|
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
|
|
|
HC CONT PHYSICS CONSULT
|
Facility
|
IP
|
$661.00
|
|
|
Service Code
|
CPT 77336
|
| Hospital Charge Code |
33300015
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$290.84 |
| Max. Negotiated Rate |
$594.90 |
| Rate for Payer: Aetna American Axle |
$429.65
|
| Rate for Payer: Aetna American Axle |
$372.61
|
| Rate for Payer: Aetna Commercial |
$487.25
|
| Rate for Payer: Aetna Commercial |
$561.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.65
|
| Rate for Payer: Cash Price |
$528.80
|
| Rate for Payer: Cash Price |
$458.59
|
| Rate for Payer: Cofinity Commercial |
$401.27
|
| Rate for Payer: Cofinity Commercial |
$568.46
|
| Rate for Payer: Cofinity Commercial |
$462.70
|
| Rate for Payer: Cofinity Commercial |
$492.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$528.80
|
| Rate for Payer: Healthscope Commercial |
$515.92
|
| Rate for Payer: Healthscope Commercial |
$594.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$462.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$401.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$495.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$487.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$561.85
|
| Rate for Payer: PHP Commercial |
$561.85
|
| Rate for Payer: PHP Commercial |
$487.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.70
|
| Rate for Payer: Priority Health SBD |
$416.43
|
| Rate for Payer: Priority Health SBD |
$361.14
|
| Rate for Payer: UMR Bronson Commercial |
$290.84
|
| Rate for Payer: UMR Bronson Commercial |
$252.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$495.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.93
|
|
|
HC CONT PHYSICS CONSULT
|
Facility
|
OP
|
$573.24
|
|
|
Service Code
|
CPT 77336
|
| Hospital Charge Code |
33300015
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$65.97 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$372.61
|
| Rate for Payer: Aetna American Axle |
$429.65
|
| Rate for Payer: Aetna Commercial |
$487.25
|
| Rate for Payer: Aetna Commercial |
$561.85
|
| Rate for Payer: Aetna Medicare |
$125.43
|
| Rate for Payer: Aetna Medicare |
$125.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.76
|
| Rate for Payer: BCBS Complete |
$69.28
|
| Rate for Payer: BCBS Complete |
$69.28
|
| Rate for Payer: BCBS MAPPO |
$120.61
|
| Rate for Payer: BCBS MAPPO |
$120.61
|
| Rate for Payer: BCBS Trust/PPO |
$163.44
|
| Rate for Payer: BCBS Trust/PPO |
$163.44
|
| Rate for Payer: BCN Medicare Advantage |
$120.61
|
| Rate for Payer: BCN Medicare Advantage |
$120.61
|
| Rate for Payer: Cash Price |
$458.59
|
| Rate for Payer: Cash Price |
$528.80
|
| Rate for Payer: Cash Price |
$458.59
|
| Rate for Payer: Cash Price |
$528.80
|
| Rate for Payer: Cash Price |
$528.80
|
| Rate for Payer: Cash Price |
$458.59
|
| Rate for Payer: Cofinity Commercial |
$401.27
|
| Rate for Payer: Cofinity Commercial |
$568.46
|
| Rate for Payer: Cofinity Commercial |
$462.70
|
| Rate for Payer: Cofinity Commercial |
$492.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$528.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.61
|
| Rate for Payer: Healthscope Commercial |
$515.92
|
| Rate for Payer: Healthscope Commercial |
$594.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$401.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$462.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$429.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$495.75
|
| Rate for Payer: Mclaren Medicaid |
$65.97
|
| Rate for Payer: Mclaren Medicaid |
$65.97
|
| Rate for Payer: Mclaren Medicare |
$120.61
|
| Rate for Payer: Mclaren Medicare |
$120.61
|
| Rate for Payer: Meridian Medicaid |
$69.28
|
| Rate for Payer: Meridian Medicaid |
$69.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$487.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$561.85
|
| Rate for Payer: PACE Medicare |
$114.58
|
| Rate for Payer: PACE Medicare |
$114.58
|
| Rate for Payer: PACE SWMI |
$120.61
|
| Rate for Payer: PACE SWMI |
$120.61
|
| Rate for Payer: PHP Commercial |
$561.85
|
| Rate for Payer: PHP Commercial |
$487.25
|
| Rate for Payer: PHP Medicare Advantage |
$120.61
|
| Rate for Payer: PHP Medicare Advantage |
$120.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$462.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$379.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$379.68
|
| Rate for Payer: Priority Health Medicare |
$120.61
|
| Rate for Payer: Priority Health Medicare |
$120.61
|
| Rate for Payer: Priority Health Narrow Network |
