|
HC HYSTEROSCOPY DIAGNOSTIC
|
Facility
|
OP
|
$4,013.52
|
|
|
Service Code
|
CPT 58555
|
| Hospital Charge Code |
76100303
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$148.33 |
| Max. Negotiated Rate |
$8,748.29 |
| Rate for Payer: Aetna American Axle |
$2,608.79
|
| Rate for Payer: Aetna Commercial |
$3,411.49
|
| Rate for Payer: Aetna Medicare |
$2,890.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,608.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,606.67
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$3,210.82
|
| Rate for Payer: Cash Price |
$3,210.82
|
| Rate for Payer: Cofinity Commercial |
$2,809.46
|
| Rate for Payer: Cofinity Commercial |
$3,451.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,210.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$3,612.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,809.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,010.14
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,411.49
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$3,411.49
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,809.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,748.29
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$6,998.63
|
| Rate for Payer: Priority Health SBD |
$2,528.52
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,778.95
|
| Rate for Payer: UHC Exchange |
$148.33
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,485.00
|
| Rate for Payer: VA VA |
$2,778.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,010.14
|
|
|
HC HYSTEROSCOPY DIAGNOSTIC
|
Facility
|
IP
|
$4,013.52
|
|
|
Service Code
|
CPT 58555
|
| Hospital Charge Code |
76100303
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,765.95 |
| Max. Negotiated Rate |
$3,612.17 |
| Rate for Payer: Aetna American Axle |
$2,608.79
|
| Rate for Payer: Aetna Commercial |
$3,411.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,608.79
|
| Rate for Payer: Cash Price |
$3,210.82
|
| Rate for Payer: Cofinity Commercial |
$2,809.46
|
| Rate for Payer: Cofinity Commercial |
$3,451.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,210.82
|
| Rate for Payer: Healthscope Commercial |
$3,612.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,809.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,010.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,411.49
|
| Rate for Payer: PHP Commercial |
$3,411.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,809.46
|
| Rate for Payer: Priority Health SBD |
$2,528.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,765.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,010.14
|
|
|
HC HYSTEROSCOPY ENDOMETR ABLATION
|
Facility
|
IP
|
$13,091.70
|
|
|
Service Code
|
CPT 58563
|
| Hospital Charge Code |
76100340
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,760.35 |
| Max. Negotiated Rate |
$11,782.53 |
| Rate for Payer: Aetna American Axle |
$8,509.60
|
| Rate for Payer: Aetna Commercial |
$11,127.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,509.60
|
| Rate for Payer: Cash Price |
$10,473.36
|
| Rate for Payer: Cofinity Commercial |
$11,258.86
|
| Rate for Payer: Cofinity Commercial |
$9,164.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,473.36
|
| Rate for Payer: Healthscope Commercial |
$11,782.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,164.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,818.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,127.94
|
| Rate for Payer: PHP Commercial |
$11,127.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,164.19
|
| Rate for Payer: Priority Health SBD |
$8,247.77
|
| Rate for Payer: UMR Bronson Commercial |
$5,760.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,818.78
|
|
|
HC HYSTEROSCOPY ENDOMETR ABLATION
|
Facility
|
OP
|
$13,091.70
|
|
|
Service Code
|
CPT 58563
|
| Hospital Charge Code |
76100340
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$240.67 |
| Max. Negotiated Rate |
$13,918.15 |
| Rate for Payer: Aetna American Axle |
$8,509.60
|
| Rate for Payer: Aetna Commercial |
$11,127.94
|
| Rate for Payer: Aetna Medicare |
$4,598.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,509.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,526.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,526.50
|
| Rate for Payer: BCBS Complete |
$2,539.54
|
| Rate for Payer: BCBS MAPPO |
$4,421.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,393.91
|
| Rate for Payer: BCN Medicare Advantage |
$4,421.20
|
| Rate for Payer: Cash Price |
$10,473.36
|
| Rate for Payer: Cash Price |
