|
ANIDULAFUNGIN 50 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$55.06
|
|
|
Service Code
|
HCPCS J0348
|
| Hospital Charge Code |
76344
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.84 |
| Max. Negotiated Rate |
$49.55 |
| Rate for Payer: Aetna American Axle |
$35.79
|
| Rate for Payer: Aetna Commercial |
$46.80
|
| Rate for Payer: Aetna Medicare |
$27.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.79
|
| Rate for Payer: BCBS Complete |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$1.62
|
| Rate for Payer: BCN Commercial |
$1.62
|
| Rate for Payer: Cash Price |
$44.05
|
| Rate for Payer: Cash Price |
$44.05
|
| Rate for Payer: Cofinity Advantage |
$38.54
|
| Rate for Payer: Cofinity Commercial |
$47.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.05
|
| Rate for Payer: Healthscope Commercial |
$49.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.30
|
| Rate for Payer: PHP Commercial |
$46.80
|
| Rate for Payer: Priority Health SBD |
$34.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.84
|
| Rate for Payer: UHC Core |
$0.84
|
| Rate for Payer: UHC Exchange |
$0.84
|
| Rate for Payer: UMR Bronson Commercial |
$20.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.30
|
|
|
ANIFROLUMAB-FNIA 300 MG/2 ML (150 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$14,357.85
|
|
|
Service Code
|
HCPCS J0491
|
| Hospital Charge Code |
197996
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$12,922.07 |
| Rate for Payer: Aetna American Axle |
$9,332.60
|
| Rate for Payer: Aetna Commercial |
$12,204.17
|
| Rate for Payer: Aetna Medicare |
$19.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,332.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.89
|
| Rate for Payer: BCBS Complete |
$10.06
|
| Rate for Payer: BCBS MAPPO |
$18.31
|
| Rate for Payer: BCBS Trust/PPO |
$59.45
|
| Rate for Payer: BCN Commercial |
$59.45
|
| Rate for Payer: BCN Medicare Advantage |
$18.31
|
| Rate for Payer: Cash Price |
$11,486.28
|
| Rate for Payer: Cash Price |
$11,486.28
|
| Rate for Payer: Cofinity Advantage |
$10,050.50
|
| Rate for Payer: Cofinity Commercial |
$12,347.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,486.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.31
|
| Rate for Payer: Healthscope Commercial |
$12,922.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,050.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,768.39
|
| Rate for Payer: Mclaren Medicaid |
$18.31
|
| Rate for Payer: Mclaren Medicare |
$18.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.23
|
| Rate for Payer: Meridian Medicaid |
$19.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,204.17
|
| Rate for Payer: Nomi Health Commercial |
$54.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,768.39
|
| Rate for Payer: PACE Medicare |
$17.39
|
| Rate for Payer: PACE SWMI |
$18.31
|
| Rate for Payer: PHP Commercial |
$12,204.17
|
| Rate for Payer: PHP Medicare Advantage |
$18.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$57.03
|
| Rate for Payer: Priority Health Medicare |
$18.31
|
| Rate for Payer: Priority Health SBD |
$9,045.45
|
| Rate for Payer: Priority Health Tiered Network |
$45.62
|
| Rate for Payer: Railroad Medicare Medicare |
$18.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.26
|
| Rate for Payer: UHC Core |
$30.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.31
|
| Rate for Payer: UHC Exchange |
$30.26
|
| Rate for Payer: UHC Medicaid |
$9.58
|
| Rate for Payer: UHCCP Medicaid |
$9.58
|
| Rate for Payer: UMR Bronson Commercial |
$5,312.40
|
| Rate for Payer: VA VA |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,768.39
|
|
|
