|
HC DEBRIDE BONE FIRST 20 SQ CM OR LESS
|
Facility
|
IP
|
$2,165.56
|
|
|
Service Code
|
CPT 11044
|
| Hospital Charge Code |
45000070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$952.85 |
| Max. Negotiated Rate |
$1,949.00 |
| Rate for Payer: Aetna American Axle |
$1,407.61
|
| Rate for Payer: Aetna Commercial |
$1,840.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,407.61
|
| Rate for Payer: Cash Price |
$1,732.45
|
| Rate for Payer: Cofinity Commercial |
$1,515.89
|
| Rate for Payer: Cofinity Commercial |
$1,862.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,732.45
|
| Rate for Payer: Healthscope Commercial |
$1,949.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,515.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,624.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,840.73
|
| Rate for Payer: PHP Commercial |
$1,840.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,515.89
|
| Rate for Payer: Priority Health SBD |
$1,364.30
|
| Rate for Payer: UMR Bronson Commercial |
$952.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,624.17
|
|
|
HC DEBRIDE ECZEMTOUS/INFECT SKIN UP TO 10%
|
Facility
|
OP
|
$524.69
|
|
|
Service Code
|
CPT 11000
|
| Hospital Charge Code |
76100078
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$26.85 |
| Max. Negotiated Rate |
$1,757.43 |
| Rate for Payer: Aetna American Axle |
$341.05
|
| Rate for Payer: Aetna Commercial |
$445.99
|
| Rate for Payer: Aetna Medicare |
$580.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$697.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$697.82
|
| Rate for Payer: BCBS Complete |
$320.66
|
| Rate for Payer: BCBS MAPPO |
$558.26
|
| Rate for Payer: BCBS Trust/PPO |
$40.29
|
| Rate for Payer: BCN Medicare Advantage |
$558.26
|
| Rate for Payer: Cash Price |
$419.75
|
| Rate for Payer: Cash Price |
$419.75
|
| Rate for Payer: Cofinity Commercial |
$451.23
|
| Rate for Payer: Cofinity Commercial |
$367.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.26
|
| Rate for Payer: Healthscope Commercial |
$472.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$367.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.52
|
| Rate for Payer: Mclaren Medicaid |
$305.37
|
| Rate for Payer: Mclaren Medicare |
$558.26
|
| Rate for Payer: Meridian Medicaid |
$320.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$445.99
|
| Rate for Payer: PACE Medicare |
$530.35
|
| Rate for Payer: PACE SWMI |
$558.26
|
| Rate for Payer: PHP Commercial |
$445.99
|
| Rate for Payer: PHP Medicare Advantage |
$558.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,757.43
|
| Rate for Payer: Priority Health Medicare |
$558.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,405.94
|
| Rate for Payer: Priority Health SBD |
$330.55
|
| Rate for Payer: Railroad Medicare Medicare |
$558.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$558.26
|
| Rate for Payer: UHC Exchange |
$26.85
|
| Rate for Payer: UHC Medicare Advantage |
$575.01
|
| Rate for Payer: UMR Bronson Commercial |
$194.14
|
| Rate for Payer: VA VA |
$558.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.52
|
|
|
HC DEBRIDE ECZEMTOUS/INFECT SKIN UP TO 10%
|
Facility
|
IP
|
$524.69
|
|
|
Service Code
|
CPT 11000
|
| Hospital Charge Code |
76100078
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$230.86 |
| Max. Negotiated Rate |
$472.22 |
| Rate for Payer: Aetna American Axle |
$341.05
|
| Rate for Payer: Aetna Commercial |
$445.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.05
|
| Rate for Payer: Cash Price |
$419.75
|
| Rate for Payer: Cofinity Commercial |
$367.28
|
| Rate for Payer: Cofinity Commercial |
$451.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.75
|
| Rate for Payer: Healthscope Commercial |
$472.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$367.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$445.99
|
| Rate for Payer: PHP Commercial |
$445.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.28
|
| Rate for Payer: Priority Health SBD |
$330.55
|
| Rate for Payer: UMR Bronson Commercial |
$230.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.52
|
|
|
HC DEBRIDE MASTOIDECTOMY CAVITY CMPLX
|
Facility
|
OP
|
$1,316.00
|
|
|
Service Code
|
CPT 69222
|
| Hospital Charge Code |
76100483
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$135.56 |
| 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 |
$206.46
|
| 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) |
$149.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$489.06
|
| Rate for Payer: UHC Exchange |
$135.56
|
| 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 DEBRIDE MASTOIDECTOMY CAVITY CMPLX
|
Facility
|
IP
|
$1,316.00
|
|
|
Service Code
|
CPT 69222
|
| Hospital Charge Code |
76100483
|
|
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 DEBRIDEMENT BONE EACH ADDL 20 SQ CM
