|
HC APPLY LC SKIN SUB 100 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
IP
|
$1,909.32
|
|
|
Service Code
|
HCPCS 15277
|
| Hospital Charge Code |
76100055
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$840.10 |
| Max. Negotiated Rate |
$1,718.39 |
| Rate for Payer: Aetna American Axle |
$1,241.06
|
| Rate for Payer: Aetna Commercial |
$1,622.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,241.06
|
| Rate for Payer: Cash Price |
$1,527.46
|
| Rate for Payer: Cofinity Commercial |
$1,336.52
|
| Rate for Payer: Cofinity Commercial |
$1,642.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,527.46
|
| Rate for Payer: Healthscope Commercial |
$1,718.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,336.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,431.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,622.92
|
| Rate for Payer: PHP Commercial |
$1,622.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,336.52
|
| Rate for Payer: Priority Health SBD |
$1,202.87
|
| Rate for Payer: UMR Bronson Commercial |
$840.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,431.99
|
|
|
HC APPLY LC SKIN SUB 100 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
OP
|
$1,909.32
|
|
|
Service Code
|
HCPCS 15277
|
| Hospital Charge Code |
76100055
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$216.44 |
| Max. Negotiated Rate |
$5,102.91 |
| Rate for Payer: Aetna American Axle |
$1,241.06
|
| Rate for Payer: Aetna Commercial |
$1,622.92
|
| Rate for Payer: Aetna Medicare |
$1,685.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,241.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$4,132.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Cash Price |
$1,527.46
|
| Rate for Payer: Cash Price |
$1,527.46
|
| Rate for Payer: Cofinity Commercial |
$1,642.02
|
| Rate for Payer: Cofinity Commercial |
$1,336.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,527.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Healthscope Commercial |
$1,718.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,336.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,431.99
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,622.92
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Commercial |
$1,622.92
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,336.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,102.91
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$4,082.33
|
| Rate for Payer: Priority Health SBD |
$1,202.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,620.98
|
| Rate for Payer: UHC Exchange |
$216.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: UMR Bronson Commercial |
$706.45
|
| Rate for Payer: VA VA |
$1,620.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,431.99
|
|
|
HC APPLY LC SKIN SUB 1ST 100 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
IP
|
$2,520.30
|
|
|
Service Code
|
HCPCS 15273
|
| Hospital Charge Code |
76100051
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,108.93 |
| Max. Negotiated Rate |
$2,268.27 |
| Rate for Payer: Aetna American Axle |
$1,638.20
|
| Rate for Payer: Aetna Commercial |
$2,142.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,638.20
|
| Rate for Payer: Cash Price |
$2,016.24
|
| Rate for Payer: Cofinity Commercial |
$1,764.21
|
| Rate for Payer: Cofinity Commercial |
$2,167.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,016.24
|
| Rate for Payer: Healthscope Commercial |
$2,268.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,764.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,890.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,142.26
|
| Rate for Payer: PHP Commercial |
$2,142.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.21
|
| Rate for Payer: Priority Health SBD |
$1,587.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,108.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,890.22
|
|
|
HC APPLY LC SKIN SUB 1ST 100 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
OP
|
$2,520.30
|
|
|
Service Code
|
HCPCS 15273
|
| Hospital Charge Code |
76100051
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$189.92 |
| Max. Negotiated Rate |
$10,039.01 |
| Rate for Payer: Aetna American Axle |
$1,638.20
|
| Rate for Payer: Aetna Commercial |
$2,142.26
|
| Rate for Payer: Aetna Medicare |
$3,316.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,638.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,986.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,986.20
|
| Rate for Payer: BCBS Complete |
$1,831.74
|
| Rate for Payer: BCBS MAPPO |
$3,188.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,626.17
|
| Rate for Payer: BCN Medicare Advantage |
$3,188.96
|
| Rate for Payer: Cash Price |
$2,016.24
|
| Rate for Payer: Cash Price |
$2,016.24
|
| Rate for Payer: Cofinity Commercial |
$1,764.21
|
| Rate for Payer: Cofinity Commercial |
$2,167.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,016.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,188.96
|
| Rate for Payer: Healthscope Commercial |