$10,473.36
|
| Rate for Payer: Cofinity Commercial |
$9,164.19
|
| Rate for Payer: Cofinity Commercial |
$11,258.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,473.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,421.20
|
| Rate for Payer: Healthscope Commercial |
$11,782.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,164.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,818.78
|
| Rate for Payer: Mclaren Medicaid |
$2,418.40
|
| Rate for Payer: Mclaren Medicare |
$4,421.20
|
| Rate for Payer: Meridian Medicaid |
$2,539.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,642.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,084.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,127.94
|
| Rate for Payer: PACE Medicare |
$4,200.14
|
| Rate for Payer: PACE SWMI |
$4,421.20
|
| Rate for Payer: PHP Commercial |
$11,127.94
|
| Rate for Payer: PHP Medicare Advantage |
$4,421.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,418.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,164.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13,918.15
|
| Rate for Payer: Priority Health Medicare |
$4,421.20
|
| Rate for Payer: Priority Health Narrow Network |
$11,134.52
|
| Rate for Payer: Priority Health SBD |
$8,247.77
|
| Rate for Payer: Railroad Medicare Medicare |
$4,421.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,421.20
|
| Rate for Payer: UHC Exchange |
$240.67
|
| Rate for Payer: UHC Medicare Advantage |
$4,553.84
|
| Rate for Payer: UMR Bronson Commercial |
$4,843.93
|
| Rate for Payer: VA VA |
$4,421.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,818.78
|
|
|
HC HYSTEROSCOPY REMOVE FB
|
Facility
|
IP
|
$7,789.74
|
|
|
Service Code
|
CPT 58562
|
| Hospital Charge Code |
76100339
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,427.49 |
| Max. Negotiated Rate |
$7,010.77 |
| Rate for Payer: Aetna American Axle |
$5,063.33
|
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,063.33
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$5,452.82
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,452.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health SBD |
$4,907.54
|
| Rate for Payer: UMR Bronson Commercial |
$3,427.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC HYSTEROSCOPY REMOVE FB
|
Facility
|
OP
|
$7,789.74
|
|
|
Service Code
|
CPT 58562
|
| Hospital Charge Code |
76100339
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$217.09 |
| Max. Negotiated Rate |
$8,748.29 |
| Rate for Payer: Aetna American Axle |
$5,063.33
|
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: Aetna Medicare |
$2,890.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,063.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,575.71
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Cofinity Commercial |
$5,452.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,452.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,748.29
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$6,998.63
|
| Rate for Payer: Priority Health SBD |
$4,907.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$238.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,778.95
|
| Rate for Payer: UHC Exchange |
$217.09
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: UMR Bronson Commercial |
$2,882.20
|
| Rate for Payer: VA VA |
$2,778.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC HYSTEROSCOPY REMOVE MYOMA
|
Facility
|
OP
|
$13,091.70
|
|
|
Service Code
|
CPT 58561
|
| Hospital Charge Code |
76100338
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$350.36 |
| Max. Negotiated Rate |
$13,918.15 |
| Rate for Payer: Aetna American Axle |
$8,509.60
|
| Rate for Payer: Aetna Commercial |
$11,127.94
|
| Rate for Payer: Aetna Medicare |
$4,598.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,509.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,526.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,526.50
|
| Rate for Payer: BCBS Complete |
$2,539.54
|
| Rate for Payer: BCBS MAPPO |
$4,421.20
|
| Rate for Payer: BCBS Trust/PPO |
$4,098.13
|
| Rate for Payer: BCN Medicare Advantage |
$4,421.20
|
| Rate for Payer: Cash Price |
$10,473.36
|
| Rate for Payer: Cash Price |
$10,473.36
|
| Rate for Payer: Cofinity Commercial |
$9,164.19
|
| Rate for Payer: Cofinity Commercial |
$11,258.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,473.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,421.20
|
| Rate for Payer: Healthscope Commercial |
$11,782.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,164.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,818.78