|
Facility
|
IP
|
$1,624.71
|
|
|
Service Code
|
CPT 11047
|
| Hospital Charge Code |
76100034
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$714.87 |
| Max. Negotiated Rate |
$1,462.24 |
| Rate for Payer: Aetna American Axle |
$1,056.06
|
| Rate for Payer: Aetna Commercial |
$1,381.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,056.06
|
| Rate for Payer: Cash Price |
$1,299.77
|
| Rate for Payer: Cofinity Commercial |
$1,137.30
|
| Rate for Payer: Cofinity Commercial |
$1,397.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,299.77
|
| Rate for Payer: Healthscope Commercial |
$1,462.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,137.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,218.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,381.00
|
| Rate for Payer: PHP Commercial |
$1,381.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,137.30
|
| Rate for Payer: Priority Health SBD |
$1,023.57
|
| Rate for Payer: UMR Bronson Commercial |
$714.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,218.53
|
|
|
HC DEBRIDEMENT BONE EACH ADDL 20 SQ CM
|
Facility
|
OP
|
$1,624.71
|
|
|
Service Code
|
CPT 11047
|
| Hospital Charge Code |
76100034
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$94.30 |
| Max. Negotiated Rate |
$1,462.24 |
| Rate for Payer: Aetna American Axle |
$1,056.06
|
| Rate for Payer: Aetna Commercial |
$1,381.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,056.06
|
| Rate for Payer: BCBS Complete |
$649.88
|
| Rate for Payer: BCBS Trust/PPO |
$427.66
|
| Rate for Payer: Cash Price |
$1,299.77
|
| Rate for Payer: Cash Price |
$1,299.77
|
| Rate for Payer: Cofinity Commercial |
$1,397.25
|
| Rate for Payer: Cofinity Commercial |
$1,137.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,299.77
|
| Rate for Payer: Healthscope Commercial |
$1,462.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,137.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,218.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,381.00
|
| Rate for Payer: PHP Commercial |
$1,381.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,137.30
|
| Rate for Payer: Priority Health SBD |
$1,023.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.73
|
| Rate for Payer: UHC Exchange |
$94.30
|
| Rate for Payer: UMR Bronson Commercial |
$601.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,218.53
|
|
|
HC DEBRIDEMENT EA ADDL GT 20 SQ CM
|
Facility
|
OP
|
$368.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
42000036
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8.90 |
| Max. Negotiated Rate |
$331.20 |
| Rate for Payer: Aetna American Axle |
$239.20
|
| Rate for Payer: Aetna Commercial |
$312.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.20
|
| Rate for Payer: BCBS Complete |
$147.20
|
| Rate for Payer: BCBS Trust/PPO |
$84.33
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cofinity Commercial |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$316.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.40
|
| Rate for Payer: Healthscope Commercial |
$331.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$257.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.80
|
| Rate for Payer: PHP Commercial |
$312.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.13
|
| Rate for Payer: Priority Health Narrow Network |
$8.90
|
| Rate for Payer: Priority Health SBD |
$231.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.29
|
| Rate for Payer: UHC Exchange |
$23.90
|
| Rate for Payer: UMR Bronson Commercial |
$136.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.00
|
|
|
HC DEBRIDEMENT EA ADDL GT 20 SQ CM
|
Facility
|
IP
|
$368.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
42000036
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$161.92 |
| Max. Negotiated Rate |
$331.20 |
| Rate for Payer: Aetna American Axle |
$239.20
|
| Rate for Payer: Aetna Commercial |
$312.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.20
|
| Rate for Payer: Cash Price |
$294.40
|
| Rate for Payer: Cofinity Commercial |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$316.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.40
|
| Rate for Payer: Healthscope Commercial |
$331.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$257.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.80
|
| Rate for Payer: PHP Commercial |
$312.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.60
|
| Rate for Payer: Priority Health SBD |
$231.84
|
| Rate for Payer: UMR Bronson Commercial |
$161.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.00
|
|
|
HC DEBRIDEMENT FIRST 20 SQ CM
|
Facility
|
OP
|
$375.36
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
42000035
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$18.95 |
| Max. Negotiated Rate |
$337.82 |
