|
DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION
|
Facility
|
IP
|
$46,942.95
|
|
|
Service Code
|
HCPCS J9153
|
| Hospital Charge Code |
184345
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20,654.90 |
| Max. Negotiated Rate |
$42,248.66 |
| Rate for Payer: Aetna American Axle |
$30,512.92
|
| Rate for Payer: Aetna Commercial |
$39,901.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30,512.92
|
| Rate for Payer: Cash Price |
$37,554.36
|
| Rate for Payer: Cofinity Commercial |
$32,860.06
|
| Rate for Payer: Cofinity Commercial |
$40,370.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$32,860.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37,554.36
|
| Rate for Payer: Healthscope Commercial |
$42,248.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32,860.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35,207.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39,901.51
|
| Rate for Payer: PHP Commercial |
$39,901.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30,512.92
|
| Rate for Payer: Priority Health SBD |
$29,574.06
|
| Rate for Payer: UMR Bronson Commercial |
$20,654.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35,207.21
|
|
|
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$510.66
|
|
|
Service Code
|
HCPCS J9150
|
| Hospital Charge Code |
22661
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$224.69 |
| Max. Negotiated Rate |
$459.59 |
| Rate for Payer: Aetna American Axle |
$331.93
|
| Rate for Payer: Aetna American Axle |
$208.44
|
| Rate for Payer: Aetna American Axle |
$750.07
|
| Rate for Payer: Aetna American Axle |
$734.71
|
| Rate for Payer: Aetna Commercial |
$272.57
|
| Rate for Payer: Aetna Commercial |
$980.87
|
| Rate for Payer: Aetna Commercial |
$434.06
|
| Rate for Payer: Aetna Commercial |
$960.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$750.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$734.71
|
| Rate for Payer: Cash Price |
$408.53
|
| Rate for Payer: Cash Price |
$256.54
|
| Rate for Payer: Cash Price |
$923.17
|
| Rate for Payer: Cash Price |
$904.26
|
| Rate for Payer: Cofinity Commercial |
$357.46
|
| Rate for Payer: Cofinity Commercial |
$972.08
|
| Rate for Payer: Cofinity Commercial |
$791.22
|
| Rate for Payer: Cofinity Commercial |
$807.77
|
| Rate for Payer: Cofinity Commercial |
$992.41
|
| Rate for Payer: Cofinity Commercial |
$224.47
|
| Rate for Payer: Cofinity Commercial |
$275.78
|
| Rate for Payer: Cofinity Commercial |
$439.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$807.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$357.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$791.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$224.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$904.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$923.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.54
|
| Rate for Payer: Healthscope Commercial |
$459.59
|
| Rate for Payer: Healthscope Commercial |
$1,017.29
|
| Rate for Payer: Healthscope Commercial |
$288.60
|
| Rate for Payer: Healthscope Commercial |
$1,038.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$357.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$807.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$224.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$791.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$865.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$383.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$847.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$434.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$960.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$980.87
|
| Rate for Payer: PHP Commercial |
$960.77
|
| Rate for Payer: PHP Commercial |
$980.87
|
| Rate for Payer: PHP Commercial |
$272.57
|
| Rate for Payer: PHP Commercial |
$434.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$734.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$750.07
|
| Rate for Payer: Priority Health SBD |
$726.99
|
| Rate for Payer: Priority Health SBD |
$321.72
|
| Rate for Payer: Priority Health SBD |
$202.02
|
| Rate for Payer: Priority Health SBD |
$712.10
|
| Rate for Payer: UMR Bronson Commercial |
$141.09
|
| Rate for Payer: UMR Bronson Commercial |
$497.34
|
| Rate for Payer: UMR Bronson Commercial |
$507.74
|
| Rate for Payer: UMR Bronson Commercial |
$224.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$865.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$847.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$383.00
|
|
|
DAUNORUBICIN 5 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$510.66
|
|
|
Service Code
|
HCPCS J9150
|
| Hospital Charge Code |
22661
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.61 |
| Max. Negotiated Rate |
$459.59 |
| Rate for Payer: Priority Health Narrow Network |
$56.26
|
| Rate for Payer: Priority Health Narrow Network |
$56.26
|
| Rate for Payer: Priority Health Narrow Network |
$56.26
|
| Rate for Payer: Priority Health SBD |
$321.72
|
| Rate for Payer: Priority Health SBD |
$712.10
|
| Rate for Payer: Priority Health SBD |
$726.99
|
| Rate for Payer: Priority Health SBD |
$202.02
|
| Rate for Payer: Railroad Medicare Medicare |
$23.52
|
| Rate for Payer: Railroad Medicare Medicare |
$23.52
|
| Rate for Payer: Railroad Medicare Medicare |
$23.52
|
| Rate for Payer: Railroad Medicare Medicare |
$23.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.21
|
| Rate for Payer: Cash Price |
$256.54
|
| Rate for Payer: Cash Price |
$408.53
|
| Rate for Payer: Cash Price |
$256.54
|
| Rate for Payer: Cash Price |
$904.26
|
| Rate for Payer: Cash Price |
$923.17
|
| Rate for Payer: Cofinity Commercial |
$791.22
|
| Rate for Payer: Cofinity Commercial |
$972.08
|
| Rate for Payer: Cofinity Commercial |
$357.46
|
| Rate for Payer: Cofinity Commercial |
$439.17
|
| Rate for Payer: Cofinity Commercial |
$807.77
