|
HC ART FLOW LOWER COMPLETE
|
Facility
|
OP
|
$881.24
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$793.12 |
| Rate for Payer: Aetna American Axle |
$572.81
|
| Rate for Payer: Aetna Commercial |
$749.05
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$572.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$459.30
|
| Rate for Payer: BCN Commercial |
$459.30
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$704.99
|
| Rate for Payer: Cash Price |
$704.99
|
| Rate for Payer: Cofinity Advantage |
$616.87
|
| Rate for Payer: Cofinity Commercial |
$757.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$704.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$793.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$616.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$660.93
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$749.05
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$660.93
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$749.05
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$555.18
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$572.81
|
| Rate for Payer: UHC Core |
$459.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$346.33
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: UMR Bronson Commercial |
$326.06
|
| Rate for Payer: VA VA |
$215.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$660.93
|
|
|
HC ART FLOW LOWER COMPLETE
|
Facility
|
IP
|
$881.24
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100030
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$387.75 |
| Max. Negotiated Rate |
$793.12 |
| Rate for Payer: Aetna American Axle |
$572.81
|
| Rate for Payer: Aetna Commercial |
$749.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$572.81
|
| Rate for Payer: Cash Price |
$704.99
|
| Rate for Payer: Cofinity Advantage |
$616.87
|
| Rate for Payer: Cofinity Commercial |
$757.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$704.99
|
| Rate for Payer: Healthscope Commercial |
$793.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$616.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$660.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$749.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$660.93
|
| Rate for Payer: PHP Commercial |
$749.05
|
| Rate for Payer: Priority Health SBD |
$555.18
|
| Rate for Payer: UMR Bronson Commercial |
$387.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$660.93
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
IP
|
$739.09
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$325.20 |
| Max. Negotiated Rate |
$665.18 |
| Rate for Payer: Aetna American Axle |
$480.41
|
| Rate for Payer: Aetna Commercial |
$628.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.41
|
| Rate for Payer: Cash Price |
$591.27
|
| Rate for Payer: Cofinity Advantage |
$517.36
|
| Rate for Payer: Cofinity Commercial |
$635.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$591.27
|
| Rate for Payer: Healthscope Commercial |
$665.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$517.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$554.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$628.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$554.32
|
| Rate for Payer: PHP Commercial |
$628.23
|
| Rate for Payer: Priority Health SBD |
$465.63
|
| Rate for Payer: UMR Bronson Commercial |
$325.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$554.32
|
|
|
HC ART FLOW LOWER LIMITED
|
Facility
|
OP
|
$739.09
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100019
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$665.18 |
| Rate for Payer: Aetna American Axle |
$480.41
|
| Rate for Payer: Aetna Commercial |
$628.23
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$480.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$295.88
|
| Rate for Payer: BCN Commercial |
$295.88
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$591.27
|
| Rate for Payer: Cash Price |
$591.27
|
| Rate for Payer: Cofinity Advantage |
$517.36
|
| Rate for Payer: Cofinity Commercial |
$635.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$591.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$665.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$517.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$554.32
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$628.23
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$554.32
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$628.23
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$465.63
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.41
|
| Rate for Payer: UHC Core |
$385.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$290.46
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$273.46
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$554.32
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
IP
|
$961.35
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$422.99 |
| Max. Negotiated Rate |
$865.22 |
| Rate for Payer: Aetna American Axle |
$624.88
|
| Rate for Payer: Aetna Commercial |
$817.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.88
|
| Rate for Payer: Cash Price |
$769.08
|
| Rate for Payer: Cofinity Advantage |
$672.95
|
| Rate for Payer: Cofinity Commercial |
$826.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.08
|
| Rate for Payer: Healthscope Commercial |
$865.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$672.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$721.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$817.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.01
|
| Rate for Payer: PHP Commercial |
$817.15
|
| Rate for Payer: Priority Health SBD |
$605.65
|
| Rate for Payer: UMR Bronson Commercial |
$422.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$721.01
|
|
|
HC ART FLOW UPPER COMPLETE
|
Facility
|
OP
|