|
| Rate for Payer: Mclaren Medicaid |
$2,418.40
|
| Rate for Payer: Mclaren Medicare |
$4,421.20
|
| Rate for Payer: Meridian Medicaid |
$2,539.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,642.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,084.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,127.94
|
| Rate for Payer: PACE Medicare |
$4,200.14
|
| Rate for Payer: PACE SWMI |
$4,421.20
|
| Rate for Payer: PHP Commercial |
$11,127.94
|
| Rate for Payer: PHP Medicare Advantage |
$4,421.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,418.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,164.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13,918.15
|
| Rate for Payer: Priority Health Medicare |
$4,421.20
|
| Rate for Payer: Priority Health Narrow Network |
$11,134.52
|
| Rate for Payer: Priority Health SBD |
$8,247.77
|
| Rate for Payer: Railroad Medicare Medicare |
$4,421.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,421.20
|
| Rate for Payer: UHC Exchange |
$350.36
|
| Rate for Payer: UHC Medicare Advantage |
$4,553.84
|
| Rate for Payer: UMR Bronson Commercial |
$4,843.93
|
| Rate for Payer: VA VA |
$4,421.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,818.78
|
|
|
HC HYSTEROSCOPY REMOVE MYOMA
|
Facility
|
IP
|
$13,091.70
|
|
|
Service Code
|
CPT 58561
|
| Hospital Charge Code |
76100338
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,760.35 |
| Max. Negotiated Rate |
$11,782.53 |
| Rate for Payer: Aetna American Axle |
$8,509.60
|
| Rate for Payer: Aetna Commercial |
$11,127.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,509.60
|
| Rate for Payer: Cash Price |
$10,473.36
|
| Rate for Payer: Cofinity Commercial |
$11,258.86
|
| Rate for Payer: Cofinity Commercial |
$9,164.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,473.36
|
| Rate for Payer: Healthscope Commercial |
$11,782.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,164.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,818.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,127.94
|
| Rate for Payer: PHP Commercial |
$11,127.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,164.19
|
| Rate for Payer: Priority Health SBD |
$8,247.77
|
| Rate for Payer: UMR Bronson Commercial |
$5,760.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,818.78
|
|
|
HC HYSTEROSCOPY RESECT SEPTUM
|
Facility
|
OP
|
$13,091.70
|
|
|
Service Code
|
CPT 58560
|
| Hospital Charge Code |
76100337
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$306.16 |
| Max. Negotiated Rate |
$13,918.15 |
| Rate for Payer: Aetna American Axle |
$8,509.60
|
| Rate for Payer: Aetna Commercial |
$11,127.94
|
| Rate for Payer: Aetna Medicare |
$4,598.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,509.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,526.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,526.50
|
| Rate for Payer: BCBS Complete |
$2,539.54
|
| Rate for Payer: BCBS MAPPO |
$4,421.20
|
| Rate for Payer: BCBS Trust/PPO |
$3,112.66
|
| Rate for Payer: BCN Medicare Advantage |
$4,421.20
|
| Rate for Payer: Cash Price |
$10,473.36
|
| Rate for Payer: Cash Price |
$10,473.36
|
| Rate for Payer: Cofinity Commercial |
$9,164.19
|
| Rate for Payer: Cofinity Commercial |
$11,258.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,473.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,421.20
|
| Rate for Payer: Healthscope Commercial |
$11,782.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,164.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,818.78
|
| Rate for Payer: Mclaren Medicaid |
$2,418.40
|
| Rate for Payer: Mclaren Medicare |
$4,421.20
|
| Rate for Payer: Meridian Medicaid |
$2,539.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,642.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,084.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,127.94
|
| Rate for Payer: PACE Medicare |
$4,200.14
|
| Rate for Payer: PACE SWMI |
$4,421.20
|
| Rate for Payer: PHP Commercial |
$11,127.94
|
| Rate for Payer: PHP Medicare Advantage |
$4,421.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,418.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,164.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13,918.15
|
| Rate for Payer: Priority Health Medicare |
$4,421.20
|
| Rate for Payer: Priority Health Narrow Network |
$11,134.52
|
| Rate for Payer: Priority Health SBD |
$8,247.77
|
| Rate for Payer: Railroad Medicare Medicare |
$4,421.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,421.20
|
| Rate for Payer: UHC Exchange |