ANIFROLUMAB-FNIA 300 MG/2 ML (150 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$14,357.85
|
|
|
Service Code
|
HCPCS J0491
|
| Hospital Charge Code |
197996
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6,317.45 |
| Max. Negotiated Rate |
$12,922.07 |
| Rate for Payer: Aetna American Axle |
$9,332.60
|
| Rate for Payer: Aetna Commercial |
$12,204.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,332.60
|
| Rate for Payer: Cash Price |
$11,486.28
|
| Rate for Payer: Cofinity Advantage |
$10,050.50
|
| Rate for Payer: Cofinity Commercial |
$12,347.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,486.28
|
| Rate for Payer: Healthscope Commercial |
$12,922.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,050.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,768.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,204.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,768.39
|
| Rate for Payer: PHP Commercial |
$12,204.17
|
| Rate for Payer: Priority Health SBD |
$9,045.45
|
| Rate for Payer: UMR Bronson Commercial |
$6,317.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,768.39
|
|
|
ANORECTAL EXAM, SURGICAL, REQUIRING ANESTHESIA (GENERAL, SPINAL, OR EPIDURAL), DIAGNOSTIC
|
Facility
|
OP
|
$8,943.95
|
|
|
Service Code
|
CPT 45990
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,446.45 |
| Max. Negotiated Rate |
$8,943.95 |
| Rate for Payer: Aetna Medicare |
$2,876.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,441.00
|
| Rate for Payer: BCN Commercial |
$3,441.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Mclaren Medicaid |
$2,765.68
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$2,903.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Nomi Health Commercial |
$8,297.04
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,943.95
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health Tiered Network |
$7,155.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,765.68
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: VA VA |
$2,765.68
|
|
|
ANORECTAL MANOMETRY
|
Facility
|
OP
|
$403.41
|
|
|
Service Code
|
CPT 91122
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$403.41 |
| Max. Negotiated Rate |
$403.41 |
| Rate for Payer: BCBS Trust/PPO |
$403.41
|
| Rate for Payer: BCN Commercial |
$403.41
|
|
|
ANOSCOPY; WITH BIOPSY, SINGLE OR MULTIPLE
|
Facility
|
OP
|
$3,855.91
|
|
|
Service Code
|
CPT 46606
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$289.12 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$289.12
|
| Rate for Payer: BCN Commercial |
$289.12
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
ANOSCOPY; WITH CONTROL OF BLEEDING (EG, INJECTION, BIPOLAR CAUTERY, UNIPOLAR CAUTERY, LASER, HEATER PROBE, STAPLER, PLASMA COAGULATOR)
|
Facility
|
OP
|
$3,855.91
|
|
|
Service Code
|
CPT 46614
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$143.41 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$143.41
|
| Rate for Payer: BCN Commercial |
$143.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
ANOSCOPY; WITH HIGH-RESOLUTION MAGNIFICATION (HRA) (EG, COLPOSCOPE, OPERATING MICROSCOPE) AND CHEMICAL AGENT ENHANCEMENT, WITH BIOPSY, SINGLE OR MULTIPLE
|
Facility
|
OP
|
$3,855.91
|
|
|
Service Code
|
CPT 46607
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$623.59 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,041.07
|
| Rate for Payer: BCN Commercial |
$1,041.07
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: VA VA |
$1,192.34
|
|
|
ANOXIC AND OTHER SEVERE BRAIN DAMAGE
|
Facility
|
IP
|
$15,848.62
|
|
|
Service Code
|
APR-DRG 0594
|
| Min. Negotiated Rate |
$15,093.92 |
| Max. Negotiated Rate |
$15,848.62 |
