|
HC CERETEC PER DOSE
|
Facility
|
IP
|
$2,020.58
|
|
|
Service Code
|
HCPCS A9521
|
| Hospital Charge Code |
34300002
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$889.06 |
| Max. Negotiated Rate |
$1,818.52 |
| Rate for Payer: Aetna American Axle |
$1,313.38
|
| Rate for Payer: Aetna Commercial |
$1,717.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,313.38
|
| Rate for Payer: Cash Price |
$1,616.46
|
| Rate for Payer: Cofinity Commercial |
$1,414.41
|
| Rate for Payer: Cofinity Commercial |
$1,737.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,616.46
|
| Rate for Payer: Healthscope Commercial |
$1,818.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,414.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,515.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,717.49
|
| Rate for Payer: PHP Commercial |
$1,717.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,414.41
|
| Rate for Payer: Priority Health SBD |
$1,272.97
|
| Rate for Payer: UMR Bronson Commercial |
$889.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,515.44
|
|
|
HC CERETEC PER DOSE
|
Facility
|
OP
|
$2,020.58
|
|
|
Service Code
|
HCPCS A9521
|
| Hospital Charge Code |
34300002
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$747.61 |
| Max. Negotiated Rate |
$1,818.52 |
| Rate for Payer: Aetna American Axle |
$1,313.38
|
| Rate for Payer: Aetna Commercial |
$1,717.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,313.38
|
| Rate for Payer: BCBS Complete |
$808.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,347.80
|
| Rate for Payer: Cash Price |
$1,616.46
|
| Rate for Payer: Cash Price |
$1,616.46
|
| Rate for Payer: Cofinity Commercial |
$1,414.41
|
| Rate for Payer: Cofinity Commercial |
$1,737.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,616.46
|
| Rate for Payer: Healthscope Commercial |
$1,818.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,414.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,515.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,717.49
|
| Rate for Payer: PHP Commercial |
$1,717.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,414.41
|
| Rate for Payer: Priority Health SBD |
$1,272.97
|
| Rate for Payer: UMR Bronson Commercial |
$747.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,515.44
|
|
|
HC CERTOLIZUMAB
|
Facility
|
OP
|
$163.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100675
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.45 |
| Max. Negotiated Rate |
$146.70 |
| Rate for Payer: Aetna American Axle |
$105.95
|
| Rate for Payer: Aetna Commercial |
$138.55
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.92
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$15.53
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Cofinity Commercial |
$114.10
|
| Rate for Payer: Cofinity Commercial |
$140.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$146.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.25
|
| Rate for Payer: Mclaren Medicaid |
$9.45
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Medicaid |
$9.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.55
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$138.55
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.76
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$14.21
|
| Rate for Payer: Priority Health SBD |
$102.69
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.72
|
| Rate for Payer: UHC Core |
$21.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$17.27
|
| Rate for Payer: UHC Medicare Advantage |
$17.79
|
| Rate for Payer: UMR Bronson Commercial |
$60.31
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.25
|
|
|
HC CERTOLIZUMAB
|
Facility
|
IP
|
$163.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100675
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.72 |
| Max. Negotiated Rate |
$146.70 |
| Rate for Payer: Aetna American Axle |
$105.95
|
| Rate for Payer: Aetna Commercial |
$138.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.95
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Cofinity Commercial |
$140.18
|
| Rate for Payer: Cofinity Commercial |
$114.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.40
|
| Rate for Payer: Healthscope Commercial |
$146.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.55
|
| Rate for Payer: PHP Commercial |
$138.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.10
|
| Rate for Payer: Priority Health SBD |
$102.69
|
| Rate for Payer: UMR Bronson Commercial |
$71.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.25
|
|
|
HC CERTOLIZUMAB CMPT
|
Facility
|
IP
|
$128.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100676
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.32 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Aetna American Axle |
$83.20
|
| Rate for Payer: Aetna Commercial |
$108.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.20
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$110.08
|
| Rate for Payer: Cofinity Commercial |
$89.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.40