$2,268.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,764.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,890.22
|
| Rate for Payer: Mclaren Medicaid |
$1,744.36
|
| Rate for Payer: Mclaren Medicare |
$3,188.96
|
| Rate for Payer: Meridian Medicaid |
$1,831.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,348.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,667.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,142.26
|
| Rate for Payer: PACE Medicare |
$3,029.51
|
| Rate for Payer: PACE SWMI |
$3,188.96
|
| Rate for Payer: PHP Commercial |
$2,142.26
|
| Rate for Payer: PHP Medicare Advantage |
$3,188.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,744.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,039.01
|
| Rate for Payer: Priority Health Medicare |
$3,188.96
|
| Rate for Payer: Priority Health Narrow Network |
$8,031.21
|
| Rate for Payer: Priority Health SBD |
$1,587.79
|
| Rate for Payer: Railroad Medicare Medicare |
$3,188.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,188.96
|
| Rate for Payer: UHC Exchange |
$189.92
|
| Rate for Payer: UHC Medicare Advantage |
$3,284.63
|
| Rate for Payer: UMR Bronson Commercial |
$932.51
|
| Rate for Payer: VA VA |
$3,188.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,890.22
|
|
|
HC APPLY LC SKIN SUB 1ST 25 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
IP
|
$2,553.43
|
|
|
Service Code
|
HCPCS 15275
|
| Hospital Charge Code |
76100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,123.51 |
| Max. Negotiated Rate |
$2,298.09 |
| Rate for Payer: Aetna American Axle |
$1,659.73
|
| Rate for Payer: Aetna Commercial |
$2,170.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,659.73
|
| Rate for Payer: Cash Price |
$2,042.74
|
| Rate for Payer: Cofinity Commercial |
$1,787.40
|
| Rate for Payer: Cofinity Commercial |
$2,195.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,042.74
|
| Rate for Payer: Healthscope Commercial |
$2,298.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,787.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,915.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,170.42
|
| Rate for Payer: PHP Commercial |
$2,170.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,787.40
|
| Rate for Payer: Priority Health SBD |
$1,608.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,123.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,915.07
|
|
|
HC APPLY LC SKIN SUB 1ST 25 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
OP
|
$2,553.43
|
|
|
Service Code
|
HCPCS 15275
|
| Hospital Charge Code |
76100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$90.70 |
| Max. Negotiated Rate |
$5,102.91 |
| Rate for Payer: Aetna American Axle |
$1,659.73
|
| Rate for Payer: Aetna Commercial |
$2,170.42
|
| Rate for Payer: Aetna Medicare |
$1,685.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,659.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,578.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Cash Price |
$2,042.74
|
| Rate for Payer: Cash Price |
$2,042.74
|
| Rate for Payer: Cofinity Commercial |
$1,787.40
|
| Rate for Payer: Cofinity Commercial |
$2,195.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,042.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Healthscope Commercial |
$2,298.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,787.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,915.07
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,170.42
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Commercial |
$2,170.42
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,787.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,102.91
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$4,082.33
|
| Rate for Payer: Priority Health SBD |
$1,608.66
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,620.98
|
| Rate for Payer: UHC Exchange |
$90.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: UMR Bronson Commercial |
$944.77
|
| Rate for Payer: VA VA |
$1,620.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,915.07
|
|
|
HC APPLY LC SKIN SUB 1ST 25 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
IP
|
$2,340.63
|
|
|
Service Code
|
HCPCS 15271
|
| Hospital Charge Code |
76100049
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,029.88 |
| Max. Negotiated Rate |
$2,106.57 |
| Rate for Payer: Aetna American Axle |
$1,521.41
|
| Rate for Payer: Aetna Commercial |
$1,989.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,521.41
|
| Rate for Payer: Cash Price |
$1,872.50
|
| Rate for Payer: Cofinity Commercial |
$2,012.94
|
| Rate for Payer: Cofinity Commercial |
$1,638.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,872.50
|
| Rate for Payer: Healthscope Commercial |
$2,106.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,638.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,755.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,989.54
|
| Rate for Payer: PHP Commercial |
$1,989.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,638.44
