|
HC ASPERGILLUS ANTIGEN, BAL
|
Facility
|
IP
|
$89.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600290
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.16 |
| Max. Negotiated Rate |
$80.10 |
| Rate for Payer: Aetna American Axle |
$57.85
|
| Rate for Payer: Aetna Commercial |
$75.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.85
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cofinity Commercial |
$62.30
|
| Rate for Payer: Cofinity Commercial |
$76.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.20
|
| Rate for Payer: Healthscope Commercial |
$80.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.65
|
| Rate for Payer: PHP Commercial |
$75.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.30
|
| Rate for Payer: Priority Health SBD |
$56.07
|
| Rate for Payer: UMR Bronson Commercial |
$39.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.75
|
|
|
HC ASPERGILLUS FUMIGATUS IGG AB
|
Facility
|
OP
|
$57.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$51.30 |
| Rate for Payer: Aetna American Axle |
$37.05
|
| Rate for Payer: Aetna Commercial |
$48.45
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: BCBS Complete |
$8.64
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$13.54
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$49.02
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$51.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.75
|
| Rate for Payer: Mclaren Medicaid |
$8.23
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Medicaid |
$8.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.45
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$48.45
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$14.58
|
| Rate for Payer: Priority Health SBD |
$35.91
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.06
|
| Rate for Payer: UHC Core |
$24.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.05
|
| Rate for Payer: UHC Exchange |
$15.05
|
| Rate for Payer: UHC Medicare Advantage |
$15.50
|
| Rate for Payer: UMR Bronson Commercial |
$21.09
|
| Rate for Payer: VA VA |
$15.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.75
|
|
|
HC ASPERGILLUS FUMIGATUS IGG AB
|
Facility
|
IP
|
$57.00
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.08 |
| Max. Negotiated Rate |
$51.30 |
| Rate for Payer: Aetna American Axle |
$37.05
|
| Rate for Payer: Aetna Commercial |
$48.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.05
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$49.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.60
|
| Rate for Payer: Healthscope Commercial |
$51.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.45
|
| Rate for Payer: PHP Commercial |
$48.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.90
|
| Rate for Payer: Priority Health SBD |
$35.91
|
| Rate for Payer: UMR Bronson Commercial |
$25.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.75
|
|
|
HC ASP INTERVERTEBRAL DISC
|
Facility
|
IP
|
$826.95
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
36100297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$363.86 |
| Max. Negotiated Rate |
$744.26 |
| Rate for Payer: Aetna American Axle |
$537.52
|
| Rate for Payer: Aetna Commercial |
$702.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.52
|
| Rate for Payer: Cash Price |
$661.56
|
| Rate for Payer: Cofinity Commercial |
$578.86
|
| Rate for Payer: Cofinity Commercial |
$711.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$661.56
|
| Rate for Payer: Healthscope Commercial |
$744.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$578.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$620.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$702.91
|
| Rate for Payer: PHP Commercial |
$702.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$578.86
|
| Rate for Payer: Priority Health SBD |
$520.98
|
| Rate for Payer: UMR Bronson Commercial |
$363.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$620.21
|
|
|
HC ASP INTERVERTEBRAL DISC
|
Facility
|
OP
|
$826.95
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
36100297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$148.99 |
| Max. Negotiated Rate |
$1,968.76 |
| Rate for Payer: Aetna American Axle |
$537.52
|
| Rate for Payer: Aetna Commercial |
$702.91
|
| Rate for Payer: Aetna Medicare |
$650.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$586.35
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$661.56
|
| Rate for Payer: Cash Price |
$661.56
|
| Rate for Payer: Cofinity Commercial |
$578.86
|
| Rate for Payer: Cofinity Commercial |
$711.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$661.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$744.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$578.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$620.21
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$702.91
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$702.91
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$578.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.76
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.01
|
| Rate for Payer: Priority Health SBD |
$520.98
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.89
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.39