|
| Rate for Payer: Healthscope Commercial |
$115.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$108.80
|
| Rate for Payer: PHP Commercial |
$108.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.60
|
| Rate for Payer: Priority Health SBD |
$80.64
|
| Rate for Payer: UMR Bronson Commercial |
$56.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.00
|
|
|
HC CERTOLIZUMAB CMPT
|
Facility
|
OP
|
$128.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100676
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Aetna American Axle |
$83.20
|
| Rate for Payer: Aetna Commercial |
$108.80
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.71
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$16.76
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$89.60
|
| Rate for Payer: Cofinity Commercial |
$110.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$115.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.00
|
| Rate for Payer: Mclaren Medicaid |
$10.20
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Medicaid |
$10.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$108.80
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$108.80
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.60
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health SBD |
$80.64
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.37
|
| Rate for Payer: UHC Core |
$22.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.64
|
| Rate for Payer: UHC Exchange |
$18.64
|
| Rate for Payer: UHC Medicare Advantage |
$19.20
|
| Rate for Payer: UMR Bronson Commercial |
$47.36
|
| Rate for Payer: VA VA |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.00
|
|
|
HC CERULOPLASMIN
|
Facility
|
OP
|
$41.82
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
30100140
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.87 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Aetna American Axle |
$27.18
|
| Rate for Payer: Aetna Commercial |
$35.55
|
| Rate for Payer: Aetna Medicare |
$11.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.42
|
| Rate for Payer: BCBS Complete |
$6.17
|
| Rate for Payer: BCBS MAPPO |
$10.74
|
| Rate for Payer: BCBS Trust/PPO |
$9.66
|
| Rate for Payer: BCN Medicare Advantage |
$10.74
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$35.97
|
| Rate for Payer: Cofinity Commercial |
$29.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.74
|
| Rate for Payer: Healthscope Commercial |
$37.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.36
|
| Rate for Payer: Mclaren Medicaid |
$5.87
|
| Rate for Payer: Mclaren Medicare |
$10.74
|
| Rate for Payer: Meridian Medicaid |
$6.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.55
|
| Rate for Payer: PACE Medicare |
$10.20
|
| Rate for Payer: PACE SWMI |
$10.74
|
| Rate for Payer: PHP Commercial |
$35.55
|
| Rate for Payer: PHP Medicare Advantage |
$10.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.73
|
| Rate for Payer: Priority Health Medicare |
$10.74
|
| Rate for Payer: Priority Health Narrow Network |
$11.78
|
| Rate for Payer: Priority Health SBD |
$26.35
|
| Rate for Payer: Railroad Medicare Medicare |
$10.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.89
|
| Rate for Payer: UHC Core |
$17.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.74
|
| Rate for Payer: UHC Exchange |
$10.74
|
| Rate for Payer: UHC Medicare Advantage |
$11.06
|
| Rate for Payer: UMR Bronson Commercial |
$15.47
|
| Rate for Payer: VA VA |
$10.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.36
|
|
|
HC CERULOPLASMIN
|
Facility
|
IP
|
$41.82
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
30100140
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Aetna American Axle |
$27.18
|
| Rate for Payer: Aetna Commercial |
$35.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.18
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$29.27
|
| Rate for Payer: Cofinity Commercial |
$35.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$37.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.55
|
| Rate for Payer: PHP Commercial |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.27
|
| Rate for Payer: Priority Health SBD |
$26.35
|
| Rate for Payer: UMR Bronson Commercial |
$18.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.36
|
|
|
HC CERVILENZ
|
Facility
|
IP
|
$167.34
|
|
| Hospital Charge Code |
27200171
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$73.63 |
| Max. Negotiated Rate |
$150.61 |
| Rate for Payer: Aetna American Axle |
$108.77
|
| Rate for Payer: Aetna Commercial |
$142.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.77
|
| Rate for Payer: Cash Price |
$133.87
|
| Rate for Payer: Cofinity Commercial |
$117.14
|
| Rate for Payer: Cofinity Commercial |
$143.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.87
|
| Rate for Payer: Healthscope Commercial |
$150.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.24
|
| Rate for Payer: PHP Commercial |
$142.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.14
|