|
| Rate for Payer: Priority Health SBD |
$1,474.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,029.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,755.47
|
|
|
HC APPLY LC SKIN SUB 1ST 25 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
OP
|
$2,340.63
|
|
|
Service Code
|
HCPCS 15271
|
| Hospital Charge Code |
76100049
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.86 |
| Max. Negotiated Rate |
$5,102.91 |
| Rate for Payer: Aetna American Axle |
$1,521.41
|
| Rate for Payer: Aetna Commercial |
$1,989.54
|
| Rate for Payer: Aetna Medicare |
$1,685.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,521.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,971.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Cash Price |
$1,872.50
|
| Rate for Payer: Cash Price |
$1,872.50
|
| Rate for Payer: Cofinity Commercial |
$1,638.44
|
| Rate for Payer: Cofinity Commercial |
$2,012.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,872.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Healthscope Commercial |
$2,106.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,638.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,755.47
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,989.54
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Commercial |
$1,989.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,638.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,102.91
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$4,082.33
|
| Rate for Payer: Priority Health SBD |
$1,474.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,620.98
|
| Rate for Payer: UHC Exchange |
$81.86
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: UMR Bronson Commercial |
$866.03
|
| Rate for Payer: VA VA |
$1,620.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,755.47
|
|
|
HC APPLY LC SKIN SUB ADDL 100 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
OP
|
$909.21
|
|
|
Service Code
|
HCPCS 15278
|
| Hospital Charge Code |
76100056
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$54.03 |
| Max. Negotiated Rate |
$818.29 |
| Rate for Payer: Aetna American Axle |
$590.99
|
| Rate for Payer: Aetna Commercial |
$772.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$590.99
|
| Rate for Payer: BCBS Complete |
$363.68
|
| Rate for Payer: BCBS Trust/PPO |
$293.94
|
| Rate for Payer: Cash Price |
$727.37
|
| Rate for Payer: Cash Price |
$727.37
|
| Rate for Payer: Cofinity Commercial |
$781.92
|
| Rate for Payer: Cofinity Commercial |
$636.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$727.37
|
| Rate for Payer: Healthscope Commercial |
$818.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$636.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$772.83
|
| Rate for Payer: PHP Commercial |
$772.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$636.45
|
| Rate for Payer: Priority Health SBD |
$572.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.43
|
| Rate for Payer: UHC Exchange |
$54.03
|
| Rate for Payer: UMR Bronson Commercial |
$336.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.91
|
|
|
HC APPLY LC SKIN SUB ADDL 100 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
IP
|
$909.21
|
|
|
Service Code
|
HCPCS 15278
|
| Hospital Charge Code |
76100056
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$400.05 |
| Max. Negotiated Rate |
$818.29 |
| Rate for Payer: Aetna American Axle |
$590.99
|
| Rate for Payer: Aetna Commercial |
$772.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$590.99
|
| Rate for Payer: Cash Price |
$727.37
|
| Rate for Payer: Cofinity Commercial |
$636.45
|
| Rate for Payer: Cofinity Commercial |
$781.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$727.37
|
| Rate for Payer: Healthscope Commercial |
$818.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$636.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$772.83
|
| Rate for Payer: PHP Commercial |
$772.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$636.45
|
| Rate for Payer: Priority Health SBD |
$572.80
|
| Rate for Payer: UMR Bronson Commercial |
$400.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.91
|
|
|
HC APPLY LC SKIN SUB ADDL 100 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
IP
|
$909.21
|
|
|
Service Code
|
HCPCS 15274
|
| Hospital Charge Code |
76100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$400.05 |
| Max. Negotiated Rate |
$818.29 |
| Rate for Payer: Aetna American Axle |
$590.99
|
| Rate for Payer: Aetna Commercial |
$772.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$590.99
|
| Rate for Payer: Cash Price |
$727.37
|
| Rate for Payer: Cofinity Commercial |
$636.45
|
| Rate for Payer: Cofinity Commercial |
$781.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$727.37
|
| Rate for Payer: Healthscope Commercial |
$818.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$636.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$772.83
|
| Rate for Payer: PHP Commercial |
$772.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$636.45
