|
HC CLIP FIX DEVICE ROTATABLE
|
Facility
|
OP
|
$775.77
|
|
| Hospital Charge Code |
27200290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$287.03 |
| Max. Negotiated Rate |
$698.19 |
| Rate for Payer: Aetna American Axle |
$504.25
|
| Rate for Payer: Aetna Commercial |
$659.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$504.25
|
| Rate for Payer: BCBS Complete |
$310.31
|
| Rate for Payer: Cash Price |
$620.62
|
| Rate for Payer: Cofinity Commercial |
$543.04
|
| Rate for Payer: Cofinity Commercial |
$667.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.62
|
| Rate for Payer: Healthscope Commercial |
$698.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$543.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$581.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$659.40
|
| Rate for Payer: PHP Commercial |
$659.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.04
|
| Rate for Payer: Priority Health SBD |
$488.74
|
| Rate for Payer: UMR Bronson Commercial |
$287.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$581.83
|
|
|
HC CLIP FIX DEVICE ROTATABLE
|
Facility
|
IP
|
$775.77
|
|
| Hospital Charge Code |
27200290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$341.34 |
| Max. Negotiated Rate |
$698.19 |
| Rate for Payer: Aetna American Axle |
$504.25
|
| Rate for Payer: Aetna Commercial |
$659.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$504.25
|
| Rate for Payer: Cash Price |
$620.62
|
| Rate for Payer: Cofinity Commercial |
$543.04
|
| Rate for Payer: Cofinity Commercial |
$667.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.62
|
| Rate for Payer: Healthscope Commercial |
$698.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$543.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$581.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$659.40
|
| Rate for Payer: PHP Commercial |
$659.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$543.04
|
| Rate for Payer: Priority Health SBD |
$488.74
|
| Rate for Payer: UMR Bronson Commercial |
$341.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$581.83
|
|
|
HC CLOSED RX CARPAL FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 25630
|
| Hospital Charge Code |
76100165
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$193.44
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$291.75
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$127.42
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX CARPAL FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 25630
|
| Hospital Charge Code |
76100165
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$151.53 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: UMR Bronson Commercial |
$151.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX DIST FIBULA FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
76100174
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$249.04
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$293.72
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$127.42
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX DIST FIBULA FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
76100174
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$151.53 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: UMR Bronson Commercial |
$151.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX DIST RAD/ULNA FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
76100163
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$186.72
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$333.34
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$127.42
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX DIST RAD/ULNA FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
76100163
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$151.53 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: UMR Bronson Commercial |
$151.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX METACARPAL FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
76100166
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$151.53 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: UMR Bronson Commercial |
$151.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX METACARPAL FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
76100166
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$188.17
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$295.35
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$127.42
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX METACARPAL FX, MANIP
|
Facility
|
OP
|
$413.27
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
76100167
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$268.63
|
| Rate for Payer: Aetna Commercial |
$351.28
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$337.05
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$330.62
|
| Rate for Payer: Cash Price |
$330.62
|
| Rate for Payer: Cofinity Commercial |
$355.41
|
| Rate for Payer: Cofinity Commercial |
$289.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$371.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$289.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.95
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$351.28
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$351.28
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$260.36
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$304.85
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$152.91
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.95
|
|
|
HC CLOSED RX METACARPAL FX, MANIP
|
Facility
|
IP
|
$413.27
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
76100167
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$181.84 |
| Max. Negotiated Rate |
$371.94 |
| Rate for Payer: Aetna American Axle |
$268.63
|
| Rate for Payer: Aetna Commercial |
$351.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$268.63
|
| Rate for Payer: Cash Price |
$330.62
|
| Rate for Payer: Cofinity Commercial |
$289.29
|
| Rate for Payer: Cofinity Commercial |
$355.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$330.62
|
| Rate for Payer: Healthscope Commercial |
$371.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$289.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$351.28
|
| Rate for Payer: PHP Commercial |
$351.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.29
|
| Rate for Payer: Priority Health SBD |
$260.36
|
| Rate for Payer: UMR Bronson Commercial |
$181.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.95
|
|
|
HC CLOSED RX METATARSAL FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 28470
|
| Hospital Charge Code |
76100175
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$151.53 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: UMR Bronson Commercial |
$151.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX METATARSAL FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 28470
|
| Hospital Charge Code |
76100175
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$152.09
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$208.91
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$127.42