| Rate for Payer: BCBS Complete |
$15,848.62
|
| Rate for Payer: Mclaren Medicaid |
$15,093.92
|
| Rate for Payer: Meridian Medicaid |
$15,848.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,093.92
|
| Rate for Payer: UHC Medicaid |
$15,093.92
|
| Rate for Payer: UHCCP Medicaid |
$15,093.92
|
|
|
ANOXIC AND OTHER SEVERE BRAIN DAMAGE
|
Facility
|
IP
|
$4,635.58
|
|
|
Service Code
|
APR-DRG 0591
|
| Min. Negotiated Rate |
$4,414.84 |
| Max. Negotiated Rate |
$4,635.58 |
| Rate for Payer: BCBS Complete |
$4,635.58
|
| Rate for Payer: Mclaren Medicaid |
$4,414.84
|
| Rate for Payer: Meridian Medicaid |
$4,635.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,414.84
|
| Rate for Payer: UHC Medicaid |
$4,414.84
|
| Rate for Payer: UHCCP Medicaid |
$4,414.84
|
|
|
ANOXIC AND OTHER SEVERE BRAIN DAMAGE
|
Facility
|
IP
|
$7,421.28
|
|
|
Service Code
|
APR-DRG 0592
|
| Min. Negotiated Rate |
$7,067.89 |
| Max. Negotiated Rate |
$7,421.28 |
| Rate for Payer: BCBS Complete |
$7,421.28
|
| Rate for Payer: Mclaren Medicaid |
$7,067.89
|
| Rate for Payer: Meridian Medicaid |
$7,421.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,067.89
|
| Rate for Payer: UHC Medicaid |
$7,067.89
|
| Rate for Payer: UHCCP Medicaid |
$7,067.89
|
|
|
ANOXIC AND OTHER SEVERE BRAIN DAMAGE
|
Facility
|
IP
|
$9,596.82
|
|
|
Service Code
|
APR-DRG 0593
|
| Min. Negotiated Rate |
$9,139.83 |
| Max. Negotiated Rate |
$9,596.82 |
| Rate for Payer: BCBS Complete |
$9,596.82
|
| Rate for Payer: Mclaren Medicaid |
$9,139.83
|
| Rate for Payer: Meridian Medicaid |
$9,596.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,139.83
|
| Rate for Payer: UHC Medicaid |
$9,139.83
|
| Rate for Payer: UHCCP Medicaid |
$9,139.83
|
|
|
ANTEPARTUM WITH O.R. PROCEDURE
|
Facility
|
IP
|
$5,769.96
|
|
|
Service Code
|
APR-DRG 5472
|
| Min. Negotiated Rate |
$5,495.20 |
| Max. Negotiated Rate |
$5,769.96 |
| Rate for Payer: BCBS Complete |
$5,769.96
|
| Rate for Payer: Mclaren Medicaid |
$5,495.20
|
| Rate for Payer: Meridian Medicaid |
$5,769.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,495.20
|
| Rate for Payer: UHC Medicaid |
$5,495.20
|
| Rate for Payer: UHCCP Medicaid |
$5,495.20
|
|
|
ANTEPARTUM WITH O.R. PROCEDURE
|
Facility
|
IP
|
$8,740.29
|
|
|
Service Code
|
APR-DRG 5473
|
| Min. Negotiated Rate |
$8,324.08 |
| Max. Negotiated Rate |
$8,740.29 |
| Rate for Payer: BCBS Complete |
$8,740.29
|
| Rate for Payer: Mclaren Medicaid |
$8,324.08
|
| Rate for Payer: Meridian Medicaid |
$8,740.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,324.08
|
| Rate for Payer: UHC Medicaid |
$8,324.08
|
| Rate for Payer: UHCCP Medicaid |
$8,324.08
|
|
|
ANTEPARTUM WITH O.R. PROCEDURE
|
Facility
|
IP
|
$3,044.78
|
|
|
Service Code
|
APR-DRG 5471
|
| Min. Negotiated Rate |
$2,899.80 |
| Max. Negotiated Rate |
$3,044.78 |
| Rate for Payer: BCBS Complete |
$3,044.78
|
| Rate for Payer: Mclaren Medicaid |
$2,899.80
|
| Rate for Payer: Meridian Medicaid |
$3,044.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,899.80
|
| Rate for Payer: UHC Medicaid |
$2,899.80
|
| Rate for Payer: UHCCP Medicaid |
$2,899.80
|
|
|
ANTEPARTUM WITH O.R. PROCEDURE
|
Facility
|
IP
|
$16,676.10
|
|
|
Service Code
|
APR-DRG 5474
|
| Min. Negotiated Rate |
$15,882.00 |
| Max. Negotiated Rate |
$16,676.10 |
| Rate for Payer: BCBS Complete |
$16,676.10
|
| Rate for Payer: Mclaren Medicaid |
$15,882.00
|
| Rate for Payer: Meridian Medicaid |
$16,676.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$15,882.00
|
| Rate for Payer: UHC Medicaid |
$15,882.00
|
| Rate for Payer: UHCCP Medicaid |
$15,882.00
|
|
|
ANTEPARTUM WITHOUT O.R. PROCEDURE
|
Facility
|
IP
|
$3,056.89
|
|
|
Service Code
