HC DEMO EVAL NEB MDI IPPB
|
Facility
|
IP
|
$240.13
|
|
Service Code
|
CPT 94664
|
Hospital Charge Code |
41000009
|
Hospital Revenue Code
|
410
|
Min. Negotiated Rate |
$105.66 |
Max. Negotiated Rate |
$216.12 |
Rate for Payer: Aetna American Axle |
$156.08
|
Rate for Payer: Aetna Commercial |
$204.11
|
Rate for Payer: Aetna New Business (MI Preferred) |
$156.08
|
Rate for Payer: Cash Price |
$192.10
|
Rate for Payer: Cofinity Commercial |
$168.09
|
Rate for Payer: Cofinity Commercial |
$206.51
|
Rate for Payer: Encore Health Key Benefits Commercial |
$192.10
|
Rate for Payer: Healthscope Commercial |
$216.12
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.09
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.10
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$204.11
|
Rate for Payer: PHP Commercial |
$204.11
|
Rate for Payer: Priority Health Cigna Priority Health |
$168.09
|
Rate for Payer: Priority Health SBD |
$151.28
|
Rate for Payer: UMR Bronson Commercial |
$105.66
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.10
|
|
HC DEMO HOME USE INR MONITOR
|
Facility
|
OP
|
$555.42
|
|
Service Code
|
HCPCS G0248
|
Hospital Charge Code |
51000042
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$64.27 |
Max. Negotiated Rate |
$499.88 |
Rate for Payer: Aetna American Axle |
$361.02
|
Rate for Payer: Aetna Commercial |
$472.11
|
Rate for Payer: Aetna Medicare |
$122.20
|
Rate for Payer: Aetna New Business (MI Preferred) |
$361.02
|
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 |
$480.89
|
Rate for Payer: BCN Medicare Advantage |
$117.50
|
Rate for Payer: Cash Price |
$444.34
|
Rate for Payer: Cash Price |
$444.34
|
Rate for Payer: Cofinity Commercial |
$477.66
|
Rate for Payer: Cofinity Commercial |
$388.79
|
Rate for Payer: Encore Health Key Benefits Commercial |
$444.34
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.50
|
Rate for Payer: Healthscope Commercial |
$499.88
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$388.79
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$416.56
|
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 |
$472.11
|
Rate for Payer: PACE Medicare |
$111.62
|
Rate for Payer: PACE SWMI |
$117.50
|
Rate for Payer: PHP Commercial |
$472.11
|
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 |
$388.79
|
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 |
$349.91
|
Rate for Payer: Railroad Medicare Medicare |
$117.50
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$108.05
|
Rate for Payer: UHC Dual Complete DSNP |
$117.50
|
Rate for Payer: UHC Exchange |
$98.23
|
Rate for Payer: UHC Medicare Advantage |
$121.02
|
Rate for Payer: UMR Bronson Commercial |
$205.51
|
Rate for Payer: VA VA |
$117.50
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$416.56
|
|
HC DEMO HOME USE INR MONITOR
|
Facility
|
IP
|
$555.42
|
|
Service Code
|
HCPCS G0248
|
Hospital Charge Code |
51000042
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$244.38 |
Max. Negotiated Rate |
$499.88 |
Rate for Payer: Aetna American Axle |
$361.02
|
Rate for Payer: Aetna Commercial |
$472.11
|
Rate for Payer: Aetna New Business (MI Preferred) |
$361.02
|
Rate for Payer: Cash Price |
$444.34
|
Rate for Payer: Cofinity Commercial |
$388.79
|
Rate for Payer: Cofinity Commercial |
$477.66
|
Rate for Payer: Encore Health Key Benefits Commercial |
$444.34
|
Rate for Payer: Healthscope Commercial |
$499.88
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$388.79
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$416.56
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$472.11
|
Rate for Payer: PHP Commercial |
$472.11
|
Rate for Payer: Priority Health Cigna Priority Health |
$388.79
|
Rate for Payer: Priority Health SBD |
$349.91
|
Rate for Payer: UMR Bronson Commercial |
$244.38
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$416.56
|
|
HC DENTAL NERVE BLOCK TRIGEMINAL
|
Facility
|
IP
|
$484.32
|
|
Service Code
|
CPT 64400
|
Hospital Charge Code |
45000014
|
Hospital Revenue Code
|
450
|
Min. Negotiated Rate |
$213.10 |
Max. Negotiated Rate |
$435.89 |
Rate for Payer: Aetna American Axle |
$314.81
|
Rate for Payer: Aetna Commercial |
$411.67
|
Rate for Payer: Aetna New Business (MI Preferred) |
$314.81
|
Rate for Payer: Cash Price |
$387.46
|
Rate for Payer: Cofinity Commercial |
$339.02
|
Rate for Payer: Cofinity Commercial |
$416.52
|
Rate for Payer: Encore Health Key Benefits Commercial |
$387.46
|
Rate for Payer: Healthscope Commercial |
$435.89
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$339.02
