|
HC CAST SUP SHT ARM SPLINT PED PLST
|
Facility
|
OP
|
$16.00
|
|
| Hospital Charge Code |
27000713
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.92 |
| Max. Negotiated Rate |
$14.40 |
| Rate for Payer: Aetna American Axle |
$10.40
|
| Rate for Payer: Aetna Commercial |
$13.60
|
| Rate for Payer: Aetna Medicare |
$8.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.40
|
| Rate for Payer: BCBS Complete |
$6.40
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cofinity Advantage |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$13.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.80
|
| Rate for Payer: Healthscope Commercial |
$14.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.00
|
| Rate for Payer: PHP Commercial |
$13.60
|
| Rate for Payer: Priority Health SBD |
$10.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.40
|
| Rate for Payer: UHC Core |
$8.34
|
| Rate for Payer: UHC Exchange |
$6.29
|
| Rate for Payer: UMR Bronson Commercial |
$5.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.00
|
|
|
HC CAST SUP SHT ARM SPLINT PED PLST
|
Facility
|
IP
|
$16.00
|
|
| Hospital Charge Code |
27000713
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.04 |
| Max. Negotiated Rate |
$14.40 |
| Rate for Payer: Aetna American Axle |
$10.40
|
| Rate for Payer: Aetna Commercial |
$13.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.40
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cofinity Advantage |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$13.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.80
|
| Rate for Payer: Healthscope Commercial |
$14.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.00
|
| Rate for Payer: PHP Commercial |
$13.60
|
| Rate for Payer: Priority Health SBD |
$10.08
|
| Rate for Payer: UMR Bronson Commercial |
$7.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.00
|
|
|
HC CAST SUP SHT GAUNTLET FBRGLS
|
Facility
|
IP
|
$58.36
|
|
| Hospital Charge Code |
27200331
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$25.68 |
| Max. Negotiated Rate |
$52.52 |
| Rate for Payer: Aetna American Axle |
$37.93
|
| Rate for Payer: Aetna Commercial |
$49.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.93
|
| Rate for Payer: Cash Price |
$46.69
|
| Rate for Payer: Cofinity Advantage |
$40.85
|
| Rate for Payer: Cofinity Commercial |
$50.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.69
|
| Rate for Payer: Healthscope Commercial |
$52.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.77
|
| Rate for Payer: PHP Commercial |
$49.61
|
| Rate for Payer: Priority Health SBD |
$36.77
|
| Rate for Payer: UMR Bronson Commercial |
$25.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.77
|
|
|
HC CAST SUP SHT GAUNTLET FBRGLS
|
Facility
|
OP
|
$58.36
|
|
| Hospital Charge Code |
27200331
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.59 |
| Max. Negotiated Rate |
$52.52 |
| Rate for Payer: Aetna American Axle |
$37.93
|
| Rate for Payer: Aetna Commercial |
$49.61
|
| Rate for Payer: Aetna Medicare |
$29.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.93
|
| Rate for Payer: BCBS Complete |
$23.34
|
| Rate for Payer: Cash Price |
$46.69
|
| Rate for Payer: Cofinity Advantage |
$40.85
|
| Rate for Payer: Cofinity Commercial |
$50.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.69
|
| Rate for Payer: Healthscope Commercial |
$52.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.77
|
| Rate for Payer: PHP Commercial |
$49.61
|
| Rate for Payer: Priority Health SBD |
$36.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.93
|
| Rate for Payer: UHC Core |
$30.41
|
| Rate for Payer: UHC Exchange |
$22.94
|
| Rate for Payer: UMR Bronson Commercial |
$21.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.77
|
|
|
HC CAST SUP SHT GAUNTLET PLST
|
Facility
|
OP
|
$34.68
|
|
| Hospital Charge Code |
27000710
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.83 |
| 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 |
$17.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.54
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cofinity Advantage |
$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: MI Amish Medical Board Commercial |
$27.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.01
|
| Rate for Payer: PHP Commercial |
$29.48
|
| Rate for Payer: Priority Health SBD |
$21.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.54
|
| Rate for Payer: UHC Core |
$18.07
|
| Rate for Payer: UHC Exchange |
$13.63
|
| Rate for Payer: UMR Bronson Commercial |
$12.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.01
|
|
|
HC CAST SUP SHT GAUNTLET PLST
|
Facility
|