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX NAVICULAR FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 25622
|
| Hospital Charge Code |
76100164
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$136.31
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$292.08
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$127.42
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX NAVICULAR FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 25622
|
| Hospital Charge Code |
76100164
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$151.53 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: UMR Bronson Commercial |
$151.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX PATELLA FX
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
76100171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$151.53 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: UMR Bronson Commercial |
$151.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX PATELLA FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
76100171
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$160.37
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$308.45
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$127.42
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX POST HIP ARTHRPLAS DISLOC
|
Facility
|
IP
|
$622.66
|
|
|
Service Code
|
CPT 27265
|
| Hospital Charge Code |
76100363
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.97 |
| Max. Negotiated Rate |
$560.39 |
| Rate for Payer: Aetna American Axle |
$404.73
|
| Rate for Payer: Aetna Commercial |
$529.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.73
|
| Rate for Payer: Cash Price |
$498.13
|
| Rate for Payer: Cofinity Commercial |
$435.86
|
| Rate for Payer: Cofinity Commercial |
$535.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.13
|
| Rate for Payer: Healthscope Commercial |
$560.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$435.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$467.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$529.26
|
| Rate for Payer: PHP Commercial |
$529.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.86
|
| Rate for Payer: Priority Health SBD |
$392.28
|
| Rate for Payer: UMR Bronson Commercial |
$273.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$467.00
|
|
|
HC CLOSED RX POST HIP ARTHRPLAS DISLOC
|
Facility
|
OP
|
$622.66
|
|
|
Service Code
|
CPT 27265
|
| Hospital Charge Code |
76100363
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$404.73
|
| Rate for Payer: Aetna Commercial |
$529.26
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$414.84
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$498.13
|
| Rate for Payer: Cash Price |
$498.13
|
| Rate for Payer: Cofinity Commercial |
$435.86
|
| Rate for Payer: Cofinity Commercial |
$535.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$560.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$435.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$467.00
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$529.26
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$529.26
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$392.28
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$464.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$422.40
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$230.38
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$467.00
|
|
|
HC CLOSED RX PROX HUMERUS FRACTURE
|
Facility
|
IP
|
$344.39
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
76100160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$151.53 |
| Max. Negotiated Rate |
$309.95 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: UMR Bronson Commercial |
$151.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX PROX HUMERUS FRACTURE
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
76100160
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$142.40
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$324.50
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$127.42
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
|
HC CLOSED RX PROX THIGH FX
|
Facility
|
OP
|
$609.96
|
|
|
Service Code
|
CPT 27230
|
| Hospital Charge Code |
76100317
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$396.47
|
| Rate for Payer: Aetna Commercial |
$518.47
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$187.09
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$487.97
|
| Rate for Payer: Cash Price |
$487.97
|
| Rate for Payer: Cofinity Commercial |
$524.57
|
| Rate for Payer: Cofinity Commercial |
$426.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$487.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$548.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$426.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.47
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.47
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$518.47
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$426.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$384.27
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$530.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$482.32
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$225.69
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.47
|
|
|
HC CLOSED RX PROX THIGH FX
|
Facility
|
IP
|
$609.96
|
|
|
Service Code
|
CPT 27230
|
| Hospital Charge Code |
76100317
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$268.38 |
| Max. Negotiated Rate |
$548.96 |
| Rate for Payer: Aetna American Axle |
$396.47
|
| Rate for Payer: Aetna Commercial |
$518.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.47
|
| Rate for Payer: Cash Price |
$487.97
|
| Rate for Payer: Cofinity Commercial |
$524.57
|
| Rate for Payer: Cofinity Commercial |
$426.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$487.97
|
| Rate for Payer: Healthscope Commercial |
$548.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$426.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.47
|
| Rate for Payer: PHP Commercial |
$518.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$426.97
|
| Rate for Payer: Priority Health SBD |
$384.27
|
| Rate for Payer: UMR Bronson Commercial |
$268.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.47
|
|
|
HC CLOSED RX RADIAL HEAD/NECK FX
|
Facility
|
OP
|
$344.39
|
|
|
Service Code
|
CPT 24650
|
| Hospital Charge Code |
76100161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$223.85
|
| Rate for Payer: Aetna Commercial |
$292.73
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$177.45
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cash Price |
$275.51
|
| Rate for Payer: Cofinity Commercial |
$296.18
|
| Rate for Payer: Cofinity Commercial |
$241.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$309.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.29
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$292.73
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$292.73
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$216.97
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$253.44
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$127.42
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.29
|
|