$961.35
|
|
|
Service Code
|
CPT 93923
|
| Hospital Charge Code |
92100018
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$865.22 |
| Rate for Payer: Aetna American Axle |
$624.88
|
| Rate for Payer: Aetna Commercial |
$817.15
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$624.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$459.30
|
| Rate for Payer: BCN Commercial |
$459.30
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$769.08
|
| Rate for Payer: Cash Price |
$769.08
|
| Rate for Payer: Cofinity Advantage |
$672.95
|
| Rate for Payer: Cofinity Commercial |
$826.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$865.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$672.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$721.01
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$817.15
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.01
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$817.15
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$605.65
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$624.88
|
| Rate for Payer: UHC Core |
$500.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$377.81
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: UMR Bronson Commercial |
$355.70
|
| Rate for Payer: VA VA |
$215.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$721.01
|
|
|
HC ART FLOW UPPER LIMITED
|
Facility
|
OP
|
$806.28
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100031
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$725.65 |
| Rate for Payer: Aetna American Axle |
$524.08
|
| Rate for Payer: Aetna Commercial |
$685.34
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$524.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$295.88
|
| Rate for Payer: BCN Commercial |
$295.88
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$645.02
|
| Rate for Payer: Cash Price |
$645.02
|
| Rate for Payer: Cofinity Advantage |
$564.40
|
| Rate for Payer: Cofinity Commercial |
$693.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$645.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$725.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$564.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$604.71
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$685.34
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$604.71
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$685.34
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$507.96
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$524.08
|
| Rate for Payer: UHC Core |
$420.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$316.87
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$298.32
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$604.71
|
|
|
HC ART FLOW UPPER LIMITED
|
Facility
|
IP
|
$806.28
|
|
|
Service Code
|
CPT 93922
|
| Hospital Charge Code |
92100031
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$354.76 |
| Max. Negotiated Rate |
$725.65 |
| Rate for Payer: Aetna American Axle |
$524.08
|
| Rate for Payer: Aetna Commercial |
$685.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$524.08
|
| Rate for Payer: Cash Price |
$645.02
|
| Rate for Payer: Cofinity Advantage |
$564.40
|
| Rate for Payer: Cofinity Commercial |
$693.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$645.02
|
| Rate for Payer: Healthscope Commercial |
$725.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$564.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$604.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$685.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$604.71
|
| Rate for Payer: PHP Commercial |
$685.34
|
| Rate for Payer: Priority Health SBD |
$507.96
|
| Rate for Payer: UMR Bronson Commercial |
$354.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$604.71
|
|
|
HC ARTHROCENTESIS
|
Facility
|
OP
|
$385.45
|
|
| Hospital Charge Code |
45000030
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$346.90 |
| Rate for Payer: Aetna American Axle |
$250.54
|
| Rate for Payer: Aetna Commercial |
$327.63
|
| Rate for Payer: Aetna Medicare |
$192.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.54
|
| Rate for Payer: BCBS Complete |
$154.18
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cofinity Advantage |
$269.81
|
| Rate for Payer: Cofinity Commercial |
$331.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.36
|
| Rate for Payer: Healthscope Commercial |
$346.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.09
|
| Rate for Payer: PHP Commercial |
$327.63
|
| Rate for Payer: Priority Health SBD |
$242.83
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: UMR Bronson Commercial |
$142.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.09
|
|
|
HC ARTHROCENTESIS
|
Facility
|
IP
|
$385.45
|
|
| Hospital Charge Code |
45000030
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$169.60 |
| Max. Negotiated Rate |
$346.90 |
| Rate for Payer: Aetna American Axle |
$250.54
|
| Rate for Payer: Aetna Commercial |
$327.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.54
|
| Rate for Payer: Cash Price |
$308.36
|
| Rate for Payer: Cofinity Advantage |
$269.81
|
| Rate for Payer: Cofinity Commercial |
$331.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.36
|
| Rate for Payer: Healthscope Commercial |
$346.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.09
|
| Rate for Payer: PHP Commercial |
$327.63
|
| Rate for Payer: Priority Health SBD |
$242.83
|
| Rate for Payer: UMR Bronson Commercial |
$169.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.09
|
|
|
HC ARTHROCENTESIS INTERMED JT
|
Facility
|
IP
|
$347.15
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100024
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$152.75 |
| Max. Negotiated Rate |
$312.44 |
| Rate for Payer: Aetna American Axle |
$225.65
|
| Rate for Payer: Aetna Commercial |