$303.74
|
| Rate for Payer: Priority Health Narrow Network |
$303.74
|
| Rate for Payer: Priority Health SBD |
$416.43
|
| Rate for Payer: Priority Health SBD |
$361.14
|
| Rate for Payer: Railroad Medicare Medicare |
$120.61
|
| Rate for Payer: Railroad Medicare Medicare |
$120.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.17
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.61
|
| Rate for Payer: UHC Exchange |
$87.43
|
| Rate for Payer: UHC Exchange |
$87.43
|
| Rate for Payer: UHC Medicare Advantage |
$124.23
|
| Rate for Payer: UHC Medicare Advantage |
$124.23
|
| Rate for Payer: UMR Bronson Commercial |
$212.10
|
| Rate for Payer: UMR Bronson Commercial |
$244.57
|
| Rate for Payer: VA VA |
$120.61
|
| Rate for Payer: VA VA |
$120.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$429.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$495.75
|
|
|
HC CONTRAST BATHS EACH 15 MIN
|
Facility
|
OP
|
$103.70
|
|
|
Service Code
|
CPT 97034
|
| Hospital Charge Code |
42000017
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$67.40
|
| Rate for Payer: Aetna Commercial |
$88.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.40
|
| Rate for Payer: BCBS Complete |
$41.48
|
| Rate for Payer: BCBS Trust/PPO |
$10.09
|
| Rate for Payer: Cash Price |
$82.96
|
| Rate for Payer: Cash Price |
$82.96
|
| Rate for Payer: Cash Price |
$82.96
|
| Rate for Payer: Cofinity Commercial |
$72.59
|
| Rate for Payer: Cofinity Commercial |
$89.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.96
|
| Rate for Payer: Healthscope Commercial |
$93.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.14
|
| Rate for Payer: PHP Commercial |
$88.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.00
|
| Rate for Payer: Priority Health Narrow Network |
$11.20
|
| Rate for Payer: Priority Health SBD |
$65.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.12
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$13.75
|
| Rate for Payer: UMR Bronson Commercial |
$38.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.78
|
|
|
HC CONTRAST BATHS EACH 15 MIN
|
Facility
|
IP
|
$103.70
|
|
|
Service Code
|
CPT 97034
|
| Hospital Charge Code |
42000017
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$45.63 |
| Max. Negotiated Rate |
$93.33 |
| Rate for Payer: Aetna American Axle |
$67.40
|
| Rate for Payer: Aetna Commercial |
$88.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.40
|
| Rate for Payer: Cash Price |
$82.96
|
| Rate for Payer: Cofinity Commercial |
$72.59
|
| Rate for Payer: Cofinity Commercial |
$89.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.96
|
| Rate for Payer: Healthscope Commercial |
$93.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.14
|
| Rate for Payer: PHP Commercial |
$88.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.59
|
| Rate for Payer: Priority Health SBD |
$65.33
|
| Rate for Payer: UMR Bronson Commercial |
$45.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.78
|
|
|
HC CONTROL NOSEBLEED ANTERIOR SIMPLE
|
Facility
|
IP
|
$406.51
|
|
|
Service Code
|
CPT 30901
|
| Hospital Charge Code |
45000011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$178.86 |
| Max. Negotiated Rate |
$365.86 |
| Rate for Payer: Aetna American Axle |
$264.23
|
| Rate for Payer: Aetna Commercial |
$345.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.23
|
| Rate for Payer: Cash Price |
$325.21
|
| Rate for Payer: Cofinity Commercial |
$284.56
|
| Rate for Payer: Cofinity Commercial |
$349.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.21
|
| Rate for Payer: Healthscope Commercial |
$365.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$345.53
|
| Rate for Payer: PHP Commercial |
$345.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.56
|
| Rate for Payer: Priority Health SBD |
$256.10
|
| Rate for Payer: UMR Bronson Commercial |
$178.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.88
|
|
|
HC CONTROL NOSEBLEED ANTERIOR SIMPLE
|
Facility
|
OP
|
$406.51
|
|
|
Service Code
|
CPT 30901
|
| Hospital Charge Code |
45000011
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.34 |
| Max. Negotiated Rate |
$365.86 |
| Rate for Payer: Aetna American Axle |
$264.23
|
| Rate for Payer: Aetna Commercial |
$345.53
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.23
|
| 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 |
$171.21
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$325.21
|
| Rate for Payer: Cash Price |
$325.21
|
| Rate for Payer: Cofinity Commercial |
$284.56
|
| Rate for Payer: Cofinity Commercial |