|
| Rate for Payer: UHC Exchange |
$148.99
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: UMR Bronson Commercial |
$305.97
|
| Rate for Payer: VA VA |
$625.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$620.21
|
|
|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
OP
|
$378.64
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$40.28 |
| Max. Negotiated Rate |
$828.79 |
| Rate for Payer: Aetna American Axle |
$246.12
|
| Rate for Payer: Aetna Commercial |
$321.84
|
| Rate for Payer: Aetna Medicare |
$273.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$42.11
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$302.91
|
| Rate for Payer: Cash Price |
$302.91
|
| Rate for Payer: Cofinity Commercial |
$325.63
|
| Rate for Payer: Cofinity Commercial |
$265.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$340.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$265.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.98
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$321.84
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$321.84
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$828.79
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$663.03
|
| Rate for Payer: Priority Health SBD |
$238.54
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.27
|
| Rate for Payer: UHC Exchange |
$40.28
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: UMR Bronson Commercial |
$140.10
|
| Rate for Payer: VA VA |
$263.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.98
|
|
|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
IP
|
$378.64
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$166.60 |
| Max. Negotiated Rate |
$340.78 |
| Rate for Payer: Aetna American Axle |
$246.12
|
| Rate for Payer: Aetna Commercial |
$321.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.12
|
| Rate for Payer: Cash Price |
$302.91
|
| Rate for Payer: Cofinity Commercial |
$265.05
|
| Rate for Payer: Cofinity Commercial |
$325.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.91
|
| Rate for Payer: Healthscope Commercial |
$340.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$265.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$321.84
|
| Rate for Payer: PHP Commercial |
$321.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.05
|
| Rate for Payer: Priority Health SBD |
$238.54
|
| Rate for Payer: UMR Bronson Commercial |
$166.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.98
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
IP
|
$3,066.89
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,349.43 |
| Max. Negotiated Rate |
$2,760.20 |
| Rate for Payer: Aetna American Axle |
$1,993.48
|
| Rate for Payer: Aetna Commercial |
$2,606.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,993.48
|
| Rate for Payer: Cash Price |
$2,453.51
|
| Rate for Payer: Cofinity Commercial |
$2,146.82
|
| Rate for Payer: Cofinity Commercial |
$2,637.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,453.51
|
| Rate for Payer: Healthscope Commercial |
$2,760.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,146.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,300.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,606.86
|
| Rate for Payer: PHP Commercial |
$2,606.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,146.82
|
| Rate for Payer: Priority Health SBD |
$1,932.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,349.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,300.17
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
OP
|
$3,066.89
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$138.18 |
| Max. Negotiated Rate |
$5,699.47 |
| Rate for Payer: Aetna American Axle |
$1,993.48
|
| Rate for Payer: Aetna Commercial |
$2,606.86
|
| Rate for Payer: Aetna Medicare |
$1,882.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,993.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,372.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,453.51
|
| Rate for Payer: Cash Price |
$2,453.51
|
| Rate for Payer: Cofinity Commercial |
$2,146.82
|
| Rate for Payer: Cofinity Commercial |
$2,637.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,453.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$2,760.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,146.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,300.17
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,606.86
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$2,606.86
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,146.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,699.47
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$4,559.58
|
| Rate for Payer: Priority Health SBD |
$1,932.14
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.00
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,810.48
|
| Rate for Payer: UHC Exchange |
$138.18
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,134.75
|
| Rate for Payer: VA VA |
$1,810.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,300.17
|
|
|
HC ASPIRATION CYST OVARIAN ABDOMINAL APPROACH UNI OR BIL
|
Facility
|
IP
|
$4,249.39
|
|
|
Service Code
|
CPT 58805
|
| Hospital Charge Code |
36100258
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,869.73 |