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.24
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$411.67
|
Rate for Payer: PHP Commercial |
$411.67
|
Rate for Payer: Priority Health Cigna Priority Health |
$339.02
|
Rate for Payer: Priority Health SBD |
$305.12
|
Rate for Payer: UMR Bronson Commercial |
$213.10
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.24
|
|
HC DENTAL NERVE BLOCK TRIGEMINAL
|
Facility
|
OP
|
$484.32
|
|
Service Code
|
CPT 64400
|
Hospital Charge Code |
45000014
|
Hospital Revenue Code
|
450
|
Min. Negotiated Rate |
$50.75 |
Max. Negotiated Rate |
$828.79 |
Rate for Payer: Aetna American Axle |
$314.81
|
Rate for Payer: Aetna Commercial |
$411.67
|
Rate for Payer: Aetna Medicare |
$273.80
|
Rate for Payer: Aetna New Business (MI Preferred) |
$314.81
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
Rate for Payer: BCBS Complete |
$151.22
|
Rate for Payer: BCBS MAPPO |
$263.27
|
Rate for Payer: BCBS Trust/PPO |
$290.76
|
Rate for Payer: BCN Medicare Advantage |
$263.27
|
Rate for Payer: Cash Price |
$387.46
|
Rate for Payer: Cash Price |
$387.46
|
Rate for Payer: Cofinity Commercial |
$416.52
|
Rate for Payer: Cofinity Commercial |
$339.02
|
Rate for Payer: Encore Health Key Benefits Commercial |
$387.46
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
Rate for Payer: Healthscope Commercial |
$435.89
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$339.02
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.24
|
Rate for Payer: Mclaren Medicaid |
$144.01
|
Rate for Payer: Mclaren Medicare |
$263.27
|
Rate for Payer: Meridian Medicaid |
$151.22
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$411.67
|
Rate for Payer: PACE Medicare |
$250.11
|
Rate for Payer: PACE SWMI |
$263.27
|
Rate for Payer: PHP Commercial |
$411.67
|
Rate for Payer: PHP Medicare Advantage |
$263.27
|
Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
Rate for Payer: Priority Health Cigna Priority Health |
$339.02
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$828.79
|
Rate for Payer: Priority Health Medicare |
$263.27
|
Rate for Payer: Priority Health Narrow Network |
$663.03
|
Rate for Payer: Priority Health SBD |
$305.12
|
Rate for Payer: Railroad Medicare Medicare |
$263.27
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$55.82
|
Rate for Payer: UHC Dual Complete DSNP |
$263.27
|
Rate for Payer: UHC Exchange |
$50.75
|
Rate for Payer: UHC Medicare Advantage |
$271.17
|
Rate for Payer: UMR Bronson Commercial |
$179.20
|
Rate for Payer: VA VA |
$263.27
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.24
|
|
HC DERMAGRAFT PER SQ CM
|
Facility
|
OP
|
$83.88
|
|
Service Code
|
HCPCS Q4106
|
Hospital Charge Code |
63600004
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$31.04 |
Max. Negotiated Rate |
$3,899.37 |
Rate for Payer: Aetna American Axle |
$54.52
|
Rate for Payer: Aetna Commercial |
$71.30
|
Rate for Payer: Aetna New Business (MI Preferred) |
$54.52
|
Rate for Payer: BCBS Complete |
$33.55
|
Rate for Payer: BCBS Trust/PPO |
$3,899.37
|
Rate for Payer: Cash Price |
$67.10
|
Rate for Payer: Cash Price |
$67.10
|
Rate for Payer: Cofinity Commercial |
$58.72
|
Rate for Payer: Cofinity Commercial |
$72.14
|
Rate for Payer: Encore Health Key Benefits Commercial |
$67.10
|
Rate for Payer: Healthscope Commercial |
$75.49
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.72
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.91
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.30
|
Rate for Payer: PHP Commercial |
$71.30
|
Rate for Payer: Priority Health Cigna Priority Health |
$58.72
|
Rate for Payer: Priority Health SBD |
$52.84
|
Rate for Payer: UMR Bronson Commercial |
$31.04
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.91
|
|
HC DERMAGRAFT PER SQ CM
|
Facility
|
IP
|
$83.88
|
|
Service Code
|
HCPCS Q4106
|
Hospital Charge Code |
63600004
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$36.91 |
Max. Negotiated Rate |
$75.49 |
Rate for Payer: Aetna American Axle |
$54.52
|
Rate for Payer: Aetna Commercial |
$71.30
|
Rate for Payer: Aetna New Business (MI Preferred) |
$54.52
|
Rate for Payer: Cash Price |
$67.10
|
Rate for Payer: Cofinity Commercial |
$58.72
|
Rate for Payer: Cofinity Commercial |
$72.14
|
Rate for Payer: Encore Health Key Benefits Commercial |
$67.10
|
Rate for Payer: Healthscope Commercial |
$75.49
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.72
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.91
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.30
