rate for Payer: VA VA |
$1,048.94
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,315.72
|
|
HC ACAPELLA SUPPLY
|
Facility
|
IP
|
$192.14
|
|
Hospital Charge Code |
27000025
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$84.54 |
Max. Negotiated Rate |
$172.93 |
Rate for Payer: Aetna American Axle |
$124.89
|
Rate for Payer: Aetna Commercial |
$163.32
|
Rate for Payer: Aetna New Business (MI Preferred) |
$124.89
|
Rate for Payer: Cash Price |
$153.71
|
Rate for Payer: Cofinity Commercial |
$134.50
|
Rate for Payer: Cofinity Commercial |
$165.24
|
Rate for Payer: Encore Health Key Benefits Commercial |
$153.71
|
Rate for Payer: Healthscope Commercial |
$172.93
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$134.50
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.10
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.32
|
Rate for Payer: PHP Commercial |
$163.32
|
Rate for Payer: Priority Health Cigna Priority Health |
$134.50
|
Rate for Payer: Priority Health SBD |
$121.05
|
Rate for Payer: UMR Bronson Commercial |
$84.54
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.10
|
|
HC ACAPELLA SUPPLY
|
Facility
|
OP
|
$192.14
|
|
Hospital Charge Code |
27000025
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$71.09 |
Max. Negotiated Rate |
$172.93 |
Rate for Payer: Aetna American Axle |
$124.89
|
Rate for Payer: Aetna Commercial |
$163.32
|
Rate for Payer: Aetna New Business (MI Preferred) |
$124.89
|
Rate for Payer: BCBS Complete |
$76.86
|
Rate for Payer: Cash Price |
$153.71
|
Rate for Payer: Cofinity Commercial |
$134.50
|
Rate for Payer: Cofinity Commercial |
$165.24
|
Rate for Payer: Encore Health Key Benefits Commercial |
$153.71
|
Rate for Payer: Healthscope Commercial |
$172.93
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$134.50
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.10
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.32
|
Rate for Payer: PHP Commercial |
$163.32
|
Rate for Payer: Priority Health Cigna Priority Health |
$134.50
|
Rate for Payer: Priority Health SBD |
$121.05
|
Rate for Payer: UMR Bronson Commercial |
$71.09
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.10
|
|
HC ACB APLIGRAF PER SQ CM
|
Facility
|
IP
|
$92.44
|
|
Service Code
|
HCPCS Q4101
|
Hospital Charge Code |
63600031
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$40.67 |
Max. Negotiated Rate |
$83.20 |
Rate for Payer: Aetna American Axle |
$60.09
|
Rate for Payer: Aetna Commercial |
$78.57
|
Rate for Payer: Aetna New Business (MI Preferred) |
$60.09
|
Rate for Payer: Cash Price |
$73.95
|
Rate for Payer: Cofinity Commercial |
$64.71
|
Rate for Payer: Cofinity Commercial |
$79.50
|
Rate for Payer: Encore Health Key Benefits Commercial |
$73.95
|
Rate for Payer: Healthscope Commercial |
$83.20
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.71
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.33
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.57
|
Rate for Payer: PHP Commercial |
$78.57
|
Rate for Payer: Priority Health Cigna Priority Health |
$64.71
|
Rate for Payer: Priority Health SBD |
$58.24
|
Rate for Payer: UMR Bronson Commercial |
$40.67
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.33
|
|
HC ACB APLIGRAF PER SQ CM
|
Facility
|
OP
|
$92.44
|
|
Service Code
|
HCPCS Q4101
|
Hospital Charge Code |
63600031
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$34.20 |
Max. Negotiated Rate |
$2,099.22 |
Rate for Payer: Aetna American Axle |
$60.09
|
Rate for Payer: Aetna Commercial |
$78.57
|
Rate for Payer: Aetna New Business (MI Preferred) |
$60.09
|
Rate for Payer: BCBS Complete |
$36.98
|
Rate for Payer: BCBS Trust/PPO |
$2,099.22
|
Rate for Payer: Cash Price |
$73.95
|
Rate for Payer: Cash Price |
$73.95
|
Rate for Payer: Cofinity Commercial |
$64.71
|
Rate for Payer: Cofinity Commercial |
$79.50
|
Rate for Payer: Encore Health Key Benefits Commercial |
$73.95
|
Rate for Payer: Healthscope Commercial |
$83.20
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.71
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.33
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.57
|
Rate for Payer: PHP Commercial |
$78.57
|
Rate for Payer: Priority Health Cigna Priority Health |
$64.71
|
Rate for Payer: Priority Health SBD |
$58.24
|
Rate for Payer: UMR Bronson Commercial |
$34.20
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.33
|
|
HC ACB ESTABLISHED PT LEVEL 1
|
Facility
|
OP
|
$355.31
|
|
Service Code
|
CPT 99211
|
Hospital Charge Code |
51000072
|
Hospital Revenue Code
|
510
|
Min. Negotiated Rate |
$8.51 |
Max. Negotiated Rate |