| Max. Negotiated Rate |
$3,824.45 |
| Rate for Payer: Aetna American Axle |
$2,762.10
|
| Rate for Payer: Aetna Commercial |
$3,611.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,762.10
|
| Rate for Payer: Cash Price |
$3,399.51
|
| Rate for Payer: Cofinity Commercial |
$2,974.57
|
| Rate for Payer: Cofinity Commercial |
$3,654.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,399.51
|
| Rate for Payer: Healthscope Commercial |
$3,824.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,974.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,187.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,611.98
|
| Rate for Payer: PHP Commercial |
$3,611.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,974.57
|
| Rate for Payer: Priority Health SBD |
$2,677.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,869.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,187.04
|
|
|
HC ASPIRATION CYST OVARIAN ABDOMINAL APPROACH UNI OR BIL
|
Facility
|
OP
|
$4,249.39
|
|
|
Service Code
|
CPT 58805
|
| Hospital Charge Code |
36100258
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$425.02 |
| Max. Negotiated Rate |
$8,748.29 |
| Rate for Payer: Aetna American Axle |
$2,762.10
|
| Rate for Payer: Aetna Commercial |
$3,611.98
|
| Rate for Payer: Aetna Medicare |
$2,890.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,762.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,847.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$3,399.51
|
| Rate for Payer: Cash Price |
$3,399.51
|
| Rate for Payer: Cofinity Commercial |
$2,974.57
|
| Rate for Payer: Cofinity Commercial |
$3,654.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,399.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$3,824.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,974.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,187.04
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,611.98
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$3,611.98
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,974.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,748.29
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$6,998.63
|
| Rate for Payer: Priority Health SBD |
$2,677.12
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$467.52
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,778.95
|
| Rate for Payer: UHC Exchange |
$425.02
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,572.27
|
| Rate for Payer: VA VA |
$2,778.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,187.04
|
|
|
HC ASPIRATION CYST OVARIAN VAGINAL APPROACH UNI OR BIL
|
Facility
|
OP
|
$2,494.41
|
|
|
Service Code
|
CPT 58800
|
| Hospital Charge Code |
36100257
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$313.36 |
| Max. Negotiated Rate |
$8,748.29 |
| Rate for Payer: Aetna American Axle |
$1,621.37
|
| Rate for Payer: Aetna Commercial |
$2,120.25
|
| Rate for Payer: Aetna Medicare |
$2,890.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,621.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,583.45
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$1,995.53
|
| Rate for Payer: Cash Price |
$1,995.53
|
| Rate for Payer: Cofinity Commercial |
$1,746.09
|
| Rate for Payer: Cofinity Commercial |
$2,145.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,995.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$2,244.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,746.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,870.81
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,120.25
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$2,120.25
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,748.29
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$6,998.63
|
| Rate for Payer: Priority Health SBD |
$1,571.48
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$344.70
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,778.95
|
| Rate for Payer: UHC Exchange |
$313.36
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: UMR Bronson Commercial |
$922.93
|
| Rate for Payer: VA VA |
$2,778.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,870.81
|
|
|
HC ASPIRATION CYST OVARIAN VAGINAL APPROACH UNI OR BIL
|
Facility
|
IP
|
$2,494.41
|
|
|
Service Code
|
CPT 58800
|
| Hospital Charge Code |
36100257
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,097.54 |
| Max. Negotiated Rate |
$2,244.97 |
| Rate for Payer: Aetna American Axle |
$1,621.37
|
| Rate for Payer: Aetna Commercial |
$2,120.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,621.37
|
| Rate for Payer: Cash Price |
$1,995.53
|
| Rate for Payer: Cofinity Commercial |
$1,746.09
|
| Rate for Payer: Cofinity Commercial |
$2,145.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,995.53
|
| Rate for Payer: Healthscope Commercial |
$2,244.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,746.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,870.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,120.25
|
| Rate for Payer: PHP Commercial |
$2,120.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.09
|
| Rate for Payer: Priority Health SBD |
$1,571.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,097.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,870.81
|
|
|