$306.16
|
| Rate for Payer: UHC Medicare Advantage |
$4,553.84
|
| Rate for Payer: UMR Bronson Commercial |
$4,843.93
|
| Rate for Payer: VA VA |
$4,421.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,818.78
|
|
|
HC HYSTEROSCOPY RESECT SEPTUM
|
Facility
|
IP
|
$13,091.70
|
|
|
Service Code
|
CPT 58560
|
| Hospital Charge Code |
76100337
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,760.35 |
| Max. Negotiated Rate |
$11,782.53 |
| Rate for Payer: Aetna American Axle |
$8,509.60
|
| Rate for Payer: Aetna Commercial |
$11,127.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,509.60
|
| Rate for Payer: Cash Price |
$10,473.36
|
| Rate for Payer: Cofinity Commercial |
$11,258.86
|
| Rate for Payer: Cofinity Commercial |
$9,164.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,473.36
|
| Rate for Payer: Healthscope Commercial |
$11,782.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,164.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,818.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,127.94
|
| Rate for Payer: PHP Commercial |
$11,127.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,164.19
|
| Rate for Payer: Priority Health SBD |
$8,247.77
|
| Rate for Payer: UMR Bronson Commercial |
$5,760.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,818.78
|
|
|
HC HYSTEROSCOPY W BX AND/OR POLYPECTOMY W OR WO D&C
|
Facility
|
IP
|
$4,013.52
|
|
|
Service Code
|
CPT 58558
|
| Hospital Charge Code |
76100304
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,765.95 |
| Max. Negotiated Rate |
$3,612.17 |
| Rate for Payer: Aetna American Axle |
$2,608.79
|
| Rate for Payer: Aetna Commercial |
$3,411.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,608.79
|
| Rate for Payer: Cash Price |
$3,210.82
|
| Rate for Payer: Cofinity Commercial |
$2,809.46
|
| Rate for Payer: Cofinity Commercial |
$3,451.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,210.82
|
| Rate for Payer: Healthscope Commercial |
$3,612.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,809.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,010.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,411.49
|
| Rate for Payer: PHP Commercial |
$3,411.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,809.46
|
| Rate for Payer: Priority Health SBD |
$2,528.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,765.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,010.14
|
|
|
HC HYSTEROSCOPY W BX AND/OR POLYPECTOMY W OR WO D&C
|
Facility
|
OP
|
$4,013.52
|
|
|
Service Code
|
CPT 58558
|
| Hospital Charge Code |
76100304
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$226.59 |
| Max. Negotiated Rate |
$8,748.29 |
| Rate for Payer: Aetna American Axle |
$2,608.79
|
| Rate for Payer: Aetna Commercial |
$3,411.49
|
| Rate for Payer: Aetna Medicare |
$2,890.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,608.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,078.05
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$3,210.82
|
| Rate for Payer: Cash Price |
$3,210.82
|
| Rate for Payer: Cofinity Commercial |
$2,809.46
|
| Rate for Payer: Cofinity Commercial |
$3,451.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,210.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$3,612.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,809.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,010.14
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,411.49
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$3,411.49
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,809.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,748.29
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$6,998.63
|
| Rate for Payer: Priority Health SBD |
$2,528.52
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,778.95
|
| Rate for Payer: UHC Exchange |
$226.59
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,485.00
|
| Rate for Payer: VA VA |
$2,778.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,010.14
|
|
|
HC I-123 CAPSULE PER 100 UCI
|
Facility
|
OP
|
$103.60
|
|
|
Service Code
|
HCPCS A9516
|
| Hospital Charge Code |
34300009
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$38.33 |
| Max. Negotiated Rate |
$93.24 |
| Rate for Payer: Aetna American Axle |
$67.34
|
| Rate for Payer: Aetna Commercial |
$88.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.34
|
| Rate for Payer: BCBS Complete |
$41.44
|
| Rate for Payer: BCBS Trust/PPO |
$69.10
|
| Rate for Payer: Cash Price |
$82.88
|
| Rate for Payer: Cash Price |
$82.88
|
