|
HC FOREARM/ARM CUFFS FREE MOTIO
|
Facility
|
IP
|
$637.50
|
|
|
Service Code
|
HCPCS L3720
|
| Hospital Charge Code |
27400049
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$280.50 |
| Max. Negotiated Rate |
$573.75 |
| Rate for Payer: Aetna American Axle |
$414.38
|
| Rate for Payer: Aetna Commercial |
$541.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.38
|
| Rate for Payer: Cash Price |
$510.00
|
| Rate for Payer: Cofinity Commercial |
$446.25
|
| Rate for Payer: Cofinity Commercial |
$548.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.00
|
| Rate for Payer: Healthscope Commercial |
$573.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$446.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$478.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$541.88
|
| Rate for Payer: PHP Commercial |
$541.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.25
|
| Rate for Payer: Priority Health SBD |
$401.62
|
| Rate for Payer: UMR Bronson Commercial |
$280.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$478.12
|
|
|
HC FOREARM/ARM CUFFS FREE MOTIO
|
Facility
|
OP
|
$637.50
|
|
|
Service Code
|
HCPCS L3720
|
| Hospital Charge Code |
27400049
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$235.88 |
| Max. Negotiated Rate |
$2,261.87 |
| Rate for Payer: Aetna American Axle |
$414.38
|
| Rate for Payer: Aetna Commercial |
$541.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.38
|
| Rate for Payer: BCBS Complete |
$255.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,261.87
|
| Rate for Payer: Cash Price |
$510.00
|
| Rate for Payer: Cash Price |
$510.00
|
| Rate for Payer: Cofinity Commercial |
$548.25
|
| Rate for Payer: Cofinity Commercial |
$446.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.00
|
| Rate for Payer: Healthscope Commercial |
$573.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$446.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$478.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$541.88
|
| Rate for Payer: PHP Commercial |
$541.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$731.68
|
| Rate for Payer: Priority Health Narrow Network |
$585.34
|
| Rate for Payer: Priority Health SBD |
$401.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,126.67
|
| Rate for Payer: UHC Exchange |
$938.89
|
| Rate for Payer: UMR Bronson Commercial |
$235.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$478.12
|
|
|
HC FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$276.07
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
76100068
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.47 |
| Max. Negotiated Rate |
$248.46 |
| Rate for Payer: Aetna American Axle |
$179.45
|
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.45
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$193.25
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health SBD |
$173.92
|
| Rate for Payer: UMR Bronson Commercial |
$121.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
|
HC FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$450.54
|
|
| Hospital Charge Code |
45000042
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$198.24 |
| Max. Negotiated Rate |
$405.49 |
| Rate for Payer: Aetna American Axle |
$292.85
|
| Rate for Payer: Aetna Commercial |
$382.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.85
|
| Rate for Payer: Cash Price |
$360.43
|
| Rate for Payer: Cofinity Commercial |
$315.38
|
| Rate for Payer: Cofinity Commercial |
$387.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.43
|
| Rate for Payer: Healthscope Commercial |
$405.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$315.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$382.96
|
| Rate for Payer: PHP Commercial |
$382.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.38
|
| Rate for Payer: Priority Health SBD |
$283.84
|
| Rate for Payer: UMR Bronson Commercial |
$198.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.90
|
|
|
HC FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$276.07
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
76100068
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$102.15 |
| Max. Negotiated Rate |
$1,115.78 |
| Rate for Payer: Aetna American Axle |
$179.45
|
| Rate for Payer: Aetna Commercial |
$234.66
|
| Rate for Payer: Aetna Medicare |
$368.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$398.96
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cash Price |
$220.86
|
| Rate for Payer: Cofinity Commercial |
$237.42
|
| Rate for Payer: Cofinity Commercial |
$193.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$248.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.05
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$234.66
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$234.66
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.78
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$892.62
|
| Rate for Payer: Priority Health SBD |
$173.92
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.43
|
| Rate for Payer: UHC Exchange |
$104.45
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: UMR Bronson Commercial |
$102.15
|
| Rate for Payer: VA VA |
$354.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.05
|
|
|
HC FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$450.54
|
|
| Hospital Charge Code |
45000042
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$166.70 |
| Max. Negotiated Rate |
$405.49 |
| Rate for Payer: Aetna American Axle |
$292.85
