|
HC CONIZ CERVIX W/WO D&C RPR ELTRD EXC
|
Facility
|
IP
|
$7,789.74
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
76100334
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,427.49 |
| Max. Negotiated Rate |
$7,010.77 |
| Rate for Payer: Aetna American Axle |
$5,063.33
|
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,063.33
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$5,452.82
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,452.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health SBD |
$4,907.54
|
| Rate for Payer: UMR Bronson Commercial |
$3,427.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC CONIZ CERVIX W/WO D&C RPR ELTRD EXC
|
Facility
|
OP
|
$7,789.74
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
76100334
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$253.44 |
| Max. Negotiated Rate |
$8,748.29 |
| Rate for Payer: Aetna American Axle |
$5,063.33
|
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: Aetna Medicare |
$2,890.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,063.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,201.07
|
| Rate for Payer: BCCCP Commercial |
$322.14
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$5,452.82
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,452.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,748.29
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$6,998.63
|
| Rate for Payer: Priority Health SBD |
$4,907.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,778.95
|
| Rate for Payer: UHC Exchange |
$253.44
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: UMR Bronson Commercial |
$2,882.20
|
| Rate for Payer: VA VA |
$2,778.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC CONNECTIVE TISSUE CASCADE ANA & CCP
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
30200156
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.73 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna American Axle |
$20.29
|
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.53
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.85
|
| Rate for Payer: Priority Health SBD |
$19.66
|
| Rate for Payer: UMR Bronson Commercial |
$13.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC CONNECTIVE TISSUE CASCADE ANA & CCP
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
30200156
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.08 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna American Axle |
$20.29
|
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$13.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.19
|
| Rate for Payer: BCBS Complete |
$7.44
|
| Rate for Payer: BCBS MAPPO |
$12.95
|
| Rate for Payer: BCBS Trust/PPO |
$11.64
|
| Rate for Payer: BCN Medicare Advantage |
$12.95
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.95
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$7.08
|
| Rate for Payer: Mclaren Medicare |
$12.95
|
| Rate for Payer: Meridian Medicaid |
$7.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.53
|
| Rate for Payer: PACE Medicare |
$12.30
|
| Rate for Payer: PACE SWMI |
$12.95
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$12.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.76
|
| Rate for Payer: Priority Health Medicare |
$12.95
|
| Rate for Payer: Priority Health Narrow Network |
$14.21
|
| Rate for Payer: Priority Health SBD |
$19.66
|
| Rate for Payer: Railroad Medicare Medicare |
$12.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.54
|
| Rate for Payer: UHC Core |
$21.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.95
|
| Rate for Payer: UHC Exchange |
$12.95
|
| Rate for Payer: UHC Medicare Advantage |
$13.34
|
| Rate for Payer: UMR Bronson Commercial |
$11.55
|
| Rate for Payer: VA VA |
$12.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC CONNECTOR 3/8 W/ LL
|
Facility
|
OP
|
$5.25
|
|
| Hospital Charge Code |
27000448
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna American Axle |
$3.41
|
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.41
|
| Rate for Payer: BCBS Complete |
$2.10
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Commercial |
$3.68
|
| Rate for Payer: Cofinity Commercial |
$4.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.46
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.68
|
| Rate for Payer: Priority Health SBD |
$3.31
|
| Rate for Payer: UMR Bronson Commercial |
$1.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
HC CONNECTOR 3/8 W/ LL
|
Facility
|
IP
|
$5.25
|
|
| Hospital Charge Code |
27000448
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.31 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna American Axle |
$3.41
|
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.41