|
| Rate for Payer: Priority Health SBD |
$572.80
|
| Rate for Payer: UMR Bronson Commercial |
$400.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.91
|
|
|
HC APPLY LC SKIN SUB ADDL 100 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
OP
|
$909.21
|
|
|
Service Code
|
HCPCS 15274
|
| Hospital Charge Code |
76100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.22 |
| Max. Negotiated Rate |
$818.29 |
| Rate for Payer: Aetna American Axle |
$590.99
|
| Rate for Payer: Aetna Commercial |
$772.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$590.99
|
| Rate for Payer: BCBS Complete |
$363.68
|
| Rate for Payer: BCBS Trust/PPO |
$245.76
|
| Rate for Payer: Cash Price |
$727.37
|
| Rate for Payer: Cash Price |
$727.37
|
| Rate for Payer: Cofinity Commercial |
$781.92
|
| Rate for Payer: Cofinity Commercial |
$636.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$727.37
|
| Rate for Payer: Healthscope Commercial |
$818.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$636.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$681.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$772.83
|
| Rate for Payer: PHP Commercial |
$772.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$636.45
|
| Rate for Payer: Priority Health SBD |
$572.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.54
|
| Rate for Payer: UHC Exchange |
$43.22
|
| Rate for Payer: UMR Bronson Commercial |
$336.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$681.91
|
|
|
HC APPLY LC SKIN SUB ADDL 25 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
IP
|
$696.66
|
|
|
Service Code
|
HCPCS 15276
|
| Hospital Charge Code |
76100054
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$306.53 |
| Max. Negotiated Rate |
$626.99 |
| Rate for Payer: Aetna American Axle |
$452.83
|
| Rate for Payer: Aetna Commercial |
$592.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.83
|
| Rate for Payer: Cash Price |
$557.33
|
| Rate for Payer: Cofinity Commercial |
$487.66
|
| Rate for Payer: Cofinity Commercial |
$599.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.33
|
| Rate for Payer: Healthscope Commercial |
$626.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$487.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$592.16
|
| Rate for Payer: PHP Commercial |
$592.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.66
|
| Rate for Payer: Priority Health SBD |
$438.90
|
| Rate for Payer: UMR Bronson Commercial |
$306.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.50
|
|
|
HC APPLY LC SKIN SUB ADDL 25 SQ CM TO HEAD, HANDS, FEET
|
Facility
|
OP
|
$696.66
|
|
|
Service Code
|
HCPCS 15276
|
| Hospital Charge Code |
76100054
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$24.23 |
| Max. Negotiated Rate |
$626.99 |
| Rate for Payer: Aetna American Axle |
$452.83
|
| Rate for Payer: Aetna Commercial |
$592.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.83
|
| Rate for Payer: BCBS Complete |
$278.66
|
| Rate for Payer: BCBS Trust/PPO |
$119.28
|
| Rate for Payer: Cash Price |
$557.33
|
| Rate for Payer: Cash Price |
$557.33
|
| Rate for Payer: Cofinity Commercial |
$487.66
|
| Rate for Payer: Cofinity Commercial |
$599.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.33
|
| Rate for Payer: Healthscope Commercial |
$626.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$487.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$592.16
|
| Rate for Payer: PHP Commercial |
$592.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.66
|
| Rate for Payer: Priority Health SBD |
$438.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.65
|
| Rate for Payer: UHC Exchange |
$24.23
|
| Rate for Payer: UMR Bronson Commercial |
$257.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.50
|
|
|
HC APPLY LC SKIN SUB ADDL 25 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
OP
|
$696.66
|
|
|
Service Code
|
HCPCS 15272
|
| Hospital Charge Code |
76100050
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$16.37 |
| Max. Negotiated Rate |
$626.99 |
| Rate for Payer: Aetna American Axle |
$452.83
|
| Rate for Payer: Aetna Commercial |
$592.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.83
|
| Rate for Payer: BCBS Complete |
$278.66
|
| Rate for Payer: BCBS Trust/PPO |
$92.76
|
| Rate for Payer: Cash Price |
$557.33
|
| Rate for Payer: Cash Price |
$557.33
|
| Rate for Payer: Cofinity Commercial |
$599.13
|
| Rate for Payer: Cofinity Commercial |
$487.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.33
|
| Rate for Payer: Healthscope Commercial |
$626.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$487.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$592.16
|
| Rate for Payer: PHP Commercial |
$592.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.66
|
| Rate for Payer: Priority Health SBD |
$438.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.01
|
| Rate for Payer: UHC Exchange |
$16.37
|
| Rate for Payer: UMR Bronson Commercial |
$257.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.50