| Rate for Payer: Cofinity Commercial |
$72.52
|
| Rate for Payer: Cofinity Commercial |
$89.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.88
|
| Rate for Payer: Healthscope Commercial |
$93.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.06
|
| Rate for Payer: PHP Commercial |
$88.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.52
|
| Rate for Payer: Priority Health SBD |
$65.27
|
| Rate for Payer: UMR Bronson Commercial |
$38.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.70
|
|
|
HC I-123 CAPSULE PER 100 UCI
|
Facility
|
IP
|
$103.60
|
|
|
Service Code
|
HCPCS A9516
|
| Hospital Charge Code |
34300009
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$93.24 |
| Rate for Payer: Aetna American Axle |
$67.34
|
| Rate for Payer: Aetna Commercial |
$88.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.34
|
| Rate for Payer: Cash Price |
$82.88
|
| Rate for Payer: Cofinity Commercial |
$72.52
|
| Rate for Payer: Cofinity Commercial |
$89.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.88
|
| Rate for Payer: Healthscope Commercial |
$93.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.06
|
| Rate for Payer: PHP Commercial |
$88.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.52
|
| Rate for Payer: Priority Health SBD |
$65.27
|
| Rate for Payer: UMR Bronson Commercial |
$45.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.70
|
|
|
HC I-123 MIBG PER STUDY
|
Facility
|
OP
|
$11,938.04
|
|
|
Service Code
|
HCPCS A9582
|
| Hospital Charge Code |
34300010
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$4,417.07 |
| Max. Negotiated Rate |
$10,744.24 |
| Rate for Payer: Aetna American Axle |
$7,759.73
|
| Rate for Payer: Aetna Commercial |
$10,147.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,759.73
|
| Rate for Payer: BCBS Complete |
$4,775.22
|
| Rate for Payer: BCBS Trust/PPO |
$7,079.70
|
| Rate for Payer: Cash Price |
$9,550.43
|
| Rate for Payer: Cash Price |
$9,550.43
|
| Rate for Payer: Cofinity Commercial |
$10,266.71
|
| Rate for Payer: Cofinity Commercial |
$8,356.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,550.43
|
| Rate for Payer: Healthscope Commercial |
$10,744.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,356.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,953.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,147.33
|
| Rate for Payer: PHP Commercial |
$10,147.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,356.63
|
| Rate for Payer: Priority Health SBD |
$7,520.97
|
| Rate for Payer: UMR Bronson Commercial |
$4,417.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,953.53
|
|
|
HC I-123 MIBG PER STUDY
|
Facility
|
IP
|
$11,938.04
|
|
|
Service Code
|
HCPCS A9582
|
| Hospital Charge Code |
34300010
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$5,252.74 |
| Max. Negotiated Rate |
$10,744.24 |
| Rate for Payer: Aetna American Axle |
$7,759.73
|
| Rate for Payer: Aetna Commercial |
$10,147.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,759.73
|
| Rate for Payer: Cash Price |
$9,550.43
|
| Rate for Payer: Cofinity Commercial |
$8,356.63
|
| Rate for Payer: Cofinity Commercial |
$10,266.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,550.43
|
| Rate for Payer: Healthscope Commercial |
$10,744.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,356.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,953.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,147.33
|
| Rate for Payer: PHP Commercial |
$10,147.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,356.63
|
| Rate for Payer: Priority Health SBD |
$7,520.97
|
| Rate for Payer: UMR Bronson Commercial |
$5,252.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,953.53
|
|
|
HC I-131 CAP (DX) PER MCI
|
Facility
|
IP
|
$73.47
|
|
|
Service Code
|
HCPCS A9528
|
| Hospital Charge Code |
34300011
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$32.33 |
| Max. Negotiated Rate |
$66.12 |
| Rate for Payer: Aetna American Axle |
$47.76
|
| Rate for Payer: Aetna Commercial |
$62.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.76
|
| Rate for Payer: Cash Price |
$58.78
|
| Rate for Payer: Cofinity Commercial |
$63.18
|
| Rate for Payer: Cofinity Commercial |
$51.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$66.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.45
|
| Rate for Payer: PHP Commercial |
$62.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.43
|
| Rate for Payer: Priority Health SBD |
$46.29
|
| Rate for Payer: UMR Bronson Commercial |
$32.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.10
