|
HC BILATERAL INJECT CARPAL TUNNEL
|
Facility
|
IP
|
$600.76
|
|
|
Service Code
|
CPT 20526
|
| Hospital Charge Code |
76100242
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$264.33 |
| Max. Negotiated Rate |
$540.68 |
| Rate for Payer: Aetna American Axle |
$390.49
|
| Rate for Payer: Aetna Commercial |
$510.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.49
|
| Rate for Payer: Cash Price |
$480.61
|
| Rate for Payer: Cofinity Commercial |
$420.53
|
| Rate for Payer: Cofinity Commercial |
$516.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.61
|
| Rate for Payer: Healthscope Commercial |
$540.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.65
|
| Rate for Payer: PHP Commercial |
$510.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.53
|
| Rate for Payer: Priority Health SBD |
$378.48
|
| Rate for Payer: UMR Bronson Commercial |
$264.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.57
|
|
|
HC BILATERAL INJECT CARPAL TUNNEL
|
Facility
|
OP
|
$600.76
|
|
|
Service Code
|
CPT 20526
|
| Hospital Charge Code |
76100242
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.67 |
| Max. Negotiated Rate |
$828.79 |
| Rate for Payer: Aetna American Axle |
$390.49
|
| Rate for Payer: Aetna Commercial |
$510.65
|
| Rate for Payer: Aetna Medicare |
$273.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.49
|
| 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 |
$290.76
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$480.61
|
| Rate for Payer: Cash Price |
$480.61
|
| Rate for Payer: Cofinity Commercial |
$516.65
|
| Rate for Payer: Cofinity Commercial |
$420.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$540.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.57
|
| 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 |
$510.65
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$510.65
|
| 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 |
$420.53
|
| 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 |
$378.48
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.27
|
| Rate for Payer: UHC Exchange |
$55.67
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: UMR Bronson Commercial |
$222.28
|
| Rate for Payer: VA VA |
$263.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.57
|
|
|
HC BILATERAL MULTILAYER COMP DSG BK
|
Facility
|
OP
|
$724.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100048
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$25.87 |
| Max. Negotiated Rate |
$651.60 |
| Rate for Payer: Aetna American Axle |
$470.60
|
| Rate for Payer: Aetna Commercial |
$615.40
|
| Rate for Payer: Aetna Medicare |
$145.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$470.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.08
|
| Rate for Payer: BCBS Complete |
$80.45
|
| Rate for Payer: BCBS MAPPO |
$140.06
|
| Rate for Payer: BCBS Trust/PPO |
$145.99
|
| Rate for Payer: BCN Medicare Advantage |
$140.06
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cofinity Commercial |
$506.80
|
| Rate for Payer: Cofinity Commercial |
$622.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$579.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$651.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$506.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$543.00
|
| Rate for Payer: Mclaren Medicaid |
$76.61
|
| Rate for Payer: Mclaren Medicare |
$140.06
|
| Rate for Payer: Meridian Medicaid |
$80.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$615.40
|
| Rate for Payer: PACE Medicare |
$133.06
|
| Rate for Payer: PACE SWMI |
$140.06
|
| Rate for Payer: PHP Commercial |
$615.40
|
| Rate for Payer: PHP Medicare Advantage |
$140.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$506.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$440.92
|
| Rate for Payer: Priority Health Medicare |
$140.06
|
| Rate for Payer: Priority Health Narrow Network |
$352.74
|
| Rate for Payer: Priority Health SBD |
$456.12
|
| Rate for Payer: Railroad Medicare Medicare |
$140.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.06
|
| Rate for Payer: UHC Exchange |
$25.87
|
| Rate for Payer: UHC Medicare Advantage |
$144.26
|
| Rate for Payer: UMR Bronson Commercial |
$267.88
|
| Rate for Payer: VA VA |
$140.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$543.00
|
|
|
HC BILATERAL MULTILAYER COMP DSG BK
|
Facility
|
IP
|
$724.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100048
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$318.56 |
| Max. Negotiated Rate |
$651.60 |
| Rate for Payer: Aetna American Axle |
$470.60
|
| Rate for Payer: Aetna Commercial |
$615.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$470.60
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cofinity Commercial |
$506.80
|
| Rate for Payer: Cofinity Commercial |
$622.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$579.20
|
| Rate for Payer: Healthscope Commercial |
$651.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$506.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$543.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$615.40
|
| Rate for Payer: PHP Commercial |
$615.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$506.80
|