|
| Rate for Payer: Cofinity Commercial |
$275.78
|
| Rate for Payer: Cofinity Commercial |
$224.47
|
| Rate for Payer: Cofinity Commercial |
$992.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$807.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$791.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$224.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$357.46
|
| Rate for Payer: Priority Health Medicare |
$23.52
|
| Rate for Payer: Priority Health Narrow Network |
$56.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.52
|
| Rate for Payer: UHC Exchange |
$44.95
|
| Rate for Payer: UHC Exchange |
$44.95
|
| Rate for Payer: UHC Exchange |
$44.95
|
| Rate for Payer: UHC Exchange |
$44.95
|
| Rate for Payer: UHC Medicare Advantage |
$23.52
|
| Rate for Payer: UHC Medicare Advantage |
$23.52
|
| Rate for Payer: UHC Medicare Advantage |
$23.52
|
| Rate for Payer: UHC Medicare Advantage |
$23.52
|
| Rate for Payer: UHCCP Medicaid |
$12.61
|
| Rate for Payer: UHCCP Medicaid |
$12.61
|
| Rate for Payer: UHCCP Medicaid |
$12.61
|
| Rate for Payer: UHCCP Medicaid |
$12.61
|
| Rate for Payer: UMR Bronson Commercial |
$118.65
|
| Rate for Payer: UMR Bronson Commercial |
$188.94
|
| Rate for Payer: UMR Bronson Commercial |
$426.97
|
| Rate for Payer: UMR Bronson Commercial |
$418.22
|
| Rate for Payer: VA VA |
$23.52
|
| Rate for Payer: VA VA |
$23.52
|
| Rate for Payer: VA VA |
$23.52
|
| Rate for Payer: VA VA |
$23.52
|
| Rate for Payer: Aetna American Axle |
$331.93
|
| Rate for Payer: Aetna American Axle |
$208.44
|
| Rate for Payer: Aetna American Axle |
$734.71
|
| Rate for Payer: Aetna American Axle |
$750.07
|
| Rate for Payer: Aetna Commercial |
$434.06
|
| Rate for Payer: Aetna Commercial |
$980.87
|
| Rate for Payer: Aetna Commercial |
$960.77
|
| Rate for Payer: Aetna Commercial |
$272.57
|
| Rate for Payer: Aetna Medicare |
$24.46
|
| Rate for Payer: Aetna Medicare |
$24.46
|
| Rate for Payer: Aetna Medicare |
$24.46
|
| Rate for Payer: Aetna Medicare |
$24.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$734.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$750.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.40
|
| Rate for Payer: BCBS Complete |
$13.24
|
| Rate for Payer: BCBS Complete |
$13.24
|
| Rate for Payer: BCBS Complete |
$13.24
|
| Rate for Payer: BCBS Complete |
$13.24
|
| Rate for Payer: BCBS MAPPO |
$23.52
|
| Rate for Payer: BCBS MAPPO |
$23.52
|
| Rate for Payer: BCBS MAPPO |
$23.52
|
| Rate for Payer: BCBS MAPPO |
$23.52
|
| Rate for Payer: BCBS Trust/PPO |
$65.87
|
| Rate for Payer: BCBS Trust/PPO |
$65.87
|
| Rate for Payer: BCBS Trust/PPO |
$65.87
|
| Rate for Payer: BCBS Trust/PPO |
$65.87
|
| Rate for Payer: BCN Commercial |
$65.87
|
| Rate for Payer: BCN Commercial |
$65.87
|
| Rate for Payer: BCN Commercial |
$65.87
|
| Rate for Payer: BCN Commercial |
$65.87
|
| Rate for Payer: BCN Medicare Advantage |
$23.52
|
| Rate for Payer: BCN Medicare Advantage |
$23.52
|
| Rate for Payer: BCN Medicare Advantage |
$23.52
|
| Rate for Payer: BCN Medicare Advantage |
$23.52
|
| Rate for Payer: Cash Price |
$904.26
|
| Rate for Payer: Cash Price |
$923.17
|
| Rate for Payer: Cash Price |
$408.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$923.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$904.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.52
|
| Rate for Payer: Healthscope Commercial |
$288.60
|
| Rate for Payer: Healthscope Commercial |
$1,017.29
|
| Rate for Payer: Healthscope Commercial |
$459.59
|
| Rate for Payer: Healthscope Commercial |
$1,038.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$224.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$791.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$357.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$807.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$865.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$847.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$383.00
|
| Rate for Payer: Mclaren Medicaid |
$12.61
|
| Rate for Payer: Mclaren Medicaid |
$12.61
|
| Rate for Payer: Mclaren Medicaid |
$12.61
|
| Rate for Payer: Mclaren Medicaid |
$12.61
|
| Rate for Payer: Mclaren Medicare |
$23.52
|
| Rate for Payer: Mclaren Medicare |
$23.52
|
| Rate for Payer: Mclaren Medicare |
$23.52
|
| Rate for Payer: Mclaren Medicare |
$23.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.70
|
| Rate for Payer: Meridian Medicaid |
$13.24
|
| Rate for Payer: Meridian Medicaid |
$13.24
|
| Rate for Payer: Meridian Medicaid |
$13.24
|
| Rate for Payer: Meridian Medicaid |
$13.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$434.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$980.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$960.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.57
|
| Rate for Payer: Nomi Health Commercial |
$70.56
|
| Rate for Payer: Nomi Health Commercial |
$70.56
|
| Rate for Payer: Nomi Health Commercial |
$70.56
|
| Rate for Payer: Nomi Health Commercial |
$70.56
|
| Rate for Payer: PACE Medicare |
$22.34
|
| Rate for Payer: PACE Medicare |
$22.34
|
| Rate for Payer: PACE Medicare |
$22.34
|
| Rate for Payer: PACE Medicare |
$22.34
|
| Rate for Payer: PACE SWMI |
$23.52
|
| Rate for Payer: PACE SWMI |
$23.52
|
| Rate for Payer: PACE SWMI |
$23.52
|
| Rate for Payer: PACE SWMI |
$23.52
|
| Rate for Payer: PHP Commercial |
$434.06
|
| Rate for Payer: PHP Commercial |
$980.87
|
| Rate for Payer: PHP Commercial |
$960.77
|
| Rate for Payer: PHP Commercial |
$272.57
|
| Rate for Payer: PHP Medicare Advantage |
$23.52
|
| Rate for Payer: PHP Medicare Advantage |
$23.52
|
| Rate for Payer: PHP Medicare Advantage |
$23.52
|
| Rate for Payer: PHP Medicare Advantage |
$23.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$750.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$734.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.32
|