|
| Rate for Payer: Aetna Commercial |
$382.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.85
|
| Rate for Payer: BCBS Complete |
$180.22
|
| Rate for Payer: Cash Price |
$360.43
|
| Rate for Payer: Cofinity Commercial |
$315.38
|
| Rate for Payer: Cofinity Commercial |
$387.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.43
|
| Rate for Payer: Healthscope Commercial |
$405.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$315.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$382.96
|
| Rate for Payer: PHP Commercial |
$382.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.38
|
| Rate for Payer: Priority Health SBD |
$283.84
|
| Rate for Payer: UMR Bronson Commercial |
$166.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.90
|
|
|
HC FOREIGN BODY REMOVAL EAR
|
Facility
|
OP
|
$212.50
|
|
|
Service Code
|
CPT 69200
|
| Hospital Charge Code |
45000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$46.50 |
| Max. Negotiated Rate |
$357.43 |
| Rate for Payer: Aetna American Axle |
$138.12
|
| Rate for Payer: Aetna Commercial |
$180.62
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$111.19
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$170.00
|
| Rate for Payer: Cash Price |
$170.00
|
| Rate for Payer: Cofinity Commercial |
$148.75
|
| Rate for Payer: Cofinity Commercial |
$182.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$191.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.38
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$180.62
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$180.62
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.43
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$285.94
|
| Rate for Payer: Priority Health SBD |
$133.88
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$46.50
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$78.62
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.38
|
|
|
HC FOREIGN BODY REMOVAL EAR
|
Facility
|
IP
|
$212.50
|
|
|
Service Code
|
CPT 69200
|
| Hospital Charge Code |
45000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.50 |
| Max. Negotiated Rate |
$191.25 |
| Rate for Payer: Aetna American Axle |
$138.12
|
| Rate for Payer: Aetna Commercial |
$180.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.12
|
| Rate for Payer: Cash Price |
$170.00
|
| Rate for Payer: Cofinity Commercial |
$148.75
|
| Rate for Payer: Cofinity Commercial |
$182.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.00
|
| Rate for Payer: Healthscope Commercial |
$191.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$180.62
|
| Rate for Payer: PHP Commercial |
$180.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.75
|
| Rate for Payer: Priority Health SBD |
$133.88
|
| Rate for Payer: UMR Bronson Commercial |
$93.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.38
|
|
|
HC FOREIGN BODY REMOVAL MUSCLE OR TENDON SHEATH SIMPLE
|
Facility
|
OP
|
$1,152.99
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
76100133
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$146.37 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$749.44
|
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,603.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$807.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$726.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$146.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$426.61
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC FOREIGN BODY REMOVAL MUSCLE OR TENDON SHEATH SIMPLE
|
Facility
|
IP
|
$1,152.99
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
76100133
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$507.32 |
| Max. Negotiated Rate |
$1,037.69 |
| Rate for Payer: Aetna American Axle |
$749.44
|
| Rate for Payer: Aetna Commercial |
$980.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$749.44
|
| Rate for Payer: Cash Price |
$922.39
|
| Rate for Payer: Cofinity Commercial |
$807.09
|
| Rate for Payer: Cofinity Commercial |
$991.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$922.39
|
| Rate for Payer: Healthscope Commercial |
$1,037.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$807.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$864.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$980.04
|
| Rate for Payer: PHP Commercial |
$980.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$807.09
|
| Rate for Payer: Priority Health SBD |
$726.38
|
| Rate for Payer: UMR Bronson Commercial |
$507.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$864.74
|
|
|
HC FOREIGN BODY REMOVAL NOSE
|
Facility
|
OP
|
$227.11
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
45000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$357.43 |
| Rate for Payer: Aetna American Axle |
$147.62
|
| Rate for Payer: Aetna Commercial |
$193.04
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$71.97
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$181.69
|
| Rate for Payer: Cash Price |
$181.69
|
| Rate for Payer: Cofinity Commercial |
$195.31
|
| Rate for Payer: Cofinity Commercial |
$158.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$204.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.33
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.04
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$193.04
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.43
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$285.94
|
| Rate for Payer: Priority Health SBD |
$143.08