| Rate for Payer: Priority Health SBD |
$105.42
|
| Rate for Payer: UMR Bronson Commercial |
$73.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.50
|
|
|
HC CERVILENZ
|
Facility
|
OP
|
$167.34
|
|
| Hospital Charge Code |
27200171
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.92 |
| Max. Negotiated Rate |
$150.61 |
| Rate for Payer: Aetna American Axle |
$108.77
|
| Rate for Payer: Aetna Commercial |
$142.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.77
|
| Rate for Payer: BCBS Complete |
$66.94
|
| Rate for Payer: Cash Price |
$133.87
|
| Rate for Payer: Cofinity Commercial |
$117.14
|
| Rate for Payer: Cofinity Commercial |
$143.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.87
|
| Rate for Payer: Healthscope Commercial |
$150.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.24
|
| Rate for Payer: PHP Commercial |
$142.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.14
|
| Rate for Payer: Priority Health SBD |
$105.42
|
| Rate for Payer: UMR Bronson Commercial |
$61.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.50
|
|
|
HC CERV OR VAG CA SCREEN PELVIC/BREAST EXAM
|
Facility
|
OP
|
$138.02
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
77000001
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$26.85 |
| Max. Negotiated Rate |
$249.42 |
| Rate for Payer: Aetna American Axle |
$89.71
|
| Rate for Payer: Aetna Commercial |
$117.32
|
| Rate for Payer: Aetna Medicare |
$82.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$99.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$99.04
|
| Rate for Payer: BCBS Complete |
$45.51
|
| Rate for Payer: BCBS MAPPO |
$79.23
|
| Rate for Payer: BCBS Trust/PPO |
$108.92
|
| Rate for Payer: BCN Medicare Advantage |
$79.23
|
| Rate for Payer: Cash Price |
$110.42
|
| Rate for Payer: Cash Price |
$110.42
|
| Rate for Payer: Cofinity Commercial |
$118.70
|
| Rate for Payer: Cofinity Commercial |
$96.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.23
|
| Rate for Payer: Healthscope Commercial |
$124.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.52
|
| Rate for Payer: Mclaren Medicaid |
$43.34
|
| Rate for Payer: Mclaren Medicare |
$79.23
|
| Rate for Payer: Meridian Medicaid |
$45.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$83.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$117.32
|
| Rate for Payer: PACE Medicare |
$75.27
|
| Rate for Payer: PACE SWMI |
$79.23
|
| Rate for Payer: PHP Commercial |
$117.32
|
| Rate for Payer: PHP Medicare Advantage |
$79.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.42
|
| Rate for Payer: Priority Health Medicare |
$79.23
|
| Rate for Payer: Priority Health Narrow Network |
$199.54
|
| Rate for Payer: Priority Health SBD |
$86.95
|
| Rate for Payer: Railroad Medicare Medicare |
$79.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.23
|
| Rate for Payer: UHC Exchange |
$26.85
|
| Rate for Payer: UHC Medicare Advantage |
$81.61
|
| Rate for Payer: UMR Bronson Commercial |
$51.07
|
| Rate for Payer: VA VA |
$79.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.52
|
|
|
HC CERV OR VAG CA SCREEN PELVIC/BREAST EXAM
|
Facility
|
IP
|
$138.02
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
77000001
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$60.73 |
| Max. Negotiated Rate |
$124.22 |
| Rate for Payer: Aetna American Axle |
$89.71
|
| Rate for Payer: Aetna Commercial |
$117.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.71
|
| Rate for Payer: Cash Price |
$110.42
|
| Rate for Payer: Cofinity Commercial |
$96.61
|
| Rate for Payer: Cofinity Commercial |
$118.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.42
|
| Rate for Payer: Healthscope Commercial |
$124.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$117.32
|
| Rate for Payer: PHP Commercial |
$117.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.61
|
| Rate for Payer: Priority Health SBD |
$86.95
|
| Rate for Payer: UMR Bronson Commercial |
$60.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.52
|
|
|
HC CESIUM 137 PER SOURCE
|
Facility
|
OP
|
$762.46
|
|
| Hospital Charge Code |
34000001
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$282.11 |
| Max. Negotiated Rate |
$832.00 |
| Rate for Payer: Aetna American Axle |
$495.60
|
| Rate for Payer: Aetna Commercial |
$648.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$495.60
|
| Rate for Payer: BCBS Complete |
$304.98
|
| Rate for Payer: Cash Price |
$609.97
|
| Rate for Payer: Cash Price |
$609.97
|
| Rate for Payer: Cofinity Commercial |
$655.72
|
| Rate for Payer: Cofinity Commercial |
$533.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$609.97
|
| Rate for Payer: Healthscope Commercial |
$686.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$533.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$571.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$648.09
|
| Rate for Payer: PHP Commercial |
$648.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.72
|
| Rate for Payer: Priority Health SBD |
$480.35
