|
HC AMPUTATION TOE INTERPHALANGEAL JOINT
|
Facility
|
OP
|
$9,426.02
|
|
|
Service Code
|
CPT 28825
|
| Hospital Charge Code |
76100428
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,705.10 |
| Max. Negotiated Rate |
$10,543.31 |
| Rate for Payer: Aetna American Axle |
$6,126.91
|
| Rate for Payer: Aetna Commercial |
$8,012.12
|
| Rate for Payer: Aetna Medicare |
$3,390.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,126.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,075.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,075.29
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$3,075.54
|
| Rate for Payer: BCN Commercial |
$3,075.54
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Cash Price |
$7,540.82
|
| Rate for Payer: Cash Price |
$7,540.82
|
| Rate for Payer: Cash Price |
$7,540.82
|
| Rate for Payer: Cofinity Advantage |
$6,598.21
|
| Rate for Payer: Cofinity Commercial |
$8,106.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,540.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Healthscope Commercial |
$8,483.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,598.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,069.52
|
| Rate for Payer: Mclaren Medicaid |
$3,260.23
|
| Rate for Payer: Mclaren Medicare |
$3,260.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,423.24
|
| Rate for Payer: Meridian Medicaid |
$3,423.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,749.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,586.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,012.12
|
| Rate for Payer: Nomi Health Commercial |
$9,780.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,069.52
|
| Rate for Payer: PACE Medicare |
$3,097.22
|
| Rate for Payer: PACE SWMI |
$3,260.23
|
| Rate for Payer: PHP Commercial |
$8,012.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,260.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,705.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,543.31
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health SBD |
$5,938.39
|
| Rate for Payer: Priority Health Tiered Network |
$8,434.65
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,126.91
|
| Rate for Payer: UHC Core |
$4,910.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,260.23
|
| Rate for Payer: UHC Exchange |
$3,704.43
|
| Rate for Payer: UHC Medicaid |
$1,705.10
|
| Rate for Payer: UHCCP Medicaid |
$1,705.10
|
| Rate for Payer: UMR Bronson Commercial |
$3,487.63
|
| Rate for Payer: VA VA |
$3,260.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,069.52
|
|
|
HC AMPUTATION TOE INTERPHALANGEAL JOINT
|
Facility
|
IP
|
$9,426.02
|
|
|
Service Code
|
CPT 28825
|
| Hospital Charge Code |
76100428
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,147.45 |
| Max. Negotiated Rate |
$8,483.42 |
| Rate for Payer: Aetna American Axle |
$6,126.91
|
| Rate for Payer: Aetna Commercial |
$8,012.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,126.91
|
| Rate for Payer: Cash Price |
$7,540.82
|
| Rate for Payer: Cofinity Advantage |
$6,598.21
|
| Rate for Payer: Cofinity Commercial |
$8,106.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,540.82
|
| Rate for Payer: Healthscope Commercial |
$8,483.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,598.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,069.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,012.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,069.52
|
| Rate for Payer: PHP Commercial |
$8,012.12
|
| Rate for Payer: Priority Health SBD |
$5,938.39
|
| Rate for Payer: UMR Bronson Commercial |
$4,147.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,069.52
|
|
|
HC AMU OBSERVATION PER HOUR
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200008
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$70.40 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna American Axle |
$104.00
|
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Advantage |
$112.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health SBD |
$100.80
|
| Rate for Payer: UMR Bronson Commercial |
$70.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC AMU OBSERVATION PER HOUR
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200008
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$59.20 |
| Max. Negotiated Rate |
$1,608.00 |
| Rate for Payer: Aetna American Axle |
$104.00
|
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna Medicare |
$80.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.00
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: BCBS Trust/PPO |
$107.13
|
| Rate for Payer: BCN Commercial |
$107.13
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Advantage |
$112.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health SBD |
$100.80
|
| Rate for Payer: UHC Medicaid |