$295.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.65
|
| Rate for Payer: Cash Price |
$277.72
|
| Rate for Payer: Cofinity Advantage |
$243.00
|
| Rate for Payer: Cofinity Commercial |
$298.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.72
|
| Rate for Payer: Healthscope Commercial |
$312.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$243.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$260.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.36
|
| Rate for Payer: PHP Commercial |
$295.08
|
| Rate for Payer: Priority Health SBD |
$218.70
|
| Rate for Payer: UMR Bronson Commercial |
$152.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.36
|
|
|
HC ARTHROCENTESIS INTERMED JT
|
Facility
|
OP
|
$347.15
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100024
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.45 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna American Axle |
$225.65
|
| Rate for Payer: Aetna Commercial |
$295.08
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$368.41
|
| Rate for Payer: BCN Commercial |
$368.41
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$277.72
|
| Rate for Payer: Cash Price |
$277.72
|
| Rate for Payer: Cash Price |
$277.72
|
| Rate for Payer: Cofinity Advantage |
$243.00
|
| Rate for Payer: Cofinity Commercial |
$298.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$312.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$243.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$260.36
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$321.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.08
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.36
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$295.08
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$989.08
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health SBD |
$218.70
|
| Rate for Payer: Priority Health Tiered Network |
$791.26
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.65
|
| Rate for Payer: UHC Core |
$180.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$136.43
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$128.45
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.36
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL
|
Facility
|
IP
|
$446.38
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$196.41 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna American Axle |
$290.15
|
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.15
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Advantage |
$312.47
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: Priority Health SBD |
$281.22
|
| Rate for Payer: UMR Bronson Commercial |
$196.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL
|
Facility
|
OP
|
$446.38
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
36100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.96 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna American Axle |
$290.15
|
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$368.41
|
| Rate for Payer: BCN Commercial |
$368.41
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Advantage |
$312.47
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$321.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$989.08
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health SBD |
$281.22
|
| Rate for Payer: Priority Health Tiered Network |
$791.26
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.15
|
| Rate for Payer: UHC Core |
$232.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$175.43
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$165.16
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL W US GUIDE
|
Facility
|
IP
|
$1,492.44
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100457
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$656.67 |
| Max. Negotiated Rate |
$1,343.20 |
| Rate for Payer: Aetna American Axle |
$970.09
|
| Rate for Payer: Aetna Commercial |
$1,268.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$970.09
|
| Rate for Payer: Cash Price |
$1,193.95
|
| Rate for Payer: Cofinity Advantage |
$1,044.71
|
| Rate for Payer: Cofinity Commercial |
$1,283.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.95
|
| Rate for Payer: Healthscope Commercial |
$1,343.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,044.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,119.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.33
|
| Rate for Payer: PHP Commercial |
$1,268.57
|
| Rate for Payer: Priority Health SBD |
$940.24
|
| Rate for Payer: UMR Bronson Commercial |
$656.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,119.33
|
|
|
HC ARTHROCENTESIS INTERMED JT BIL W US GUIDE
|
Facility
|
OP
|
$1,492.44
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100457
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$2,274.56 |
| Rate for Payer: Aetna American Axle |
$970.09
|
| Rate for Payer: Aetna Commercial |
$1,268.57
|
| Rate for Payer: Aetna Medicare |
$731.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$970.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$873.08
|
| Rate for Payer: BCN Commercial |
$873.08
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$1,193.95
|
| Rate for Payer: Cash Price |
$1,193.95
|
| Rate for Payer: Cash Price |
$1,193.95
|
| Rate for Payer: Cofinity Advantage |
$1,044.71
|
| Rate for Payer: Cofinity Commercial |
$1,283.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$1,343.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,044.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,119.33
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$738.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.57
|
| Rate for Payer: Nomi Health Commercial |
$2,110.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.33
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$1,268.57