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$121.81
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$84.03
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.33
|
|
|
HC FOREIGN BODY REMOVAL NOSE
|
Facility
|
IP
|
$227.11
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
45000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$99.93 |
| Max. Negotiated Rate |
$204.40 |
| Rate for Payer: Aetna American Axle |
$147.62
|
| Rate for Payer: Aetna Commercial |
$193.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.62
|
| Rate for Payer: Cash Price |
$181.69
|
| Rate for Payer: Cofinity Commercial |
$158.98
|
| Rate for Payer: Cofinity Commercial |
$195.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.69
|
| Rate for Payer: Healthscope Commercial |
$204.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.04
|
| Rate for Payer: PHP Commercial |
$193.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.98
|
| Rate for Payer: Priority Health SBD |
$143.08
|
| Rate for Payer: UMR Bronson Commercial |
$99.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.33
|
|
|
HC FOREIGN BODY RETRIEV (VASC)
|
Facility
|
IP
|
$3,820.61
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
36100375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,681.07 |
| Max. Negotiated Rate |
$3,438.55 |
| Rate for Payer: Aetna American Axle |
$2,483.40
|
| Rate for Payer: Aetna Commercial |
$3,247.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,483.40
|
| Rate for Payer: Cash Price |
$3,056.49
|
| Rate for Payer: Cofinity Commercial |
$3,285.72
|
| Rate for Payer: Cofinity Commercial |
$2,674.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,056.49
|
| Rate for Payer: Healthscope Commercial |
$3,438.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,674.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,865.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,247.52
|
| Rate for Payer: PHP Commercial |
$3,247.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,674.43
|
| Rate for Payer: Priority Health SBD |
$2,406.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,681.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,865.46
|
|
|
HC FOREIGN BODY RETRIEV (VASC)
|
Facility
|
OP
|
$3,820.61
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
36100375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$286.84 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$2,483.40
|
| Rate for Payer: Aetna Commercial |
$3,247.52
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,483.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,210.06
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,056.49
|
| Rate for Payer: Cash Price |
$3,056.49
|
| Rate for Payer: Cofinity Commercial |
$2,674.43
|
| Rate for Payer: Cofinity Commercial |
$3,285.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,056.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$3,438.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,674.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,865.46
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,247.52
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,247.52
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,674.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$2,406.98
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.52
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$286.84
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,413.63
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,865.46
|
|
|
HC FORESKIN MANIP W LYSIS ADH AND STRETCH
|
Facility
|
OP
|
$359.40
|
|
|
Service Code
|
CPT 54450
|
| Hospital Charge Code |
76100269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.34 |
| Max. Negotiated Rate |
$691.57 |
| Rate for Payer: Aetna American Axle |
$233.61
|
| Rate for Payer: Aetna Commercial |
$305.49
|
| Rate for Payer: Aetna Medicare |
$228.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.60
|
| Rate for Payer: BCBS Complete |
$126.18
|
| Rate for Payer: BCBS MAPPO |
$219.68
|
| Rate for Payer: BCBS Trust/PPO |
$173.36
|
| Rate for Payer: BCN Medicare Advantage |
$219.68
|
| Rate for Payer: Cash Price |
$287.52
|
| Rate for Payer: Cash Price |
$287.52
|
| Rate for Payer: Cofinity Commercial |
$309.08
|
| Rate for Payer: Cofinity Commercial |
$251.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.68
|
| Rate for Payer: Healthscope Commercial |
$323.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.55
|
| Rate for Payer: Mclaren Medicaid |
$120.16
|
| Rate for Payer: Mclaren Medicare |
$219.68
|
| Rate for Payer: Meridian Medicaid |
$126.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$305.49
|
| Rate for Payer: PACE Medicare |
$208.70
|
| Rate for Payer: PACE SWMI |
$219.68
|
| Rate for Payer: PHP Commercial |
$305.49
|
| Rate for Payer: PHP Medicare Advantage |
$219.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$691.57
|
| Rate for Payer: Priority Health Medicare |
$219.68
|
| Rate for Payer: Priority Health Narrow Network |
$553.26
|
| Rate for Payer: Priority Health SBD |
$226.42
|
| Rate for Payer: Railroad Medicare Medicare |
$219.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.68
|
| Rate for Payer: UHC Exchange |
$55.34
|
| Rate for Payer: UHC Medicare Advantage |
$226.27
|
| Rate for Payer: UMR Bronson Commercial |
$132.98
|
| Rate for Payer: VA VA |
$219.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.55
|
|
|
HC FORESKIN MANIP W LYSIS ADH AND STRETCH
|
Facility
|
IP
|
$359.40
|
|
|