|
APR-DRG 5662
|
| Min. Negotiated Rate |
$2,911.32 |
| Max. Negotiated Rate |
$3,056.89 |
| Rate for Payer: BCBS Complete |
$3,056.89
|
| Rate for Payer: Mclaren Medicaid |
$2,911.32
|
| Rate for Payer: Meridian Medicaid |
$3,056.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,911.32
|
| Rate for Payer: UHC Medicaid |
$2,911.32
|
| Rate for Payer: UHCCP Medicaid |
$2,911.32
|
|
|
ANTEPARTUM WITHOUT O.R. PROCEDURE
|
Facility
|
IP
|
$10,276.60
|
|
|
Service Code
|
APR-DRG 5664
|
| Min. Negotiated Rate |
$9,787.24 |
| Max. Negotiated Rate |
$10,276.60 |
| Rate for Payer: BCBS Complete |
$10,276.60
|
| Rate for Payer: Mclaren Medicaid |
$9,787.24
|
| Rate for Payer: Meridian Medicaid |
$10,276.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,787.24
|
| Rate for Payer: UHC Medicaid |
$9,787.24
|
| Rate for Payer: UHCCP Medicaid |
$9,787.24
|
|
|
ANTEPARTUM WITHOUT O.R. PROCEDURE
|
Facility
|
IP
|
$5,370.44
|
|
|
Service Code
|
APR-DRG 5663
|
| Min. Negotiated Rate |
$5,114.71 |
| Max. Negotiated Rate |
$5,370.44 |
| Rate for Payer: BCBS Complete |
$5,370.44
|
| Rate for Payer: Mclaren Medicaid |
$5,114.71
|
| Rate for Payer: Meridian Medicaid |
$5,370.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,114.71
|
| Rate for Payer: UHC Medicaid |
$5,114.71
|
| Rate for Payer: UHCCP Medicaid |
$5,114.71
|
|
|
ANTEPARTUM WITHOUT O.R. PROCEDURE
|
Facility
|
IP
|
$2,129.53
|
|
|
Service Code
|
APR-DRG 5661
|
| Min. Negotiated Rate |
$2,028.13 |
| Max. Negotiated Rate |
$2,129.53 |
| Rate for Payer: BCBS Complete |
$2,129.53
|
| Rate for Payer: Mclaren Medicaid |
$2,028.13
|
| Rate for Payer: Meridian Medicaid |
$2,129.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,028.13
|
| Rate for Payer: UHC Medicaid |
$2,028.13
|
| Rate for Payer: UHCCP Medicaid |
$2,028.13
|
|
|
ANTERIOR COLPORRHAPHY, REPAIR OF CYSTOCELE WITH OR WITHOUT REPAIR OF URETHROCELE, INCLUDING CYSTOURETHROSCOPY, WHEN PERFORMED
|
Facility
|
OP
|
$16,119.31
|
|
|
Service Code
|
CPT 57240
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,606.87 |
| Max. Negotiated Rate |
$16,119.31 |
| Rate for Payer: Aetna Medicare |
$5,183.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,230.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,230.57
|
| Rate for Payer: BCBS Complete |
$2,737.47
|
| Rate for Payer: BCBS MAPPO |
$4,984.46
|
| Rate for Payer: BCBS Trust/PPO |
$4,409.78
|
| Rate for Payer: BCN Commercial |
$4,409.78
|
| Rate for Payer: BCN Medicare Advantage |
$4,984.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,984.46
|
| Rate for Payer: Mclaren Medicaid |
$4,984.46
|
| Rate for Payer: Mclaren Medicare |
$4,984.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,233.68
|
| Rate for Payer: Meridian Medicaid |
$5,233.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,732.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,482.91
|
| Rate for Payer: Nomi Health Commercial |
$14,953.38
|
| Rate for Payer: PACE Medicare |
$4,735.24
|
| Rate for Payer: PACE SWMI |
$4,984.46
|
| Rate for Payer: PHP Medicare Advantage |
$4,984.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,606.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16,119.31
|
| Rate for Payer: Priority Health Medicare |
$4,984.46
|
| Rate for Payer: Priority Health Tiered Network |
$12,895.45
|
| Rate for Payer: Railroad Medicare Medicare |
$4,984.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4,984.46
|
| Rate for Payer: UHC Medicaid |
$2,606.87
|
| Rate for Payer: UHCCP Medicaid |
$2,606.87
|
| Rate for Payer: VA VA |
$4,984.46
|
|
|
ANTERIOR INSTRUMENTATION; 2 TO 3 VERTEBRAL SEGMENTS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$3,269.53