$349.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$365.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.88
|
| 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 |
$345.53
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$345.53
|
| 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 |
$284.56
|
| 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 |
$256.10
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$55.34
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$150.41
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.88
|
|
|
HC CONTROL OROPHARYNGEAL HEM SIMPLE
|
Facility
|
IP
|
$738.99
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
45000100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$325.16 |
| Max. Negotiated Rate |
$665.09 |
| Rate for Payer: Aetna American Axle |
$480.34
|
| Rate for Payer: Aetna Commercial |
$628.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.34
|
| Rate for Payer: Cash Price |
$591.19
|
| Rate for Payer: Cofinity Commercial |
$517.29
|
| Rate for Payer: Cofinity Commercial |
$635.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$591.19
|
| Rate for Payer: Healthscope Commercial |
$665.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$517.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$554.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$628.14
|
| Rate for Payer: PHP Commercial |
$628.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$517.29
|
| Rate for Payer: Priority Health SBD |
$465.56
|
| Rate for Payer: UMR Bronson Commercial |
$325.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$554.24
|
|
|
HC CONTROL OROPHARYNGEAL HEM SIMPLE
|
Facility
|
OP
|
$738.99
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
45000100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$159.46 |
| Max. Negotiated Rate |
$1,539.60 |
| Rate for Payer: Aetna American Axle |
$480.34
|
| Rate for Payer: Aetna Commercial |
$628.14
|
| Rate for Payer: Aetna Medicare |
$508.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$611.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$611.32
|
| Rate for Payer: BCBS Complete |
$280.92
|
| Rate for Payer: BCBS MAPPO |
$489.06
|
| Rate for Payer: BCBS Trust/PPO |
$488.52
|
| Rate for Payer: BCN Medicare Advantage |
$489.06
|
| Rate for Payer: Cash Price |
$591.19
|
| Rate for Payer: Cash Price |
$591.19
|
| Rate for Payer: Cofinity Commercial |
$517.29
|
| Rate for Payer: Cofinity Commercial |
$635.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$591.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.06
|
| Rate for Payer: Healthscope Commercial |
$665.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$517.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$554.24
|
| Rate for Payer: Mclaren Medicaid |
$267.52
|
| Rate for Payer: Mclaren Medicare |
$489.06
|
| Rate for Payer: Meridian Medicaid |
$280.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$513.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$628.14
|
| Rate for Payer: PACE Medicare |
$464.61
|
| Rate for Payer: PACE SWMI |
$489.06
|
| Rate for Payer: PHP Commercial |
$628.14
|
| Rate for Payer: PHP Medicare Advantage |
$489.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$517.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,539.60
|
| Rate for Payer: Priority Health Medicare |
$489.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,231.68
|
| Rate for Payer: Priority Health SBD |
$465.56
|
| Rate for Payer: Railroad Medicare Medicare |
$489.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$489.06
|
| Rate for Payer: UHC Exchange |
$159.46
|
| Rate for Payer: UHC Medicare Advantage |
$503.73
|
| Rate for Payer: UMR Bronson Commercial |
$273.43
|
| Rate for Payer: VA VA |
$489.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$554.24
|
|
|
HC CONTROL OROPHARYNG HEMORRHAGE SIMPLE
|
Facility
|
IP
|
$1,316.00
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
76100478
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$579.04 |
| Max. Negotiated Rate |
$1,184.40 |
| Rate for Payer: Aetna American Axle |
$855.40
|
| Rate for Payer: Aetna Commercial |
$1,118.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$855.40
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,131.76
|
| Rate for Payer: Cofinity Commercial |
$921.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,052.80
|
| Rate for Payer: Healthscope Commercial |
$1,184.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$921.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$987.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,118.60