Service Code
|
CPT 54450
|
| Hospital Charge Code |
76100269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$158.14 |
| Max. Negotiated Rate |
$323.46 |
| Rate for Payer: Aetna American Axle |
$233.61
|
| Rate for Payer: Aetna Commercial |
$305.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.61
|
| Rate for Payer: Cash Price |
$287.52
|
| Rate for Payer: Cofinity Commercial |
$251.58
|
| Rate for Payer: Cofinity Commercial |
$309.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.52
|
| Rate for Payer: Healthscope Commercial |
$323.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$305.49
|
| Rate for Payer: PHP Commercial |
$305.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.58
|
| Rate for Payer: Priority Health SBD |
$226.42
|
| Rate for Payer: UMR Bronson Commercial |
$158.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.55
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN
|
Facility
|
OP
|
$23.66
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200017
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$21.29 |
| Rate for Payer: Aetna American Axle |
$15.38
|
| Rate for Payer: Aetna Commercial |
$20.11
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.70
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$18.93
|
| Rate for Payer: Cash Price |
$18.93
|
| Rate for Payer: Cofinity Commercial |
$16.56
|
| Rate for Payer: Cofinity Commercial |
$20.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$21.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.74
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.11
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$20.11
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.16
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$5.73
|
| Rate for Payer: Priority Health SBD |
$14.91
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: UMR Bronson Commercial |
$8.75
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.74
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN
|
Facility
|
IP
|
$23.66
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200017
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.41 |
| Max. Negotiated Rate |
$21.29 |
| Rate for Payer: Aetna American Axle |
$15.38
|
| Rate for Payer: Aetna Commercial |
$20.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.38
|
| Rate for Payer: Cash Price |
$18.93
|
| Rate for Payer: Cofinity Commercial |
$16.56
|
| Rate for Payer: Cofinity Commercial |
$20.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.93
|
| Rate for Payer: Healthscope Commercial |
$21.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.11
|
| Rate for Payer: PHP Commercial |
$20.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.56
|
| Rate for Payer: Priority Health SBD |
$14.91
|
| Rate for Payer: UMR Bronson Commercial |
$10.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.74
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN REF LAB
|
Facility
|
OP
|
$34.68
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200125
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna American Axle |
$22.54
|
| Rate for Payer: Aetna Commercial |
$29.48
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.70
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cofinity Commercial |
$29.82
|
| Rate for Payer: Cofinity Commercial |
$24.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.01
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.48
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$29.48
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.16
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$5.73
|
| Rate for Payer: Priority Health SBD |
$21.85
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: UMR Bronson Commercial |
$12.83
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.01
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN REF LAB
|
Facility
|
IP
|
$34.68
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200125
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.26 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna American Axle |
$22.54
|
| Rate for Payer: Aetna Commercial |
$29.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.54
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cofinity Commercial |
$24.28
|
| Rate for Payer: Cofinity Commercial |
$29.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.74
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.48
|
| Rate for Payer: PHP Commercial |
$29.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.28
|
| Rate for Payer: Priority Health SBD |
$21.85
|
| Rate for Payer: UMR Bronson Commercial |
$15.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.01
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL 1
|
Facility
|
OP
|
$690.61
|
|
| Hospital Charge Code |
45000044
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$255.53 |
| Max. Negotiated Rate |
$621.55 |
| Rate for Payer: Aetna American Axle |
$448.90
|
| Rate for Payer: Aetna Commercial |
$587.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$448.90
|
| Rate for Payer: BCBS Complete |
$276.24
|
| Rate for Payer: Cash Price |
$552.49
|
| Rate for Payer: Cofinity Commercial |
$483.43
|
| Rate for Payer: Cofinity Commercial |
$593.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.49
|
| Rate for Payer: Healthscope Commercial |
$621.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$483.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$517.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.02