HC ASPIRATION DISK
|
Facility
|
OP
|
$4,523.74
|
|
|
Service Code
|
CPT 62287
|
| Hospital Charge Code |
32000003
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$5,402.75 |
| Rate for Payer: Aetna American Axle |
$2,940.43
|
| Rate for Payer: Aetna Commercial |
$3,845.18
|
| Rate for Payer: Aetna Medicare |
$1,784.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,940.43
|
| 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: BCBS Trust/PPO |
$2,801.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,716.23
|
| Rate for Payer: Cash Price |
$3,618.99
|
| Rate for Payer: Cash Price |
$3,618.99
|
| Rate for Payer: Cofinity Commercial |
$3,890.42
|
| Rate for Payer: Cofinity Commercial |
$3,166.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,618.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,716.23
|
| Rate for Payer: Healthscope Commercial |
$4,071.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,166.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,392.80
|
| 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 |
$3,845.18
|
| Rate for Payer: PACE Medicare |
$1,630.42
|
| Rate for Payer: PACE SWMI |
$1,716.23
|
| Rate for Payer: PHP Commercial |
$3,845.18
|
| 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 |
$3,166.62
|
| 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 |
$2,849.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,716.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$651.57
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,716.23
|
| Rate for Payer: UHC Exchange |
$592.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,767.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,673.78
|
| Rate for Payer: VA VA |
$1,716.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,392.80
|
|
|
HC ASPIRATION DISK
|
Facility
|
IP
|
$4,523.74
|
|
|
Service Code
|
CPT 62287
|
| Hospital Charge Code |
32000003
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,990.45 |
| Max. Negotiated Rate |
$4,071.37 |
| Rate for Payer: Aetna American Axle |
$2,940.43
|
| Rate for Payer: Aetna Commercial |
$3,845.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,940.43
|
| Rate for Payer: Cash Price |
$3,618.99
|
| Rate for Payer: Cofinity Commercial |
$3,166.62
|
| Rate for Payer: Cofinity Commercial |
$3,890.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,618.99
|
| Rate for Payer: Healthscope Commercial |
$4,071.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,166.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,392.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,845.18
|
| Rate for Payer: PHP Commercial |
$3,845.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,166.62
|
| Rate for Payer: Priority Health SBD |
$2,849.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,990.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,392.80
|
|
|
HC ASPIRATION SIMPLE
|
Facility
|
OP
|
$406.40
|
|
| Hospital Charge Code |
45000031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$150.37 |
| Max. Negotiated Rate |
$365.76 |
| Rate for Payer: Aetna American Axle |
$264.16
|
| Rate for Payer: Aetna Commercial |
$345.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.16
|
| Rate for Payer: BCBS Complete |
$162.56
|
| Rate for Payer: Cash Price |
$325.12
|
| Rate for Payer: Cofinity Commercial |
$284.48
|
| Rate for Payer: Cofinity Commercial |
$349.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.12
|
| Rate for Payer: Healthscope Commercial |
$365.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$345.44
|
| Rate for Payer: PHP Commercial |
$345.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.48
|
| Rate for Payer: Priority Health SBD |
$256.03
|
| Rate for Payer: UMR Bronson Commercial |
$150.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.80
|
|
|
HC ASPIRATION SIMPLE
|
Facility
|
IP
|
$406.40
|
|
| Hospital Charge Code |
45000031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$178.82 |
| Max. Negotiated Rate |
$365.76 |
| Rate for Payer: Aetna American Axle |
$264.16
|
| Rate for Payer: Aetna Commercial |
$345.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.16
|
| Rate for Payer: Cash Price |
$325.12
|
| Rate for Payer: Cofinity Commercial |
$284.48
|
| Rate for Payer: Cofinity Commercial |
$349.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.12
|
| Rate for Payer: Healthscope Commercial |
$365.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$345.44
|
| Rate for Payer: PHP Commercial |
$345.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.48
|
| Rate for Payer: Priority Health SBD |
$256.03
|
| Rate for Payer: UMR Bronson Commercial |
$178.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.80
|
|
|
HC ASPIRATION THYROID CYST
|
Facility
|
IP
|
$484.17
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
36100266
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$213.03 |
| Max. Negotiated Rate |
$435.75 |
| Rate for Payer: Aetna American Axle |
$314.71
|
| Rate for Payer: Aetna Commercial |
$411.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$314.71
|
| Rate for Payer: Cash Price |
$387.34
|
| Rate for Payer: Cofinity Commercial |
$338.92
|
| Rate for Payer: Cofinity Commercial |
$416.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.34
|