$1,608.00
|
| Rate for Payer: UHCCP Medicaid |
$850.00
|
| Rate for Payer: UMR Bronson Commercial |
$59.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC AMYLASE FLUID
|
Facility
|
IP
|
$62.84
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.65 |
| Max. Negotiated Rate |
$56.56 |
| Rate for Payer: Aetna American Axle |
$40.85
|
| Rate for Payer: Aetna Commercial |
$53.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.85
|
| Rate for Payer: Cash Price |
$50.27
|
| Rate for Payer: Cofinity Advantage |
$43.99
|
| Rate for Payer: Cofinity Commercial |
$54.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.27
|
| Rate for Payer: Healthscope Commercial |
$56.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.13
|
| Rate for Payer: PHP Commercial |
$53.41
|
| Rate for Payer: Priority Health SBD |
$39.59
|
| Rate for Payer: UMR Bronson Commercial |
$27.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.13
|
|
|
HC AMYLASE FLUID
|
Facility
|
OP
|
$62.84
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$56.56 |
| Rate for Payer: Aetna American Axle |
$40.85
|
| Rate for Payer: Aetna Commercial |
$53.41
|
| Rate for Payer: Aetna Medicare |
$6.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.10
|
| Rate for Payer: BCBS Complete |
$3.56
|
| Rate for Payer: BCBS MAPPO |
$6.48
|
| Rate for Payer: BCBS Trust/PPO |
$7.49
|
| Rate for Payer: BCN Commercial |
$7.49
|
| Rate for Payer: BCN Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$50.27
|
| Rate for Payer: Cash Price |
$50.27
|
| Rate for Payer: Cofinity Advantage |
$43.99
|
| Rate for Payer: Cofinity Commercial |
$54.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.48
|
| Rate for Payer: Healthscope Commercial |
$56.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.13
|
| Rate for Payer: Mclaren Medicaid |
$6.48
|
| Rate for Payer: Mclaren Medicare |
$6.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$6.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.41
|
| Rate for Payer: Nomi Health Commercial |
$9.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.13
|
| Rate for Payer: PACE Medicare |
$6.16
|
| Rate for Payer: PACE SWMI |
$6.48
|
| Rate for Payer: PHP Commercial |
$53.41
|
| Rate for Payer: PHP Medicare Advantage |
$6.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.48
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health SBD |
$39.59
|
| Rate for Payer: Priority Health Tiered Network |
$5.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.72
|
| Rate for Payer: UHC Core |
$9.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.48
|
| Rate for Payer: UHC Exchange |
$9.72
|
| Rate for Payer: UHC Medicaid |
$3.39
|
| Rate for Payer: UHCCP Medicaid |
$3.39
|
| Rate for Payer: UMR Bronson Commercial |
$23.25
|
| Rate for Payer: VA VA |
$6.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.13
|
|
|
HC AMYLASE PANCREATIC CYST FLUID
|
Facility
|
OP
|
$217.76
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100711
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$195.98 |
| Rate for Payer: Aetna American Axle |
$141.54
|
| Rate for Payer: Aetna Commercial |
$185.10
|
| Rate for Payer: Aetna Medicare |
$6.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.10
|
| Rate for Payer: BCBS Complete |
$3.56
|
| Rate for Payer: BCBS MAPPO |
$6.48
|
| Rate for Payer: BCBS Trust/PPO |
$7.49
|
| Rate for Payer: BCN Commercial |
$7.49
|
| Rate for Payer: BCN Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$174.21
|
| Rate for Payer: Cash Price |
$174.21
|
| Rate for Payer: Cofinity Advantage |
$152.43
|
| Rate for Payer: Cofinity Commercial |
$187.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.48
|
| Rate for Payer: Healthscope Commercial |
$195.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.32
|
| Rate for Payer: Mclaren Medicaid |
$6.48
|
| Rate for Payer: Mclaren Medicare |
$6.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$6.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.10
|
| Rate for Payer: Nomi Health Commercial |
$9.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.32
|
| Rate for Payer: PACE Medicare |
$6.16
|
| Rate for Payer: PACE SWMI |
$6.48
|
| Rate for Payer: PHP Commercial |
$185.10
|
| Rate for Payer: PHP Medicare Advantage |
$6.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.48
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health SBD |
$137.19
|
| Rate for Payer: Priority Health Tiered Network |
$5.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.72
|
| Rate for Payer: UHC Core |
$9.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.48
|
| Rate for Payer: UHC Exchange |
$9.72
|
| Rate for Payer: UHC Medicaid |
$3.39
|
| Rate for Payer: UHCCP Medicaid |
$3.39
|
| Rate for Payer: UMR Bronson Commercial |
$80.57
|
| Rate for Payer: VA VA |