$319.78 |
Rate for Payer: Aetna American Axle |
$230.95
|
Rate for Payer: Aetna Commercial |
$302.01
|
Rate for Payer: Aetna New Business (MI Preferred) |
$230.95
|
Rate for Payer: BCBS Complete |
$142.12
|
Rate for Payer: BCBS Trust/PPO |
$56.49
|
Rate for Payer: BCCCP Commercial |
$22.00
|
Rate for Payer: Cash Price |
$284.25
|
Rate for Payer: Cash Price |
$284.25
|
Rate for Payer: Cofinity Commercial |
$248.72
|
Rate for Payer: Cofinity Commercial |
$305.57
|
Rate for Payer: Encore Health Key Benefits Commercial |
$284.25
|
Rate for Payer: Healthscope Commercial |
$319.78
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$248.72
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.48
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$302.01
|
Rate for Payer: PHP Commercial |
$302.01
|
Rate for Payer: Priority Health Cigna Priority Health |
$248.72
|
Rate for Payer: Priority Health SBD |
$223.85
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$9.36
|
Rate for Payer: UHC Exchange |
$8.51
|
Rate for Payer: UMR Bronson Commercial |
$131.46
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.48
|
|
HC ACB ESTABLISHED PT LEVEL 1
|
Facility
|
IP
|
$355.31
|
|
Service Code
|
CPT 99211
|
Hospital Charge Code |
51000072
|
Hospital Revenue Code
|
510
|
Min. Negotiated Rate |
$156.34 |
Max. Negotiated Rate |
$319.78 |
Rate for Payer: Aetna American Axle |
$230.95
|
Rate for Payer: Aetna Commercial |
$302.01
|
Rate for Payer: Aetna New Business (MI Preferred) |
$230.95
|
Rate for Payer: Cash Price |
$284.25
|
Rate for Payer: Cofinity Commercial |
$248.72
|
Rate for Payer: Cofinity Commercial |
$305.57
|
Rate for Payer: Encore Health Key Benefits Commercial |
$284.25
|
Rate for Payer: Healthscope Commercial |
$319.78
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$248.72
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.48
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$302.01
|
Rate for Payer: PHP Commercial |
$302.01
|
Rate for Payer: Priority Health Cigna Priority Health |
$248.72
|
Rate for Payer: Priority Health SBD |
$223.85
|
Rate for Payer: UMR Bronson Commercial |
$156.34
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.48
|
|
HC ACB ESTABLISHED PT LEVEL 2
|
Facility
|
IP
|
$494.43
|
|
Service Code
|
CPT 99212
|
Hospital Charge Code |
51000073
|
Hospital Revenue Code
|
510
|
Min. Negotiated Rate |
$217.55 |
Max. Negotiated Rate |
$444.99 |
Rate for Payer: Aetna American Axle |
$321.38
|
Rate for Payer: Aetna Commercial |
$420.27
|
Rate for Payer: Aetna New Business (MI Preferred) |
$321.38
|
Rate for Payer: Cash Price |
$395.54
|
Rate for Payer: Cofinity Commercial |
$346.10
|
Rate for Payer: Cofinity Commercial |
$425.21
|
Rate for Payer: Encore Health Key Benefits Commercial |
$395.54
|
Rate for Payer: Healthscope Commercial |
$444.99
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$346.10
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.82
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$420.27
|
Rate for Payer: PHP Commercial |
$420.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$346.10
|
Rate for Payer: Priority Health SBD |
$311.49
|
Rate for Payer: UMR Bronson Commercial |
$217.55
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.82
|
|
HC ACB ESTABLISHED PT LEVEL 2
|
Facility
|
OP
|
$494.43
|
|
Service Code
|
CPT 99212
|
Hospital Charge Code |
51000073
|
Hospital Revenue Code
|
510
|
Min. Negotiated Rate |
$22.00 |
Max. Negotiated Rate |
$444.99 |
Rate for Payer: Aetna American Axle |
$321.38
|
Rate for Payer: Aetna Commercial |
$420.27
|
Rate for Payer: Aetna New Business (MI Preferred) |
$321.38
|
Rate for Payer: BCBS Complete |
$197.77
|
Rate for Payer: BCBS Trust/PPO |
$101.49
|
Rate for Payer: BCCCP Commercial |
$22.00
|
Rate for Payer: Cash Price |
$395.54
|
Rate for Payer: Cash Price |
$395.54
|
Rate for Payer: Cofinity Commercial |
$425.21
|
Rate for Payer: Cofinity Commercial |
$346.10
|
Rate for Payer: Encore Health Key Benefits Commercial |
$395.54
|
Rate for Payer: Healthscope Commercial |
$444.99
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$346.10
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.82
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$420.27
|
Rate for Payer: PHP Commercial |
$420.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$346.10
|
Rate for Payer: Priority Health SBD |
$311.49
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$37.82
|
Rate for Payer: UHC Exchange |
$34.38
|
Rate for Payer: UMR Bronson Commercial |
$182.94
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.82
|
|