|
HC ASMT VERTEBRAL FX VIA DXA
|
Facility
|
IP
|
$199.57
|
|
|
Service Code
|
CPT 77086
|
| Hospital Charge Code |
32000302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$87.81 |
| Max. Negotiated Rate |
$179.61 |
| Rate for Payer: Aetna American Axle |
$129.72
|
| Rate for Payer: Aetna Commercial |
$169.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.72
|
| Rate for Payer: Cash Price |
$159.66
|
| Rate for Payer: Cofinity Advantage |
$139.70
|
| Rate for Payer: Cofinity Commercial |
$171.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.66
|
| Rate for Payer: Healthscope Commercial |
$179.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$139.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.68
|
| Rate for Payer: PHP Commercial |
$169.63
|
| Rate for Payer: Priority Health SBD |
$125.73
|
| Rate for Payer: UMR Bronson Commercial |
$87.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.68
|
|
|
HC ASMT VERTEBRAL FX VIA DXA
|
Facility
|
OP
|
$199.57
|
|
|
Service Code
|
CPT 77086
|
| Hospital Charge Code |
32000302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$280.42 |
| Rate for Payer: Aetna American Axle |
$129.72
|
| Rate for Payer: Aetna Commercial |
$169.63
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$64.86
|
| Rate for Payer: BCN Commercial |
$64.86
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$159.66
|
| Rate for Payer: Cash Price |
$159.66
|
| Rate for Payer: Cofinity Advantage |
$139.70
|
| Rate for Payer: Cofinity Commercial |
$171.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$179.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$139.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.68
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.63
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.68
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$169.63
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$125.73
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.72
|
| Rate for Payer: UHC Core |
$103.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$78.43
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$73.84
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.68
|
|
|
HC ASP AND OR INJ RENAL CYST OR PELVIS
|
Facility
|
OP
|
$1,296.72
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
36100242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna American Axle |
$842.87
|
| Rate for Payer: Aetna Commercial |
$1,102.21
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$842.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$817.23
|
| Rate for Payer: BCN Commercial |
$817.23
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$1,037.38
|
| Rate for Payer: Cash Price |
$1,037.38
|
| Rate for Payer: Cash Price |
$1,037.38
|
| Rate for Payer: Cofinity Advantage |
$907.70
|
| Rate for Payer: Cofinity Commercial |
$1,115.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,037.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$1,167.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$907.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$972.54
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,102.21
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$972.54
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$1,102.21
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$816.93
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: UMR Bronson Commercial |
$479.79
|
| Rate for Payer: VA VA |
$705.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$972.54
|
|
|
HC ASP AND OR INJ RENAL CYST OR PELVIS
|
Facility
|
IP
|
$1,296.72
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
36100242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$570.56 |
| Max. Negotiated Rate |
$1,167.05 |
| Rate for Payer: Aetna American Axle |
$842.87
|
| Rate for Payer: Aetna Commercial |
$1,102.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$842.87
|
| Rate for Payer: Cash Price |
$1,037.38
|
| Rate for Payer: Cofinity Advantage |
$907.70
|
| Rate for Payer: Cofinity Commercial |
$1,115.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,037.38
|
| Rate for Payer: Healthscope Commercial |
$1,167.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$907.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$972.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,102.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$972.54
|
| Rate for Payer: PHP Commercial |
$1,102.21
|
| Rate for Payer: Priority Health SBD |
$816.93
|
| Rate for Payer: UMR Bronson Commercial |
$570.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$972.54
|
|
|
HC ASPERGILLIS IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200028
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ASPERGILLIS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200028
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ASPERGILLUS ANTIBODIES
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200221
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.01 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna American Axle |
$31.04
|
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.04
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Advantage |
$33.43
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: Priority Health SBD |
$30.09
|
| Rate for Payer: UMR Bronson Commercial |
$21.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC ASPERGILLUS ANTIBODIES
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200221
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna American Axle |
$31.04
|
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.40
|