|
| Rate for Payer: PHP Commercial |
$1,118.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.20
|
| Rate for Payer: Priority Health SBD |
$829.08
|
| Rate for Payer: UMR Bronson Commercial |
$579.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$987.00
|
|
|
HC CONTROL OROPHARYNG HEMORRHAGE SIMPLE
|
Facility
|
OP
|
$1,316.00
|
|
|
Service Code
|
CPT 42960
|
| Hospital Charge Code |
76100478
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.46 |
| Max. Negotiated Rate |
$1,539.60 |
| Rate for Payer: Aetna American Axle |
$855.40
|
| Rate for Payer: Aetna Commercial |
$1,118.60
|
| Rate for Payer: Aetna Medicare |
$508.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$855.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$611.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$611.32
|
| Rate for Payer: BCBS Complete |
$280.92
|
| Rate for Payer: BCBS MAPPO |
$489.06
|
| Rate for Payer: BCBS Trust/PPO |
$488.52
|
| Rate for Payer: BCN Medicare Advantage |
$489.06
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cofinity Commercial |
$921.20
|
| Rate for Payer: Cofinity Commercial |
$1,131.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,052.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.06
|
| Rate for Payer: Healthscope Commercial |
$1,184.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$921.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$987.00
|
| Rate for Payer: Mclaren Medicaid |
$267.52
|
| Rate for Payer: Mclaren Medicare |
$489.06
|
| Rate for Payer: Meridian Medicaid |
$280.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$513.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,118.60
|
| Rate for Payer: PACE Medicare |
$464.61
|
| Rate for Payer: PACE SWMI |
$489.06
|
| Rate for Payer: PHP Commercial |
$1,118.60
|
| Rate for Payer: PHP Medicare Advantage |
$489.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,539.60
|
| Rate for Payer: Priority Health Medicare |
$489.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,231.68
|
| Rate for Payer: Priority Health SBD |
$829.08
|
| Rate for Payer: Railroad Medicare Medicare |
$489.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$489.06
|
| Rate for Payer: UHC Exchange |
$159.46
|
| Rate for Payer: UHC Medicare Advantage |
$503.73
|
| Rate for Payer: UMR Bronson Commercial |
$486.92
|
| Rate for Payer: VA VA |
$489.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$987.00
|
|
|
HC CONVERT EXTERNAL BILIARY DRAIN TO INTERNAL EXTERNAL
|
Facility
|
IP
|
$3,610.82
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
36100492
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,588.76 |
| Max. Negotiated Rate |
$3,249.74 |
| Rate for Payer: Aetna American Axle |
$2,347.03
|
| Rate for Payer: Aetna Commercial |
$3,069.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,347.03
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cofinity Commercial |
$2,527.57
|
| Rate for Payer: Cofinity Commercial |
$3,105.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,888.66
|
| Rate for Payer: Healthscope Commercial |
$3,249.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,527.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,708.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,069.20
|
| Rate for Payer: PHP Commercial |
$3,069.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,527.57
|
| Rate for Payer: Priority Health SBD |
$2,274.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,588.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,708.12
|
|
|
HC CONVERT EXTERNAL BILIARY DRAIN TO INTERNAL EXTERNAL
|
Facility
|
OP
|
$3,610.82
|
|
|
Service Code
|
CPT 47535
|
| Hospital Charge Code |
36100492
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$185.99 |
| Max. Negotiated Rate |
$9,680.93 |
| Rate for Payer: Aetna American Axle |
$2,347.03
|
| Rate for Payer: Aetna Commercial |
$3,069.20
|
| Rate for Payer: Aetna Medicare |
$3,198.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,347.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,844.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,844.02
|
| Rate for Payer: BCBS Complete |
$1,766.41
|
| Rate for Payer: BCBS MAPPO |
$3,075.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,421.13
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cofinity Commercial |
$2,527.57
|
| Rate for Payer: Cofinity Commercial |
$3,105.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,888.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$3,249.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,527.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,708.12