|
Rate for Payer: PHP Commercial |
$71.30
|
Rate for Payer: Priority Health Cigna Priority Health |
$58.72
|
Rate for Payer: Priority Health SBD |
$52.84
|
Rate for Payer: UMR Bronson Commercial |
$36.91
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.91
|
|
HC DES ADD.BRANCH
|
Facility
|
OP
|
$16,677.03
|
|
Service Code
|
CPT C9601
|
Hospital Charge Code |
48100076
|
Hospital Revenue Code
|
481
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$15,009.33 |
Rate for Payer: Aetna American Axle |
$10,840.07
|
Rate for Payer: Aetna Commercial |
$14,175.48
|
Rate for Payer: Aetna New Business (MI Preferred) |
$10,840.07
|
Rate for Payer: BCBS Complete |
$6,670.81
|
Rate for Payer: BCBS Trust/PPO |
$0.01
|
Rate for Payer: Cash Price |
$13,341.62
|
Rate for Payer: Cash Price |
$13,341.62
|
Rate for Payer: Cofinity Commercial |
$14,342.25
|
Rate for Payer: Cofinity Commercial |
$11,673.92
|
Rate for Payer: Encore Health Key Benefits Commercial |
$13,341.62
|
Rate for Payer: Healthscope Commercial |
$15,009.33
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,673.92
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,507.77
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,175.48
|
Rate for Payer: PHP Commercial |
$14,175.48
|
Rate for Payer: Priority Health Cigna Priority Health |
$11,673.92
|
Rate for Payer: Priority Health SBD |
$10,506.53
|
Rate for Payer: UHC Core |
$700.00
|
Rate for Payer: UMR Bronson Commercial |
$6,170.50
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,507.77
|
|
HC DES ADD.BRANCH
|
Facility
|
IP
|
$16,677.03
|
|
Service Code
|
CPT C9601
|
Hospital Charge Code |
48100076
|
Hospital Revenue Code
|
481
|
Min. Negotiated Rate |
$7,337.89 |
Max. Negotiated Rate |
$15,009.33 |
Rate for Payer: Aetna American Axle |
$10,840.07
|
Rate for Payer: Aetna Commercial |
$14,175.48
|
Rate for Payer: Aetna New Business (MI Preferred) |
$10,840.07
|
Rate for Payer: Cash Price |
$13,341.62
|
Rate for Payer: Cofinity Commercial |
$11,673.92
|
Rate for Payer: Cofinity Commercial |
$14,342.25
|
Rate for Payer: Encore Health Key Benefits Commercial |
$13,341.62
|
Rate for Payer: Healthscope Commercial |
$15,009.33
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,673.92
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,507.77
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,175.48
|
Rate for Payer: PHP Commercial |
$14,175.48
|
Rate for Payer: Priority Health Cigna Priority Health |
$11,673.92
|
Rate for Payer: Priority Health SBD |
$10,506.53
|
Rate for Payer: UMR Bronson Commercial |
$7,337.89
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,507.77
|
|
HC DESTR LESION ROOF OF MOUTH
|
Facility
|
OP
|
$7,950.00
|
|
Service Code
|
CPT 42160
|
Hospital Charge Code |
76100393
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$139.16 |
Max. Negotiated Rate |
$9,009.23 |
Rate for Payer: Aetna American Axle |
$5,167.50
|
Rate for Payer: Aetna Commercial |
$6,757.50
|
Rate for Payer: Aetna Medicare |
$2,976.31
|
Rate for Payer: Aetna New Business (MI Preferred) |
$5,167.50
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
Rate for Payer: BCBS Complete |
$1,643.84
|
Rate for Payer: BCBS MAPPO |
$2,861.84
|
Rate for Payer: BCBS Trust/PPO |
$206.91
|
Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
Rate for Payer: Cash Price |
$6,360.00
|
Rate for Payer: Cash Price |
$6,360.00
|
Rate for Payer: Cofinity Commercial |
$5,565.00
|
Rate for Payer: Cofinity Commercial |
$6,837.00
|
Rate for Payer: Encore Health Key Benefits Commercial |
$6,360.00
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
Rate for Payer: Healthscope Commercial |
$7,155.00
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,565.00
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,962.50
|
Rate for Payer: Mclaren Medicaid |
$1,565.43
|
Rate for Payer: Mclaren Medicare |
$2,861.84
|
Rate for Payer: Meridian Medicaid |
$1,643.84
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,757.50
|
Rate for Payer: PACE Medicare |
$2,718.75
|
Rate for Payer: PACE SWMI |
$2,861.84
|
Rate for Payer: PHP Commercial |
$6,757.50
|
Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
Rate for Payer: Priority Health Cigna Priority Health |
$5,565.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,009.23
|
Rate for Payer: Priority Health Medicare |
$2,861.84
|
Rate for Payer: Priority Health Narrow Network |
$7,207.38
|
Rate for Payer: Priority Health SBD |
$5,008.50
|
Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$153.08
|