| Rate for Payer: Aetna American Axle |
$243.98
|
| Rate for Payer: Aetna Commercial |
$319.06
|
| Rate for Payer: Aetna Medicare |
$185.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$158.22
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Commercial |
$262.75
|
| Rate for Payer: Cofinity Commercial |
$322.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$337.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$262.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.52
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$319.06
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$319.06
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.69
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$18.95
|
| Rate for Payer: Priority Health SBD |
$236.48
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.95
|
| Rate for Payer: UHC Exchange |
$34.38
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: UMR Bronson Commercial |
$138.88
|
| Rate for Payer: VA VA |
$177.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.52
|
|
|
HC DEBRIDEMENT FIRST 20 SQ CM
|
Facility
|
IP
|
$375.36
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
42000035
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$165.16 |
| Max. Negotiated Rate |
$337.82 |
| Rate for Payer: Aetna American Axle |
$243.98
|
| Rate for Payer: Aetna Commercial |
$319.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.98
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Commercial |
$262.75
|
| Rate for Payer: Cofinity Commercial |
$322.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Healthscope Commercial |
$337.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$262.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$319.06
|
| Rate for Payer: PHP Commercial |
$319.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.75
|
| Rate for Payer: Priority Health SBD |
$236.48
|
| Rate for Payer: UMR Bronson Commercial |
$165.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.52
|
|
|
HC DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE
|
Facility
|
IP
|
$510.00
|
|
|
Service Code
|
CPT 69220
|
| Hospital Charge Code |
76100376
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$224.40 |
| Max. Negotiated Rate |
$459.00 |
| Rate for Payer: Aetna American Axle |
$331.50
|
| Rate for Payer: Aetna Commercial |
$433.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.50
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$357.00
|
| Rate for Payer: Cofinity Commercial |
$438.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.00
|
| Rate for Payer: Healthscope Commercial |
$459.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$357.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$433.50
|
| Rate for Payer: PHP Commercial |
$433.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.00
|
| Rate for Payer: Priority Health SBD |
$321.30
|
| Rate for Payer: UMR Bronson Commercial |
$224.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.50
|
|
|
HC DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE
|
Facility
|
OP
|
$510.00
|
|
|
Service Code
|
CPT 69220
|
| Hospital Charge Code |
76100376
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$50.43 |
| Max. Negotiated Rate |
$560.20 |
| Rate for Payer: Aetna American Axle |
$331.50
|
| Rate for Payer: Aetna Commercial |
$433.50
|
| Rate for Payer: Aetna Medicare |
$185.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$100.76
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cash Price |
$408.00
|
| Rate for Payer: Cofinity Commercial |
$357.00
|
| Rate for Payer: Cofinity Commercial |
$438.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$459.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$357.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.50
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$433.50
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$433.50
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.20
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$448.16
|
| Rate for Payer: Priority Health SBD |
$321.30
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.95
|
| Rate for Payer: UHC Exchange |
$50.43
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: UMR Bronson Commercial |
$188.70
|
| Rate for Payer: VA VA |
$177.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.50
|
|
|
HC DEBRIDEMENT MUSCLE EACH ADDL 20 SQ CM
|
Facility
|
IP
|
$834.46
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
76100033
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.16 |
| Max. Negotiated Rate |
$751.01 |
| Rate for Payer: Aetna American Axle |
$542.40
|
| Rate for Payer: Aetna Commercial |
$709.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$542.40
|
| Rate for Payer: Cash Price |
$667.57
|
| Rate for Payer: Cofinity Commercial |
$584.12
|
| Rate for Payer: Cofinity Commercial |