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UMR Bronson Commercial |
$282.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$571.84
|
|
|
HC CESIUM 137 PER SOURCE
|
Facility
|
IP
|
$762.46
|
|
| Hospital Charge Code |
34000001
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$335.48 |
| Max. Negotiated Rate |
$686.21 |
| Rate for Payer: Aetna American Axle |
$495.60
|
| Rate for Payer: Aetna Commercial |
$648.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$495.60
|
| Rate for Payer: Cash Price |
$609.97
|
| Rate for Payer: Cofinity Commercial |
$533.72
|
| Rate for Payer: Cofinity Commercial |
$655.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$609.97
|
| Rate for Payer: Healthscope Commercial |
$686.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$533.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$571.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$648.09
|
| Rate for Payer: PHP Commercial |
$648.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.72
|
| Rate for Payer: Priority Health SBD |
$480.35
|
| Rate for Payer: UMR Bronson Commercial |
$335.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$571.84
|
|
|
HC CHAMBER HOLDING OPTI CHAMBER
|
Facility
|
OP
|
$21.88
|
|
| Hospital Charge Code |
27000044
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.10 |
| Max. Negotiated Rate |
$19.69 |
| Rate for Payer: Aetna American Axle |
$14.22
|
| Rate for Payer: Aetna Commercial |
$18.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.22
|
| Rate for Payer: BCBS Complete |
$8.75
|
| Rate for Payer: Cash Price |
$17.50
|
| Rate for Payer: Cofinity Commercial |
$15.32
|
| Rate for Payer: Cofinity Commercial |
$18.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.50
|
| Rate for Payer: Healthscope Commercial |
$19.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.60
|
| Rate for Payer: PHP Commercial |
$18.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.32
|
| Rate for Payer: Priority Health SBD |
$13.78
|
| Rate for Payer: UMR Bronson Commercial |
$8.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.41
|
|
|
HC CHAMBER HOLDING OPTI CHAMBER
|
Facility
|
IP
|
$21.88
|
|
| Hospital Charge Code |
27000044
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.63 |
| Max. Negotiated Rate |
$19.69 |
| Rate for Payer: Aetna American Axle |
$14.22
|
| Rate for Payer: Aetna Commercial |
$18.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.22
|
| Rate for Payer: Cash Price |
$17.50
|
| Rate for Payer: Cofinity Commercial |
$15.32
|
| Rate for Payer: Cofinity Commercial |
$18.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.50
|
| Rate for Payer: Healthscope Commercial |
$19.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.60
|
| Rate for Payer: PHP Commercial |
$18.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.32
|
| Rate for Payer: Priority Health SBD |
$13.78
|
| Rate for Payer: UMR Bronson Commercial |
$9.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.41
|
|
|
HC CHANGE CYSTOSTOMY TUBE COMPLICATED
|
Facility
|
OP
|
$996.54
|
|
|
Service Code
|
CPT 51710
|
| Hospital Charge Code |
76100297
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$78.26 |
| Max. Negotiated Rate |
$1,911.48 |
| Rate for Payer: Aetna American Axle |
$647.75
|
| Rate for Payer: Aetna Commercial |
$847.06
|
| Rate for Payer: Aetna Medicare |
$631.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$647.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$759.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$759.00
|
| Rate for Payer: BCBS Complete |
$348.78
|
| Rate for Payer: BCBS MAPPO |
$607.20
|
| Rate for Payer: BCBS Trust/PPO |
$514.40
|
| Rate for Payer: BCN Medicare Advantage |
$607.20
|
| Rate for Payer: Cash Price |
$797.23
|
| Rate for Payer: Cash Price |
$797.23
|
| Rate for Payer: Cofinity Commercial |
$857.02
|
| Rate for Payer: Cofinity Commercial |
$697.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$797.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.20
|
| Rate for Payer: Healthscope Commercial |
$896.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$697.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$747.40
|
| Rate for Payer: Mclaren Medicaid |
$332.14
|
| Rate for Payer: Mclaren Medicare |
$607.20
|
| Rate for Payer: Meridian Medicaid |
$348.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$637.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$698.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$847.06
|
| Rate for Payer: PACE Medicare |
$576.84
|
| Rate for Payer: PACE SWMI |
$607.20
|
| Rate for Payer: PHP Commercial |
$847.06
|
| Rate for Payer: PHP Medicare Advantage |
$607.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,911.48
|
| Rate for Payer: Priority Health Medicare |
$607.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,529.18
|
| Rate for Payer: Priority Health SBD |
$627.82
|
| Rate for Payer: Railroad Medicare Medicare |
$607.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$607.20
|
| Rate for Payer: UHC Exchange |
$78.26
|