| Rate for Payer: BCN Commercial |
$17.40
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Advantage |
$33.43
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Mclaren Medicaid |
$15.05
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: Meridian Medicaid |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$22.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.05
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health SBD |
$30.09
|
| Rate for Payer: Priority Health Tiered Network |
$12.04
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.58
|
| Rate for Payer: UHC Core |
$22.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.05
|
| Rate for Payer: UHC Exchange |
$22.58
|
| Rate for Payer: UHC Medicaid |
$7.87
|
| Rate for Payer: UHCCP Medicaid |
$7.87
|
| Rate for Payer: UMR Bronson Commercial |
$17.67
|
| Rate for Payer: VA VA |
$15.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC ASPERGILLUS ANTIBODIES CMPT
|
Facility
|
OP
|
$41.39
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200222
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$37.25 |
| Rate for Payer: Aetna American Axle |
$26.90
|
| Rate for Payer: Aetna Commercial |
$35.18
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.40
|
| Rate for Payer: BCN Commercial |
$17.40
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$33.11
|
| Rate for Payer: Cash Price |
$33.11
|
| Rate for Payer: Cofinity Advantage |
$28.97
|
| Rate for Payer: Cofinity Commercial |
$35.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$37.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.04
|
| Rate for Payer: Mclaren Medicaid |
$15.05
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: Meridian Medicaid |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.18
|
| Rate for Payer: Nomi Health Commercial |
$22.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.04
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$35.18
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.05
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health SBD |
$26.08
|
| Rate for Payer: Priority Health Tiered Network |
$12.04
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.58
|
| Rate for Payer: UHC Core |
$22.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.05
|
| Rate for Payer: UHC Exchange |
$22.58
|
| Rate for Payer: UHC Medicaid |
$7.87
|
| Rate for Payer: UHCCP Medicaid |
$7.87
|
| Rate for Payer: UMR Bronson Commercial |
$15.31
|
| Rate for Payer: VA VA |
$15.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.04
|
|
|
HC ASPERGILLUS ANTIBODIES CMPT
|
Facility
|
IP
|
$41.39
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200222
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.21 |
| Max. Negotiated Rate |
$37.25 |
| Rate for Payer: Aetna American Axle |
$26.90
|
| Rate for Payer: Aetna Commercial |
$35.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.90
|
| Rate for Payer: Cash Price |
$33.11
|
| Rate for Payer: Cofinity Advantage |
$28.97
|
| Rate for Payer: Cofinity Commercial |
$35.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.11
|
| Rate for Payer: Healthscope Commercial |
$37.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.04
|
| Rate for Payer: PHP Commercial |
$35.18
|
| Rate for Payer: Priority Health SBD |
$26.08
|
| Rate for Payer: UMR Bronson Commercial |
$18.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.04
|
|
|
HC ASPERGILLUS ANTIGEN
|
Facility
|
IP
|
$85.31
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600135
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.54 |
| Max. Negotiated Rate |
$76.78 |
| Rate for Payer: Aetna American Axle |
$55.45
|
| Rate for Payer: Aetna Commercial |
$72.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.45
|
| Rate for Payer: Cash Price |
$68.25
|
| Rate for Payer: Cofinity Advantage |
$59.72
|
| Rate for Payer: Cofinity Commercial |
$73.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.25
|
| Rate for Payer: Healthscope Commercial |
$76.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.98
|
| Rate for Payer: PHP Commercial |
$72.51
|
| Rate for Payer: Priority Health SBD |
$53.75
|
| Rate for Payer: UMR Bronson Commercial |
$37.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.98
|
|
|
HC ASPERGILLUS ANTIGEN
|
Facility
|
OP
|
$85.31
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600135
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$76.78 |
| Rate for Payer: Aetna American Axle |
$55.45
|
| Rate for Payer: Aetna Commercial |
$72.51
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: BCBS Complete |
$6.58
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$13.86
|
| Rate for Payer: BCN Commercial |
$13.86
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$68.25
|
| Rate for Payer: Cash Price |
$68.25
|
| Rate for Payer: Cofinity Advantage |
$59.72
|
| Rate for Payer: Cofinity Commercial |
$73.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$76.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.98
|
| Rate for Payer: Mclaren Medicaid |
$11.98
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.51
|
| Rate for Payer: Nomi Health Commercial |
$17.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.98
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$72.51
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.98
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health SBD |
$53.75
|
| Rate for Payer: Priority Health Tiered Network |
$9.58
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.97
|
| Rate for Payer: UHC Core |
$17.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.98
|
| Rate for Payer: UHC Exchange |
$17.97