|
| Rate for Payer: Mclaren Medicaid |
$1,682.15
|
| Rate for Payer: Mclaren Medicare |
$3,075.22
|
| Rate for Payer: Meridian Medicaid |
$1,766.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,228.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,536.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,069.20
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$3,069.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,075.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,682.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,527.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,680.93
|
| Rate for Payer: Priority Health Medicare |
$3,075.22
|
| Rate for Payer: Priority Health Narrow Network |
$7,744.74
|
| Rate for Payer: Priority Health SBD |
$2,274.82
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.59
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,075.22
|
| Rate for Payer: UHC Exchange |
$185.99
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,336.00
|
| Rate for Payer: VA VA |
$3,075.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,708.12
|
|
|
HC CONVERT NEPHROSTOMY TO NEPHROURETERAL CATH
|
Facility
|
OP
|
$1,180.78
|
|
|
Service Code
|
CPT 50434
|
| Hospital Charge Code |
36100506
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$182.06 |
| Max. Negotiated Rate |
$5,699.47 |
| Rate for Payer: Aetna American Axle |
$767.51
|
| Rate for Payer: Aetna Commercial |
$1,003.66
|
| Rate for Payer: Aetna Medicare |
$1,882.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$576.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$944.62
|
| Rate for Payer: Cash Price |
$944.62
|
| Rate for Payer: Cofinity Commercial |
$1,015.47
|
| Rate for Payer: Cofinity Commercial |
$826.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$1,062.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$826.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$885.58
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,003.66
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$1,003.66
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,699.47
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$4,559.58
|
| Rate for Payer: Priority Health SBD |
$743.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.27
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,810.48
|
| Rate for Payer: UHC Exchange |
$182.06
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: UMR Bronson Commercial |
$436.89
|
| Rate for Payer: VA VA |
$1,810.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$885.58
|
|
|
HC CONVERT NEPHROSTOMY TO NEPHROURETERAL CATH
|
Facility
|
IP
|
$1,180.78
|
|
|
Service Code
|
CPT 50434
|
| Hospital Charge Code |
36100506
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$519.54 |
| Max. Negotiated Rate |
$1,062.70 |
| Rate for Payer: Aetna American Axle |
$767.51
|
| Rate for Payer: Aetna Commercial |
$1,003.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$767.51
|
| Rate for Payer: Cash Price |
$944.62
|
| Rate for Payer: Cofinity Commercial |
$1,015.47
|
| Rate for Payer: Cofinity Commercial |
$826.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$944.62
|
| Rate for Payer: Healthscope Commercial |
$1,062.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$826.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$885.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,003.66
|
| Rate for Payer: PHP Commercial |
$1,003.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$826.55
|
| Rate for Payer: Priority Health SBD |
$743.89
|
| Rate for Payer: UMR Bronson Commercial |
$519.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$885.58
|
|
|
HC CONVEX WAFER
|
Facility
|
IP
|
$55.92
|
|
| Hospital Charge Code |
27000049
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.60 |
| Max. Negotiated Rate |
$50.33 |
| Rate for Payer: Aetna American Axle |
$36.35
|
| Rate for Payer: Aetna Commercial |
$47.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.35
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$39.14
|
| Rate for Payer: Cofinity Commercial |
$48.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Healthscope Commercial |
$50.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.53
|
| Rate for Payer: PHP Commercial |
$47.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.14
|
| Rate for Payer: Priority Health SBD |
$35.23
|
| Rate for Payer: UMR Bronson Commercial |
$24.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.94
|
|
|
HC CONVEX WAFER