IP
|
$34.68
|
|
| Hospital Charge Code |
27000710
|
|
Hospital Revenue Code
|
270
|
| 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 Advantage |
$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 Commercial |
$29.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.01
|
| Rate for Payer: PHP Commercial |
$29.48
|
| 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 CAST SUP SHT LEG SPLINT ADULT FBRGLS
|
Facility
|
OP
|
$31.83
|
|
| Hospital Charge Code |
27200341
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.78 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna American Axle |
$20.69
|
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.69
|
| Rate for Payer: BCBS Complete |
$12.73
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Advantage |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health SBD |
$20.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.69
|
| Rate for Payer: UHC Core |
$16.58
|
| Rate for Payer: UHC Exchange |
$12.51
|
| Rate for Payer: UMR Bronson Commercial |
$11.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC CAST SUP SHT LEG SPLINT ADULT FBRGLS
|
Facility
|
IP
|
$31.83
|
|
| Hospital Charge Code |
27200341
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.01 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna American Axle |
$20.69
|
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.69
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Advantage |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health SBD |
$20.05
|
| Rate for Payer: UMR Bronson Commercial |
$14.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC CAST SUP SHT LEG SPLINT PED FBRGLS
|
Facility
|
IP
|
$26.53
|
|
| Hospital Charge Code |
27200342
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC CAST SUP SHT LEG SPLINT PED FBRGLS
|
Facility
|
OP
|
$26.53
|
|
| Hospital Charge Code |
27200342
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.82 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$13.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: BCBS Complete |
$10.61
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.24
|
| Rate for Payer: UHC Core |
$13.82
|
| Rate for Payer: UHC Exchange |
$10.43
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC CAST TOTAL CONTACT
|
Facility
|
IP
|
$507.83
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
70000021
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$223.45 |
| Max. Negotiated Rate |
$457.05 |
| Rate for Payer: Aetna American Axle |
$330.09
|
| Rate for Payer: Aetna Commercial |
$431.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.09
|
| Rate for Payer: Cash Price |
$406.26
|
| Rate for Payer: Cofinity Advantage |
$355.48
|
| Rate for Payer: Cofinity Commercial |
$436.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.26
|
| Rate for Payer: Healthscope Commercial |
$457.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$355.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$380.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$431.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$380.87
|
| Rate for Payer: PHP Commercial |
$431.66
|
| Rate for Payer: Priority Health SBD |
$319.93
|
| Rate for Payer: UMR Bronson Commercial |
$223.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$380.87
|
|
|
HC CAST TOTAL CONTACT
|
Facility
|
OP
|
$507.83
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
70000021
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$145.75 |
| Max. Negotiated Rate |
$901.26 |
| Rate for Payer: Aetna American Axle |
$330.09
|
| Rate for Payer: Aetna Commercial |
$431.66
|
| Rate for Payer: Aetna Medicare |
$289.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.36
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$259.02
|
| Rate for Payer: BCN Commercial |
$259.02
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$406.26
|
| Rate for Payer: Cash Price |
$406.26
|
| Rate for Payer: Cash Price |
$406.26
|
| Rate for Payer: Cofinity Advantage |
$355.48
|
| Rate for Payer: Cofinity Commercial |
$436.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$457.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$355.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$380.87
|
| Rate for Payer: Mclaren Medicaid |
$278.69
|
| Rate for Payer: Mclaren Medicare |
$278.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.62
|
| Rate for Payer: Meridian Medicaid |
$292.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$431.66
|
| Rate for Payer: Nomi Health Commercial |
$836.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$380.87
|
| Rate for Payer: PACE Medicare |
$264.76
|
| Rate for Payer: PACE SWMI |