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Commercial |
$3.68
|
| Rate for Payer: Cofinity Commercial |
$4.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.46
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.68
|
| Rate for Payer: Priority Health SBD |
$3.31
|
| Rate for Payer: UMR Bronson Commercial |
$2.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
HC CONNECTOR REDUCER
|
Facility
|
IP
|
$5.25
|
|
| Hospital Charge Code |
27000651
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.31 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna American Axle |
$3.41
|
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.41
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Commercial |
$3.68
|
| Rate for Payer: Cofinity Commercial |
$4.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.46
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.68
|
| Rate for Payer: Priority Health SBD |
$3.31
|
| Rate for Payer: UMR Bronson Commercial |
$2.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
HC CONNECTOR REDUCER
|
Facility
|
OP
|
$5.25
|
|
| Hospital Charge Code |
27000651
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna American Axle |
$3.41
|
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.41
|
| Rate for Payer: BCBS Complete |
$2.10
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Commercial |
$3.68
|
| Rate for Payer: Cofinity Commercial |
$4.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.46
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.68
|
| Rate for Payer: Priority Health SBD |
$3.31
|
| Rate for Payer: UMR Bronson Commercial |
$1.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
HC CONNECTOR ST 1/2 X 1/2
|
Facility
|
IP
|
$7.50
|
|
| Hospital Charge Code |
27000047
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$6.75 |
| Rate for Payer: Aetna American Axle |
$4.88
|
| Rate for Payer: Aetna Commercial |
$6.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.88
|
| Rate for Payer: Cash Price |
$6.00
|
| Rate for Payer: Cofinity Commercial |
$5.25
|
| Rate for Payer: Cofinity Commercial |
$6.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.00
|
| Rate for Payer: Healthscope Commercial |
$6.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6.38
|
| Rate for Payer: PHP Commercial |
$6.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.25
|
| Rate for Payer: Priority Health SBD |
$4.72
|
| Rate for Payer: UMR Bronson Commercial |
$3.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.62
|
|
|
HC CONNECTOR ST 1/2 X 1/2
|
Facility
|
OP
|
$7.50
|
|
| Hospital Charge Code |
27000047
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.78 |
| Max. Negotiated Rate |
$6.75 |
| Rate for Payer: Aetna American Axle |
$4.88
|
| Rate for Payer: Aetna Commercial |
$6.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.88
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: Cash Price |
$6.00
|
| Rate for Payer: Cofinity Commercial |
$5.25
|
| Rate for Payer: Cofinity Commercial |
$6.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.00
|
| Rate for Payer: Healthscope Commercial |
$6.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6.38
|
| Rate for Payer: PHP Commercial |
$6.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.25
|
| Rate for Payer: Priority Health SBD |
$4.72
|
| Rate for Payer: UMR Bronson Commercial |
$2.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.62
|
|
|
HC CONNECTOR ST 3/8 OR 1/4
|
Facility
|
OP
|
$5.25
|
|
| Hospital Charge Code |
27000685
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna American Axle |
$3.41
|
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.41
|
| Rate for Payer: BCBS Complete |
$2.10
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Commercial |
$3.68
|
| Rate for Payer: Cofinity Commercial |
$4.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.46
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.68
|
| Rate for Payer: Priority Health SBD |
$3.31
|
| Rate for Payer: UMR Bronson Commercial |
$1.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
HC CONNECTOR ST 3/8 OR 1/4
|
Facility
|
IP
|
$5.25
|
|
| Hospital Charge Code |
27000685
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.31 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna American Axle |
$3.41
|
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.41
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Commercial |
$3.68
|
| Rate for Payer: Cofinity Commercial |
$4.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.46
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.68
|
| Rate for Payer: Priority Health SBD |
$3.31
|
| Rate for Payer: UMR Bronson Commercial |
$2.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
HC CONNECTOR V
|
Facility
|
IP
|
$7.50
|
|