| Rate for Payer: Priority Health Medicare |
$23.52
|
| Rate for Payer: Priority Health Medicare |
$23.52
|
| Rate for Payer: Priority Health Medicare |
$23.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$383.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$865.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$847.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.50
|
|
|
DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASCIA, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
CPT 11047
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$94.16 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: BCBS Trust/PPO |
$448.54
|
| Rate for Payer: BCN Commercial |
$448.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.58
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$94.16
|
|
|
DEBRIDEMENT, BONE (INCLUDES EPIDERMIS, DERMIS, SUBCUTANEOUS TISSUE, MUSCLE AND/OR FASCIA, IF PERFORMED); FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$4,989.41
|
|
|
Service Code
|
CPT 11044
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$218.07 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,448.95
|
| Rate for Payer: BCN Commercial |
$1,448.95
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.88
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$218.07
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: VA VA |
$1,587.48
|
|
|
DEBRIDEMENT (EG, HIGH PRESSURE WATERJET WITH/WITHOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT WITH SCISSORS, SCALPEL AND FORCEPS), OPEN WOUND, (EG, FIBRIN, DEVITALIZED EPIDERMIS AND/OR DERMIS, EXUDATE, DEBRIS, BIOFILM), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, USE OF A WHIRLPOOL, WHEN PERFORMED AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION, TOTAL WOUND(S) SURFACE AREA; FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
CPT 97597
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$34.08 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna Medicare |
$202.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$165.94
|
| Rate for Payer: BCN Commercial |
$165.94
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Nomi Health Commercial |
$408.83
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.90
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$489.52
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.49
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$34.08
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: VA VA |
$194.68
|
|
|
DEBRIDEMENT (EG, HIGH PRESSURE WATERJET WITH/WITHOUT SUCTION, SHARP SELECTIVE DEBRIDEMENT WITH SCISSORS, SCALPEL AND FORCEPS), OPEN WOUND, (EG, FIBRIN, DEVITALIZED EPIDERMIS AND/OR DERMIS, EXUDATE, DEBRIS, BIOFILM), INCLUDING TOPICAL APPLICATION(S), WOUND ASSESSMENT, USE OF A WHIRLPOOL, WHEN PERFORMED AND INSTRUCTION(S) FOR ONGOING CARE, PER SESSION, TOTAL WOUND(S) SURFACE AREA; FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
CPT 97597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$34.08 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna Medicare |
$202.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$165.94
|
| Rate for Payer: BCN Commercial |
$165.94
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Nomi Health Commercial |
$408.83
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.90
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$489.52
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.49
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$34.08
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: VA VA |
$194.68
|
|
|
DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL AT THE SITE OF AN OPEN FRACTURE AND/OR AN OPEN DISLOCATION (EG, EXCISIONAL DEBRIDEMENT); SKIN AND SUBCUTANEOUS TISSUES
|
Facility
|
OP
|
$2,166.65
|
|
|
Service Code
|
CPT 11010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$264.95 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$614.97
|
| Rate for Payer: BCN Commercial |
$614.97
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.44
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$264.95
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL AT THE SITE OF AN OPEN FRACTURE AND/OR AN OPEN DISLOCATION (EG, EXCISIONAL DEBRIDEMENT); SKIN AND SUBCUTANEOUS TISSUES
|
Facility
|
OP
|
$2,166.65
|
|
|
Service Code
|
CPT 11010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$264.95 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$614.97
|
| Rate for Payer: BCN Commercial |
$614.97
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.44
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$264.95
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL AT THE SITE OF AN OPEN FRACTURE AND/OR AN OPEN DISLOCATION (EG, EXCISIONAL DEBRIDEMENT); SKIN, SUBCUTANEOUS TISSUE, MUSCLE FASCIA, AND MUSCLE
|
Facility
|
OP
|
$2,166.65
|
|
|
Service Code
|
CPT 11011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$287.61 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$453.74
|
| Rate for Payer: BCN Commercial |
$453.74
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.37
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$287.61
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: VA VA |
$689.36
|
|
|
DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL AT THE SITE OF AN OPEN FRACTURE AND/OR AN OPEN DISLOCATION (EG, EXCISIONAL DEBRIDEMENT); SKIN, SUBCUTANEOUS TISSUE, MUSCLE FASCIA, MUSCLE, AND BONE
|
Facility
|
OP
|
$8,813.49
|
|
|
Service Code
|
CPT 11012
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$401.41 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,606.51
|
| Rate for Payer: BCN Commercial |
$1,606.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.55
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$401.41
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL AT THE SITE OF AN OPEN FRACTURE AND/OR AN OPEN DISLOCATION (EG, EXCISIONAL DEBRIDEMENT); SKIN, SUBCUTANEOUS TISSUE, MUSCLE FASCIA, MUSCLE, AND BONE