|
|
|
Service Code
|
CPT 22845
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,269.53 |
| Max. Negotiated Rate |
$3,269.53 |
| Rate for Payer: BCBS Trust/PPO |
$3,269.53
|
| Rate for Payer: BCN Commercial |
$3,269.53
|
|
|
ANTERIOR INSTRUMENTATION; 4 TO 7 VERTEBRAL SEGMENTS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)
|
Facility
|
OP
|
$3,394.72
|
|
|
Service Code
|
CPT 22846
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,394.72 |
| Max. Negotiated Rate |
$3,394.72 |
| Rate for Payer: BCBS Trust/PPO |
$3,394.72
|
| Rate for Payer: BCN Commercial |
$3,394.72
|
|
|
ANTIHEMOPHILIC FACTOR (RECOMB) 1,000 (+/-) UNIT INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$3.46
|
|
|
Service Code
|
HCPCS J7192
|
| Hospital Charge Code |
24926
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.52 |
| Max. Negotiated Rate |
$3.11 |
| Rate for Payer: Aetna American Axle |
$2.25
|
| Rate for Payer: Aetna Commercial |
$2.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.25
|
| Rate for Payer: Cash Price |
$2.77
|
| Rate for Payer: Cofinity Advantage |
$2.42
|
| Rate for Payer: Cofinity Commercial |
$2.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.77
|
| Rate for Payer: Healthscope Commercial |
$3.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.60
|
| Rate for Payer: PHP Commercial |
$2.94
|
| Rate for Payer: Priority Health SBD |
$2.18
|
| Rate for Payer: UMR Bronson Commercial |
$1.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.60
|
|
|
ANTIHEMOPHILIC FACTOR (RECOMB) 1,000 (+/-) UNIT INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$3.46
|
|
|
Service Code
|
HCPCS J7192
|
| Hospital Charge Code |
24926
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$5.16 |
| Rate for Payer: Aetna American Axle |
$2.25
|
| Rate for Payer: Aetna Commercial |
$2.94
|
| Rate for Payer: Aetna Medicare |
$1.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.96
|
| Rate for Payer: BCBS Complete |
$0.86
|
| Rate for Payer: BCBS MAPPO |
$1.57
|
| Rate for Payer: BCBS Trust/PPO |
$5.16
|
| Rate for Payer: BCN Commercial |
$5.16
|
| Rate for Payer: BCN Medicare Advantage |
$1.57
|
| Rate for Payer: Cash Price |
$2.77
|
| Rate for Payer: Cash Price |
$2.77
|
| Rate for Payer: Cofinity Advantage |
$2.42
|
| Rate for Payer: Cofinity Commercial |
$2.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.57
|
| Rate for Payer: Healthscope Commercial |
$3.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.60
|
| Rate for Payer: Mclaren Medicaid |
$1.57
|
| Rate for Payer: Mclaren Medicare |
$1.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.65
|
| Rate for Payer: Meridian Medicaid |
$1.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.94
|
| Rate for Payer: Nomi Health Commercial |
$4.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.60
|
| Rate for Payer: PACE Medicare |
$1.49
|
| Rate for Payer: PACE SWMI |
$1.57
|
| Rate for Payer: PHP Commercial |
$2.94
|
| Rate for Payer: PHP Medicare Advantage |
$1.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.07
|
| Rate for Payer: Priority Health Medicare |
$1.57
|
| Rate for Payer: Priority Health SBD |
$2.18
|
| Rate for Payer: Priority Health Tiered Network |
$4.06
|
| Rate for Payer: Railroad Medicare Medicare |
$1.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.62
|
| Rate for Payer: UHC Core |
$2.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1.57
|
| Rate for Payer: UHC Exchange |
$2.62
|
| Rate for Payer: UHC Medicaid |
$0.82
|
| Rate for Payer: UHCCP Medicaid |
$0.82
|
| Rate for Payer: UMR Bronson Commercial |
$1.28
|
| Rate for Payer: VA VA |
$1.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.60
|
|