| Hospital Charge Code |
27000678
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$6.75 |
| Rate for Payer: Aetna American Axle |
$4.88
|
| Rate for Payer: Aetna Commercial |
$6.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.88
|
| Rate for Payer: Cash Price |
$6.00
|
| Rate for Payer: Cofinity Commercial |
$5.25
|
| Rate for Payer: Cofinity Commercial |
$6.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.00
|
| Rate for Payer: Healthscope Commercial |
$6.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6.38
|
| Rate for Payer: PHP Commercial |
$6.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.25
|
| Rate for Payer: Priority Health SBD |
$4.72
|
| Rate for Payer: UMR Bronson Commercial |
$3.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.62
|
|
|
HC CONNECTOR V
|
Facility
|
OP
|
$7.50
|
|
| Hospital Charge Code |
27000678
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.78 |
| Max. Negotiated Rate |
$6.75 |
| Rate for Payer: Aetna American Axle |
$4.88
|
| Rate for Payer: Aetna Commercial |
$6.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.88
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: Cash Price |
$6.00
|
| Rate for Payer: Cofinity Commercial |
$5.25
|
| Rate for Payer: Cofinity Commercial |
$6.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.00
|
| Rate for Payer: Healthscope Commercial |
$6.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6.38
|
| Rate for Payer: PHP Commercial |
$6.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.25
|
| Rate for Payer: Priority Health SBD |
$4.72
|
| Rate for Payer: UMR Bronson Commercial |
$2.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.62
|
|
|
HC CONNECTOR Y
|
Facility
|
IP
|
$5.25
|
|
| Hospital Charge Code |
27000048
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.31 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna American Axle |
$3.41
|
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.41
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Commercial |
$3.68
|
| Rate for Payer: Cofinity Commercial |
$4.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.46
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.68
|
| Rate for Payer: Priority Health SBD |
$3.31
|
| Rate for Payer: UMR Bronson Commercial |
$2.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
HC CONNECTOR Y
|
Facility
|
OP
|
$5.25
|
|
| Hospital Charge Code |
27000048
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$4.72 |
| Rate for Payer: Aetna American Axle |
$3.41
|
| Rate for Payer: Aetna Commercial |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.41
|
| Rate for Payer: BCBS Complete |
$2.10
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Cofinity Commercial |
$3.68
|
| Rate for Payer: Cofinity Commercial |
$4.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$4.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.46
|
| Rate for Payer: PHP Commercial |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.68
|
| Rate for Payer: Priority Health SBD |
$3.31
|
| Rate for Payer: UMR Bronson Commercial |
$1.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.94
|
|
|
HC CONSULT NUTRITIONAL
|
Facility
|
IP
|
$34.27
|
|
| Hospital Charge Code |
94200010
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$15.08 |
| Max. Negotiated Rate |
$30.84 |
| Rate for Payer: Aetna American Axle |
$22.28
|
| Rate for Payer: Aetna Commercial |
$29.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.28
|
| Rate for Payer: Cash Price |
$27.42
|
| Rate for Payer: Cofinity Commercial |
$23.99
|
| Rate for Payer: Cofinity Commercial |
$29.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.42
|
| Rate for Payer: Healthscope Commercial |
$30.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.13
|
| Rate for Payer: PHP Commercial |
$29.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.99
|
| Rate for Payer: Priority Health SBD |
$21.59
|
| Rate for Payer: UMR Bronson Commercial |
$15.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.70
|
|
|
HC CONSULT NUTRITIONAL
|
Facility
|
OP
|
$34.27
|
|
| Hospital Charge Code |
94200010
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$12.68 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$22.28
|
| Rate for Payer: Aetna Commercial |
$29.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.28
|
| Rate for Payer: BCBS Complete |
$13.71
|
| Rate for Payer: Cash Price |
$27.42
|
| Rate for Payer: Cash Price |
$27.42
|
| Rate for Payer: Cofinity Commercial |
$23.99
|
| Rate for Payer: Cofinity Commercial |
$29.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.42
|
| Rate for Payer: Healthscope Commercial |
$30.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.13
|
| Rate for Payer: PHP Commercial |