|
| Rate for Payer: UHC Medicaid |
$6.27
|
| Rate for Payer: UHCCP Medicaid |
$6.27
|
| Rate for Payer: UMR Bronson Commercial |
$31.56
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.98
|
|
|
HC ASPERGILLUS ANTIGEN, BAL
|
Facility
|
IP
|
$92.60
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600290
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.74 |
| Max. Negotiated Rate |
$83.34 |
| Rate for Payer: Aetna American Axle |
$60.19
|
| Rate for Payer: Aetna Commercial |
$78.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.19
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cofinity Advantage |
$64.82
|
| Rate for Payer: Cofinity Commercial |
$79.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.08
|
| Rate for Payer: Healthscope Commercial |
$83.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.45
|
| Rate for Payer: PHP Commercial |
$78.71
|
| Rate for Payer: Priority Health SBD |
$58.34
|
| Rate for Payer: UMR Bronson Commercial |
$40.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.45
|
|
|
HC ASPERGILLUS ANTIGEN, BAL
|
Facility
|
OP
|
$92.60
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600290
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$83.34 |
| Rate for Payer: Aetna American Axle |
$60.19
|
| Rate for Payer: Aetna Commercial |
$78.71
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: BCBS Complete |
$6.58
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$13.86
|
| Rate for Payer: BCN Commercial |
$13.86
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cofinity Advantage |
$64.82
|
| Rate for Payer: Cofinity Commercial |
$79.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$83.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.45
|
| Rate for Payer: Mclaren Medicaid |
$11.98
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.71
|
| Rate for Payer: Nomi Health Commercial |
$17.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.45
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$78.71
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.98
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health SBD |
$58.34
|
| Rate for Payer: Priority Health Tiered Network |
$9.58
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.97
|
| Rate for Payer: UHC Core |
$17.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.98
|
| Rate for Payer: UHC Exchange |
$17.97
|
| Rate for Payer: UHC Medicaid |
$6.27
|
| Rate for Payer: UHCCP Medicaid |
$6.27
|
| Rate for Payer: UMR Bronson Commercial |
$34.26
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.45
|
|
|
HC ASPERGILLUS FUMIGATUS IGG AB
|
Facility
|
OP
|
$59.30
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
30200224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.09 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna American Axle |
$38.55
|
| Rate for Payer: Aetna Commercial |
$50.41
|
| Rate for Payer: Aetna Medicare |
$8.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.78
|
| Rate for Payer: BCBS Complete |
$4.29
|
| Rate for Payer: BCBS MAPPO |
$7.82
|
| Rate for Payer: BCBS Trust/PPO |
$9.05
|
| Rate for Payer: BCN Commercial |
$9.05
|
| Rate for Payer: BCN Medicare Advantage |
$7.82
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Advantage |
$41.51
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.82
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: Mclaren Medicaid |
$7.82
|
| Rate for Payer: Mclaren Medicare |
$7.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.21
|
| Rate for Payer: Meridian Medicaid |
$8.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: Nomi Health Commercial |
$11.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.48
|
| Rate for Payer: PACE Medicare |
$7.43
|
| Rate for Payer: PACE SWMI |
$7.82
|
| Rate for Payer: PHP Commercial |
$50.41
|
| Rate for Payer: PHP Medicare Advantage |
$7.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7.82
|
| Rate for Payer: Priority Health Medicare |
$7.82
|
| Rate for Payer: Priority Health SBD |
$37.36
|
| Rate for Payer: Priority Health Tiered Network |
$6.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.73
|
| Rate for Payer: UHC Core |
$11.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.82
|
| Rate for Payer: UHC Exchange |
$11.73
|
| Rate for Payer: UHC Medicaid |
$4.09
|
| Rate for Payer: UHCCP Medicaid |
$4.09
|
| Rate for Payer: UMR Bronson Commercial |
$21.94
|
| Rate for Payer: VA VA |
$7.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC ASPERGILLUS FUMIGATUS IGG AB
|
Facility
|
IP
|
$59.30
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
30200224
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.09 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna American Axle |
$38.55
|
| Rate for Payer: Aetna Commercial |
$50.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.55
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Advantage |
$41.51
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.48
|
| Rate for Payer: PHP Commercial |
$50.41
|
| Rate for Payer: Priority Health SBD |
$37.36
|
| Rate for Payer: UMR Bronson Commercial |
$26.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC ASP INTERVERTEBRAL DISC
|
Facility
|
OP
|
$885.66
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
36100297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$327.69 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna American Axle |
$575.68
|
| Rate for Payer: Aetna Commercial |
$752.81
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$575.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$742.95
|
| Rate for Payer: BCN Commercial |
$742.95