|
Facility
|
OP
|
$8,813.49
|
|
|
Service Code
|
CPT 11012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$401.41 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,606.51
|
| Rate for Payer: BCN Commercial |
$1,606.51
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.55
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$401.41
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: VA VA |
$2,804.18
|
|
|
DEBRIDEMENT, MASTOIDECTOMY CAVITY, COMPLEX (EG, WITH ANESTHESIA OR MORE THAN ROUTINE CLEANING)
|
Facility
|
OP
|
$1,568.21
|
|
|
Service Code
|
CPT 69222
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$129.52 |
| Max. Negotiated Rate |
$1,568.21 |
| Rate for Payer: Aetna Medicare |
$518.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$623.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$623.69
|
| Rate for Payer: BCBS Complete |
$280.81
|
| Rate for Payer: BCBS MAPPO |
$498.95
|
| Rate for Payer: BCBS Trust/PPO |
$216.54
|
| Rate for Payer: BCN Commercial |
$216.54
|
| Rate for Payer: BCN Medicare Advantage |
$498.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.95
|
| Rate for Payer: Mclaren Medicaid |
$267.44
|
| Rate for Payer: Mclaren Medicare |
$498.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.90
|
| Rate for Payer: Meridian Medicaid |
$280.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$573.79
|
| Rate for Payer: Nomi Health Commercial |
$1,047.80
|
| Rate for Payer: PACE Medicare |
$474.00
|
| Rate for Payer: PACE SWMI |
$498.95
|
| Rate for Payer: PHP Medicare Advantage |
$498.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,568.21
|
| Rate for Payer: Priority Health Medicare |
$498.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,254.57
|
| Rate for Payer: Railroad Medicare Medicare |
$498.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.47
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.95
|
| Rate for Payer: UHC Exchange |
$129.52
|
| Rate for Payer: UHC Medicare Advantage |
$498.95
|
| Rate for Payer: UHCCP Medicaid |
$267.44
|
| Rate for Payer: VA VA |
$498.95
|
|
|
DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
CPT 11046
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$53.25 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: BCBS Trust/PPO |
$264.07
|
| Rate for Payer: BCN Commercial |
$264.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.58
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$53.25
|
|
|
DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$1,885.01
|
|
|
Service Code
|
CPT 11043
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$147.92 |
| Max. Negotiated Rate |
$1,885.01 |
| Rate for Payer: Aetna Medicare |
$623.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$749.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$749.69
|
| Rate for Payer: BCBS Complete |
$337.54
|
| Rate for Payer: BCBS MAPPO |
$599.75
|
| Rate for Payer: BCBS Trust/PPO |
$749.60
|
| Rate for Payer: BCN Commercial |
$749.60
|
| Rate for Payer: BCN Medicare Advantage |
$599.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.75
|
| Rate for Payer: Mclaren Medicaid |
$321.47
|
| Rate for Payer: Mclaren Medicare |
$599.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.74
|
| Rate for Payer: Meridian Medicaid |
$337.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$689.71
|
| Rate for Payer: Nomi Health Commercial |
$1,259.48
|
| Rate for Payer: PACE Medicare |
$569.76
|
| Rate for Payer: PACE SWMI |
$599.75
|
| Rate for Payer: PHP Medicare Advantage |
$599.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,885.01
|
| Rate for Payer: Priority Health Medicare |
$599.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,508.01
|
| Rate for Payer: Railroad Medicare Medicare |
$599.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.71
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.75
|
| Rate for Payer: UHC Exchange |
$147.92
|
| Rate for Payer: UHC Medicare Advantage |
$599.75
|
| Rate for Payer: UHCCP Medicaid |
$321.47
|
| Rate for Payer: VA VA |
$599.75
|
|
|
DEBRIDEMENT OF EXTENSIVE ECZEMATOUS OR INFECTED SKIN; UP TO 10% OF BODY SURFACE
|
Facility
|
OP
|
$1,885.01
|
|
|
Service Code
|
CPT 11000
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$26.64 |
| Max. Negotiated Rate |
$1,885.01 |
| Rate for Payer: Aetna Medicare |
$623.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$749.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$749.69
|
| Rate for Payer: BCBS Complete |
$337.54
|
| Rate for Payer: BCBS MAPPO |
$599.75
|
| Rate for Payer: BCBS Trust/PPO |
$42.26
|
| Rate for Payer: BCN Commercial |
$42.26
|
| Rate for Payer: BCN Medicare Advantage |
$599.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.75
|
| Rate for Payer: Mclaren Medicaid |
$321.47
|
| Rate for Payer: Mclaren Medicare |
$599.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.74
|
| Rate for Payer: Meridian Medicaid |
$337.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$689.71
|
| Rate for Payer: Nomi Health Commercial |
$1,259.48
|
| Rate for Payer: PACE Medicare |
$569.76
|
| Rate for Payer: PACE SWMI |
$599.75
|
| Rate for Payer: PHP Medicare Advantage |
$599.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,885.01
|
| Rate for Payer: Priority Health Medicare |
$599.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,508.01
|
| Rate for Payer: Railroad Medicare Medicare |
$599.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.30
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.75
|
| Rate for Payer: UHC Exchange |
$26.64
|
| Rate for Payer: UHC Medicare Advantage |
$599.75
|
| Rate for Payer: UHCCP Medicaid |
$321.47
|
| Rate for Payer: VA VA |
$599.75
|
|
|
DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); 1 TO 5
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
CPT 11720