$717.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.57
|
| Rate for Payer: Healthscope Commercial |
$751.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$584.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$625.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$709.29
|
| Rate for Payer: PHP Commercial |
$709.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$584.12
|
| Rate for Payer: Priority Health SBD |
$525.71
|
| Rate for Payer: UMR Bronson Commercial |
$367.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$625.84
|
|
|
HC DEBRIDEMENT MUSCLE EACH ADDL 20 SQ CM
|
Facility
|
OP
|
$834.46
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
76100033
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$53.37 |
| Max. Negotiated Rate |
$751.01 |
| Rate for Payer: Aetna American Axle |
$542.40
|
| Rate for Payer: Aetna Commercial |
$709.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$542.40
|
| Rate for Payer: BCBS Complete |
$333.78
|
| Rate for Payer: BCBS Trust/PPO |
$251.78
|
| Rate for Payer: Cash Price |
$667.57
|
| Rate for Payer: Cash Price |
$667.57
|
| Rate for Payer: Cofinity Commercial |
$584.12
|
| Rate for Payer: Cofinity Commercial |
$717.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$667.57
|
| Rate for Payer: Healthscope Commercial |
$751.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$584.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$625.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$709.29
|
| Rate for Payer: PHP Commercial |
$709.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$584.12
|
| Rate for Payer: Priority Health SBD |
$525.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.71
|
| Rate for Payer: UHC Exchange |
$53.37
|
| Rate for Payer: UMR Bronson Commercial |
$308.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$625.84
|
|
|
HC DEBRIDEMENT OF 1-5 NAILS
|
Facility
|
IP
|
$92.57
|
|
|
Service Code
|
CPT 11720
|
| Hospital Charge Code |
76100043
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$40.73 |
| Max. Negotiated Rate |
$83.31 |
| Rate for Payer: Aetna American Axle |
$60.17
|
| Rate for Payer: Aetna Commercial |
$78.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.17
|
| Rate for Payer: Cash Price |
$74.06
|
| Rate for Payer: Cofinity Commercial |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$79.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.06
|
| Rate for Payer: Healthscope Commercial |
$83.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.68
|
| Rate for Payer: PHP Commercial |
$78.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.80
|
| Rate for Payer: Priority Health SBD |
$58.32
|
| Rate for Payer: UMR Bronson Commercial |
$40.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.43
|
|
|
HC DEBRIDEMENT OF 1-5 NAILS
|
Facility
|
OP
|
$92.57
|
|
|
Service Code
|
CPT 11720
|
| Hospital Charge Code |
76100043
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$171.15 |
| Rate for Payer: Aetna American Axle |
$60.17
|
| Rate for Payer: Aetna Commercial |
$78.68
|
| Rate for Payer: Aetna Medicare |
$56.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.17
|
| 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 |
$49.33
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$74.06
|
| Rate for Payer: Cash Price |
$74.06
|
| Rate for Payer: Cofinity Commercial |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$79.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$83.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.43
|
| 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 |
$78.68
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$78.68
|
| 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 |
$64.80
|
| 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 |
$58.32
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.37
|
| Rate for Payer: UHC Exchange |
$13.75
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: UMR Bronson Commercial |
$34.25
|
| Rate for Payer: VA VA |
$54.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.43
|
|
|
HC DEBRIDEMENT OF 6 OR MORE NAILS
|
Facility
|
IP
|
$112.22
|
|
|
Service Code
|
CPT 11721
|
| Hospital Charge Code |
76100044
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.38 |
| Max. Negotiated Rate |
$101.00 |
| Rate for Payer: Aetna American Axle |
$72.94
|
| Rate for Payer: Aetna Commercial |
$95.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.94
|
| Rate for Payer: Cash Price |
$89.78
|
| Rate for Payer: Cofinity Commercial |
$78.55
|
| Rate for Payer: Cofinity Commercial |
$96.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.78
|
| Rate for Payer: Healthscope Commercial |
$101.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$95.39
|
| Rate for Payer: PHP Commercial |
$95.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.55