$6.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.32
|
|
|
HC AMYLASE PANCREATIC CYST FLUID
|
Facility
|
IP
|
$217.76
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100711
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$95.81 |
| Max. Negotiated Rate |
$195.98 |
| Rate for Payer: Aetna American Axle |
$141.54
|
| Rate for Payer: Aetna Commercial |
$185.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.54
|
| Rate for Payer: Cash Price |
$174.21
|
| Rate for Payer: Cofinity Advantage |
$152.43
|
| Rate for Payer: Cofinity Commercial |
$187.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.21
|
| Rate for Payer: Healthscope Commercial |
$195.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.32
|
| Rate for Payer: PHP Commercial |
$185.10
|
| Rate for Payer: Priority Health SBD |
$137.19
|
| Rate for Payer: UMR Bronson Commercial |
$95.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.32
|
|
|
HC AMYLASE SERUM
|
Facility
|
IP
|
$31.83
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100099
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.01 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna American Axle |
$20.69
|
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.69
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Advantage |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health SBD |
$20.05
|
| Rate for Payer: UMR Bronson Commercial |
$14.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC AMYLASE SERUM
|
Facility
|
OP
|
$31.83
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100099
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna American Axle |
$20.69
|
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna Medicare |
$6.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.10
|
| Rate for Payer: BCBS Complete |
$3.56
|
| Rate for Payer: BCBS MAPPO |
$6.48
|
| Rate for Payer: BCBS Trust/PPO |
$7.49
|
| Rate for Payer: BCN Commercial |
$7.49
|
| Rate for Payer: BCN Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Advantage |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.48
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Mclaren Medicaid |
$6.48
|
| Rate for Payer: Mclaren Medicare |
$6.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$6.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$9.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PACE Medicare |
$6.16
|
| Rate for Payer: PACE SWMI |
$6.48
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: PHP Medicare Advantage |
$6.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.48
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health SBD |
$20.05
|
| Rate for Payer: Priority Health Tiered Network |
$5.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.72
|
| Rate for Payer: UHC Core |
$9.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.48
|
| Rate for Payer: UHC Exchange |
$9.72
|
| Rate for Payer: UHC Medicaid |
$3.39
|
| Rate for Payer: UHCCP Medicaid |
$3.39
|
| Rate for Payer: UMR Bronson Commercial |
$11.78
|
| Rate for Payer: VA VA |
$6.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC ANAEROBIC CULTURE
|
Facility
|
IP
|
$127.03
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
30600077
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$55.89 |
| Max. Negotiated Rate |
$114.33 |
| Rate for Payer: Aetna American Axle |
$82.57
|
| Rate for Payer: Aetna Commercial |
$107.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.57
|
| Rate for Payer: Cash Price |
$101.62
|
| Rate for Payer: Cofinity Advantage |
$88.92
|
| Rate for Payer: Cofinity Commercial |
$109.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.62
|
| Rate for Payer: Healthscope Commercial |
$114.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.27
|
| Rate for Payer: PHP Commercial |
$107.98
|
| Rate for Payer: Priority Health SBD |
$80.03
|
| Rate for Payer: UMR Bronson Commercial |
$55.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.27
|
|
|
HC ANAEROBIC CULTURE
|
Facility
|
OP
|
$127.03
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
30600077
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$114.33 |
| Rate for Payer: Aetna American Axle |
$82.57
|
| Rate for Payer: Aetna Commercial |
$107.98
|
| Rate for Payer: Aetna Medicare |
$9.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.84
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: BCBS MAPPO |
$9.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.94
|
| Rate for Payer: BCN Commercial |
$10.94
|
| Rate for Payer: BCN Medicare Advantage |
$9.47
|
| Rate for Payer: Cash Price |
$101.62
|
| Rate for Payer: Cash Price |
$101.62
|
| Rate for Payer: Cofinity Advantage |
$88.92
|
| Rate for Payer: Cofinity Commercial |
$109.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.47
|
| Rate for Payer: Healthscope Commercial |