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$708.53
|
| Rate for Payer: Cash Price |
$708.53
|
| Rate for Payer: Cash Price |
$708.53
|
| Rate for Payer: Cofinity Advantage |
$619.96
|
| Rate for Payer: Cofinity Commercial |
$761.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$708.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$797.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$619.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$664.25
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.81
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$664.25
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$752.81
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$557.97
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: UMR Bronson Commercial |
$327.69
|
| Rate for Payer: VA VA |
$705.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$664.25
|
|
|
HC ASP INTERVERTEBRAL DISC
|
Facility
|
IP
|
$885.66
|
|
|
Service Code
|
CPT 62267
|
| Hospital Charge Code |
36100297
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$389.69 |
| Max. Negotiated Rate |
$797.09 |
| Rate for Payer: Aetna American Axle |
$575.68
|
| Rate for Payer: Aetna Commercial |
$752.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$575.68
|
| Rate for Payer: Cash Price |
$708.53
|
| Rate for Payer: Cofinity Advantage |
$619.96
|
| Rate for Payer: Cofinity Commercial |
$761.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$708.53
|
| Rate for Payer: Healthscope Commercial |
$797.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$619.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$664.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$752.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$664.25
|
| Rate for Payer: PHP Commercial |
$752.81
|
| Rate for Payer: Priority Health SBD |
$557.97
|
| Rate for Payer: UMR Bronson Commercial |
$389.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$664.25
|
|
|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
IP
|
$393.93
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$173.33 |
| Max. Negotiated Rate |
$354.54 |
| Rate for Payer: Aetna American Axle |
$256.05
|
| Rate for Payer: Aetna Commercial |
$334.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.05
|
| Rate for Payer: Cash Price |
$315.14
|
| Rate for Payer: Cofinity Advantage |
$275.75
|
| Rate for Payer: Cofinity Commercial |
$338.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.14
|
| Rate for Payer: Healthscope Commercial |
$354.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$275.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$334.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$295.45
|
| Rate for Payer: PHP Commercial |
$334.84
|
| Rate for Payer: Priority Health SBD |
$248.18
|
| Rate for Payer: UMR Bronson Commercial |
$173.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.45
|
|
|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
OP
|
$393.93
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$53.36 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna American Axle |
$256.05
|
| Rate for Payer: Aetna Commercial |
$334.84
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.05
|
| 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 |
$53.36
|
| Rate for Payer: BCN Commercial |
$53.36
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$315.14
|
| Rate for Payer: Cash Price |
$315.14
|
| Rate for Payer: Cash Price |
$315.14
|
| Rate for Payer: Cofinity Advantage |
$275.75
|
| Rate for Payer: Cofinity Commercial |
$338.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$354.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$275.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.45
|
| 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 |
$334.84
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$295.45
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$334.84
|
| 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 |
$248.18
|
| 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) |
$256.05
|
| Rate for Payer: UHC Core |
$205.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$154.81
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$145.75
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.45
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
OP
|
$3,190.79
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna American Axle |
$2,074.01
|
| Rate for Payer: Aetna Commercial |
$2,712.17
|
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,074.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,739.40
|
| Rate for Payer: BCN Commercial |
$1,739.40
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$2,552.63
|
| Rate for Payer: Cash Price |
$2,552.63
|
| Rate for Payer: Cash Price |
$2,552.63
|
| Rate for Payer: Cofinity Advantage |
$2,233.55
|
| Rate for Payer: Cofinity Commercial |
$2,744.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,552.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$2,871.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,233.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,393.09
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$2,187.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,712.17
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,393.09
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$2,712.17
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,735.82
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health SBD |
$2,010.20
|
| Rate for Payer: Priority Health Tiered Network |
$5,388.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,180.59
|
| Rate for Payer: VA VA |