|
Facility
|
OP
|
$55.92
|
|
| Hospital Charge Code |
27000049
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.69 |
| Max. Negotiated Rate |
$50.33 |
| Rate for Payer: Aetna American Axle |
$36.35
|
| Rate for Payer: Aetna Commercial |
$47.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.35
|
| Rate for Payer: BCBS Complete |
$22.37
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$39.14
|
| Rate for Payer: Cofinity Commercial |
$48.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Healthscope Commercial |
$50.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.53
|
| Rate for Payer: PHP Commercial |
$47.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.14
|
| Rate for Payer: Priority Health SBD |
$35.23
|
| Rate for Payer: UMR Bronson Commercial |
$20.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.94
|
|
|
HC COOK GUIDEWIRE
|
Facility
|
OP
|
$46.93
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200019
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.36 |
| Max. Negotiated Rate |
$42.24 |
| Rate for Payer: Aetna American Axle |
$30.50
|
| Rate for Payer: Aetna Commercial |
$39.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.50
|
| Rate for Payer: BCBS Complete |
$18.77
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Cofinity Commercial |
$40.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.54
|
| Rate for Payer: Healthscope Commercial |
$42.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.89
|
| Rate for Payer: PHP Commercial |
$39.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.85
|
| Rate for Payer: Priority Health SBD |
$29.57
|
| Rate for Payer: UMR Bronson Commercial |
$17.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.20
|
|
|
HC COOK GUIDEWIRE
|
Facility
|
IP
|
$46.93
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200019
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.65 |
| Max. Negotiated Rate |
$42.24 |
| Rate for Payer: Aetna American Axle |
$30.50
|
| Rate for Payer: Aetna Commercial |
$39.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.50
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Cofinity Commercial |
$40.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.54
|
| Rate for Payer: Healthscope Commercial |
$42.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.89
|
| Rate for Payer: PHP Commercial |
$39.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.85
|
| Rate for Payer: Priority Health SBD |
$29.57
|
| Rate for Payer: UMR Bronson Commercial |
$20.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.20
|
|
|
HC COOK PIGTAIL
|
Facility
|
OP
|
$459.14
|
|
| Hospital Charge Code |
27200233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$169.88 |
| Max. Negotiated Rate |
$413.23 |
| Rate for Payer: Aetna American Axle |
$298.44
|
| Rate for Payer: Aetna Commercial |
$390.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.44
|
| Rate for Payer: BCBS Complete |
$183.66
|
| Rate for Payer: Cash Price |
$367.31
|
| Rate for Payer: Cofinity Commercial |
$321.40
|
| Rate for Payer: Cofinity Commercial |
$394.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.31
|
| Rate for Payer: Healthscope Commercial |
$413.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$321.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$390.27
|
| Rate for Payer: PHP Commercial |
$390.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.40
|
| Rate for Payer: Priority Health SBD |
$289.26
|
| Rate for Payer: UMR Bronson Commercial |
$169.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.36
|
|
|
HC COOK PIGTAIL
|
Facility
|
IP
|
$459.14
|
|
| Hospital Charge Code |
27200233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.02 |
| Max. Negotiated Rate |
$413.23 |
| Rate for Payer: Aetna American Axle |
$298.44
|
| Rate for Payer: Aetna Commercial |
$390.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.44
|
| Rate for Payer: Cash Price |
$367.31
|
| Rate for Payer: Cofinity Commercial |
$321.40
|
| Rate for Payer: Cofinity Commercial |
$394.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.31
|
| Rate for Payer: Healthscope Commercial |
$413.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$321.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$390.27
|
| Rate for Payer: PHP Commercial |
$390.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.40
|
| Rate for Payer: Priority Health SBD |
$289.26
|
| Rate for Payer: UMR Bronson Commercial |
$202.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.36
|
|
|
HC COOLIEF RF PROBE
|
Facility
|
OP
|
$1,875.00
|
|
| Hospital Charge Code |