$278.69
|
| Rate for Payer: PHP Commercial |
$431.66
|
| Rate for Payer: PHP Medicare Advantage |
$278.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$901.26
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health SBD |
$319.93
|
| Rate for Payer: Priority Health Tiered Network |
$721.01
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.09
|
| Rate for Payer: UHC Core |
$264.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.69
|
| Rate for Payer: UHC Exchange |
$199.58
|
| Rate for Payer: UHC Medicaid |
$145.75
|
| Rate for Payer: UHCCP Medicaid |
$145.75
|
| Rate for Payer: UMR Bronson Commercial |
$187.90
|
| Rate for Payer: VA VA |
$278.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$380.87
|
|
|
HC CAST WEDGE
|
Facility
|
IP
|
$365.82
|
|
|
Service Code
|
CPT 29740
|
| Hospital Charge Code |
70000019
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$160.96 |
| Max. Negotiated Rate |
$329.24 |
| Rate for Payer: Aetna American Axle |
$237.78
|
| Rate for Payer: Aetna Commercial |
$310.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.78
|
| Rate for Payer: Cash Price |
$292.66
|
| Rate for Payer: Cofinity Advantage |
$256.07
|
| Rate for Payer: Cofinity Commercial |
$314.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.66
|
| Rate for Payer: Healthscope Commercial |
$329.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$256.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.37
|
| Rate for Payer: PHP Commercial |
$310.95
|
| Rate for Payer: Priority Health SBD |
$230.47
|
| Rate for Payer: UMR Bronson Commercial |
$160.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.37
|
|
|
HC CAST WEDGE
|
Facility
|
OP
|
$365.82
|
|
|
Service Code
|
CPT 29740
|
| Hospital Charge Code |
70000019
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$86.06 |
| Max. Negotiated Rate |
$901.26 |
| Rate for Payer: Aetna American Axle |
$237.78
|
| Rate for Payer: Aetna Commercial |
$310.95
|
| Rate for Payer: Aetna Medicare |
$289.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.36
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$86.06
|
| Rate for Payer: BCN Commercial |
$86.06
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$292.66
|
| Rate for Payer: Cash Price |
$292.66
|
| Rate for Payer: Cash Price |
$292.66
|
| Rate for Payer: Cofinity Advantage |
$256.07
|
| Rate for Payer: Cofinity Commercial |
$314.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$329.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$256.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.37
|
| Rate for Payer: Mclaren Medicaid |
$278.69
|
| Rate for Payer: Mclaren Medicare |
$278.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.62
|
| Rate for Payer: Meridian Medicaid |
$292.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.95
|
| Rate for Payer: Nomi Health Commercial |
$836.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.37
|
| Rate for Payer: PACE Medicare |
$264.76
|
| Rate for Payer: PACE SWMI |
$278.69
|
| Rate for Payer: PHP Commercial |
$310.95
|
| Rate for Payer: PHP Medicare Advantage |
$278.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$901.26
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health SBD |
$230.47
|
| Rate for Payer: Priority Health Tiered Network |
$721.01
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.78
|
| Rate for Payer: UHC Core |
$190.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.69
|
| Rate for Payer: UHC Exchange |
$143.77
|
| Rate for Payer: UHC Medicaid |
$145.75
|
| Rate for Payer: UHCCP Medicaid |
$145.75
|
| Rate for Payer: UMR Bronson Commercial |
$135.35
|
| Rate for Payer: VA VA |
$278.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.37
|
|
|
HC CAST WINDOW
|
Facility
|
IP
|
$197.79
|
|
|
Service Code
|
CPT 29730
|
| Hospital Charge Code |
70000018
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$87.03 |
| Max. Negotiated Rate |
$178.01 |
| Rate for Payer: Aetna American Axle |
$128.56
|
| Rate for Payer: Aetna Commercial |
$168.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.56
|
| Rate for Payer: Cash Price |
$158.23
|
| Rate for Payer: Cofinity Advantage |
$138.45
|
| Rate for Payer: Cofinity Commercial |
$170.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.23
|
| Rate for Payer: Healthscope Commercial |
$178.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$138.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.34
|
| Rate for Payer: PHP Commercial |
$168.12
|
| Rate for Payer: Priority Health SBD |
$124.61
|
| Rate for Payer: UMR Bronson Commercial |
$87.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.34
|
|
|