| Rate for Payer: Priority Health SBD |
$456.12
|
| Rate for Payer: UMR Bronson Commercial |
$318.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$543.00
|
|
|
HC BILATERAL TOMOSYNTHESIS
|
Facility
|
IP
|
$106.25
|
|
|
Service Code
|
CPT 77062
|
| Hospital Charge Code |
32000300
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$46.75 |
| Max. Negotiated Rate |
$95.62 |
| Rate for Payer: Aetna American Axle |
$69.06
|
| Rate for Payer: Aetna Commercial |
$90.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.06
|
| Rate for Payer: Cash Price |
$85.00
|
| Rate for Payer: Cofinity Commercial |
$74.38
|
| Rate for Payer: Cofinity Commercial |
$91.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.00
|
| Rate for Payer: Healthscope Commercial |
$95.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$90.31
|
| Rate for Payer: PHP Commercial |
$90.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.38
|
| Rate for Payer: Priority Health SBD |
$66.94
|
| Rate for Payer: UMR Bronson Commercial |
$46.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.69
|
|
|
HC BILATERAL TOMOSYNTHESIS
|
Facility
|
OP
|
$106.25
|
|
|
Service Code
|
CPT 77062
|
| Hospital Charge Code |
32000300
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$39.31 |
| Max. Negotiated Rate |
$332.00 |
| Rate for Payer: Aetna American Axle |
$69.06
|
| Rate for Payer: Aetna Commercial |
$90.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.06
|
| Rate for Payer: BCBS Complete |
$42.50
|
| Rate for Payer: BCBS Trust/PPO |
$63.86
|
| Rate for Payer: Cash Price |
$85.00
|
| Rate for Payer: Cash Price |
$85.00
|
| Rate for Payer: Cash Price |
$85.00
|
| Rate for Payer: Cofinity Commercial |
$74.38
|
| Rate for Payer: Cofinity Commercial |
$91.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.00
|
| Rate for Payer: Healthscope Commercial |
$95.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$90.31
|
| Rate for Payer: PHP Commercial |
$90.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.66
|
| Rate for Payer: Priority Health Narrow Network |
$97.33
|
| Rate for Payer: Priority Health SBD |
$66.94
|
| Rate for Payer: UHC Core |
$332.00
|
| Rate for Payer: UMR Bronson Commercial |
$39.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.69
|
|
|
HC BILATERAL UNNA BOOT
|
Facility
|
IP
|
$448.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
76100047
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$197.12 |
| Max. Negotiated Rate |
$403.20 |
| Rate for Payer: Aetna American Axle |
$291.20
|
| Rate for Payer: Aetna Commercial |
$380.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.20
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cofinity Commercial |
$313.60
|
| Rate for Payer: Cofinity Commercial |
$385.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.40
|
| Rate for Payer: Healthscope Commercial |
$403.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$313.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$336.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$380.80
|
| Rate for Payer: PHP Commercial |
$380.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.60
|
| Rate for Payer: Priority Health SBD |
$282.24
|
| Rate for Payer: UMR Bronson Commercial |
$197.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$336.00
|
|
|
HC BILATERAL UNNA BOOT
|
Facility
|
OP
|
$448.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
76100047
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$25.54 |
| Max. Negotiated Rate |
$440.92 |
| Rate for Payer: Aetna American Axle |
$291.20
|
| Rate for Payer: Aetna Commercial |
$380.80
|
| Rate for Payer: Aetna Medicare |
$145.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.08
|
| Rate for Payer: BCBS Complete |
$80.45
|
| Rate for Payer: BCBS MAPPO |
$140.06
|
| Rate for Payer: BCBS Trust/PPO |
$155.88
|
| Rate for Payer: BCN Medicare Advantage |
$140.06
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cofinity Commercial |
$385.28
|
| Rate for Payer: Cofinity Commercial |
$313.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$403.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$313.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$336.00
|
| Rate for Payer: Mclaren Medicaid |
$76.61
|
| Rate for Payer: Mclaren Medicare |
$140.06
|
| Rate for Payer: Meridian Medicaid |
$80.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$380.80
|
| Rate for Payer: PACE Medicare |
$133.06
|
| Rate for Payer: PACE SWMI |
$140.06
|
| Rate for Payer: PHP Commercial |
$380.80
|
| Rate for Payer: PHP Medicare Advantage |
$140.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$440.92
|
| Rate for Payer: Priority Health Medicare |
$140.06
|
| Rate for Payer: Priority Health Narrow Network |
$352.74
|
| Rate for Payer: Priority Health SBD |
$282.24
|
| Rate for Payer: Railroad Medicare Medicare |
$140.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.06
|
| Rate for Payer: UHC Exchange |
$25.54
|
| Rate for Payer: UHC Medicare Advantage |
$144.26
|
| Rate for Payer: UMR Bronson Commercial |
$165.76
|
| Rate for Payer: VA VA |
$140.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$336.00
|
|
|
HC BILAT PERC IMPLANT NEUROSTIM ELTRD,SACRAL NERVE W/IMAG
|
Facility
|