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$13.72 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna Medicare |
$60.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$51.74
|
| Rate for Payer: BCN Commercial |
$51.74
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Nomi Health Commercial |
$174.60
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.90
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$146.32
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.09
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$13.72
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: VA VA |
$58.20
|
|
|
DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
CPT 11045
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$24.52 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: BCBS Trust/PPO |
$146.57
|
| Rate for Payer: BCN Commercial |
$146.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.97
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$24.52
|
|
|
DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$700.00
|
|
|
Service Code
|
CPT 11045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$24.52 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: BCBS Trust/PPO |
$146.57
|
| Rate for Payer: BCN Commercial |
$146.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.97
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$24.52
|
|
|
DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$1,230.33
|
|
|
Service Code
|
CPT 11042
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$58.05 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$321.35
|
| Rate for Payer: BCN Commercial |
$321.35
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.86
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Exchange |
$58.05
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$209.82
|
| Rate for Payer: VA VA |
$391.45
|
|
|
DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$1,230.33
|
|
|
Service Code
|
CPT 11042
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$58.05 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$321.35
|
| Rate for Payer: BCN Commercial |
$321.35
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.86
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Exchange |
$58.05
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$209.82
|
| Rate for Payer: VA VA |
$391.45
|
|
|
DECITABINE 50 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$865.25
|
|
|
Service Code
|
HCPCS J0894
|
| Hospital Charge Code |
76364
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$380.71 |
| Max. Negotiated Rate |
$778.72 |
| Rate for Payer: Cofinity Commercial |
$399.34
|
| Rate for Payer: Aetna American Axle |
$562.41
|
| Rate for Payer: Aetna American Axle |
$241.65
|
| Rate for Payer: Aetna American Axle |
$171.29
|
| Rate for Payer: Aetna American Axle |
$256.51
|
| Rate for Payer: Aetna American Axle |
$301.83
|
| Rate for Payer: Aetna American Axle |
$325.16
|
| Rate for Payer: Aetna American Axle |
$337.01
|
| Rate for Payer: Aetna American Axle |
$278.83
|
| Rate for Payer: Aetna American Axle |
$360.27
|
| Rate for Payer: Aetna American Axle |
$4,316.46
|
| Rate for Payer: Aetna Commercial |
$471.12
|
| Rate for Payer: Aetna Commercial |
$335.44
|
| Rate for Payer: Aetna Commercial |
$364.62
|
| Rate for Payer: Aetna Commercial |
$735.46
|
| Rate for Payer: Aetna Commercial |
$316.00
|
| Rate for Payer: Aetna Commercial |
$224.00
|
| Rate for Payer: Aetna Commercial |
$394.70
|
| Rate for Payer: Aetna Commercial |
$440.70
|
| Rate for Payer: Aetna Commercial |
$5,644.60
|
| Rate for Payer: Aetna Commercial |
$425.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$562.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,316.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$360.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.16
|
| Rate for Payer: Cash Price |
$210.82
|
| Rate for Payer: Cash Price |
$400.19
|
| Rate for Payer: Cash Price |
$692.20
|
| Rate for Payer: Cash Price |
$371.48
|
| Rate for Payer: Cash Price |
$443.41
|
| Rate for Payer: Cash Price |
$5,312.57
|
| Rate for Payer: Cash Price |
$414.78
|
| Rate for Payer: Cash Price |
$297.42
|
| Rate for Payer: Cash Price |
$343.18
|
| Rate for Payer: Cash Price |
$315.70
|
| Rate for Payer: Cofinity Commercial |
$387.98
|
| Rate for Payer: Cofinity Commercial |
$319.72
|
| Rate for Payer: Cofinity Commercial |
$260.24
|
| Rate for Payer: Cofinity Commercial |
$339.38
|
| Rate for Payer: Cofinity Commercial |
$300.28
|
| Rate for Payer: Cofinity Commercial |
$445.88
|
| Rate for Payer: Cofinity Commercial |
$362.93
|
| Rate for Payer: Cofinity Commercial |
$368.91
|
| Rate for Payer: Cofinity Commercial |
$5,711.01
|
| Rate for Payer: Cofinity Commercial |
$184.47
|
| Rate for Payer: Cofinity Commercial |
$430.21
|
| Rate for Payer: Cofinity Commercial |
$350.17
|
| Rate for Payer: Cofinity Commercial |
$226.64
|
| Rate for Payer: Cofinity Commercial |
$4,648.50
|
| Rate for Payer: Cofinity Commercial |
$744.12
|
| Rate for Payer: Cofinity Commercial |
$605.68
|
| Rate for Payer: Cofinity Commercial |
$276.24
|
| Rate for Payer: Cofinity Commercial |
$325.04
|
| Rate for Payer: Cofinity Commercial |
$476.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$184.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,648.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$276.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$387.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$362.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$325.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$300.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$350.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$605.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$260.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$371.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,312.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$692.20
|