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,274.56
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health SBD |
$940.24
|
| Rate for Payer: Priority Health Tiered Network |
$1,819.65
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$970.09
|
| Rate for Payer: UHC Core |
$777.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$586.53
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UMR Bronson Commercial |
$552.20
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,119.33
|
|
|
HC ARTHROCENTESIS INTERMED JT W US GUIDE
|
Facility
|
IP
|
$1,106.41
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100456
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$486.82 |
| Max. Negotiated Rate |
$995.77 |
| Rate for Payer: Aetna American Axle |
$719.17
|
| Rate for Payer: Aetna Commercial |
$940.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$719.17
|
| Rate for Payer: Cash Price |
$885.13
|
| Rate for Payer: Cofinity Advantage |
$774.49
|
| Rate for Payer: Cofinity Commercial |
$951.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$885.13
|
| Rate for Payer: Healthscope Commercial |
$995.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$774.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$829.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$940.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$829.81
|
| Rate for Payer: PHP Commercial |
$940.45
|
| Rate for Payer: Priority Health SBD |
$697.04
|
| Rate for Payer: UMR Bronson Commercial |
$486.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$829.81
|
|
|
HC ARTHROCENTESIS INTERMED JT W US GUIDE
|
Facility
|
OP
|
$1,106.41
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
36100456
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$2,274.56 |
| Rate for Payer: Aetna American Axle |
$719.17
|
| Rate for Payer: Aetna Commercial |
$940.45
|
| Rate for Payer: Aetna Medicare |
$731.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$719.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$873.08
|
| Rate for Payer: BCN Commercial |
$873.08
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$885.13
|
| Rate for Payer: Cash Price |
$885.13
|
| Rate for Payer: Cash Price |
$885.13
|
| Rate for Payer: Cofinity Advantage |
$774.49
|
| Rate for Payer: Cofinity Commercial |
$951.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$885.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$995.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$774.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$829.81
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$738.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$940.45
|
| Rate for Payer: Nomi Health Commercial |
$2,110.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$829.81
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$940.45
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,274.56
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health SBD |
$697.04
|
| Rate for Payer: Priority Health Tiered Network |
$1,819.65
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$719.17
|
| Rate for Payer: UHC Core |
$576.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$434.82
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UMR Bronson Commercial |
$409.37
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$829.81
|
|
|
HC ARTHROCENTESIS MAJOR JOINT
|
Facility
|
OP
|
$335.76
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$124.23 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna American Axle |
$218.24
|
| Rate for Payer: Aetna Commercial |
$285.40
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$368.41
|
| Rate for Payer: BCN Commercial |
$368.41
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$268.61
|
| Rate for Payer: Cash Price |
$268.61
|
| Rate for Payer: Cash Price |
$268.61
|
| Rate for Payer: Cofinity Advantage |
$235.03
|
| Rate for Payer: Cofinity Commercial |
$288.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$302.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$235.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$251.82
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$321.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.40
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.82
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$285.40
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$989.08
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health SBD |
$211.53
|
| Rate for Payer: Priority Health Tiered Network |
$791.26
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.24
|
| Rate for Payer: UHC Core |
$174.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$131.95
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$124.23
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$251.82
|
|
|
HC ARTHROCENTESIS MAJOR JOINT
|
Facility
|
IP
|
$335.76
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$147.73 |
| Max. Negotiated Rate |
$302.18 |
| Rate for Payer: Aetna American Axle |
$218.24
|
| Rate for Payer: Aetna Commercial |
$285.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.24
|
| Rate for Payer: Cash Price |
$268.61
|
| Rate for Payer: Cofinity Advantage |
$235.03
|
| Rate for Payer: Cofinity Commercial |
$288.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.61
|
| Rate for Payer: Healthscope Commercial |
$302.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$235.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$251.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.82
|
| Rate for Payer: PHP Commercial |
$285.40
|
| Rate for Payer: Priority Health SBD |
$211.53
|
| Rate for Payer: UMR Bronson Commercial |
$147.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$251.82
|
|
|
HC ARTHROCENTESIS MAJOR JOINT BIL
|
Facility
|
OP
|
$429.70
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100027