| Rate for Payer: Healthscope Commercial |
$435.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$338.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$411.54
|
| Rate for Payer: PHP Commercial |
$411.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.92
|
| Rate for Payer: Priority Health SBD |
$305.03
|
| Rate for Payer: UMR Bronson Commercial |
$213.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.13
|
|
|
HC ASPIRATION THYROID CYST
|
Facility
|
OP
|
$484.17
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
36100266
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$46.82 |
| Max. Negotiated Rate |
$1,968.76 |
| Rate for Payer: Aetna American Axle |
$314.71
|
| Rate for Payer: Aetna Commercial |
$411.54
|
| Rate for Payer: Aetna Medicare |
$650.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$314.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$103.24
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$387.34
|
| Rate for Payer: Cash Price |
$387.34
|
| Rate for Payer: Cofinity Commercial |
$338.92
|
| Rate for Payer: Cofinity Commercial |
$416.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$435.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$338.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.13
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$411.54
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$411.54
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.76
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.01
|
| Rate for Payer: Priority Health SBD |
$305.03
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.50
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.39
|
| Rate for Payer: UHC Exchange |
$46.82
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: UMR Bronson Commercial |
$179.14
|
| Rate for Payer: VA VA |
$625.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.13
|
|
|
HC ASSMT & CARE PLN PT COG IMP
|
Facility
|
OP
|
$229.10
|
|
|
Service Code
|
CPT 99483
|
| Hospital Charge Code |
51000106
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$43.34 |
| Max. Negotiated Rate |
$485.21 |
| Rate for Payer: Aetna American Axle |
$148.92
|
| Rate for Payer: Aetna Commercial |
$194.74
|
| Rate for Payer: Aetna Medicare |
$82.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$99.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$99.04
|
| Rate for Payer: BCBS Complete |
$45.51
|
| Rate for Payer: BCBS MAPPO |
$79.23
|
| Rate for Payer: BCBS Trust/PPO |
$485.21
|
| Rate for Payer: BCN Medicare Advantage |
$79.23
|
| Rate for Payer: Cash Price |
$183.28
|
| Rate for Payer: Cash Price |
$183.28
|
| Rate for Payer: Cofinity Commercial |
$160.37
|
| Rate for Payer: Cofinity Commercial |
$197.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.23
|
| Rate for Payer: Healthscope Commercial |
$206.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.82
|
| Rate for Payer: Mclaren Medicaid |
$43.34
|
| Rate for Payer: Mclaren Medicare |
$79.23
|
| Rate for Payer: Meridian Medicaid |
$45.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$83.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$194.74
|
| Rate for Payer: PACE Medicare |
$75.27
|
| Rate for Payer: PACE SWMI |
$79.23
|
| Rate for Payer: PHP Commercial |
$194.74
|
| Rate for Payer: PHP Medicare Advantage |
$79.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.42
|
| Rate for Payer: Priority Health Medicare |
$79.23
|
| Rate for Payer: Priority Health Narrow Network |
$199.54
|
| Rate for Payer: Priority Health SBD |
$144.33
|
| Rate for Payer: Railroad Medicare Medicare |
$79.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.23
|
| Rate for Payer: UHC Exchange |
$187.95
|
| Rate for Payer: UHC Medicare Advantage |
$81.61
|
| Rate for Payer: UMR Bronson Commercial |
$84.77
|
| Rate for Payer: VA VA |
$79.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.82
|
|
|
HC ASSMT & CARE PLN PT COG IMP
|
Facility
|
IP
|
$229.10
|
|
|
Service Code
|
CPT 99483
|
| Hospital Charge Code |
51000106
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$100.80 |
| Max. Negotiated Rate |
$206.19 |
| Rate for Payer: Aetna American Axle |
$148.92
|
| Rate for Payer: Aetna Commercial |
$194.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.92
|
| Rate for Payer: Cash Price |
$183.28
|
| Rate for Payer: Cofinity Commercial |
$197.03
|
| Rate for Payer: Cofinity Commercial |
$160.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.28
|
| Rate for Payer: Healthscope Commercial |
$206.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$194.74
|
| Rate for Payer: PHP Commercial |
$194.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.37
|
| Rate for Payer: Priority Health SBD |
$144.33
|
| Rate for Payer: UMR Bronson Commercial |
$100.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.82
|
|
|
HC ASTIGMATISM CORRECT FXN IOL
|
Facility
|
OP
|
$1,573.87
|
|
|
Service Code
|
HCPCS V2787
|
| Hospital Charge Code |
27600002
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$582.33 |
| Max. Negotiated Rate |
$1,416.48 |
| Rate for Payer: Aetna American Axle |
$1,023.02
|
| Rate for Payer: Aetna Commercial |
$1,337.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,023.02
|
| Rate for Payer: BCBS Complete |
$629.55
|
| Rate for Payer: Cash Price |