OP
|
$14,199.46
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$296.66 |
| Max. Negotiated Rate |
$19,137.49 |
| Rate for Payer: Aetna American Axle |
$9,229.65
|
| Rate for Payer: Aetna Commercial |
$12,069.54
|
| Rate for Payer: Aetna Medicare |
$6,322.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,229.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,598.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,598.96
|
| Rate for Payer: BCBS Complete |
$3,491.88
|
| Rate for Payer: BCBS MAPPO |
$6,079.17
|
| Rate for Payer: BCBS Trust/PPO |
$7,707.23
|
| Rate for Payer: BCN Medicare Advantage |
$6,079.17
|
| Rate for Payer: Cash Price |
$11,359.57
|
| Rate for Payer: Cash Price |
$11,359.57
|
| Rate for Payer: Cofinity Commercial |
$9,939.62
|
| Rate for Payer: Cofinity Commercial |
$12,211.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,359.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,079.17
|
| Rate for Payer: Healthscope Commercial |
$12,779.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,939.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,649.60
|
| Rate for Payer: Mclaren Medicaid |
$3,325.31
|
| Rate for Payer: Mclaren Medicare |
$6,079.17
|
| Rate for Payer: Meridian Medicaid |
$3,491.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,383.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,991.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,069.54
|
| Rate for Payer: PACE Medicare |
$5,775.21
|
| Rate for Payer: PACE SWMI |
$6,079.17
|
| Rate for Payer: PHP Commercial |
$12,069.54
|
| Rate for Payer: PHP Medicare Advantage |
$6,079.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,325.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,939.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,137.49
|
| Rate for Payer: Priority Health Medicare |
$6,079.17
|
| Rate for Payer: Priority Health Narrow Network |
$15,309.99
|
| Rate for Payer: Priority Health SBD |
$8,945.66
|
| Rate for Payer: Railroad Medicare Medicare |
$6,079.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,079.17
|
| Rate for Payer: UHC Exchange |
$296.66
|
| Rate for Payer: UHC Medicare Advantage |
$6,261.55
|
| Rate for Payer: UMR Bronson Commercial |
$5,253.80
|
| Rate for Payer: VA VA |
$6,079.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,649.60
|
|
|
HC BILAT PERC IMPLANT NEUROSTIM ELTRD,SACRAL NERVE W/IMAG
|
Facility
|
IP
|
$14,199.46
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,247.76 |
| Max. Negotiated Rate |
$12,779.51 |
| Rate for Payer: Aetna American Axle |
$9,229.65
|
| Rate for Payer: Aetna Commercial |
$12,069.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,229.65
|
| Rate for Payer: Cash Price |
$11,359.57
|
| Rate for Payer: Cofinity Commercial |
$12,211.54
|
| Rate for Payer: Cofinity Commercial |
$9,939.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,359.57
|
| Rate for Payer: Healthscope Commercial |
$12,779.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,939.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,649.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,069.54
|
| Rate for Payer: PHP Commercial |
$12,069.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,939.62
|
| Rate for Payer: Priority Health SBD |
$8,945.66
|
| Rate for Payer: UMR Bronson Commercial |
$6,247.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,649.60
|
|
|
HC BIL COMPLEX MULTILAYER COMP DSG
|
Facility
|
IP
|
$890.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100072
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$391.60 |
| Max. Negotiated Rate |
$801.00 |
| Rate for Payer: Aetna American Axle |
$578.50
|
| Rate for Payer: Aetna Commercial |
$756.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$578.50
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$765.40
|
| Rate for Payer: Cofinity Commercial |
$623.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.00
|
| Rate for Payer: Healthscope Commercial |
$801.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$623.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.50
|
| Rate for Payer: PHP Commercial |
$756.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.00
|
| Rate for Payer: Priority Health SBD |
$560.70
|
| Rate for Payer: UMR Bronson Commercial |
$391.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.50
|
|
|
HC BIL COMPLEX MULTILAYER COMP DSG
|
Facility
|
OP
|
$890.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100072
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$25.87 |
| Max. Negotiated Rate |
$801.00 |
| Rate for Payer: Aetna American Axle |
$578.50
|
| Rate for Payer: Aetna Commercial |
$756.50
|
| Rate for Payer: Aetna Medicare |
$145.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$578.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.08
|
| Rate for Payer: BCBS Complete |
$80.45
|
| Rate for Payer: BCBS MAPPO |
$140.06
|
| Rate for Payer: BCBS Trust/PPO |
$145.99
|
| Rate for Payer: BCN Medicare Advantage |
$140.06
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$765.40
|
| Rate for Payer: Cofinity Commercial |
$623.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$801.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$623.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.50