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$158.99 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna American Axle |
$279.31
|
| Rate for Payer: Aetna Commercial |
$365.25
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$368.41
|
| Rate for Payer: BCN Commercial |
$368.41
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$343.76
|
| Rate for Payer: Cash Price |
$343.76
|
| Rate for Payer: Cash Price |
$343.76
|
| Rate for Payer: Cofinity Advantage |
$300.79
|
| Rate for Payer: Cofinity Commercial |
$369.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$386.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.27
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$321.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.25
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$322.27
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$365.25
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$989.08
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health SBD |
$270.71
|
| Rate for Payer: Priority Health Tiered Network |
$791.26
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$279.31
|
| Rate for Payer: UHC Core |
$223.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$168.87
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$158.99
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.27
|
|
|
HC ARTHROCENTESIS MAJOR JOINT BIL
|
Facility
|
IP
|
$429.70
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
36100027
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$189.07 |
| Max. Negotiated Rate |
$386.73 |
| Rate for Payer: Aetna American Axle |
$279.31
|
| Rate for Payer: Aetna Commercial |
$365.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.31
|
| Rate for Payer: Cash Price |
$343.76
|
| Rate for Payer: Cofinity Advantage |
$300.79
|
| Rate for Payer: Cofinity Commercial |
$369.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.76
|
| Rate for Payer: Healthscope Commercial |
$386.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$322.27
|
| Rate for Payer: PHP Commercial |
$365.25
|
| Rate for Payer: Priority Health SBD |
$270.71
|
| Rate for Payer: UMR Bronson Commercial |
$189.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.27
|
|
|
HC ARTHROCENTESIS MAJOR JOINT BIL W US GUIDE
|
Facility
|
OP
|
$1,253.34
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
36100455
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.96 |
| Max. Negotiated Rate |
$1,128.01 |
| Rate for Payer: Aetna American Axle |
$814.67
|
| Rate for Payer: Aetna Commercial |
$1,065.34
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$368.41
|
| Rate for Payer: BCN Commercial |
$368.41
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$1,002.67
|
| Rate for Payer: Cash Price |
$1,002.67
|
| Rate for Payer: Cash Price |
$1,002.67
|
| Rate for Payer: Cofinity Advantage |
$877.34
|
| Rate for Payer: Cofinity Commercial |
$1,077.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$1,128.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$877.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$940.00
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$321.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.34
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$940.00
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$1,065.34
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$989.08
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health SBD |
$789.60
|
| Rate for Payer: Priority Health Tiered Network |
$791.26
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$814.67
|
| Rate for Payer: UHC Core |
$652.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$492.56
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$463.74
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$940.00
|
|
|
HC ARTHROCENTESIS MAJOR JOINT BIL W US GUIDE
|
Facility
|
IP
|
$1,253.34
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
36100455
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$551.47 |
| Max. Negotiated Rate |
$1,128.01 |
| Rate for Payer: Aetna American Axle |
$814.67
|
| Rate for Payer: Aetna Commercial |
$1,065.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.67
|
| Rate for Payer: Cash Price |
$1,002.67
|
| Rate for Payer: Cofinity Advantage |
$877.34
|
| Rate for Payer: Cofinity Commercial |
$1,077.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.67
|
| Rate for Payer: Healthscope Commercial |
$1,128.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$877.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$940.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$940.00
|
| Rate for Payer: PHP Commercial |
$1,065.34
|
| Rate for Payer: Priority Health SBD |
$789.60
|
| Rate for Payer: UMR Bronson Commercial |
$551.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$940.00
|
|
|
HC ARTHROCENTESIS MAJOR JOINT W US GUIDE
|
Facility
|
IP
|
$1,163.91
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
36100454
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$512.12 |
| Max. Negotiated Rate |
$1,047.52 |
| Rate for Payer: Aetna American Axle |
$756.54
|
| Rate for Payer: Aetna Commercial |
$989.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$756.54
|
| Rate for Payer: Cash Price |
$931.13
|
| Rate for Payer: Cofinity Advantage |
$814.74
|
| Rate for Payer: Cofinity Commercial |
$1,000.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$931.13
|
| Rate for Payer: Healthscope Commercial |
$1,047.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$814.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$872.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$989.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$872.93
|
| Rate for Payer: PHP Commercial |
$989.32
|
| Rate for Payer: Priority Health SBD |
$733.26
|
| Rate for Payer: UMR Bronson Commercial |
$512.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$872.93
|
|