| Rate for Payer: Healthscope Commercial |
$386.07
|
| Rate for Payer: Healthscope Commercial |
$417.92
|
| Rate for Payer: Healthscope Commercial |
$355.17
|
| Rate for Payer: Healthscope Commercial |
$450.22
|
| Rate for Payer: Healthscope Commercial |
$498.83
|
| Rate for Payer: Healthscope Commercial |
$466.62
|
| Rate for Payer: Healthscope Commercial |
$778.72
|
| Rate for Payer: Healthscope Commercial |
$334.59
|
| Rate for Payer: Healthscope Commercial |
$237.18
|
| Rate for Payer: Healthscope Commercial |
$5,976.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$276.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$362.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$605.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$325.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,648.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$387.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$278.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,980.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$648.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$348.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$415.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$388.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$394.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$471.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,644.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$735.46
|
| Rate for Payer: PHP Commercial |
$394.70
|
| Rate for Payer: PHP Commercial |
$471.12
|
| Rate for Payer: PHP Commercial |
$364.62
|
| Rate for Payer: PHP Commercial |
$735.46
|
| Rate for Payer: PHP Commercial |
$425.20
|
| Rate for Payer: PHP Commercial |
$5,644.60
|
| Rate for Payer: PHP Commercial |
$316.00
|
| Rate for Payer: PHP Commercial |
$335.44
|
| Rate for Payer: PHP Commercial |
$440.70
|
| Rate for Payer: PHP Commercial |
$224.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$360.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,316.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$337.01
|
| Rate for Payer: Priority Health SBD |
$545.11
|
| Rate for Payer: Priority Health SBD |
$292.54
|
| Rate for Payer: Priority Health SBD |
$166.02
|
| Rate for Payer: Priority Health SBD |
$326.64
|
| Rate for Payer: Priority Health SBD |
$4,183.65
|
| Rate for Payer: Priority Health SBD |
$315.15
|
| Rate for Payer: Priority Health SBD |
$270.25
|
| Rate for Payer: Priority Health SBD |
$349.18
|
| Rate for Payer: Priority Health SBD |
$234.22
|
| Rate for Payer: Priority Health SBD |
$248.62
|
| Rate for Payer: UMR Bronson Commercial |
$228.13
|
| Rate for Payer: UMR Bronson Commercial |
$204.31
|
| Rate for Payer: UMR Bronson Commercial |
$163.58
|
| Rate for Payer: UMR Bronson Commercial |
$380.71
|
| Rate for Payer: UMR Bronson Commercial |
$173.64
|
| Rate for Payer: UMR Bronson Commercial |
$115.95
|
| Rate for Payer: UMR Bronson Commercial |
$220.11
|
| Rate for Payer: UMR Bronson Commercial |
$2,921.91
|
| Rate for Payer: UMR Bronson Commercial |
$188.75
|
| Rate for Payer: UMR Bronson Commercial |
$243.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$348.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,980.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$415.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$388.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$648.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$278.83
|
|
|
DECITABINE 50 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$901.88
|
|
|
Service Code
|
HCPCS J0893
|
| Hospital Charge Code |
76364
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.29 |
| Max. Negotiated Rate |
$811.69 |
| Rate for Payer: Aetna American Axle |
$586.22
|
| Rate for Payer: Aetna Commercial |
$766.60
|
| Rate for Payer: Aetna Medicare |
$450.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.22
|
| Rate for Payer: BCBS Complete |
$360.75
|
| Rate for Payer: BCBS Trust/PPO |
$5.29
|
| Rate for Payer: BCN Commercial |
$5.29
|
| Rate for Payer: Cash Price |
$721.50
|
| Rate for Payer: Cash Price |
$721.50
|
| Rate for Payer: Cofinity Commercial |
$631.32
|
| Rate for Payer: Cofinity Commercial |
$775.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$631.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$721.50
|
| Rate for Payer: Healthscope Commercial |
$811.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$631.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$676.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$766.60
|
| Rate for Payer: PHP Commercial |
$766.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$586.22
|
| Rate for Payer: Priority Health SBD |
$568.18
|
| Rate for Payer: UMR Bronson Commercial |
$333.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$676.41
|
|
|
DECITABINE 50 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$554.26
|
|
|
Service Code
|
HCPCS J0894
|
| Hospital Charge Code |
76364
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.39 |
| Max. Negotiated Rate |
$498.83 |
| Rate for Payer: Aetna American Axle |
$360.27
|
| Rate for Payer: Aetna American Axle |
$241.65
|
| Rate for Payer: Aetna American Axle |
$301.83
|
| Rate for Payer: Aetna American Axle |
$337.01
|
| Rate for Payer: Aetna American Axle |
$171.29
|
| Rate for Payer: Aetna American Axle |
$256.51
|
| Rate for Payer: Aetna American Axle |
$326.60
|
| Rate for Payer: Aetna American Axle |
$278.83
|
| Rate for Payer: Aetna American Axle |
$559.16
|
| Rate for Payer: Aetna American Axle |
$325.16
|
| Rate for Payer: Aetna American Axle |
$562.41
|
| Rate for Payer: Aetna American Axle |
$4,316.46
|
| Rate for Payer: Aetna American Axle |
$646.05
|
| Rate for Payer: Aetna Commercial |
$316.00
|
| Rate for Payer: Aetna Commercial |
$335.44
|
| Rate for Payer: Aetna Commercial |
$427.09
|
| Rate for Payer: Aetna Commercial |
$440.70
|
| Rate for Payer: Aetna Commercial |