HC CAST WINDOW
|
Facility
|
OP
|
$197.79
|
|
|
Service Code
|
CPT 29730
|
| Hospital Charge Code |
70000018
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$55.66 |
| Max. Negotiated Rate |
$523.62 |
| Rate for Payer: Aetna American Axle |
$128.56
|
| Rate for Payer: Aetna Commercial |
$168.12
|
| Rate for Payer: Aetna Medicare |
$168.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$202.40
|
| Rate for Payer: BCBS Complete |
$88.93
|
| Rate for Payer: BCBS MAPPO |
$161.92
|
| Rate for Payer: BCBS Trust/PPO |
$55.66
|
| Rate for Payer: BCN Commercial |
$55.66
|
| Rate for Payer: BCN Medicare Advantage |
$161.92
|
| Rate for Payer: Cash Price |
$158.23
|
| Rate for Payer: Cash Price |
$158.23
|
| Rate for Payer: Cash Price |
$158.23
|
| Rate for Payer: Cofinity Advantage |
$138.45
|
| Rate for Payer: Cofinity Commercial |
$170.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.92
|
| Rate for Payer: Healthscope Commercial |
$178.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$138.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.34
|
| Rate for Payer: Mclaren Medicaid |
$161.92
|
| Rate for Payer: Mclaren Medicare |
$161.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.02
|
| Rate for Payer: Meridian Medicaid |
$170.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.12
|
| Rate for Payer: Nomi Health Commercial |
$485.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.34
|
| Rate for Payer: PACE Medicare |
$153.82
|
| Rate for Payer: PACE SWMI |
$161.92
|
| Rate for Payer: PHP Commercial |
$168.12
|
| Rate for Payer: PHP Medicare Advantage |
$161.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$523.62
|
| Rate for Payer: Priority Health Medicare |
$161.92
|
| Rate for Payer: Priority Health SBD |
$124.61
|
| Rate for Payer: Priority Health Tiered Network |
$418.90
|
| Rate for Payer: Railroad Medicare Medicare |
$161.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.56
|
| Rate for Payer: UHC Core |
$103.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$161.92
|
| Rate for Payer: UHC Exchange |
$77.73
|
| Rate for Payer: UHC Medicaid |
$84.68
|
| Rate for Payer: UHCCP Medicaid |
$84.68
|
| Rate for Payer: UMR Bronson Commercial |
$73.18
|
| Rate for Payer: VA VA |
$161.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.34
|
|
|
HC CATECHOLAMINE FRACTION URINE
|
Facility
|
IP
|
$61.55
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
30100139
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.08 |
| Max. Negotiated Rate |
$55.40 |
| Rate for Payer: Aetna American Axle |
$40.01
|
| Rate for Payer: Aetna Commercial |
$52.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.01
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cofinity Advantage |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$52.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.24
|
| Rate for Payer: Healthscope Commercial |
$55.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.16
|
| Rate for Payer: PHP Commercial |
$52.32
|
| Rate for Payer: Priority Health SBD |
$38.78
|
| Rate for Payer: UMR Bronson Commercial |
$27.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.16
|
|
|
HC CATECHOLAMINE FRACTION URINE
|
Facility
|
OP
|
$61.55
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
30100139
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.21 |
| Max. Negotiated Rate |
$55.40 |
| Rate for Payer: Aetna American Axle |
$40.01
|
| Rate for Payer: Aetna Commercial |
$52.32
|
| Rate for Payer: Aetna Medicare |
$26.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.56
|
| Rate for Payer: BCBS Complete |
$13.87
|
| Rate for Payer: BCBS MAPPO |
$25.25
|
| Rate for Payer: BCBS Trust/PPO |
$29.19
|
| Rate for Payer: BCN Commercial |
$29.19
|
| Rate for Payer: BCN Medicare Advantage |
$25.25
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cofinity Advantage |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$52.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.25
|
| Rate for Payer: Healthscope Commercial |
$55.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.16
|
| Rate for Payer: Mclaren Medicaid |
$25.25
|
| Rate for Payer: Mclaren Medicare |
$25.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.51
|
| Rate for Payer: Meridian Medicaid |
$26.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.32
|
| Rate for Payer: Nomi Health Commercial |
$37.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.16
|
| Rate for Payer: PACE Medicare |
$23.99
|
| Rate for Payer: PACE SWMI |
$25.25
|
| Rate for Payer: PHP Commercial |
$52.32
|
| Rate for Payer: PHP Medicare Advantage |
$25.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25.25