| Rate for Payer: UHC Medicare Advantage |
$625.42
|
| Rate for Payer: UMR Bronson Commercial |
$368.72
|
| Rate for Payer: VA VA |
$607.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$747.40
|
|
|
HC CHANGE CYSTOSTOMY TUBE COMPLICATED
|
Facility
|
IP
|
$996.54
|
|
|
Service Code
|
CPT 51710
|
| Hospital Charge Code |
76100297
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$438.48 |
| Max. Negotiated Rate |
$896.89 |
| Rate for Payer: Aetna American Axle |
$647.75
|
| Rate for Payer: Aetna Commercial |
$847.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$647.75
|
| Rate for Payer: Cash Price |
$797.23
|
| Rate for Payer: Cofinity Commercial |
$697.58
|
| Rate for Payer: Cofinity Commercial |
$857.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$797.23
|
| Rate for Payer: Healthscope Commercial |
$896.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$697.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$747.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$847.06
|
| Rate for Payer: PHP Commercial |
$847.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.58
|
| Rate for Payer: Priority Health SBD |
$627.82
|
| Rate for Payer: UMR Bronson Commercial |
$438.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$747.40
|
|
|
HC CHANNEL RFA ENDO CATHETER
|
Facility
|
IP
|
$3,648.61
|
|
| Hospital Charge Code |
27200289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,605.39 |
| Max. Negotiated Rate |
$3,283.75 |
| Rate for Payer: Aetna American Axle |
$2,371.60
|
| Rate for Payer: Aetna Commercial |
$3,101.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,371.60
|
| Rate for Payer: Cash Price |
$2,918.89
|
| Rate for Payer: Cofinity Commercial |
$2,554.03
|
| Rate for Payer: Cofinity Commercial |
$3,137.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,918.89
|
| Rate for Payer: Healthscope Commercial |
$3,283.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,554.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,736.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,101.32
|
| Rate for Payer: PHP Commercial |
$3,101.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,554.03
|
| Rate for Payer: Priority Health SBD |
$2,298.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,605.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,736.46
|
|
|
HC CHANNEL RFA ENDO CATHETER
|
Facility
|
OP
|
$3,648.61
|
|
| Hospital Charge Code |
27200289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,349.99 |
| Max. Negotiated Rate |
$3,283.75 |
| Rate for Payer: Aetna American Axle |
$2,371.60
|
| Rate for Payer: Aetna Commercial |
$3,101.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,371.60
|
| Rate for Payer: BCBS Complete |
$1,459.44
|
| Rate for Payer: Cash Price |
$2,918.89
|
| Rate for Payer: Cofinity Commercial |
$2,554.03
|
| Rate for Payer: Cofinity Commercial |
$3,137.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,918.89
|
| Rate for Payer: Healthscope Commercial |
$3,283.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,554.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,736.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,101.32
|
| Rate for Payer: PHP Commercial |
$3,101.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,554.03
|
| Rate for Payer: Priority Health SBD |
$2,298.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,349.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,736.46
|
|
|
HC CHEM CAUTERY GRANULATION TISSUE
|
Facility
|
OP
|
$290.92
|
|
|
Service Code
|
CPT 17250
|
| Hospital Charge Code |
76100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$37.00 |
| Max. Negotiated Rate |
$560.20 |
| Rate for Payer: Aetna American Axle |
$189.10
|
| Rate for Payer: Aetna Commercial |
$247.28
|
| Rate for Payer: Aetna Medicare |
$185.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$123.11
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$232.74
|
| Rate for Payer: Cash Price |
$232.74
|
| Rate for Payer: Cofinity Commercial |
$250.19
|
| Rate for Payer: Cofinity Commercial |
$203.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$261.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$203.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.19
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$247.28
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$247.28
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.20
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$448.16
|
| Rate for Payer: Priority Health SBD |
$183.28
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.95
|
| Rate for Payer: UHC Exchange |
$37.00
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: UMR Bronson Commercial |
$107.64
|
| Rate for Payer: VA VA |
$177.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.19
|
|
|
HC CHEM CAUTERY GRANULATION TISSUE
|
Facility
|
IP
|
$290.92
|
|
|
Service Code
|
CPT 17250
|
| Hospital Charge Code |
76100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.00 |
| Max. Negotiated Rate |
$261.83 |
| Rate for Payer: Aetna American Axle |
$189.10