|
| Rate for Payer: Mclaren Medicaid |
$76.61
|
| Rate for Payer: Mclaren Medicare |
$140.06
|
| Rate for Payer: Meridian Medicaid |
$80.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.50
|
| Rate for Payer: PACE Medicare |
$133.06
|
| Rate for Payer: PACE SWMI |
$140.06
|
| Rate for Payer: PHP Commercial |
$756.50
|
| Rate for Payer: PHP Medicare Advantage |
$140.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$440.92
|
| Rate for Payer: Priority Health Medicare |
$140.06
|
| Rate for Payer: Priority Health Narrow Network |
$352.74
|
| Rate for Payer: Priority Health SBD |
$560.70
|
| Rate for Payer: Railroad Medicare Medicare |
$140.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.06
|
| Rate for Payer: UHC Exchange |
$25.87
|
| Rate for Payer: UHC Medicare Advantage |
$144.26
|
| Rate for Payer: UMR Bronson Commercial |
$329.30
|
| Rate for Payer: VA VA |
$140.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.50
|
|
|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
IP
|
$3,187.50
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,402.50 |
| Max. Negotiated Rate |
$2,868.75 |
| Rate for Payer: Aetna American Axle |
$2,071.88
|
| Rate for Payer: Aetna Commercial |
$2,709.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,071.88
|
| Rate for Payer: Cash Price |
$2,550.00
|
| Rate for Payer: Cofinity Commercial |
$2,231.25
|
| Rate for Payer: Cofinity Commercial |
$2,741.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,550.00
|
| Rate for Payer: Healthscope Commercial |
$2,868.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,231.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,390.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,709.38
|
| Rate for Payer: PHP Commercial |
$2,709.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,231.25
|
| Rate for Payer: Priority Health SBD |
$2,008.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,402.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,390.62
|
|
|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
OP
|
$3,187.50
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.16 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$2,071.88
|
| Rate for Payer: Aetna Commercial |
$2,709.38
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,071.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,603.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$2,550.00
|
| Rate for Payer: Cash Price |
$2,550.00
|
| Rate for Payer: Cofinity Commercial |
$2,741.25
|
| Rate for Payer: Cofinity Commercial |
$2,231.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,550.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$2,868.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,231.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,390.62
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,709.38
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$2,709.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,231.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$2,008.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$65.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,179.38
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,390.62
|
|
|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
IP
|
$3,035.52
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,335.63 |
| Max. Negotiated Rate |
$2,731.97 |
| Rate for Payer: Aetna American Axle |
$1,973.09
|
| Rate for Payer: Aetna Commercial |
$2,580.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,973.09
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cofinity Commercial |
$2,124.86
|
| Rate for Payer: Cofinity Commercial |
$2,610.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,428.42
|
| Rate for Payer: Healthscope Commercial |
$2,731.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,124.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,276.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,580.19
|
| Rate for Payer: PHP Commercial |
$2,580.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,124.86
|
| Rate for Payer: Priority Health SBD |
$1,912.38
|
| Rate for Payer: UMR Bronson Commercial |
$1,335.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,276.64
|
|
|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
OP
|
$3,035.52
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.69 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$1,973.09
|
| Rate for Payer: Aetna Commercial |
$2,580.19
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,973.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,762.53
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cofinity Commercial |
$2,124.86
|
| Rate for Payer: Cofinity Commercial |
$2,610.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,428.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$2,731.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,124.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,276.64
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,580.19
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$2,580.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,124.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Priority Health SBD |