$1,259.10
|
| Rate for Payer: Cofinity Commercial |
$1,101.71
|
| Rate for Payer: Cofinity Commercial |
$1,353.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,259.10
|
| Rate for Payer: Healthscope Commercial |
$1,416.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,101.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,180.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,337.79
|
| Rate for Payer: PHP Commercial |
$1,337.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,101.71
|
| Rate for Payer: Priority Health SBD |
$991.54
|
| Rate for Payer: UMR Bronson Commercial |
$582.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,180.40
|
|
|
HC ASTIGMATISM CORRECT FXN IOL
|
Facility
|
IP
|
$1,573.87
|
|
|
Service Code
|
HCPCS V2787
|
| Hospital Charge Code |
27600002
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$692.50 |
| Max. Negotiated Rate |
$1,416.48 |
| Rate for Payer: Aetna American Axle |
$1,023.02
|
| Rate for Payer: Aetna Commercial |
$1,337.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,023.02
|
| Rate for Payer: Cash Price |
$1,259.10
|
| Rate for Payer: Cofinity Commercial |
$1,101.71
|
| Rate for Payer: Cofinity Commercial |
$1,353.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,259.10
|
| Rate for Payer: Healthscope Commercial |
$1,416.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,101.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,180.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,337.79
|
| Rate for Payer: PHP Commercial |
$1,337.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,101.71
|
| Rate for Payer: Priority Health SBD |
$991.54
|
| Rate for Payer: UMR Bronson Commercial |
$692.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,180.40
|
|
|
HC ATHERECT ABDOMINAL AORTA
|
Facility
|
OP
|
$14,597.63
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
36100300
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,348.94 |
| Max. Negotiated Rate |
$30,783.77 |
| Rate for Payer: Aetna American Axle |
$9,488.46
|
| Rate for Payer: Aetna Commercial |
$12,407.99
|
| Rate for Payer: Aetna Medicare |
$10,169.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,488.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,223.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,223.36
|
| Rate for Payer: BCBS Complete |
$5,616.88
|
| Rate for Payer: BCBS MAPPO |
$9,778.69
|
| Rate for Payer: BCBS Trust/PPO |
$8,684.72
|
| Rate for Payer: BCN Medicare Advantage |
$9,778.69
|
| Rate for Payer: Cash Price |
$11,678.10
|
| Rate for Payer: Cash Price |
$11,678.10
|
| Rate for Payer: Cofinity Commercial |
$12,553.96
|
| Rate for Payer: Cofinity Commercial |
$10,218.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,678.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,778.69
|
| Rate for Payer: Healthscope Commercial |
$13,137.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,218.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,948.22
|
| Rate for Payer: Mclaren Medicaid |
$5,348.94
|
| Rate for Payer: Mclaren Medicare |
$9,778.69
|
| Rate for Payer: Meridian Medicaid |
$5,616.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,267.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,245.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,407.99
|
| Rate for Payer: PACE Medicare |
$9,289.76
|
| Rate for Payer: PACE SWMI |
$9,778.69
|
| Rate for Payer: PHP Commercial |
$12,407.99
|
| Rate for Payer: PHP Medicare Advantage |
$9,778.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,348.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,218.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30,783.77
|
| Rate for Payer: Priority Health Medicare |
$9,778.69
|
| Rate for Payer: Priority Health Narrow Network |
$24,627.02
|
| Rate for Payer: Priority Health SBD |
$9,196.51
|
| Rate for Payer: Railroad Medicare Medicare |
$9,778.69
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,778.69
|
| Rate for Payer: UHC Medicare Advantage |
$10,072.05
|
| Rate for Payer: UMR Bronson Commercial |
$5,401.12
|
| Rate for Payer: VA VA |
$9,778.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,948.22
|
|
|
HC ATHERECT ABDOMINAL AORTA
|
Facility
|
IP
|
$14,597.63
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
36100300
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,422.96 |
| Max. Negotiated Rate |
$13,137.87 |
| Rate for Payer: Aetna American Axle |
$9,488.46
|
| Rate for Payer: Aetna Commercial |
$12,407.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,488.46
|
| Rate for Payer: Cash Price |
$11,678.10
|
| Rate for Payer: Cofinity Commercial |
$10,218.34
|
| Rate for Payer: Cofinity Commercial |
$12,553.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,678.10
|
| Rate for Payer: Healthscope Commercial |
$13,137.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,218.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,948.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,407.99
|
| Rate for Payer: PHP Commercial |
$12,407.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,218.34
|
| Rate for Payer: Priority Health SBD |
$9,196.51
|
| Rate for Payer: UMR Bronson Commercial |
$6,422.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,948.22
|
|