$2,082.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,393.09
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
IP
|
$3,190.79
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,403.95 |
| Max. Negotiated Rate |
$2,871.71 |
| Rate for Payer: Aetna American Axle |
$2,074.01
|
| Rate for Payer: Aetna Commercial |
$2,712.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,074.01
|
| Rate for Payer: Cash Price |
$2,552.63
|
| Rate for Payer: Cofinity Advantage |
$2,233.55
|
| Rate for Payer: Cofinity Commercial |
$2,744.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,552.63
|
| Rate for Payer: Healthscope Commercial |
$2,871.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,233.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,393.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,712.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,393.09
|
| Rate for Payer: PHP Commercial |
$2,712.17
|
| Rate for Payer: Priority Health SBD |
$2,010.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,403.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,393.09
|
|
|
HC ASPIRATION CYST OVARIAN ABDOMINAL APPROACH UNI OR BIL
|
Facility
|
IP
|
$4,421.07
|
|
|
Service Code
|
CPT 58805
|
| Hospital Charge Code |
36100258
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,945.27 |
| Max. Negotiated Rate |
$3,978.96 |
| Rate for Payer: Aetna American Axle |
$2,873.70
|
| Rate for Payer: Aetna Commercial |
$3,757.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,873.70
|
| Rate for Payer: Cash Price |
$3,536.86
|
| Rate for Payer: Cofinity Advantage |
$3,094.75
|
| Rate for Payer: Cofinity Commercial |
$3,802.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,536.86
|
| Rate for Payer: Healthscope Commercial |
$3,978.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,094.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,315.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,757.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,315.80
|
| Rate for Payer: PHP Commercial |
$3,757.91
|
| Rate for Payer: Priority Health SBD |
$2,785.27
|
| Rate for Payer: UMR Bronson Commercial |
$1,945.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,315.80
|
|
|
HC ASPIRATION CYST OVARIAN ABDOMINAL APPROACH UNI OR BIL
|
Facility
|
OP
|
$4,421.07
|
|
|
Service Code
|
CPT 58805
|
| Hospital Charge Code |
36100258
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,635.80 |
| Max. Negotiated Rate |
$10,430.93 |
| Rate for Payer: Aetna American Axle |
$2,873.70
|
| Rate for Payer: Aetna Commercial |
$3,757.91
|
| Rate for Payer: Aetna Medicare |
$3,354.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,873.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,340.72
|
| Rate for Payer: BCN Commercial |
$2,340.72
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$3,536.86
|
| Rate for Payer: Cash Price |
$3,536.86
|
| Rate for Payer: Cash Price |
$3,536.86
|
| Rate for Payer: Cofinity Advantage |
$3,094.75
|
| Rate for Payer: Cofinity Commercial |
$3,802.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,536.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$3,978.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,094.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,315.80
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$3,386.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,757.91
|
| Rate for Payer: Nomi Health Commercial |
$9,676.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,315.80
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$3,757.91
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,430.93
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health SBD |
$2,785.27
|
| Rate for Payer: Priority Health Tiered Network |
$8,344.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,635.80
|
| Rate for Payer: VA VA |
$3,225.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,315.80
|
|
|
HC ASPIRATION CYST OVARIAN VAGINAL APPROACH UNI OR BIL
|
Facility
|
OP
|
$2,595.19
|
|
|
Service Code
|
CPT 58800
|
| Hospital Charge Code |
36100257
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$960.22 |
| Max. Negotiated Rate |
$10,430.93 |
| Rate for Payer: Aetna American Axle |
$1,686.87
|
| Rate for Payer: Aetna Commercial |
$2,205.91
|
| Rate for Payer: Aetna Medicare |
$3,354.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,686.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,006.33
|
| Rate for Payer: BCN Commercial |
$2,006.33
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$2,076.15
|
| Rate for Payer: Cash Price |
$2,076.15
|
| Rate for Payer: Cash Price |
$2,076.15
|
| Rate for Payer: Cofinity Advantage |
$1,816.63
|
| Rate for Payer: Cofinity Commercial |
$2,231.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,076.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$2,335.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,816.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,946.39
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$3,386.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,205.91
|
| Rate for Payer: Nomi Health Commercial |
$9,676.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,946.39
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$2,205.91
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,430.93
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health SBD |
$1,634.97
|
| Rate for Payer: Priority Health Tiered Network |
$8,344.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: UMR Bronson Commercial |
$960.22
|
| Rate for Payer: VA VA |
$3,225.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,946.39
|
|