Rate for Payer: UHC Dual Complete DSNP |
$2,861.84
|
Rate for Payer: UHC Exchange |
$139.16
|
Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
Rate for Payer: UMR Bronson Commercial |
$2,941.50
|
Rate for Payer: VA VA |
$2,861.84
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,962.50
|
|
HC DESTR LESION ROOF OF MOUTH
|
Facility
|
IP
|
$7,950.00
|
|
Service Code
|
CPT 42160
|
Hospital Charge Code |
76100393
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$3,498.00 |
Max. Negotiated Rate |
$7,155.00 |
Rate for Payer: Aetna American Axle |
$5,167.50
|
Rate for Payer: Aetna Commercial |
$6,757.50
|
Rate for Payer: Aetna New Business (MI Preferred) |
$5,167.50
|
Rate for Payer: Cash Price |
$6,360.00
|
Rate for Payer: Cofinity Commercial |
$5,565.00
|
Rate for Payer: Cofinity Commercial |
$6,837.00
|
Rate for Payer: Encore Health Key Benefits Commercial |
$6,360.00
|
Rate for Payer: Healthscope Commercial |
$7,155.00
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,565.00
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,962.50
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,757.50
|
Rate for Payer: PHP Commercial |
$6,757.50
|
Rate for Payer: Priority Health Cigna Priority Health |
$5,565.00
|
Rate for Payer: Priority Health SBD |
$5,008.50
|
Rate for Payer: UMR Bronson Commercial |
$3,498.00
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,962.50
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM <0.6 CM
|
Facility
|
IP
|
$237.86
|
|
Service Code
|
CPT 17280
|
Hospital Charge Code |
76100155
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$104.66 |
Max. Negotiated Rate |
$214.07 |
Rate for Payer: Aetna American Axle |
$154.61
|
Rate for Payer: Aetna Commercial |
$202.18
|
Rate for Payer: Aetna New Business (MI Preferred) |
$154.61
|
Rate for Payer: Cash Price |
$190.29
|
Rate for Payer: Cofinity Commercial |
$166.50
|
Rate for Payer: Cofinity Commercial |
$204.56
|
Rate for Payer: Encore Health Key Benefits Commercial |
$190.29
|
Rate for Payer: Healthscope Commercial |
$214.07
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$166.50
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.40
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$202.18
|
Rate for Payer: PHP Commercial |
$202.18
|
Rate for Payer: Priority Health Cigna Priority Health |
$166.50
|
Rate for Payer: Priority Health SBD |
$149.85
|
Rate for Payer: UMR Bronson Commercial |
$104.66
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.40
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM <0.6 CM
|
Facility
|
OP
|
$237.86
|
|
Service Code
|
CPT 17280
|
Hospital Charge Code |
76100155
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$85.46 |
Max. Negotiated Rate |
$560.20 |
Rate for Payer: Aetna American Axle |
$154.61
|
Rate for Payer: Aetna Commercial |
$202.18
|
Rate for Payer: Aetna Medicare |
$185.07
|
Rate for Payer: Aetna New Business (MI Preferred) |
$154.61
|
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 |
$136.36
|
Rate for Payer: BCN Medicare Advantage |
$177.95
|
Rate for Payer: Cash Price |
$190.29
|
Rate for Payer: Cash Price |
$190.29
|
Rate for Payer: Cofinity Commercial |
$204.56
|
Rate for Payer: Cofinity Commercial |
$166.50
|
Rate for Payer: Encore Health Key Benefits Commercial |
$190.29
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
Rate for Payer: Healthscope Commercial |
$214.07
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$166.50
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.40
|
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 |
$202.18
|
Rate for Payer: PACE Medicare |
$169.05
|
Rate for Payer: PACE SWMI |
$177.95
|
Rate for Payer: PHP Commercial |
$202.18
|
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 |
$166.50
|
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 |
$149.85
|
Rate for Payer: Railroad Medicare Medicare |
$177.95
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$94.01
|
Rate for Payer: UHC Dual Complete DSNP |
$177.95
|
Rate for Payer: UHC Exchange |
$85.46
|
Rate for Payer: UHC Medicare Advantage |
$183.29
|
Rate for Payer: UMR Bronson Commercial |
$88.01
|
Rate for Payer: VA VA |
$177.95
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.40
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 0.6 TO 1.0 CM
|
Facility
|
OP
|
$384.54
|
|
Service Code
|
CPT 17281
|
Hospital Charge Code |
76100147
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$115.91 |
Max. Negotiated Rate |
$1,115.78 |
Rate for Payer: Aetna American Axle |
$249.95
|