|
| Rate for Payer: Priority Health SBD |
$70.70
|
| Rate for Payer: UMR Bronson Commercial |
$49.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.16
|
|
|
HC DEBRIDEMENT OF 6 OR MORE NAILS
|
Facility
|
OP
|
$112.22
|
|
|
Service Code
|
CPT 11721
|
| Hospital Charge Code |
76100044
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$22.92 |
| Max. Negotiated Rate |
$171.15 |
| Rate for Payer: Aetna American Axle |
$72.94
|
| Rate for Payer: Aetna Commercial |
$95.39
|
| Rate for Payer: Aetna Medicare |
$56.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.94
|
| 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 |
$80.48
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$89.78
|
| Rate for Payer: Cash Price |
$89.78
|
| Rate for Payer: Cofinity Commercial |
$78.55
|
| Rate for Payer: Cofinity Commercial |
$96.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$101.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.16
|
| 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 |
$95.39
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$95.39
|
| 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 |
$78.55
|
| 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 |
$70.70
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.37
|
| Rate for Payer: UHC Exchange |
$22.92
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: UMR Bronson Commercial |
$41.52
|
| Rate for Payer: VA VA |
$54.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.16
|
|
|
HC DEBRIDE MUSCLE FASCIA FIRST 20 SQ CM OR LESS
|
Facility
|
IP
|
$1,091.56
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
76100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$480.29 |
| Max. Negotiated Rate |
$982.40 |
| Rate for Payer: Aetna American Axle |
$709.51
|
| Rate for Payer: Aetna Commercial |
$927.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.51
|
| Rate for Payer: Cash Price |
$873.25
|
| Rate for Payer: Cofinity Commercial |
$764.09
|
| Rate for Payer: Cofinity Commercial |
$938.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.25
|
| Rate for Payer: Healthscope Commercial |
$982.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$764.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$818.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$927.83
|
| Rate for Payer: PHP Commercial |
$927.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.09
|
| Rate for Payer: Priority Health SBD |
$687.68
|
| Rate for Payer: UMR Bronson Commercial |
$480.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$818.67
|
|
|
HC DEBRIDE MUSCLE FASCIA FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$1,091.56
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
76100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$149.97 |
| Max. Negotiated Rate |
$1,757.43 |
| Rate for Payer: Aetna American Axle |
$709.51
|
| Rate for Payer: Aetna Commercial |
$927.83
|
| Rate for Payer: Aetna Medicare |
$580.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$697.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$697.82
|
| Rate for Payer: BCBS Complete |
$320.66
|
| Rate for Payer: BCBS MAPPO |
$558.26
|
| Rate for Payer: BCBS Trust/PPO |
$714.71
|
| Rate for Payer: BCN Medicare Advantage |
$558.26
|
| Rate for Payer: Cash Price |
$873.25
|
| Rate for Payer: Cash Price |
$873.25
|
| Rate for Payer: Cofinity Commercial |
$764.09
|
| Rate for Payer: Cofinity Commercial |
$938.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.26
|
| Rate for Payer: Healthscope Commercial |
$982.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$764.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$818.67
|
| Rate for Payer: Mclaren Medicaid |
$305.37
|
| Rate for Payer: Mclaren Medicare |
$558.26
|
| Rate for Payer: Meridian Medicaid |
$320.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$927.83
|
| Rate for Payer: PACE Medicare |
$530.35
|
| Rate for Payer: PACE SWMI |
$558.26
|
| Rate for Payer: PHP Commercial |
$927.83
|
| Rate for Payer: PHP Medicare Advantage |
$558.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,757.43
|
| Rate for Payer: Priority Health Medicare |
$558.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,405.94
|
| Rate for Payer: Priority Health SBD |
$687.68
|
| Rate for Payer: Railroad Medicare Medicare |
$558.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$558.26
|
| Rate for Payer: UHC Exchange |
$149.97
|
| Rate for Payer: UHC Medicare Advantage |
$575.01
|
| Rate for Payer: UMR Bronson Commercial |
$403.88
|
| Rate for Payer: VA VA |
$558.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$818.67
|
|
|
HC DEBRIDE SKIN AT FX SITE
|
Facility
|
IP
|
$1,850.00
|
|
|
Service Code
|
CPT 11010
|
| Hospital Charge Code |
76100390
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$814.00 |
| Max. Negotiated Rate |