|
|
|
HC APPLY LC SKIN SUB ADDL 25 SQ CM TO TRUNK, ARMS, LEGS
|
Facility
|
IP
|
$696.66
|
|
|
Service Code
|
HCPCS 15272
|
| Hospital Charge Code |
76100050
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$306.53 |
| Max. Negotiated Rate |
$626.99 |
| Rate for Payer: Aetna American Axle |
$452.83
|
| Rate for Payer: Aetna Commercial |
$592.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.83
|
| Rate for Payer: Cash Price |
$557.33
|
| Rate for Payer: Cofinity Commercial |
$487.66
|
| Rate for Payer: Cofinity Commercial |
$599.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.33
|
| Rate for Payer: Healthscope Commercial |
$626.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$487.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$592.16
|
| Rate for Payer: PHP Commercial |
$592.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$487.66
|
| Rate for Payer: Priority Health SBD |
$438.90
|
| Rate for Payer: UMR Bronson Commercial |
$306.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.50
|
|
|
HC APPLY SPLINT/CAST COMPLEX
|
Facility
|
OP
|
$322.41
|
|
| Hospital Charge Code |
45000027
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$119.29 |
| Max. Negotiated Rate |
$290.17 |
| Rate for Payer: Aetna American Axle |
$209.57
|
| Rate for Payer: Aetna Commercial |
$274.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.57
|
| Rate for Payer: BCBS Complete |
$128.96
|
| Rate for Payer: Cash Price |
$257.93
|
| Rate for Payer: Cofinity Commercial |
$225.69
|
| Rate for Payer: Cofinity Commercial |
$277.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.93
|
| Rate for Payer: Healthscope Commercial |
$290.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$225.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$274.05
|
| Rate for Payer: PHP Commercial |
$274.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.69
|
| Rate for Payer: Priority Health SBD |
$203.12
|
| Rate for Payer: UMR Bronson Commercial |
$119.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.81
|
|
|
HC APPLY SPLINT/CAST COMPLEX
|
Facility
|
IP
|
$322.41
|
|
| Hospital Charge Code |
45000027
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$141.86 |
| Max. Negotiated Rate |
$290.17 |
| Rate for Payer: Aetna American Axle |
$209.57
|
| Rate for Payer: Aetna Commercial |
$274.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.57
|
| Rate for Payer: Cash Price |
$257.93
|
| Rate for Payer: Cofinity Commercial |
$225.69
|
| Rate for Payer: Cofinity Commercial |
$277.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.93
|
| Rate for Payer: Healthscope Commercial |
$290.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$225.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$274.05
|
| Rate for Payer: PHP Commercial |
$274.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.69
|
| Rate for Payer: Priority Health SBD |
$203.12
|
| Rate for Payer: UMR Bronson Commercial |
$141.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.81
|
|
|
HC APPLY SPLINT/CAST SIMPLE
|
Facility
|
IP
|
$193.15
|
|
| Hospital Charge Code |
45000028
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$84.99 |
| Max. Negotiated Rate |
$173.84 |
| Rate for Payer: Aetna American Axle |
$125.55
|
| Rate for Payer: Aetna Commercial |
$164.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.55
|
| Rate for Payer: Cash Price |
$154.52
|
| Rate for Payer: Cofinity Commercial |
$135.20
|
| Rate for Payer: Cofinity Commercial |
$166.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.52
|
| Rate for Payer: Healthscope Commercial |
$173.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.18
|
| Rate for Payer: PHP Commercial |
$164.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.20
|
| Rate for Payer: Priority Health SBD |
$121.68
|
| Rate for Payer: UMR Bronson Commercial |
$84.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.86
|
|
|
HC APPLY SPLINT/CAST SIMPLE
|
Facility
|
OP
|
$193.15
|
|
| Hospital Charge Code |
45000028
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$71.47 |
| Max. Negotiated Rate |
$173.84 |
| Rate for Payer: Aetna American Axle |
$125.55
|
| Rate for Payer: Aetna Commercial |
$164.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.55
|
| Rate for Payer: BCBS Complete |
$77.26
|
| Rate for Payer: Cash Price |
$154.52
|
| Rate for Payer: Cofinity Commercial |
$135.20
|
| Rate for Payer: Cofinity Commercial |
$166.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.52
|
| Rate for Payer: Healthscope Commercial |
$173.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.18
|
| Rate for Payer: PHP Commercial |
$164.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.20
|
| Rate for Payer: Priority Health SBD |
$121.68
|
| Rate for Payer: UMR Bronson Commercial |
$71.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.86
|
|
|
HC APT DOWNEY TEST
|
Facility
|
OP
|
$90.40
|
|
|
Service Code
|
CPT 83033
|
| Hospital Charge Code |
30100237
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.38 |
| Max. Negotiated Rate |