$29.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.99
|
| Rate for Payer: Priority Health SBD |
$21.59
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$12.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.70
|
|
|
HC CONT GLUCOSE MONITOR OFFICE EQUIP
|
Facility
|
OP
|
$965.28
|
|
|
Service Code
|
CPT 95250
|
| Hospital Charge Code |
94200001
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$64.27 |
| Max. Negotiated Rate |
$868.75 |
| Rate for Payer: Aetna American Axle |
$627.43
|
| Rate for Payer: Aetna Commercial |
$820.49
|
| Rate for Payer: Aetna Medicare |
$122.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$627.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.88
|
| Rate for Payer: BCBS Complete |
$67.49
|
| Rate for Payer: BCBS MAPPO |
$117.50
|
| Rate for Payer: BCBS Trust/PPO |
$720.52
|
| Rate for Payer: BCN Medicare Advantage |
$117.50
|
| Rate for Payer: Cash Price |
$772.22
|
| Rate for Payer: Cash Price |
$772.22
|
| Rate for Payer: Cash Price |
$772.22
|
| Rate for Payer: Cofinity Commercial |
$830.14
|
| Rate for Payer: Cofinity Commercial |
$675.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$772.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.50
|
| Rate for Payer: Healthscope Commercial |
$868.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$675.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$723.96
|
| Rate for Payer: Mclaren Medicaid |
$64.27
|
| Rate for Payer: Mclaren Medicare |
$117.50
|
| Rate for Payer: Meridian Medicaid |
$67.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$123.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$820.49
|
| Rate for Payer: PACE Medicare |
$111.62
|
| Rate for Payer: PACE SWMI |
$117.50
|
| Rate for Payer: PHP Commercial |
$820.49
|
| Rate for Payer: PHP Medicare Advantage |
$117.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$369.91
|
| Rate for Payer: Priority Health Medicare |
$117.50
|
| Rate for Payer: Priority Health Narrow Network |
$295.93
|
| Rate for Payer: Priority Health SBD |
$608.13
|
| Rate for Payer: Railroad Medicare Medicare |
$117.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.57
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.50
|
| Rate for Payer: UHC Exchange |
$145.06
|
| Rate for Payer: UHC Medicare Advantage |
$121.02
|
| Rate for Payer: UMR Bronson Commercial |
$357.15
|
| Rate for Payer: VA VA |
$117.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$723.96
|
|
|
HC CONT GLUCOSE MONITOR OFFICE EQUIP
|
Facility
|
IP
|
$965.28
|
|
|
Service Code
|
CPT 95250
|
| Hospital Charge Code |
94200001
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$424.72 |
| Max. Negotiated Rate |
$868.75 |
| Rate for Payer: Aetna American Axle |
$627.43
|
| Rate for Payer: Aetna Commercial |
$820.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$627.43
|
| Rate for Payer: Cash Price |
$772.22
|
| Rate for Payer: Cofinity Commercial |
$830.14
|
| Rate for Payer: Cofinity Commercial |
$675.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$772.22
|
| Rate for Payer: Healthscope Commercial |
$868.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$675.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$723.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$820.49
|
| Rate for Payer: PHP Commercial |
$820.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$675.70
|
| Rate for Payer: Priority Health SBD |
$608.13
|
| Rate for Payer: UMR Bronson Commercial |
$424.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$723.96
|
|
|
HC CONT GLUCOSE MONITOR PATIENT EQUIP
|
Facility
|
OP
|
$376.90
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
94200038
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$29.74 |
| Max. Negotiated Rate |
$339.21 |
| Rate for Payer: Aetna American Axle |
$244.98
|
| Rate for Payer: Aetna Commercial |
$320.36
|
| Rate for Payer: Aetna Medicare |
$56.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$298.27
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$301.52
|
| Rate for Payer: Cash Price |
$301.52
|
| Rate for Payer: Cash Price |
$301.52
|
| Rate for Payer: Cofinity Commercial |
$263.83
|
| Rate for Payer: Cofinity Commercial |
$324.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$301.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$339.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$263.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$282.68
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$320.36
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$320.36
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.15
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$136.92
|
| Rate for Payer: Priority Health SBD |
$237.45
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.60