Rate for Payer: Aetna Commercial |
$326.86
|
Rate for Payer: Aetna Medicare |
$368.61
|
Rate for Payer: Aetna New Business (MI Preferred) |
$249.95
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
Rate for Payer: BCBS Complete |
$203.58
|
Rate for Payer: BCBS MAPPO |
$354.43
|
Rate for Payer: BCBS Trust/PPO |
$136.72
|
Rate for Payer: BCN Medicare Advantage |
$354.43
|
Rate for Payer: Cash Price |
$307.63
|
Rate for Payer: Cash Price |
$307.63
|
Rate for Payer: Cofinity Commercial |
$269.18
|
Rate for Payer: Cofinity Commercial |
$330.70
|
Rate for Payer: Encore Health Key Benefits Commercial |
$307.63
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
Rate for Payer: Healthscope Commercial |
$346.09
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.18
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.40
|
Rate for Payer: Mclaren Medicaid |
$193.87
|
Rate for Payer: Mclaren Medicare |
$354.43
|
Rate for Payer: Meridian Medicaid |
$203.58
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$326.86
|
Rate for Payer: PACE Medicare |
$336.71
|
Rate for Payer: PACE SWMI |
$354.43
|
Rate for Payer: PHP Commercial |
$326.86
|
Rate for Payer: PHP Medicare Advantage |
$354.43
|
Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
Rate for Payer: Priority Health Cigna Priority Health |
$269.18
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.78
|
Rate for Payer: Priority Health Medicare |
$354.43
|
Rate for Payer: Priority Health Narrow Network |
$892.62
|
Rate for Payer: Priority Health SBD |
$242.26
|
Rate for Payer: Railroad Medicare Medicare |
$354.43
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$127.50
|
Rate for Payer: UHC Dual Complete DSNP |
$354.43
|
Rate for Payer: UHC Exchange |
$115.91
|
Rate for Payer: UHC Medicare Advantage |
$365.06
|
Rate for Payer: UMR Bronson Commercial |
$142.28
|
Rate for Payer: VA VA |
$354.43
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.40
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 0.6 TO 1.0 CM
|
Facility
|
IP
|
$384.54
|
|
Service Code
|
CPT 17281
|
Hospital Charge Code |
76100147
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$169.20 |
Max. Negotiated Rate |
$346.09 |
Rate for Payer: Aetna American Axle |
$249.95
|
Rate for Payer: Aetna Commercial |
$326.86
|
Rate for Payer: Aetna New Business (MI Preferred) |
$249.95
|
Rate for Payer: Cash Price |
$307.63
|
Rate for Payer: Cofinity Commercial |
$269.18
|
Rate for Payer: Cofinity Commercial |
$330.70
|
Rate for Payer: Encore Health Key Benefits Commercial |
$307.63
|
Rate for Payer: Healthscope Commercial |
$346.09
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.18
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.40
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$326.86
|
Rate for Payer: PHP Commercial |
$326.86
|
Rate for Payer: Priority Health Cigna Priority Health |
$269.18
|
Rate for Payer: Priority Health SBD |
$242.26
|
Rate for Payer: UMR Bronson Commercial |
$169.20
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.40
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 2.1-3 CM
|
Facility
|
IP
|
$384.54
|
|
Service Code
|
CPT 17283
|
Hospital Charge Code |
76100156
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$169.20 |
Max. Negotiated Rate |
$346.09 |
Rate for Payer: Aetna American Axle |
$249.95
|
Rate for Payer: Aetna Commercial |
$326.86
|
Rate for Payer: Aetna New Business (MI Preferred) |
$249.95
|
Rate for Payer: Cash Price |
$307.63
|
Rate for Payer: Cofinity Commercial |
$269.18
|
Rate for Payer: Cofinity Commercial |
$330.70
|
Rate for Payer: Encore Health Key Benefits Commercial |
$307.63
|
Rate for Payer: Healthscope Commercial |
$346.09
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.18
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.40
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$326.86
|
Rate for Payer: PHP Commercial |
$326.86
|
Rate for Payer: Priority Health Cigna Priority Health |
$269.18
|
Rate for Payer: Priority Health SBD |
$242.26
|
Rate for Payer: UMR Bronson Commercial |
$169.20
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.40
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 2.1-3 CM
|
Facility
|
OP
|
$384.54
|
|
Service Code
|
CPT 17283
|
Hospital Charge Code |
76100156
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$142.28 |
Max. Negotiated Rate |
$1,115.78 |
Rate for Payer: Aetna American Axle |
$249.95
|
Rate for Payer: Aetna Commercial |
$326.86
|
Rate for Payer: Aetna Medicare |
$368.61
|
Rate for Payer: Aetna New Business (MI Preferred) |