|
| Rate for Payer: Aetna Commercial |
$247.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.10
|
| Rate for Payer: Cash Price |
$232.74
|
| Rate for Payer: Cofinity Commercial |
$203.64
|
| Rate for Payer: Cofinity Commercial |
$250.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.74
|
| Rate for Payer: Healthscope Commercial |
$261.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$203.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$247.28
|
| Rate for Payer: PHP Commercial |
$247.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.64
|
| Rate for Payer: Priority Health SBD |
$183.28
|
| Rate for Payer: UMR Bronson Commercial |
$128.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.19
|
|
|
HC CHEMO ADMIN INTO CNS
|
Facility
|
IP
|
$1,076.22
|
|
|
Service Code
|
CPT 96450
|
| Hospital Charge Code |
33100005
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$473.54 |
| Max. Negotiated Rate |
$968.60 |
| Rate for Payer: Aetna American Axle |
$699.54
|
| Rate for Payer: Aetna Commercial |
$914.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$699.54
|
| Rate for Payer: Cash Price |
$860.98
|
| Rate for Payer: Cofinity Commercial |
$753.35
|
| Rate for Payer: Cofinity Commercial |
$925.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.98
|
| Rate for Payer: Healthscope Commercial |
$968.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$753.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$807.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$914.79
|
| Rate for Payer: PHP Commercial |
$914.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.35
|
| Rate for Payer: Priority Health SBD |
$678.02
|
| Rate for Payer: UMR Bronson Commercial |
$473.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$807.16
|
|
|
HC CHEMO ADMIN INTO CNS
|
Facility
|
OP
|
$1,076.22
|
|
|
Service Code
|
CPT 96450
|
| Hospital Charge Code |
33100005
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$74.00 |
| Max. Negotiated Rate |
$968.60 |
| Rate for Payer: Aetna American Axle |
$699.54
|
| Rate for Payer: Aetna Commercial |
$914.79
|
| Rate for Payer: Aetna Medicare |
$313.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$699.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.29
|
| Rate for Payer: BCBS Complete |
$172.91
|
| Rate for Payer: BCBS MAPPO |
$301.03
|
| Rate for Payer: BCBS Trust/PPO |
$883.39
|
| Rate for Payer: BCN Medicare Advantage |
$301.03
|
| Rate for Payer: Cash Price |
$860.98
|
| Rate for Payer: Cash Price |
$860.98
|
| Rate for Payer: Cofinity Commercial |
$925.55
|
| Rate for Payer: Cofinity Commercial |
$753.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.03
|
| Rate for Payer: Healthscope Commercial |
$968.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$753.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$807.16
|
| Rate for Payer: Mclaren Medicaid |
$164.66
|
| Rate for Payer: Mclaren Medicare |
$301.03
|
| Rate for Payer: Meridian Medicaid |
$172.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$914.79
|
| Rate for Payer: PACE Medicare |
$285.98
|
| Rate for Payer: PACE SWMI |
$301.03
|
| Rate for Payer: PHP Commercial |
$914.79
|
| Rate for Payer: PHP Medicare Advantage |
$301.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$753.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$947.66
|
| Rate for Payer: Priority Health Medicare |
$301.03
|
| Rate for Payer: Priority Health Narrow Network |
$758.13
|
| Rate for Payer: Priority Health SBD |
$678.02
|
| Rate for Payer: Railroad Medicare Medicare |
$301.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.40
|
| Rate for Payer: UHC Core |
$284.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.03
|
| Rate for Payer: UHC Exchange |
$74.00
|
| Rate for Payer: UHC Medicare Advantage |
$310.06
|
| Rate for Payer: UMR Bronson Commercial |
$398.20
|
| Rate for Payer: VA VA |
$301.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$807.16
|
|
|
HC CHEMODENERVATION INTERNAL ANAL SPHINCTER
|
Facility
|
IP
|
$3,140.44
|
|
|
Service Code
|
CPT 46505
|
| Hospital Charge Code |
76100384
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,381.79 |
| Max. Negotiated Rate |
$2,826.40 |
| Rate for Payer: Aetna American Axle |
$2,041.29
|
| Rate for Payer: Aetna Commercial |
$2,669.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,041.29
|
| Rate for Payer: Cash Price |
$2,512.35
|
| Rate for Payer: Cofinity Commercial |
$2,198.31
|
| Rate for Payer: Cofinity Commercial |
$2,700.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,512.35
|
| Rate for Payer: Healthscope Commercial |
$2,826.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,198.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,355.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,669.37
|
| Rate for Payer: PHP Commercial |
$2,669.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,198.31
|
| Rate for Payer: Priority Health SBD |
$1,978.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,381.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,355.33
|
|