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.37
|
| Rate for Payer: UHC Exchange |
$64.18
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: UMR Bronson Commercial |
$139.45
|
| Rate for Payer: VA VA |
$54.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$282.68
|
|
|
HC CONT GLUCOSE MONITOR PATIENT EQUIP
|
Facility
|
IP
|
$376.90
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
94200038
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$165.84 |
| Max. Negotiated Rate |
$339.21 |
| Rate for Payer: Aetna American Axle |
$244.98
|
| Rate for Payer: Aetna Commercial |
$320.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.98
|
| Rate for Payer: Cash Price |
$301.52
|
| Rate for Payer: Cofinity Commercial |
$263.83
|
| Rate for Payer: Cofinity Commercial |
$324.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$301.52
|
| Rate for Payer: Healthscope Commercial |
$339.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$263.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$282.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$320.36
|
| Rate for Payer: PHP Commercial |
$320.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$263.83
|
| Rate for Payer: Priority Health SBD |
$237.45
|
| Rate for Payer: UMR Bronson Commercial |
$165.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$282.68
|
|
|
HC CONTINUOUS NEB SUBSEQUENT HR
|
Facility
|
IP
|
$102.48
|
|
|
Service Code
|
CPT 94645
|
| Hospital Charge Code |
41000007
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$45.09 |
| Max. Negotiated Rate |
$92.23 |
| Rate for Payer: Aetna American Axle |
$66.61
|
| Rate for Payer: Aetna Commercial |
$87.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.61
|
| Rate for Payer: Cash Price |
$81.98
|
| Rate for Payer: Cofinity Commercial |
$88.13
|
| Rate for Payer: Cofinity Commercial |
$71.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.98
|
| Rate for Payer: Healthscope Commercial |
$92.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.11
|
| Rate for Payer: PHP Commercial |
$87.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.74
|
| Rate for Payer: Priority Health SBD |
$64.56
|
| Rate for Payer: UMR Bronson Commercial |
$45.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.86
|
|
|
HC CONTINUOUS NEB SUBSEQUENT HR
|
Facility
|
OP
|
$102.48
|
|
|
Service Code
|
CPT 94645
|
| Hospital Charge Code |
41000007
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$16.04 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$66.61
|
| Rate for Payer: Aetna Commercial |
$87.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.61
|
| Rate for Payer: BCBS Complete |
$40.99
|
| Rate for Payer: BCBS Trust/PPO |
$77.07
|
| Rate for Payer: Cash Price |
$81.98
|
| Rate for Payer: Cash Price |
$81.98
|
| Rate for Payer: Cash Price |
$81.98
|
| Rate for Payer: Cofinity Commercial |
$71.74
|
| Rate for Payer: Cofinity Commercial |
$88.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.98
|
| Rate for Payer: Healthscope Commercial |
$92.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.11
|
| Rate for Payer: PHP Commercial |
$87.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.74
|
| Rate for Payer: Priority Health SBD |
$64.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.64
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$16.04
|
| Rate for Payer: UMR Bronson Commercial |
$37.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.86
|
|
|
HC CONTINUOUS NEB TX INITIAL HOUR
|
Facility
|
OP
|
$368.06
|
|
|
Service Code
|
CPT 94644
|
| Hospital Charge Code |
41000006
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$58.61 |
| Max. Negotiated Rate |
$357.43 |
| Rate for Payer: Aetna American Axle |
$239.24
|
| Rate for Payer: Aetna Commercial |
$312.85
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$296.59
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$294.45
|
| Rate for Payer: Cash Price |
$294.45
|
| Rate for Payer: Cash Price |
$294.45
|
| Rate for Payer: Cofinity Commercial |
$257.64
|
| Rate for Payer: Cofinity Commercial |
$316.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$331.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$257.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.04
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.85
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$312.85
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.43
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$285.94
|
| Rate for Payer: Priority Health SBD |
$231.88
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.47
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$58.61
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$136.18
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.04
|
|