27200355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$693.75 |
| Max. Negotiated Rate |
$1,687.50 |
| Rate for Payer: Aetna American Axle |
$1,218.75
|
| Rate for Payer: Aetna Commercial |
$1,593.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,218.75
|
| Rate for Payer: BCBS Complete |
$750.00
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cofinity Commercial |
$1,312.50
|
| Rate for Payer: Cofinity Commercial |
$1,612.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,500.00
|
| Rate for Payer: Healthscope Commercial |
$1,687.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,312.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,406.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,593.75
|
| Rate for Payer: PHP Commercial |
$1,593.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,312.50
|
| Rate for Payer: Priority Health SBD |
$1,181.25
|
| Rate for Payer: UMR Bronson Commercial |
$693.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,406.25
|
|
|
HC COOLIEF RF PROBE
|
Facility
|
IP
|
$1,875.00
|
|
| Hospital Charge Code |
27200355
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$825.00 |
| Max. Negotiated Rate |
$1,687.50 |
| Rate for Payer: Aetna American Axle |
$1,218.75
|
| Rate for Payer: Aetna Commercial |
$1,593.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,218.75
|
| Rate for Payer: Cash Price |
$1,500.00
|
| Rate for Payer: Cofinity Commercial |
$1,312.50
|
| Rate for Payer: Cofinity Commercial |
$1,612.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,500.00
|
| Rate for Payer: Healthscope Commercial |
$1,687.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,312.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,406.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,593.75
|
| Rate for Payer: PHP Commercial |
$1,593.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,312.50
|
| Rate for Payer: Priority Health SBD |
$1,181.25
|
| Rate for Payer: UMR Bronson Commercial |
$825.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,406.25
|
|
|
HC COPPER SERUM
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.79 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Aetna American Axle |
$28.60
|
| Rate for Payer: Aetna Commercial |
$37.40
|
| Rate for Payer: Aetna Medicare |
$12.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.51
|
| Rate for Payer: BCBS Complete |
$7.13
|
| Rate for Payer: BCBS MAPPO |
$12.41
|
| Rate for Payer: BCBS Trust/PPO |
$11.16
|
| Rate for Payer: BCN Medicare Advantage |
$12.41
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$30.80
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.41
|
| Rate for Payer: Healthscope Commercial |
$39.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.00
|
| Rate for Payer: Mclaren Medicaid |
$6.79
|
| Rate for Payer: Mclaren Medicare |
$12.41
|
| Rate for Payer: Meridian Medicaid |
$7.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.40
|
| Rate for Payer: PACE Medicare |
$11.79
|
| Rate for Payer: PACE SWMI |
$12.41
|
| Rate for Payer: PHP Commercial |
$37.40
|
| Rate for Payer: PHP Medicare Advantage |
$12.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.02
|
| Rate for Payer: Priority Health Medicare |
$12.41
|
| Rate for Payer: Priority Health Narrow Network |
$13.62
|
| Rate for Payer: Priority Health SBD |
$27.72
|
| Rate for Payer: Railroad Medicare Medicare |
$12.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.89
|
| Rate for Payer: UHC Core |
$20.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.41
|
| Rate for Payer: UHC Exchange |
$12.41
|
| Rate for Payer: UHC Medicare Advantage |
$12.78
|
| Rate for Payer: UMR Bronson Commercial |
$16.28
|
| Rate for Payer: VA VA |
$12.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.00
|
|
|
HC COPPER SERUM
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
30100170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.36 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Aetna American Axle |
$28.60
|
| Rate for Payer: Aetna Commercial |
$37.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.60
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$30.80
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.20
|
| Rate for Payer: Healthscope Commercial |
$39.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.40
|
| Rate for Payer: PHP Commercial |
$37.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.80
|
| Rate for Payer: Priority Health SBD |
$27.72
|
| Rate for Payer: UMR Bronson Commercial |
$19.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.00
|
|