$114.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.27
|
| Rate for Payer: Mclaren Medicaid |
$9.47
|
| Rate for Payer: Mclaren Medicare |
$9.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.94
|
| Rate for Payer: Meridian Medicaid |
$9.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.98
|
| Rate for Payer: Nomi Health Commercial |
$14.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.27
|
| Rate for Payer: PACE Medicare |
$9.00
|
| Rate for Payer: PACE SWMI |
$9.47
|
| Rate for Payer: PHP Commercial |
$107.98
|
| Rate for Payer: PHP Medicare Advantage |
$9.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.47
|
| Rate for Payer: Priority Health Medicare |
$9.47
|
| Rate for Payer: Priority Health SBD |
$80.03
|
| Rate for Payer: Priority Health Tiered Network |
$7.58
|
| Rate for Payer: Railroad Medicare Medicare |
$9.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.21
|
| Rate for Payer: UHC Core |
$14.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.47
|
| Rate for Payer: UHC Exchange |
$14.21
|
| Rate for Payer: UHC Medicaid |
$4.95
|
| Rate for Payer: UHCCP Medicaid |
$4.95
|
| Rate for Payer: UMR Bronson Commercial |
$47.00
|
| Rate for Payer: VA VA |
$9.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.27
|
|
|
HC ANAEROBIC ID
|
Facility
|
OP
|
$53.39
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
30600286
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$48.05 |
| Rate for Payer: Aetna American Axle |
$34.70
|
| Rate for Payer: Aetna Commercial |
$45.38
|
| Rate for Payer: Aetna Medicare |
$8.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.10
|
| Rate for Payer: BCBS Complete |
$4.44
|
| Rate for Payer: BCBS MAPPO |
$8.08
|
| Rate for Payer: BCBS Trust/PPO |
$9.34
|
| Rate for Payer: BCN Commercial |
$9.34
|
| Rate for Payer: BCN Medicare Advantage |
$8.08
|
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Cofinity Advantage |
$37.37
|
| Rate for Payer: Cofinity Commercial |
$45.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.08
|
| Rate for Payer: Healthscope Commercial |
$48.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.04
|
| Rate for Payer: Mclaren Medicaid |
$8.08
|
| Rate for Payer: Mclaren Medicare |
$8.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.48
|
| Rate for Payer: Meridian Medicaid |
$8.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.38
|
| Rate for Payer: Nomi Health Commercial |
$12.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.04
|
| Rate for Payer: PACE Medicare |
$7.68
|
| Rate for Payer: PACE SWMI |
$8.08
|
| Rate for Payer: PHP Commercial |
$45.38
|
| Rate for Payer: PHP Medicare Advantage |
$8.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.08
|
| Rate for Payer: Priority Health Medicare |
$8.08
|
| Rate for Payer: Priority Health SBD |
$33.64
|
| Rate for Payer: Priority Health Tiered Network |
$6.46
|
| Rate for Payer: Railroad Medicare Medicare |
$8.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.12
|
| Rate for Payer: UHC Core |
$12.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.08
|
| Rate for Payer: UHC Exchange |
$12.12
|
| Rate for Payer: UHC Medicaid |
$4.23
|
| Rate for Payer: UHCCP Medicaid |
$4.23
|
| Rate for Payer: UMR Bronson Commercial |
$19.75
|
| Rate for Payer: VA VA |
$8.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.04
|
|
|
HC ANAEROBIC ID
|
Facility
|
IP
|
$53.39
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
30600286
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.49 |
| Max. Negotiated Rate |
$48.05 |
| Rate for Payer: Aetna American Axle |
$34.70
|
| Rate for Payer: Aetna Commercial |
$45.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.70
|
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Cofinity Advantage |
$37.37
|
| Rate for Payer: Cofinity Commercial |
$45.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.71
|
| Rate for Payer: Healthscope Commercial |
$48.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.04
|
| Rate for Payer: PHP Commercial |
$45.38
|
| Rate for Payer: Priority Health SBD |
$33.64
|
| Rate for Payer: UMR Bronson Commercial |
$23.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.04
|
|
|
HC ANALYSIS BRAIN NPGT PRGRMG 15 MIN
|
Facility
|
IP
|
$312.12
|
|
|
Service Code
|
CPT 95983
|
| Hospital Charge Code |
76100442
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$137.33 |
| Max. Negotiated Rate |
$280.91 |
| Rate for Payer: Aetna American Axle |
$202.88
|
| Rate for Payer: Aetna Commercial |
$265.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.88
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cofinity Advantage |
$218.48
|
| Rate for Payer: Cofinity Commercial |
$268.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.70
|
| Rate for Payer: Healthscope Commercial |