$249.95
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
Rate for Payer: BCBS Complete |
$203.58
|
Rate for Payer: BCBS MAPPO |
$354.43
|
Rate for Payer: BCBS Trust/PPO |
$175.22
|
Rate for Payer: BCN Medicare Advantage |
$354.43
|
Rate for Payer: Cash Price |
$307.63
|
Rate for Payer: Cash Price |
$307.63
|
Rate for Payer: Cofinity Commercial |
$330.70
|
Rate for Payer: Cofinity Commercial |
$269.18
|
Rate for Payer: Encore Health Key Benefits Commercial |
$307.63
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
Rate for Payer: Healthscope Commercial |
$346.09
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.18
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.40
|
Rate for Payer: Mclaren Medicaid |
$193.87
|
Rate for Payer: Mclaren Medicare |
$354.43
|
Rate for Payer: Meridian Medicaid |
$203.58
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$326.86
|
Rate for Payer: PACE Medicare |
$336.71
|
Rate for Payer: PACE SWMI |
$354.43
|
Rate for Payer: PHP Commercial |
$326.86
|
Rate for Payer: PHP Medicare Advantage |
$354.43
|
Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
Rate for Payer: Priority Health Cigna Priority Health |
$269.18
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.78
|
Rate for Payer: Priority Health Medicare |
$354.43
|
Rate for Payer: Priority Health Narrow Network |
$892.62
|
Rate for Payer: Priority Health SBD |
$242.26
|
Rate for Payer: Railroad Medicare Medicare |
$354.43
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$183.70
|
Rate for Payer: UHC Dual Complete DSNP |
$354.43
|
Rate for Payer: UHC Exchange |
$167.00
|
Rate for Payer: UHC Medicare Advantage |
$365.06
|
Rate for Payer: UMR Bronson Commercial |
$142.28
|
Rate for Payer: VA VA |
$354.43
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.40
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 3.1-4 CM
|
Facility
|
IP
|
$590.58
|
|
Service Code
|
CPT 17284
|
Hospital Charge Code |
76100157
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$259.86 |
Max. Negotiated Rate |
$531.52 |
Rate for Payer: Aetna American Axle |
$383.88
|
Rate for Payer: Aetna Commercial |
$501.99
|
Rate for Payer: Aetna New Business (MI Preferred) |
$383.88
|
Rate for Payer: Cash Price |
$472.46
|
Rate for Payer: Cofinity Commercial |
$507.90
|
Rate for Payer: Cofinity Commercial |
$413.41
|
Rate for Payer: Encore Health Key Benefits Commercial |
$472.46
|
Rate for Payer: Healthscope Commercial |
$531.52
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$413.41
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$442.94
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$501.99
|
Rate for Payer: PHP Commercial |
$501.99
|
Rate for Payer: Priority Health Cigna Priority Health |
$413.41
|
Rate for Payer: Priority Health SBD |
$372.07
|
Rate for Payer: UMR Bronson Commercial |
$259.86
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$442.94
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM 3.1-4 CM
|
Facility
|
OP
|
$590.58
|
|
Service Code
|
CPT 17284
|
Hospital Charge Code |
76100157
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$193.76 |
Max. Negotiated Rate |
$1,757.43 |
Rate for Payer: Aetna American Axle |
$383.88
|
Rate for Payer: Aetna Commercial |
$501.99
|
Rate for Payer: Aetna Medicare |
$580.59
|
Rate for Payer: Aetna New Business (MI Preferred) |
$383.88
|
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 |
$193.76
|
Rate for Payer: BCN Medicare Advantage |
$558.26
|
Rate for Payer: Cash Price |
$472.46
|
Rate for Payer: Cash Price |
$472.46
|
Rate for Payer: Cofinity Commercial |
$413.41
|
Rate for Payer: Cofinity Commercial |
$507.90
|
Rate for Payer: Encore Health Key Benefits Commercial |
$472.46
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.26
|
Rate for Payer: Healthscope Commercial |
$531.52
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$413.41
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$442.94
|
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 |
$501.99
|
Rate for Payer: PACE Medicare |
$530.35
|
Rate for Payer: PACE SWMI |
$558.26
|
Rate for Payer: PHP Commercial |
$501.99
|
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 |
$413.41
|
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 |
$372.07
|
Rate for Payer: Railroad Medicare Medicare |
$558.26
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$213.59
|
Rate for Payer: UHC Dual Complete DSNP |
$558.26
|
Rate for Payer: UHC Exchange |
$194.17
|
Rate for Payer: UHC Medicare Advantage |
$575.01