|
| Rate for Payer: Priority Health Medicare |
$25.25
|
| Rate for Payer: Priority Health SBD |
$38.78
|
| Rate for Payer: Priority Health Tiered Network |
$20.20
|
| Rate for Payer: Railroad Medicare Medicare |
$25.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.88
|
| Rate for Payer: UHC Core |
$37.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.25
|
| Rate for Payer: UHC Exchange |
$37.88
|
| Rate for Payer: UHC Medicaid |
$13.21
|
| Rate for Payer: UHCCP Medicaid |
$13.21
|
| Rate for Payer: UMR Bronson Commercial |
$22.77
|
| Rate for Payer: VA VA |
$25.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.16
|
|
|
HC CATECHOLAMINES RANDOM URINE
|
Facility
|
OP
|
$59.00
|
|
|
Service Code
|
CPT 82382
|
| Hospital Charge Code |
30100138
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$53.10 |
| Rate for Payer: Aetna American Axle |
$38.35
|
| Rate for Payer: Aetna Commercial |
$50.15
|
| Rate for Payer: Aetna Medicare |
$28.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.12
|
| Rate for Payer: BCBS Complete |
$14.99
|
| Rate for Payer: BCBS MAPPO |
$27.30
|
| Rate for Payer: BCBS Trust/PPO |
$31.57
|
| Rate for Payer: BCN Commercial |
$31.57
|
| Rate for Payer: BCN Medicare Advantage |
$27.30
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Advantage |
$41.30
|
| Rate for Payer: Cofinity Commercial |
$50.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.30
|
| Rate for Payer: Healthscope Commercial |
$53.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.25
|
| Rate for Payer: Mclaren Medicaid |
$27.30
|
| Rate for Payer: Mclaren Medicare |
$27.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.66
|
| Rate for Payer: Meridian Medicaid |
$28.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.15
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.25
|
| Rate for Payer: PACE Medicare |
$25.93
|
| Rate for Payer: PACE SWMI |
$27.30
|
| Rate for Payer: PHP Commercial |
$50.15
|
| Rate for Payer: PHP Medicare Advantage |
$27.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$27.30
|
| Rate for Payer: Priority Health Medicare |
$27.30
|
| Rate for Payer: Priority Health SBD |
$37.17
|
| Rate for Payer: Priority Health Tiered Network |
$21.84
|
| Rate for Payer: Railroad Medicare Medicare |
$27.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.95
|
| Rate for Payer: UHC Core |
$40.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.30
|
| Rate for Payer: UHC Exchange |
$40.95
|
| Rate for Payer: UHC Medicaid |
$14.28
|
| Rate for Payer: UHCCP Medicaid |
$14.28
|
| Rate for Payer: UMR Bronson Commercial |
$21.83
|
| Rate for Payer: VA VA |
$27.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.25
|
|
|
HC CATECHOLAMINES RANDOM URINE
|
Facility
|
IP
|
$59.00
|
|
|
Service Code
|
CPT 82382
|
| Hospital Charge Code |
30100138
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.96 |
| Max. Negotiated Rate |
$53.10 |
| Rate for Payer: Aetna American Axle |
$38.35
|
| Rate for Payer: Aetna Commercial |
$50.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.35
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Advantage |
$41.30
|
| Rate for Payer: Cofinity Commercial |
$50.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.20
|
| Rate for Payer: Healthscope Commercial |
$53.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.25
|
| Rate for Payer: PHP Commercial |
$50.15
|
| Rate for Payer: Priority Health SBD |
$37.17
|
| Rate for Payer: UMR Bronson Commercial |
$25.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.25
|
|
|
HC CATFISH IGE
|
Facility
|
IP
|
$74.29
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200480
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.69 |
| Max. Negotiated Rate |
$66.86 |
| Rate for Payer: Aetna American Axle |
$48.29
|
| Rate for Payer: Aetna Commercial |
$63.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.29
|
| Rate for Payer: Cash Price |
$59.43
|
| Rate for Payer: Cofinity Advantage |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$63.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.43
|
| Rate for Payer: Healthscope Commercial |
$66.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.72
|
| Rate for Payer: PHP Commercial |
$63.15
|
| Rate for Payer: Priority Health SBD |
$46.80
|
| Rate for Payer: UMR Bronson Commercial |
$32.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.72
|
|
|
HC CATFISH IGE
|
Facility
|
OP
|
$74.29
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200480
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$66.86 |
| Rate for Payer: Aetna American Axle |
$48.29
|
| Rate for Payer: Aetna Commercial |
$63.15