|
|
|
HC I-131 CAP (DX) PER MCI
|
Facility
|
OP
|
$73.47
|
|
|
Service Code
|
HCPCS A9528
|
| Hospital Charge Code |
34300011
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$27.18 |
| Max. Negotiated Rate |
$149.89 |
| Rate for Payer: Aetna American Axle |
$47.76
|
| Rate for Payer: Aetna Commercial |
$62.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.76
|
| Rate for Payer: BCBS Complete |
$29.39
|
| Rate for Payer: BCBS Trust/PPO |
$149.89
|
| Rate for Payer: Cash Price |
$58.78
|
| Rate for Payer: Cash Price |
$58.78
|
| Rate for Payer: Cofinity Commercial |
$51.43
|
| Rate for Payer: Cofinity Commercial |
$63.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$66.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.45
|
| Rate for Payer: PHP Commercial |
$62.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.43
|
| Rate for Payer: Priority Health SBD |
$46.29
|
| Rate for Payer: UMR Bronson Commercial |
$27.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.10
|
|
|
HC I-131 CAP (TX) PER MCI
|
Facility
|
OP
|
$66.79
|
|
|
Service Code
|
HCPCS A9517
|
| Hospital Charge Code |
34400001
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: Aetna American Axle |
$43.41
|
| Rate for Payer: Aetna Commercial |
$56.77
|
| Rate for Payer: Aetna Medicare |
$22.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.68
|
| Rate for Payer: BCBS Complete |
$12.26
|
| Rate for Payer: BCBS MAPPO |
$21.34
|
| Rate for Payer: BCBS Trust/PPO |
$28.45
|
| Rate for Payer: BCN Medicare Advantage |
$21.34
|
| Rate for Payer: Cash Price |
$53.43
|
| Rate for Payer: Cash Price |
$53.43
|
| Rate for Payer: Cofinity Commercial |
$46.75
|
| Rate for Payer: Cofinity Commercial |
$57.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.34
|
| Rate for Payer: Healthscope Commercial |
$60.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.09
|
| Rate for Payer: Mclaren Medicaid |
$11.67
|
| Rate for Payer: Mclaren Medicare |
$21.34
|
| Rate for Payer: Meridian Medicaid |
$12.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.77
|
| Rate for Payer: PACE Medicare |
$20.27
|
| Rate for Payer: PACE SWMI |
$21.34
|
| Rate for Payer: PHP Commercial |
$56.77
|
| Rate for Payer: PHP Medicare Advantage |
$21.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.70
|
| Rate for Payer: Priority Health Medicare |
$21.34
|
| Rate for Payer: Priority Health Narrow Network |
$55.76
|
| Rate for Payer: Priority Health SBD |
$42.08
|
| Rate for Payer: Railroad Medicare Medicare |
$21.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.34
|
| Rate for Payer: UHC Medicare Advantage |
$21.98
|
| Rate for Payer: UMR Bronson Commercial |
$24.71
|
| Rate for Payer: VA VA |
$21.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.09
|
|
|
HC I-131 CAP (TX) PER MCI
|
Facility
|
IP
|
$66.79
|
|
|
Service Code
|
HCPCS A9517
|
| Hospital Charge Code |
34400001
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$29.39 |
| Max. Negotiated Rate |
$60.11 |
| Rate for Payer: Aetna American Axle |
$43.41
|
| Rate for Payer: Aetna Commercial |
$56.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.41
|
| Rate for Payer: Cash Price |
$53.43
|
| Rate for Payer: Cofinity Commercial |
$46.75
|
| Rate for Payer: Cofinity Commercial |
$57.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.43
|
| Rate for Payer: Healthscope Commercial |
$60.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$56.77
|
| Rate for Payer: PHP Commercial |
$56.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.75
|
| Rate for Payer: Priority Health SBD |
$42.08
|
| Rate for Payer: UMR Bronson Commercial |
$29.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.09
|
|
|
HC I-131 SOD IODIDE DIAG PER UCI
|
Facility
|
IP
|
$46.92
|
|
|
Service Code
|
HCPCS A9531
|
| Hospital Charge Code |
34300031
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$42.23 |
| Rate for Payer: Aetna American Axle |
$30.50
|
| Rate for Payer: Aetna Commercial |
$39.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.50
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cofinity Commercial |
$32.84
|
| Rate for Payer: Cofinity Commercial |
$40.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.54
|
| Rate for Payer: Healthscope Commercial |
$42.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.88
|
| Rate for Payer: PHP Commercial |
$39.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.84
|
| Rate for Payer: Priority Health SBD |
$29.56
|
| Rate for Payer: UMR Bronson Commercial |
$20.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.19
|
|
|