$471.12
|
| Rate for Payer: Aetna Commercial |
$425.20
|
| Rate for Payer: Aetna Commercial |
$844.83
|
| Rate for Payer: Aetna Commercial |
$394.70
|
| Rate for Payer: Aetna Commercial |
$5,644.60
|
| Rate for Payer: Aetna Commercial |
$224.00
|
| Rate for Payer: Aetna Commercial |
$364.62
|
| Rate for Payer: Aetna Commercial |
$731.21
|
| Rate for Payer: Aetna Commercial |
$735.46
|
| Rate for Payer: Aetna Medicare |
$214.48
|
| Rate for Payer: Aetna Medicare |
$259.24
|
| Rate for Payer: Aetna Medicare |
$131.76
|
| Rate for Payer: Aetna Medicare |
$197.32
|
| Rate for Payer: Aetna Medicare |
$496.96
|
| Rate for Payer: Aetna Medicare |
$432.62
|
| Rate for Payer: Aetna Medicare |
$430.12
|
| Rate for Payer: Aetna Medicare |
$3,320.36
|
| Rate for Payer: Aetna Medicare |
$232.18
|
| Rate for Payer: Aetna Medicare |
$277.13
|
| Rate for Payer: Aetna Medicare |
$250.12
|
| Rate for Payer: Aetna Medicare |
$185.88
|
| Rate for Payer: Aetna Medicare |
$251.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$562.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$360.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,316.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$559.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.05
|
| Rate for Payer: BCBS Complete |
$185.74
|
| Rate for Payer: BCBS Complete |
$105.41
|
| Rate for Payer: BCBS Complete |
$397.57
|
| Rate for Payer: BCBS Complete |
$207.39
|
| Rate for Payer: BCBS Complete |
$171.59
|
| Rate for Payer: BCBS Complete |
$346.10
|
| Rate for Payer: BCBS Complete |
$200.10
|
| Rate for Payer: BCBS Complete |
$2,656.28
|
| Rate for Payer: BCBS Complete |
$157.85
|
| Rate for Payer: BCBS Complete |
$148.71
|
| Rate for Payer: BCBS Complete |
$221.70
|
| Rate for Payer: BCBS Complete |
$344.10
|
| Rate for Payer: BCBS Complete |
$200.98
|
| Rate for Payer: BCBS Trust/PPO |
$4.39
|
| Rate for Payer: BCBS Trust/PPO |
$4.39
|
| Rate for Payer: BCBS Trust/PPO |
$4.39
|
| Rate for Payer: BCBS Trust/PPO |
$4.39
|
| Rate for Payer: BCBS Trust/PPO |
$4.39
|
| Rate for Payer: BCBS Trust/PPO |
$4.39
|
| Rate for Payer: BCBS Trust/PPO |
$4.39
|
| Rate for Payer: BCBS Trust/PPO |
$4.39
|
| Rate for Payer: BCBS Trust/PPO |
$4.39
|
| Rate for Payer: BCBS Trust/PPO |
$4.39
|
| Rate for Payer: BCBS Trust/PPO |
$4.39
|
| Rate for Payer: BCBS Trust/PPO |
$4.39
|
| Rate for Payer: BCBS Trust/PPO |
$4.39
|
| Rate for Payer: BCN Commercial |
$4.39
|
| Rate for Payer: BCN Commercial |
$4.39
|
| Rate for Payer: BCN Commercial |
$4.39
|
| Rate for Payer: BCN Commercial |
$4.39
|
| Rate for Payer: BCN Commercial |
$4.39
|
| Rate for Payer: BCN Commercial |
$4.39
|
| Rate for Payer: BCN Commercial |
$4.39
|
| Rate for Payer: BCN Commercial |
$4.39
|
| Rate for Payer: BCN Commercial |
$4.39
|
| Rate for Payer: BCN Commercial |
$4.39
|
| Rate for Payer: BCN Commercial |
$4.39
|
| Rate for Payer: BCN Commercial |
$4.39
|
| Rate for Payer: BCN Commercial |
$4.39
|
| Rate for Payer: Cash Price |
$795.14
|
| Rate for Payer: Cash Price |
$401.97
|
| Rate for Payer: Cash Price |
$315.70
|
| Rate for Payer: Cash Price |
$210.82
|
| Rate for Payer: Cash Price |
$795.14
|
| Rate for Payer: Cash Price |
$692.20
|
| Rate for Payer: Cash Price |
$297.42
|
| Rate for Payer: Cash Price |
$210.82
|
| Rate for Payer: Cash Price |
$692.20
|
| Rate for Payer: Cash Price |
$688.20
|
| Rate for Payer: Cash Price |
$414.78
|
| Rate for Payer: Cash Price |
$315.70
|
| Rate for Payer: Cash Price |
$297.42
|
| Rate for Payer: Cash Price |
$343.18
|
| Rate for Payer: Cash Price |
$343.18
|
| Rate for Payer: Cash Price |
$688.20
|
| Rate for Payer: Cash Price |
$5,312.57
|
| Rate for Payer: Cash Price |
$371.48
|
| Rate for Payer: Cash Price |
$371.48
|
| Rate for Payer: Cash Price |
$5,312.57
|
| Rate for Payer: Cash Price |
$443.41
|
| Rate for Payer: Cash Price |
$400.19
|
| Rate for Payer: Cash Price |
$401.97
|
| Rate for Payer: Cash Price |
$400.19
|
| Rate for Payer: Cash Price |
$443.41
|
| Rate for Payer: Cash Price |
$414.78
|
| Rate for Payer: Cofinity Commercial |
$325.04
|
| Rate for Payer: Cofinity Commercial |
$854.77
|
| Rate for Payer: Cofinity Commercial |
$350.17
|
| Rate for Payer: Cofinity Commercial |
$430.21
|
| Rate for Payer: Cofinity Commercial |
$351.72
|
| Rate for Payer: Cofinity Commercial |
$432.12
|
| Rate for Payer: Cofinity Commercial |
$4,648.50
|
| Rate for Payer: Cofinity Commercial |
$695.74
|
| Rate for Payer: Cofinity Commercial |
$5,711.01
|
| Rate for Payer: Cofinity Commercial |
$368.91
|
| Rate for Payer: Cofinity Commercial |
$445.88
|
| Rate for Payer: Cofinity Commercial |
$362.93
|
| Rate for Payer: Cofinity Commercial |
$744.12
|
| Rate for Payer: Cofinity Commercial |
$300.28
|
| Rate for Payer: Cofinity Commercial |
$602.18
|
| Rate for Payer: Cofinity Commercial |
$739.82
|
| Rate for Payer: Cofinity Commercial |
$605.68
|
| Rate for Payer: Cofinity Commercial |
$260.24
|
| Rate for Payer: Cofinity Commercial |
$276.24
|
| Rate for Payer: Cofinity Commercial |
$339.38
|
| Rate for Payer: Cofinity Commercial |
$226.64
|
| Rate for Payer: Cofinity Commercial |
$184.47
|
| Rate for Payer: Cofinity Commercial |
$387.98
|
| Rate for Payer: Cofinity Commercial |
$476.66
|
| Rate for Payer: Cofinity Commercial |
$319.72
|
| Rate for Payer: Cofinity Commercial |
$399.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$351.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$276.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$184.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$260.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$300.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$325.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$350.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$362.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$387.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,648.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$602.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$605.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$695.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$688.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,312.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$371.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$401.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$692.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.41