|
Rate for Payer: UMR Bronson Commercial |
$218.51
|
Rate for Payer: VA VA |
$558.26
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$442.94
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM >4 CM
|
Facility
|
OP
|
$590.58
|
|
Service Code
|
CPT 17286
|
Hospital Charge Code |
76100158
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$218.51 |
Max. Negotiated Rate |
$1,757.43 |
Rate for Payer: Aetna American Axle |
$383.88
|
Rate for Payer: Aetna Commercial |
$501.99
|
Rate for Payer: Aetna Medicare |
$580.59
|
Rate for Payer: Aetna New Business (MI Preferred) |
$383.88
|
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 |
$227.73
|
Rate for Payer: BCN Medicare Advantage |
$558.26
|
Rate for Payer: Cash Price |
$472.46
|
Rate for Payer: Cash Price |
$472.46
|
Rate for Payer: Cofinity Commercial |
$507.90
|
Rate for Payer: Cofinity Commercial |
$413.41
|
Rate for Payer: Encore Health Key Benefits Commercial |
$472.46
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.26
|
Rate for Payer: Healthscope Commercial |
$531.52
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$413.41
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$442.94
|
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 |
$501.99
|
Rate for Payer: PACE Medicare |
$530.35
|
Rate for Payer: PACE SWMI |
$558.26
|
Rate for Payer: PHP Commercial |
$501.99
|
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 |
$413.41
|
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 |
$372.07
|
Rate for Payer: Railroad Medicare Medicare |
$558.26
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$289.95
|
Rate for Payer: UHC Dual Complete DSNP |
$558.26
|
Rate for Payer: UHC Exchange |
$263.59
|
Rate for Payer: UHC Medicare Advantage |
$575.01
|
Rate for Payer: UMR Bronson Commercial |
$218.51
|
Rate for Payer: VA VA |
$558.26
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$442.94
|
|
HC DESTR MALIG LESION FACE,EAR,EYELID,NOSE,LIP,MUC MEM >4 CM
|
Facility
|
IP
|
$590.58
|
|
Service Code
|
CPT 17286
|
Hospital Charge Code |
76100158
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$259.86 |
Max. Negotiated Rate |
$531.52 |
Rate for Payer: Aetna American Axle |
$383.88
|
Rate for Payer: Aetna Commercial |
$501.99
|
Rate for Payer: Aetna New Business (MI Preferred) |
$383.88
|
Rate for Payer: Cash Price |
$472.46
|
Rate for Payer: Cofinity Commercial |
$413.41
|
Rate for Payer: Cofinity Commercial |
$507.90
|
Rate for Payer: Encore Health Key Benefits Commercial |
$472.46
|
Rate for Payer: Healthscope Commercial |
$531.52
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$413.41
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$442.94
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$501.99
|
Rate for Payer: PHP Commercial |
$501.99
|
Rate for Payer: Priority Health Cigna Priority Health |
$413.41
|
Rate for Payer: Priority Health SBD |
$372.07
|
Rate for Payer: UMR Bronson Commercial |
$259.86
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$442.94
|
|
HC DESTR PENIS LESION, SIMPLE, CRYO
|
Facility
|
OP
|
$173.40
|
|
Service Code
|
CPT 54056
|
Hospital Charge Code |
76100144
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$64.16 |
Max. Negotiated Rate |
$560.20 |
Rate for Payer: Aetna American Axle |
$112.71
|
Rate for Payer: Aetna Commercial |
$147.39
|
Rate for Payer: Aetna Medicare |
$185.07
|
Rate for Payer: Aetna New Business (MI Preferred) |
$112.71
|
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 |
$109.07
|
Rate for Payer: BCN Medicare Advantage |
$177.95
|
Rate for Payer: Cash Price |
$138.72
|
Rate for Payer: Cash Price |
$138.72
|
Rate for Payer: Cofinity Commercial |
$149.12
|
Rate for Payer: Cofinity Commercial |
$121.38
|
Rate for Payer: Encore Health Key Benefits Commercial |
$138.72
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
Rate for Payer: Healthscope Commercial |
$156.06
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.38
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.05
|
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 |
$147.39
|
Rate for Payer: PACE Medicare |
$169.05
|
Rate for Payer: PACE SWMI |
$177.95
|
Rate for Payer: PHP Commercial |
$147.39
|
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 |
$121.38
|
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 |
$109.24
|
Rate for Payer: Railroad Medicare Medicare |
$177.95
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$121.75
|
Rate for Payer: UHC Dual Complete DSNP |
$177.95
|
Rate for Payer: UHC Exchange |
$110.68
|