$280.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$218.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.09
|
| Rate for Payer: PHP Commercial |
$265.30
|
| Rate for Payer: Priority Health SBD |
$196.64
|
| Rate for Payer: UMR Bronson Commercial |
$137.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.09
|
|
|
HC ANALYSIS BRAIN NPGT PRGRMG 15 MIN
|
Facility
|
OP
|
$312.12
|
|
|
Service Code
|
CPT 95983
|
| Hospital Charge Code |
76100442
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.54 |
| Max. Negotiated Rate |
$306.34 |
| Rate for Payer: Aetna American Axle |
$202.88
|
| Rate for Payer: Aetna Commercial |
$265.30
|
| Rate for Payer: Aetna Medicare |
$98.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.41
|
| Rate for Payer: BCBS Complete |
$52.03
|
| Rate for Payer: BCBS MAPPO |
$94.73
|
| Rate for Payer: BCBS Trust/PPO |
$69.04
|
| Rate for Payer: BCN Commercial |
$69.04
|
| Rate for Payer: BCN Medicare Advantage |
$94.73
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cofinity Advantage |
$218.48
|
| Rate for Payer: Cofinity Commercial |
$268.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.73
|
| Rate for Payer: Healthscope Commercial |
$280.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$218.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.09
|
| Rate for Payer: Mclaren Medicaid |
$94.73
|
| Rate for Payer: Mclaren Medicare |
$94.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.47
|
| Rate for Payer: Meridian Medicaid |
$99.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.30
|
| Rate for Payer: Nomi Health Commercial |
$284.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.09
|
| Rate for Payer: PACE Medicare |
$89.99
|
| Rate for Payer: PACE SWMI |
$94.73
|
| Rate for Payer: PHP Commercial |
$265.30
|
| Rate for Payer: PHP Medicare Advantage |
$94.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$306.34
|
| Rate for Payer: Priority Health Medicare |
$94.73
|
| Rate for Payer: Priority Health SBD |
$196.64
|
| Rate for Payer: Priority Health Tiered Network |
$245.07
|
| Rate for Payer: Railroad Medicare Medicare |
$94.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.88
|
| Rate for Payer: UHC Core |
$162.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$94.73
|
| Rate for Payer: UHC Exchange |
$122.66
|
| Rate for Payer: UHC Medicaid |
$49.54
|
| Rate for Payer: UHCCP Medicaid |
$49.54
|
| Rate for Payer: UMR Bronson Commercial |
$115.48
|
| Rate for Payer: VA VA |
$94.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.09
|
|
|
HC ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG
|
Facility
|
IP
|
$446.76
|
|
|
Service Code
|
CPT 92603
|
| Hospital Charge Code |
47100019
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$196.57 |
| Max. Negotiated Rate |
$402.08 |
| Rate for Payer: Aetna American Axle |
$290.39
|
| Rate for Payer: Aetna Commercial |
$379.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.39
|
| Rate for Payer: Cash Price |
$357.41
|
| Rate for Payer: Cofinity Advantage |
$312.73
|
| Rate for Payer: Cofinity Commercial |
$384.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.41
|
| Rate for Payer: Healthscope Commercial |
$402.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.07
|
| Rate for Payer: PHP Commercial |
$379.75
|
| Rate for Payer: Priority Health SBD |
$281.46
|
| Rate for Payer: UMR Bronson Commercial |
$196.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.07
|
|
|
HC ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG
|
Facility
|
OP
|
$446.76
|
|
|
Service Code
|
CPT 92603
|
| Hospital Charge Code |
47100019
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$624.13 |
| Rate for Payer: Aetna American Axle |
$290.39
|
| Rate for Payer: Aetna Commercial |
$379.75
|
| Rate for Payer: Aetna Medicare |
$133.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$624.13
|
| Rate for Payer: BCN Commercial |
$624.13
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$357.41
|
| Rate for Payer: Cash Price |
$357.41
|
| Rate for Payer: Cofinity Advantage |
$312.73
|
| Rate for Payer: Cofinity Commercial |
$384.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$402.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.07
|
| Rate for Payer: Mclaren Medicaid |
$128.21
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$134.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.75
|
| Rate for Payer: Nomi Health Commercial |
$384.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.07
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$379.75
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$414.63
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health SBD |
$281.46
|
| Rate for Payer: Priority Health Tiered Network |
$331.70
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.39
|
| Rate for Payer: UHC Core |