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.29
|
| 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 |
$59.43
|
| Rate for Payer: Cash Price |
$59.43
|
| Rate for Payer: Cofinity Advantage |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$63.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$66.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.72
|
| 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 |
$63.15
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.72
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$63.15
|
| 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 |
$46.80
|
| 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 |
$27.49
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.72
|
|
|
HC CATH ATHRECT ROTATIONAL LVL 5
|
Facility
|
IP
|
$5,705.55
|
|
|
Service Code
|
HCPCS C1724
|
| Hospital Charge Code |
27200025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,510.44 |
| Max. Negotiated Rate |
$5,134.99 |
| Rate for Payer: Aetna American Axle |
$3,708.61
|
| Rate for Payer: Aetna Commercial |
$4,849.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,708.61
|
| Rate for Payer: Cash Price |
$4,564.44
|
| Rate for Payer: Cofinity Advantage |
$3,993.89
|
| Rate for Payer: Cofinity Commercial |
$4,906.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,564.44
|
| Rate for Payer: Healthscope Commercial |
$5,134.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,993.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,279.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,849.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,279.16
|
| Rate for Payer: PHP Commercial |
$4,849.72
|
| Rate for Payer: Priority Health SBD |
$3,594.50
|
| Rate for Payer: UMR Bronson Commercial |
$2,510.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,279.16
|
|
|
HC CATH ATHRECT ROTATIONAL LVL 5
|
Facility
|
OP
|
$5,705.55
|
|
|
Service Code
|
HCPCS C1724
|
| Hospital Charge Code |
27200025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$5,134.99 |
| Rate for Payer: Aetna American Axle |
$3,708.61
|
| Rate for Payer: Aetna Commercial |
$4,849.72
|
| Rate for Payer: Aetna Medicare |
$2,852.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,708.61
|
| Rate for Payer: BCBS Complete |
$2,282.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$4,564.44
|
| Rate for Payer: Cash Price |
$4,564.44
|
| Rate for Payer: Cofinity Advantage |
$3,993.89
|
| Rate for Payer: Cofinity Commercial |
$4,906.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,564.44
|
| Rate for Payer: Healthscope Commercial |
$5,134.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,993.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,279.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,564.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,849.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,279.16
|
| Rate for Payer: PHP Commercial |
$4,849.72
|
| Rate for Payer: Priority Health SBD |
$3,594.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,708.61
|
| Rate for Payer: UHC Core |
$2,972.59
|
| Rate for Payer: UHC Exchange |
$2,242.28
|
| Rate for Payer: UMR Bronson Commercial |
$2,111.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,279.16
|
|
|
HC CATH CORONARY DRUG-DELIVERY
|
Facility
|
OP
|
$11,166.37
|
|
|
Service Code
|
HCPCS C9610
|
| Hospital Charge Code |
27200405
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$10,049.73 |
| Rate for Payer: Aetna American Axle |
$7,258.14
|
| Rate for Payer: Aetna Commercial |
$9,491.41
|
| Rate for Payer: Aetna Medicare |
$5,583.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,258.14
|
| Rate for Payer: BCBS Complete |
$4,466.55
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$8,933.10
|
| Rate for Payer: Cash Price |
$8,933.10
|
| Rate for Payer: Cofinity Advantage |
$7,816.46
|
| Rate for Payer: Cofinity Commercial |
$9,603.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,933.10
|
| Rate for Payer: Healthscope Commercial |
$10,049.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,816.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,374.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,933.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,491.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,374.78
|
| Rate for Payer: PHP Commercial |
$9,491.41
|
| Rate for Payer: Priority Health SBD |
$7,034.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,258.14
|
| Rate for Payer: UHC Core |
$5,817.68
|
| Rate for Payer: UHC Exchange |
$4,388.38
|
| Rate for Payer: UMR Bronson Commercial |
$4,131.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,374.78
|
|