$1,665.00 |
| Rate for Payer: Aetna American Axle |
$1,202.50
|
| Rate for Payer: Aetna Commercial |
$1,572.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,202.50
|
| Rate for Payer: Cash Price |
$1,480.00
|
| Rate for Payer: Cofinity Commercial |
$1,295.00
|
| Rate for Payer: Cofinity Commercial |
$1,591.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,480.00
|
| Rate for Payer: Healthscope Commercial |
$1,665.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,295.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,387.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,572.50
|
| Rate for Payer: PHP Commercial |
$1,572.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,295.00
|
| Rate for Payer: Priority Health SBD |
$1,165.50
|
| Rate for Payer: UMR Bronson Commercial |
$814.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,387.50
|
|
|
HC DEBRIDE SKIN AT FX SITE
|
Facility
|
OP
|
$1,850.00
|
|
|
Service Code
|
CPT 11010
|
| Hospital Charge Code |
76100390
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$270.47 |
| Max. Negotiated Rate |
$1,968.76 |
| Rate for Payer: Aetna American Axle |
$1,202.50
|
| Rate for Payer: Aetna Commercial |
$1,572.50
|
| Rate for Payer: Aetna Medicare |
$650.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,202.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$586.35
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$1,480.00
|
| Rate for Payer: Cash Price |
$1,480.00
|
| Rate for Payer: Cofinity Commercial |
$1,295.00
|
| Rate for Payer: Cofinity Commercial |
$1,591.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,480.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$1,665.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,295.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,387.50
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,572.50
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$1,572.50
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,295.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.76
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.01
|
| Rate for Payer: Priority Health SBD |
$1,165.50
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.39
|
| Rate for Payer: UHC Exchange |
$270.47
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: UMR Bronson Commercial |
$684.50
|
| Rate for Payer: VA VA |
$625.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,387.50
|
|
|
HC DEBRIDE SKIN BONE AT FX SITE
|
Facility
|
IP
|
$4,000.00
|
|
|
Service Code
|
CPT 11012
|
| Hospital Charge Code |
76100391
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,760.00 |
| Max. Negotiated Rate |
$3,600.00 |
| Rate for Payer: Aetna American Axle |
$2,600.00
|
| Rate for Payer: Aetna Commercial |
$3,400.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,600.00
|
| Rate for Payer: Cash Price |
$3,200.00
|
| Rate for Payer: Cofinity Commercial |
$2,800.00
|
| Rate for Payer: Cofinity Commercial |
$3,440.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,200.00
|
| Rate for Payer: Healthscope Commercial |
$3,600.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,800.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,400.00
|
| Rate for Payer: PHP Commercial |
$3,400.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,800.00
|
| Rate for Payer: Priority Health SBD |
$2,520.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,760.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,000.00
|
|
|
HC DEBRIDE SKIN BONE AT FX SITE
|
Facility
|
OP
|
$4,000.00
|
|
|
Service Code
|
CPT 11012
|
| Hospital Charge Code |
76100391
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$406.03 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$2,600.00
|
| Rate for Payer: Aetna Commercial |
$3,400.00
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,600.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,531.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$3,200.00
|
| Rate for Payer: Cash Price |
$3,200.00
|
| Rate for Payer: Cofinity Commercial |
$3,440.00
|
| Rate for Payer: Cofinity Commercial |
$2,800.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,200.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$3,600.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,800.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,000.00
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,400.00
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$3,400.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,800.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Priority Health SBD |
$2,520.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$446.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$406.03
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,480.00
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,000.00
|
|