$232.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$175.58
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: UMR Bronson Commercial |
$165.30
|
| Rate for Payer: VA VA |
$128.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.07
|
|
|
HC ANALYSIS COCHLEAR IMPLT 7 YR/> SBSQ REPRGRMG
|
Facility
|
OP
|
$446.76
|
|
|
Service Code
|
CPT 92604
|
| Hospital Charge Code |
47100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$414.63 |
| Rate for Payer: Aetna American Axle |
$290.39
|
| Rate for Payer: Aetna Commercial |
$379.75
|
| Rate for Payer: Aetna Medicare |
$133.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$376.16
|
| Rate for Payer: BCN Commercial |
$376.16
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$357.41
|
| Rate for Payer: Cash Price |
$357.41
|
| Rate for Payer: Cofinity Advantage |
$312.73
|
| Rate for Payer: Cofinity Commercial |
$384.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$402.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.07
|
| Rate for Payer: Mclaren Medicaid |
$128.21
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$134.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.75
|
| Rate for Payer: Nomi Health Commercial |
$384.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.07
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$379.75
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$414.63
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health SBD |
$281.46
|
| Rate for Payer: Priority Health Tiered Network |
$331.70
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.39
|
| Rate for Payer: UHC Core |
$232.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$175.58
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: UMR Bronson Commercial |
$165.30
|
| Rate for Payer: VA VA |
$128.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.07
|
|
|
HC ANALYSIS COCHLEAR IMPLT 7 YR/> SBSQ REPRGRMG
|
Facility
|
IP
|
$446.76
|
|
|
Service Code
|
CPT 92604
|
| Hospital Charge Code |
47100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$196.57 |
| Max. Negotiated Rate |
$402.08 |
| Rate for Payer: Aetna American Axle |
$290.39
|
| Rate for Payer: Aetna Commercial |
$379.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.39
|
| Rate for Payer: Cash Price |
$357.41
|
| Rate for Payer: Cofinity Advantage |
$312.73
|
| Rate for Payer: Cofinity Commercial |
$384.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.41
|
| Rate for Payer: Healthscope Commercial |
$402.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$335.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$335.07
|
| Rate for Payer: PHP Commercial |
$379.75
|
| Rate for Payer: Priority Health SBD |
$281.46
|
| Rate for Payer: UMR Bronson Commercial |
$196.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$335.07
|
|
|
HC ANALYSIS SMPL OR COMPLEX CN NPGT PRGRMG
|
Facility
|
OP
|
$114.44
|
|
|
Service Code
|
CPT 95976
|
| Hospital Charge Code |
76100441
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$19.45 |
| Max. Negotiated Rate |
$120.26 |
| Rate for Payer: Aetna American Axle |
$74.39
|
| Rate for Payer: Aetna Commercial |
$97.27
|
| Rate for Payer: Aetna Medicare |
$38.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.49
|
| Rate for Payer: BCBS Complete |
$20.42
|
| Rate for Payer: BCBS MAPPO |
$37.19
|
| Rate for Payer: BCBS Trust/PPO |
$49.31
|
| Rate for Payer: BCN Commercial |
$49.31
|
| Rate for Payer: BCN Medicare Advantage |
$37.19
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Advantage |
$80.11
|
| Rate for Payer: Cofinity Commercial |
$98.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.19
|
| Rate for Payer: Healthscope Commercial |
$103.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.83
|
| Rate for Payer: Mclaren Medicaid |
$37.19
|
| Rate for Payer: Mclaren Medicare |
$37.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.05
|
| Rate for Payer: Meridian Medicaid |
$39.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: Nomi Health Commercial |
$111.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.83
|
| Rate for Payer: PACE Medicare |
$35.33
|
| Rate for Payer: PACE SWMI |
$37.19
|
| Rate for Payer: PHP Commercial |
$97.27
|
| Rate for Payer: PHP Medicare Advantage |
$37.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$120.26
|
| Rate for Payer: Priority Health Medicare |
$37.19
|
| Rate for Payer: Priority Health SBD |
$72.10
|
| Rate for Payer: Priority Health Tiered Network |
$96.21
|
| Rate for Payer: Railroad Medicare Medicare |
$37.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.39
|
| Rate for Payer: UHC Core |
$59.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.19
|
| Rate for Payer: UHC Exchange |
$44.97
|
| Rate for Payer: UHC Medicaid |
$19.45
|
| Rate for Payer: UHCCP Medicaid |
$19.45
|