|
| Rate for Payer: Healthscope Commercial |
$778.72
|
| Rate for Payer: Healthscope Commercial |
$386.07
|
| Rate for Payer: Healthscope Commercial |
$5,976.64
|
| Rate for Payer: Healthscope Commercial |
$894.53
|
| Rate for Payer: Healthscope Commercial |
$466.62
|
| Rate for Payer: Healthscope Commercial |
$452.21
|
| Rate for Payer: Healthscope Commercial |
$355.17
|
| Rate for Payer: Healthscope Commercial |
$334.59
|
| Rate for Payer: Healthscope Commercial |
$450.22
|
| Rate for Payer: Healthscope Commercial |
$237.18
|
| Rate for Payer: Healthscope Commercial |
$498.83
|
| Rate for Payer: Healthscope Commercial |
$417.92
|
| Rate for Payer: Healthscope Commercial |
$774.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$276.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$362.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$387.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$605.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$351.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$325.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,648.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$602.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$695.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$388.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$278.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$376.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$348.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,980.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$645.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$415.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$745.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$648.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$427.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$844.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$394.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$471.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,644.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$731.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$735.46
|
| Rate for Payer: PHP Commercial |
$316.00
|
| Rate for Payer: PHP Commercial |
$731.21
|
| Rate for Payer: PHP Commercial |
$5,644.60
|
| Rate for Payer: PHP Commercial |
$425.20
|
| Rate for Payer: PHP Commercial |
$440.70
|
| Rate for Payer: PHP Commercial |
$394.70
|
| Rate for Payer: PHP Commercial |
$844.83
|
| Rate for Payer: PHP Commercial |
$735.46
|
| Rate for Payer: PHP Commercial |
$471.12
|
| Rate for Payer: PHP Commercial |
$427.09
|
| Rate for Payer: PHP Commercial |
$335.44
|
| Rate for Payer: PHP Commercial |
$364.62
|
| Rate for Payer: PHP Commercial |
$224.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$646.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$559.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$360.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$562.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$337.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,316.46
|
| Rate for Payer: Priority Health SBD |
$541.96
|
| Rate for Payer: Priority Health SBD |
$545.11
|
| Rate for Payer: Priority Health SBD |
$626.17
|
| Rate for Payer: Priority Health SBD |
$316.55
|
| Rate for Payer: Priority Health SBD |
$270.25
|
| Rate for Payer: Priority Health SBD |
$349.18
|
| Rate for Payer: Priority Health SBD |
$4,183.65
|
| Rate for Payer: Priority Health SBD |
$292.54
|
| Rate for Payer: Priority Health SBD |
$248.62
|
| Rate for Payer: Priority Health SBD |
$326.64
|
| Rate for Payer: Priority Health SBD |
$166.02
|
| Rate for Payer: Priority Health SBD |
$234.22
|
| Rate for Payer: Priority Health SBD |
$315.15
|
| Rate for Payer: UMR Bronson Commercial |
$158.72
|
| Rate for Payer: UMR Bronson Commercial |
$185.91
|
| Rate for Payer: UMR Bronson Commercial |
$367.75
|
| Rate for Payer: UMR Bronson Commercial |
$205.08
|
| Rate for Payer: UMR Bronson Commercial |
$185.09
|
| Rate for Payer: UMR Bronson Commercial |
$146.01
|
| Rate for Payer: UMR Bronson Commercial |
$320.14
|
| Rate for Payer: UMR Bronson Commercial |
$97.51
|
| Rate for Payer: UMR Bronson Commercial |
$137.55
|
| Rate for Payer: UMR Bronson Commercial |
$171.81
|
| Rate for Payer: UMR Bronson Commercial |
$191.83
|
| Rate for Payer: UMR Bronson Commercial |
$318.29
|
| Rate for Payer: UMR Bronson Commercial |
$2,457.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$648.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$745.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,980.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$415.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$645.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$278.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$388.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$376.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$348.26
|
|
|
DECOMPRESSION FASCIOTOMY, LEG; ANTERIOR AND/OR LATERAL COMPARTMENTS ONLY
|
Facility
|
OP
|
$9,991.56
|
|
|
Service Code
|
CPT 27600
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$387.96 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,898.39
|
| Rate for Payer: BCN Commercial |
$1,898.39
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$426.76
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$387.96
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: VA VA |
$3,179.00
|
|