Rate for Payer: UHC Medicare Advantage |
$183.29
|
Rate for Payer: UMR Bronson Commercial |
$64.16
|
Rate for Payer: VA VA |
$177.95
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.05
|
|
HC DESTR PENIS LESION, SIMPLE, CRYO
|
Facility
|
IP
|
$173.40
|
|
Service Code
|
CPT 54056
|
Hospital Charge Code |
76100144
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$76.30 |
Max. Negotiated Rate |
$156.06 |
Rate for Payer: Aetna American Axle |
$112.71
|
Rate for Payer: Aetna Commercial |
$147.39
|
Rate for Payer: Aetna New Business (MI Preferred) |
$112.71
|
Rate for Payer: Cash Price |
$138.72
|
Rate for Payer: Cofinity Commercial |
$121.38
|
Rate for Payer: Cofinity Commercial |
$149.12
|
Rate for Payer: Encore Health Key Benefits Commercial |
$138.72
|
Rate for Payer: Healthscope Commercial |
$156.06
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.38
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.05
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.39
|
Rate for Payer: PHP Commercial |
$147.39
|
Rate for Payer: Priority Health Cigna Priority Health |
$121.38
|
Rate for Payer: Priority Health SBD |
$109.24
|
Rate for Payer: UMR Bronson Commercial |
$76.30
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.05
|
|
HC DESTRUCT ANAL LESN(S) SIMPLE CHEM
|
Facility
|
OP
|
$480.42
|
|
Service Code
|
CPT 46900
|
Hospital Charge Code |
76100219
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$135.89 |
Max. Negotiated Rate |
$1,115.78 |
Rate for Payer: Aetna American Axle |
$312.27
|
Rate for Payer: Aetna Commercial |
$408.36
|
Rate for Payer: Aetna Medicare |
$368.61
|
Rate for Payer: Aetna New Business (MI Preferred) |
$312.27
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
Rate for Payer: BCBS Complete |
$203.58
|
Rate for Payer: BCBS MAPPO |
$354.43
|
Rate for Payer: BCBS Trust/PPO |
$199.59
|
Rate for Payer: BCN Medicare Advantage |
$354.43
|
Rate for Payer: Cash Price |
$384.34
|
Rate for Payer: Cash Price |
$384.34
|
Rate for Payer: Cofinity Commercial |
$413.16
|
Rate for Payer: Cofinity Commercial |
$336.29
|
Rate for Payer: Encore Health Key Benefits Commercial |
$384.34
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
Rate for Payer: Healthscope Commercial |
$432.38
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$336.29
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.32
|
Rate for Payer: Mclaren Medicaid |
$193.87
|
Rate for Payer: Mclaren Medicare |
$354.43
|
Rate for Payer: Meridian Medicaid |
$203.58
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.36
|
Rate for Payer: PACE Medicare |
$336.71
|
Rate for Payer: PACE SWMI |
$354.43
|
Rate for Payer: PHP Commercial |
$408.36
|
Rate for Payer: PHP Medicare Advantage |
$354.43
|
Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
Rate for Payer: Priority Health Cigna Priority Health |
$336.29
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.78
|
Rate for Payer: Priority Health Medicare |
$354.43
|
Rate for Payer: Priority Health Narrow Network |
$892.62
|
Rate for Payer: Priority Health SBD |
$302.66
|
Rate for Payer: Railroad Medicare Medicare |
$354.43
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$149.48
|
Rate for Payer: UHC Dual Complete DSNP |
$354.43
|
Rate for Payer: UHC Exchange |
$135.89
|
Rate for Payer: UHC Medicare Advantage |
$365.06
|
Rate for Payer: UMR Bronson Commercial |
$177.76
|
Rate for Payer: VA VA |
$354.43
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.32
|
|
HC DESTRUCT ANAL LESN(S) SIMPLE CHEM
|
Facility
|
IP
|
$480.42
|
|
Service Code
|
CPT 46900
|
Hospital Charge Code |
76100219
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$211.38 |
Max. Negotiated Rate |
$432.38 |
Rate for Payer: Aetna American Axle |
$312.27
|
Rate for Payer: Aetna Commercial |
$408.36
|
Rate for Payer: Aetna New Business (MI Preferred) |
$312.27
|
Rate for Payer: Cash Price |
$384.34
|
Rate for Payer: Cofinity Commercial |
$336.29
|
Rate for Payer: Cofinity Commercial |
$413.16
|
Rate for Payer: Encore Health Key Benefits Commercial |
$384.34
|
Rate for Payer: Healthscope Commercial |
$432.38
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$336.29
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.32
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.36
|
Rate for Payer: PHP Commercial |
$408.36
|
Rate for Payer: Priority Health Cigna Priority Health |
$336.29
|
Rate for Payer: Priority Health SBD |
$302.66
|
Rate for Payer: UMR Bronson Commercial |
$211.38
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.32
|
|