| Rate for Payer: UMR Bronson Commercial |
$42.34
|
| Rate for Payer: VA VA |
$37.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.83
|
|
|
HC ANALYSIS SMPL OR COMPLEX CN NPGT PRGRMG
|
Facility
|
IP
|
$114.44
|
|
|
Service Code
|
CPT 95976
|
| Hospital Charge Code |
76100441
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$50.35 |
| Max. Negotiated Rate |
$103.00 |
| Rate for Payer: Aetna American Axle |
$74.39
|
| Rate for Payer: Aetna Commercial |
$97.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.39
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Advantage |
$80.11
|
| Rate for Payer: Cofinity Commercial |
$98.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Healthscope Commercial |
$103.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.83
|
| Rate for Payer: PHP Commercial |
$97.27
|
| Rate for Payer: Priority Health SBD |
$72.10
|
| Rate for Payer: UMR Bronson Commercial |
$50.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.83
|
|
|
HC ANCHOR/SCREW IMPLANTS
|
Facility
|
IP
|
$17.23
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$15.51 |
| Rate for Payer: Aetna American Axle |
$11.20
|
| Rate for Payer: Aetna Commercial |
$14.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.20
|
| Rate for Payer: Cash Price |
$13.78
|
| Rate for Payer: Cofinity Advantage |
$12.06
|
| Rate for Payer: Cofinity Commercial |
$14.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.78
|
| Rate for Payer: Healthscope Commercial |
$15.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.92
|
| Rate for Payer: PHP Commercial |
$14.65
|
| Rate for Payer: Priority Health SBD |
$10.85
|
| Rate for Payer: UMR Bronson Commercial |
$7.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.92
|
|
|
HC ANCHOR/SCREW IMPLANTS
|
Facility
|
OP
|
$17.23
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800001
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.38 |
| Max. Negotiated Rate |
$15.51 |
| Rate for Payer: Aetna American Axle |
$11.20
|
| Rate for Payer: Aetna Commercial |
$14.65
|
| Rate for Payer: Aetna Medicare |
$8.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.20
|
| Rate for Payer: BCBS Complete |
$6.89
|
| Rate for Payer: Cash Price |
$13.78
|
| Rate for Payer: Cofinity Advantage |
$12.06
|
| Rate for Payer: Cofinity Commercial |
$14.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.78
|
| Rate for Payer: Healthscope Commercial |
$15.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.92
|
| Rate for Payer: PHP Commercial |
$14.65
|
| Rate for Payer: Priority Health SBD |
$10.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.20
|
| Rate for Payer: UHC Core |
$8.98
|
| Rate for Payer: UHC Exchange |
$6.77
|
| Rate for Payer: UMR Bronson Commercial |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.92
|
|
|
HC ANDROSTENEDIONE LEVEL
|
Facility
|
OP
|
$55.18
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.31 |
| Max. Negotiated Rate |
$49.66 |
| Rate for Payer: Aetna American Axle |
$35.87
|
| Rate for Payer: Aetna Commercial |
$46.90
|
| Rate for Payer: Aetna Medicare |
$30.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.60
|
| Rate for Payer: BCBS Complete |
$16.08
|
| Rate for Payer: BCBS MAPPO |
$29.28
|
| Rate for Payer: BCBS Trust/PPO |
$33.85
|
| Rate for Payer: BCN Commercial |
$33.85
|
| Rate for Payer: BCN Medicare Advantage |
$29.28
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Advantage |
$38.63
|
| Rate for Payer: Cofinity Commercial |
$47.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.28
|
| Rate for Payer: Healthscope Commercial |
$49.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.38
|
| Rate for Payer: Mclaren Medicaid |
$29.28
|
| Rate for Payer: Mclaren Medicare |
$29.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.74
|
| Rate for Payer: Meridian Medicaid |
$30.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Nomi Health Commercial |
$43.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: PACE Medicare |
$27.82
|
| Rate for Payer: PACE SWMI |
$29.28
|
| Rate for Payer: PHP Commercial |
$46.90
|
| Rate for Payer: PHP Medicare Advantage |
$29.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29.28
|
| Rate for Payer: Priority Health Medicare |
$29.28
|
| Rate for Payer: Priority Health SBD |
$34.76
|
| Rate for Payer: Priority Health Tiered Network |
$23.42
|
| Rate for Payer: Railroad Medicare Medicare |
$29.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.92
|
| Rate for Payer: UHC Core |
$43.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.28
|
| Rate for Payer: UHC Exchange |
$43.92
|
| Rate for Payer: UHC Medicaid |
$15.31
|
| Rate for Payer: UHCCP Medicaid |
$15.31
|
| Rate for Payer: UMR Bronson Commercial |
$20.42
|
| Rate for Payer: VA VA |
$29.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.38
|
|