HC I-131 SOD IODIDE DIAG PER UCI
|
Facility
|
OP
|
$46.92
|
|
|
Service Code
|
HCPCS A9531
|
| Hospital Charge Code |
34300031
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$12.65 |
| Max. Negotiated Rate |
$42.23 |
| Rate for Payer: Aetna American Axle |
$30.50
|
| Rate for Payer: Aetna Commercial |
$39.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.50
|
| Rate for Payer: BCBS Complete |
$18.77
|
| Rate for Payer: BCBS Trust/PPO |
$12.65
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cofinity Commercial |
$32.84
|
| Rate for Payer: Cofinity Commercial |
$40.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.54
|
| Rate for Payer: Healthscope Commercial |
$42.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.88
|
| Rate for Payer: PHP Commercial |
$39.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.84
|
| Rate for Payer: Priority Health SBD |
$29.56
|
| Rate for Payer: UMR Bronson Commercial |
$17.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.19
|
|
|
HC I-131 SOL (DX) PER MCI
|
Facility
|
IP
|
$46.93
|
|
|
Service Code
|
HCPCS A9529
|
| Hospital Charge Code |
34300012
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$20.65 |
| Max. Negotiated Rate |
$42.24 |
| Rate for Payer: Aetna American Axle |
$30.50
|
| Rate for Payer: Aetna Commercial |
$39.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.50
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cofinity Commercial |
$40.36
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.54
|
| Rate for Payer: Healthscope Commercial |
$42.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.89
|
| Rate for Payer: PHP Commercial |
$39.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.85
|
| Rate for Payer: Priority Health SBD |
$29.57
|
| Rate for Payer: UMR Bronson Commercial |
$20.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.20
|
|
|
HC I-131 SOL (DX) PER MCI
|
Facility
|
OP
|
$46.93
|
|
|
Service Code
|
HCPCS A9529
|
| Hospital Charge Code |
34300012
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$8.17 |
| Max. Negotiated Rate |
$42.24 |
| Rate for Payer: Aetna American Axle |
$30.50
|
| Rate for Payer: Aetna Commercial |
$39.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.50
|
| Rate for Payer: BCBS Complete |
$18.77
|
| Rate for Payer: BCBS Trust/PPO |
$8.17
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Cofinity Commercial |
$40.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.54
|
| Rate for Payer: Healthscope Commercial |
$42.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.89
|
| Rate for Payer: PHP Commercial |
$39.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.85
|
| Rate for Payer: Priority Health SBD |
$29.57
|
| Rate for Payer: UMR Bronson Commercial |
$17.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.20
|
|
|
HC I-131 SOL (TX) PER MCI
|
Facility
|
OP
|
$46.93
|
|
|
Service Code
|
HCPCS A9530
|
| Hospital Charge Code |
34400002
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$11.16 |
| Max. Negotiated Rate |
$66.70 |
| Rate for Payer: Aetna American Axle |
$30.50
|
| Rate for Payer: Aetna Commercial |
$39.89
|
| Rate for Payer: Aetna Medicare |
$21.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.50
|
| Rate for Payer: BCBS Complete |
$11.72
|
| Rate for Payer: BCBS MAPPO |
$20.40
|
| Rate for Payer: BCBS Trust/PPO |
$27.23
|
| Rate for Payer: BCN Medicare Advantage |
$20.40
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cash Price |
$37.54
|
| Rate for Payer: Cofinity Commercial |
$40.36
|
| Rate for Payer: Cofinity Commercial |
$32.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$42.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.20
|
| Rate for Payer: Mclaren Medicaid |
$11.16
|
| Rate for Payer: Mclaren Medicare |
$20.40
|
| Rate for Payer: Meridian Medicaid |
$11.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.89
|
| Rate for Payer: PACE Medicare |
$19.38
|
| Rate for Payer: PACE SWMI |
$20.40
|
| Rate for Payer: PHP Commercial |
$39.89
|
| Rate for Payer: PHP Medicare Advantage |
$20.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.70
|
| Rate for Payer: Priority Health Medicare |
$20.40
|
| Rate for Payer: Priority Health Narrow Network |
$53.36
|
| Rate for Payer: Priority Health SBD |
$29.57
|
| Rate for Payer: Railroad Medicare Medicare |
$20.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.40
|
| Rate for Payer: UHC Medicare Advantage |
$21.01
|
| Rate for Payer: UMR Bronson Commercial |
$17.36
|
| Rate for Payer: VA VA |
$20.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.20
|
|