$1,912.38
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$72.69
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,123.14
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,276.64
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
IP
|
$3,035.52
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,335.63 |
| Max. Negotiated Rate |
$2,731.97 |
| Rate for Payer: Aetna American Axle |
$1,973.09
|
| Rate for Payer: Aetna Commercial |
$2,580.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,973.09
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cofinity Commercial |
$2,124.86
|
| Rate for Payer: Cofinity Commercial |
$2,610.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,428.42
|
| Rate for Payer: Healthscope Commercial |
$2,731.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,124.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,276.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,580.19
|
| Rate for Payer: PHP Commercial |
$2,580.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,124.86
|
| Rate for Payer: Priority Health SBD |
$1,912.38
|
| Rate for Payer: UMR Bronson Commercial |
$1,335.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,276.64
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
OP
|
$3,035.52
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$68.11 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$1,973.09
|
| Rate for Payer: Aetna Commercial |
$2,580.19
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,973.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,603.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cash Price |
$2,428.42
|
| Rate for Payer: Cofinity Commercial |
$2,610.55
|
| Rate for Payer: Cofinity Commercial |
$2,124.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,428.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$2,731.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,124.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,276.64
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,580.19
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$2,580.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,124.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$1,912.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$68.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,123.14
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,276.64
|
|
|
HC BILE ACIDS TOTAL
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
30100116
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.44 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: UMR Bronson Commercial |
$22.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC BILE ACIDS TOTAL
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
30100116
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$17.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.40
|
| Rate for Payer: BCBS Complete |
$9.83
|
| Rate for Payer: BCBS MAPPO |
$17.12
|
| Rate for Payer: BCBS Trust/PPO |
$15.40
|
| Rate for Payer: BCN Medicare Advantage |
$17.12
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.12
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$9.36
|
| Rate for Payer: Mclaren Medicare |
$17.12
|
| Rate for Payer: Meridian Medicaid |
$9.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Medicare |
$16.26
|
| Rate for Payer: PACE SWMI |
$17.12
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$17.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.49
|
| Rate for Payer: Priority Health Medicare |
$17.12
|
| Rate for Payer: Priority Health Narrow Network |
$18.79
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: Railroad Medicare Medicare |
$17.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.54
|
| Rate for Payer: UHC Core |
$28.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.12
|
| Rate for Payer: UHC Exchange |
$17.12
|
| Rate for Payer: UHC Medicare Advantage |
$17.63
|
| Rate for Payer: UMR Bronson Commercial |
$18.87
|
| Rate for Payer: VA VA |
$17.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC BILE BODY FLUID
|
Facility
|
IP
|
$37.90
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700007
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$16.68 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna American Axle |
$24.64
|
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.64
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Cofinity Commercial |
$26.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health SBD |
$23.88
|
| Rate for Payer: UMR Bronson Commercial |
$16.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC BILE BODY FLUID
|
Facility
|
OP
|
$37.90
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700007
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.19 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna American Axle |
$24.64
|
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: Aetna Medicare |
$2.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.71
|
| Rate for Payer: BCBS Complete |
$1.25
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCBS Trust/PPO |
$1.95
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$26.53