|
| Rate for Payer: PHP Commercial |
$587.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.43
|
| Rate for Payer: Priority Health SBD |
$435.08
|
| Rate for Payer: UMR Bronson Commercial |
$255.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$517.96
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL 1
|
Facility
|
IP
|
$690.61
|
|
| Hospital Charge Code |
45000044
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$303.87 |
| Max. Negotiated Rate |
$621.55 |
| Rate for Payer: Aetna American Axle |
$448.90
|
| Rate for Payer: Aetna Commercial |
$587.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$448.90
|
| Rate for Payer: Cash Price |
$552.49
|
| Rate for Payer: Cofinity Commercial |
$483.43
|
| Rate for Payer: Cofinity Commercial |
$593.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.49
|
| Rate for Payer: Healthscope Commercial |
$621.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$483.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$517.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$587.02
|
| Rate for Payer: PHP Commercial |
$587.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.43
|
| Rate for Payer: Priority Health SBD |
$435.08
|
| Rate for Payer: UMR Bronson Commercial |
$303.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$517.96
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL II
|
Facility
|
OP
|
$3,041.50
|
|
| Hospital Charge Code |
45000104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,125.36 |
| Max. Negotiated Rate |
$2,737.35 |
| Rate for Payer: Aetna American Axle |
$1,976.98
|
| Rate for Payer: Aetna Commercial |
$2,585.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,976.98
|
| Rate for Payer: BCBS Complete |
$1,216.60
|
| Rate for Payer: Cash Price |
$2,433.20
|
| Rate for Payer: Cofinity Commercial |
$2,129.05
|
| Rate for Payer: Cofinity Commercial |
$2,615.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,433.20
|
| Rate for Payer: Healthscope Commercial |
$2,737.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,129.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,281.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,585.28
|
| Rate for Payer: PHP Commercial |
$2,585.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,129.05
|
| Rate for Payer: Priority Health SBD |
$1,916.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,125.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,281.12
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL II
|
Facility
|
IP
|
$3,041.50
|
|
| Hospital Charge Code |
45000104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,338.26 |
| Max. Negotiated Rate |
$2,737.35 |
| Rate for Payer: Aetna American Axle |
$1,976.98
|
| Rate for Payer: Aetna Commercial |
$2,585.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,976.98
|
| Rate for Payer: Cash Price |
$2,433.20
|
| Rate for Payer: Cofinity Commercial |
$2,129.05
|
| Rate for Payer: Cofinity Commercial |
$2,615.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,433.20
|
| Rate for Payer: Healthscope Commercial |
$2,737.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,129.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,281.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,585.28
|
| Rate for Payer: PHP Commercial |
$2,585.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,129.05
|
| Rate for Payer: Priority Health SBD |
$1,916.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,338.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,281.12
|
|
|
HC FRAGILEX ANALYSIS
|
Facility
|
OP
|
$430.00
|
|
|
Service Code
|
CPT 81243
|
| Hospital Charge Code |
31000099
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$387.00 |
| Rate for Payer: Aetna American Axle |
$279.50
|
| Rate for Payer: Aetna Commercial |
$365.50
|
| Rate for Payer: Aetna Medicare |
$59.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.30
|
| Rate for Payer: BCBS Complete |
$32.76
|
| Rate for Payer: BCBS MAPPO |
$57.04
|
| Rate for Payer: BCBS Trust/PPO |
$51.30
|
| Rate for Payer: BCN Medicare Advantage |
$57.04
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cofinity Commercial |
$369.80
|
| Rate for Payer: Cofinity Commercial |
$301.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.04
|
| Rate for Payer: Healthscope Commercial |
$387.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$301.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.50
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$57.04
|
| Rate for Payer: Meridian Medicaid |
$32.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$59.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.50
|
| Rate for Payer: PACE Medicare |
$54.19
|
| Rate for Payer: PACE SWMI |
$57.04
|
| Rate for Payer: PHP Commercial |
$365.50
|
| Rate for Payer: PHP Medicare Advantage |
$57.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.51
|
| Rate for Payer: Priority Health Medicare |
$57.04
|
| Rate for Payer: Priority Health Narrow Network |
$48.41
|
| Rate for Payer: Priority Health SBD |
$270.90
|
| Rate for Payer: Railroad Medicare Medicare |
$57.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.45
|
| Rate for Payer: UHC Core |
$68.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.04
|
| Rate for Payer: UHC Exchange |
$57.04
|
| Rate for Payer: UHC Medicare Advantage |
$58.75
|
| Rate for Payer: UMR Bronson Commercial |
$159.10
|
| Rate for Payer: VA VA |
$57.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.50
|
|