$81.36 |
| Rate for Payer: Aetna American Axle |
$58.76
|
| Rate for Payer: Aetna Commercial |
$76.84
|
| Rate for Payer: Aetna Medicare |
$8.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.00
|
| Rate for Payer: BCBS Complete |
$4.60
|
| Rate for Payer: BCBS MAPPO |
$8.00
|
| Rate for Payer: BCBS Trust/PPO |
$7.19
|
| Rate for Payer: BCN Medicare Advantage |
$8.00
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cofinity Commercial |
$77.74
|
| Rate for Payer: Cofinity Commercial |
$63.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.00
|
| Rate for Payer: Healthscope Commercial |
$81.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.80
|
| Rate for Payer: Mclaren Medicaid |
$4.38
|
| Rate for Payer: Mclaren Medicare |
$8.00
|
| Rate for Payer: Meridian Medicaid |
$4.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.84
|
| Rate for Payer: PACE Medicare |
$7.60
|
| Rate for Payer: PACE SWMI |
$8.00
|
| Rate for Payer: PHP Commercial |
$76.84
|
| Rate for Payer: PHP Medicare Advantage |
$8.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.18
|
| Rate for Payer: Priority Health Medicare |
$8.00
|
| Rate for Payer: Priority Health Narrow Network |
$6.54
|
| Rate for Payer: Priority Health SBD |
$56.95
|
| Rate for Payer: Railroad Medicare Medicare |
$8.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.60
|
| Rate for Payer: UHC Core |
$9.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.00
|
| Rate for Payer: UHC Exchange |
$8.00
|
| Rate for Payer: UHC Medicare Advantage |
$8.24
|
| Rate for Payer: UMR Bronson Commercial |
$33.45
|
| Rate for Payer: VA VA |
$8.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.80
|
|
|
HC APT DOWNEY TEST
|
Facility
|
IP
|
$90.40
|
|
|
Service Code
|
CPT 83033
|
| Hospital Charge Code |
30100237
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.78 |
| Max. Negotiated Rate |
$81.36 |
| Rate for Payer: Aetna American Axle |
$58.76
|
| Rate for Payer: Aetna Commercial |
$76.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.76
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cofinity Commercial |
$63.28
|
| Rate for Payer: Cofinity Commercial |
$77.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.32
|
| Rate for Payer: Healthscope Commercial |
$81.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.84
|
| Rate for Payer: PHP Commercial |
$76.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.28
|
| Rate for Payer: Priority Health SBD |
$56.95
|
| Rate for Payer: UMR Bronson Commercial |
$39.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.80
|
|
|
HC APTT
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500063
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.22 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: UMR Bronson Commercial |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC APTT
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500063
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$6.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.51
|
| Rate for Payer: BCBS Complete |
$3.45
|
| Rate for Payer: BCBS MAPPO |
$6.01
|
| Rate for Payer: BCBS Trust/PPO |
$5.41
|
| Rate for Payer: BCN Medicare Advantage |
$6.01
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.01
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$3.29
|
| Rate for Payer: Mclaren Medicare |
$6.01
|
| Rate for Payer: Meridian Medicaid |
$3.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Medicare |
$5.71
|
| Rate for Payer: PACE SWMI |
$6.01
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.24
|
| Rate for Payer: Priority Health Medicare |
$6.01
|
| Rate for Payer: Priority Health Narrow Network |
$6.59
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: Railroad Medicare Medicare |
$6.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.21
|
| Rate for Payer: UHC Core |
$9.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.01
|
| Rate for Payer: UHC Exchange |
$6.01
|
| Rate for Payer: UHC Medicare Advantage |
$6.19
|
| Rate for Payer: UMR Bronson Commercial |
$9.44
|
| Rate for Payer: VA VA |
$6.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC APTT MIXING STUDY
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 85732
|
| Hospital Charge Code |
30500064
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$43.12 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Aetna American Axle |
$63.70
|
| Rate for Payer: Aetna Commercial |
$83.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.70
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cofinity Commercial |
$68.60
|
| Rate for Payer: Cofinity Commercial |
$84.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.40
|
| Rate for Payer: Healthscope Commercial |
$88.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$83.30
|
| Rate for Payer: PHP Commercial |
$83.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.60
|
| Rate for Payer: Priority Health SBD |
$61.74
|
| Rate for Payer: UMR Bronson Commercial |
$43.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.50
|
|