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Mclaren Medicaid |
$1.19
|
| Rate for Payer: Mclaren Medicare |
$2.17
|
| Rate for Payer: Meridian Medicaid |
$1.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PACE Medicare |
$2.06
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.97
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health Narrow Network |
$2.38
|
| Rate for Payer: Priority Health SBD |
$23.88
|
| Rate for Payer: Railroad Medicare Medicare |
$2.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.60
|
| Rate for Payer: UHC Core |
$3.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.17
|
| Rate for Payer: UHC Exchange |
$2.17
|
| Rate for Payer: UHC Medicare Advantage |
$2.24
|
| Rate for Payer: UMR Bronson Commercial |
$14.02
|
| Rate for Payer: VA VA |
$2.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC BILIARY BRUSH BIOPSY
|
Facility
|
OP
|
$3,988.27
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$266.54 |
| Max. Negotiated Rate |
$21,170.20 |
| Rate for Payer: Aetna American Axle |
$2,592.38
|
| Rate for Payer: Aetna Commercial |
$3,390.03
|
| Rate for Payer: Aetna Medicare |
$6,993.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,592.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,406.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,406.09
|
| Rate for Payer: BCBS Complete |
$3,862.77
|
| Rate for Payer: BCBS MAPPO |
$6,724.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,159.25
|
| Rate for Payer: BCN Medicare Advantage |
$6,724.87
|
| Rate for Payer: Cash Price |
$3,190.62
|
| Rate for Payer: Cash Price |
$3,190.62
|
| Rate for Payer: Cofinity Commercial |
$2,791.79
|
| Rate for Payer: Cofinity Commercial |
$3,429.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,724.87
|
| Rate for Payer: Healthscope Commercial |
$3,589.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,791.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,991.20
|
| Rate for Payer: Mclaren Medicaid |
$3,678.50
|
| Rate for Payer: Mclaren Medicare |
$6,724.87
|
| Rate for Payer: Meridian Medicaid |
$3,862.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,061.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,733.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,390.03
|
| Rate for Payer: PACE Medicare |
$6,388.63
|
| Rate for Payer: PACE SWMI |
$6,724.87
|
| Rate for Payer: PHP Commercial |
$3,390.03
|
| Rate for Payer: PHP Medicare Advantage |
$6,724.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,678.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,791.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,170.20
|
| Rate for Payer: Priority Health Medicare |
$6,724.87
|
| Rate for Payer: Priority Health Narrow Network |
$16,936.16
|
| Rate for Payer: Priority Health SBD |
$2,512.61
|
| Rate for Payer: Railroad Medicare Medicare |
$6,724.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$293.19
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,724.87
|
| Rate for Payer: UHC Exchange |
$266.54
|
| Rate for Payer: UHC Medicare Advantage |
$6,926.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,475.66
|
| Rate for Payer: VA VA |
$6,724.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,991.20
|
|
|
HC BILIARY BRUSH BIOPSY
|
Facility
|
IP
|
$3,988.27
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,754.84 |
| Max. Negotiated Rate |
$3,589.44 |
| Rate for Payer: Aetna American Axle |
$2,592.38
|
| Rate for Payer: Aetna Commercial |
$3,390.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,592.38
|
| Rate for Payer: Cash Price |
$3,190.62
|
| Rate for Payer: Cofinity Commercial |
$2,791.79
|
| Rate for Payer: Cofinity Commercial |
$3,429.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.62
|
| Rate for Payer: Healthscope Commercial |
$3,589.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,791.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,991.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,390.03
|
| Rate for Payer: PHP Commercial |
$3,390.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,791.79
|
| Rate for Payer: Priority Health SBD |
$2,512.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,754.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,991.20
|
|
|
HC BILIARY DRAINAGE
|
Facility
|
IP
|
$459.89
|
|
| Hospital Charge Code |
36000010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$202.35 |
| Max. Negotiated Rate |
$413.90 |
| Rate for Payer: Aetna American Axle |
$298.93
|
| Rate for Payer: Aetna Commercial |
$390.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.93
|
| Rate for Payer: Cash Price |
$367.91
|
| Rate for Payer: Cofinity Commercial |
$321.92
|
| Rate for Payer: Cofinity Commercial |
$395.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.91
|
| Rate for Payer: Healthscope Commercial |
$413.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$321.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$390.91
|
| Rate for Payer: PHP Commercial |
$390.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.92
|
| Rate for Payer: Priority Health SBD |
$289.73
|
| Rate for Payer: UMR Bronson Commercial |
$202.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.92
|
|
