|
HC CERTOLIZUMAB
|
Facility
|
IP
|
$169.59
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100675
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$74.62 |
| Max. Negotiated Rate |
$152.63 |
| Rate for Payer: Aetna American Axle |
$110.23
|
| Rate for Payer: Aetna Commercial |
$144.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.23
|
| Rate for Payer: Cash Price |
$135.67
|
| Rate for Payer: Cofinity Advantage |
$118.71
|
| Rate for Payer: Cofinity Commercial |
$145.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.67
|
| Rate for Payer: Healthscope Commercial |
$152.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.19
|
| Rate for Payer: PHP Commercial |
$144.15
|
| Rate for Payer: Priority Health SBD |
$106.84
|
| Rate for Payer: UMR Bronson Commercial |
$74.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.19
|
|
|
HC CERTOLIZUMAB
|
Facility
|
OP
|
$169.59
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100675
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$152.63 |
| Rate for Payer: Aetna American Axle |
$110.23
|
| Rate for Payer: Aetna Commercial |
$144.15
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$19.96
|
| Rate for Payer: BCN Commercial |
$19.96
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$135.67
|
| Rate for Payer: Cash Price |
$135.67
|
| Rate for Payer: Cofinity Advantage |
$118.71
|
| Rate for Payer: Cofinity Commercial |
$145.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$152.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.19
|
| Rate for Payer: Mclaren Medicaid |
$17.27
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.15
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.19
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$144.15
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$106.84
|
| Rate for Payer: Priority Health Tiered Network |
$13.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.91
|
| Rate for Payer: UHC Core |
$25.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$25.91
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: UMR Bronson Commercial |
$62.75
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.19
|
|
|
HC CERTOLIZUMAB CMPT
|
Facility
|
OP
|
$133.17
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100676
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$119.85 |
| Rate for Payer: Aetna American Axle |
$86.56
|
| Rate for Payer: Aetna Commercial |
$113.19
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.24
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$21.55
|
| Rate for Payer: BCN Commercial |
$21.55
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$106.54
|
| Rate for Payer: Cash Price |
$106.54
|
| Rate for Payer: Cofinity Advantage |
$93.22
|
| Rate for Payer: Cofinity Commercial |
$114.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$119.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$93.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.88
|
| Rate for Payer: Mclaren Medicaid |
$18.64
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$19.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.19
|
| Rate for Payer: Nomi Health Commercial |
$27.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.88
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$113.19
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.75
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health SBD |
$83.90
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.96
|
| Rate for Payer: UHC Core |
$27.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.64
|
| Rate for Payer: UHC Exchange |
$27.96
|
| Rate for Payer: UHC Medicaid |
$9.75
|
| Rate for Payer: UHCCP Medicaid |
$9.75
|
| Rate for Payer: UMR Bronson Commercial |
$49.27
|
| Rate for Payer: VA VA |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.88
|
|
|
HC CERTOLIZUMAB CMPT
|
Facility
|
IP
|
$133.17
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100676
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.59 |
| Max. Negotiated Rate |
$119.85 |
| Rate for Payer: Aetna American Axle |
$86.56
|
| Rate for Payer: Aetna Commercial |
$113.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.56
|
| Rate for Payer: Cash Price |
$106.54
|
| Rate for Payer: Cofinity Advantage |
$93.22
|
| Rate for Payer: Cofinity Commercial |
$114.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.54
|
| Rate for Payer: Healthscope Commercial |
$119.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$93.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.88
|
| Rate for Payer: PHP Commercial |
$113.19
|
| Rate for Payer: Priority Health SBD |
$83.90
|
| Rate for Payer: UMR Bronson Commercial |
$58.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.88
|
|
|
HC CERULOPLASMIN
|
Facility
|
IP
|
$43.51
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
30100140
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.14 |
| Max. Negotiated Rate |
$39.16 |
| Rate for Payer: Aetna American Axle |
$28.28
|
| Rate for Payer: Aetna Commercial |
$36.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.28
|
| Rate for Payer: Cash Price |
$34.81
|
| Rate for Payer: Cofinity Advantage |
$30.46
|
| Rate for Payer: Cofinity Commercial |
$37.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.81
|
| Rate for Payer: Healthscope Commercial |
$39.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.63
|
| Rate for Payer: PHP Commercial |
$36.98
|
| Rate for Payer: Priority Health SBD |
$27.41
|
| Rate for Payer: UMR Bronson Commercial |
$19.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.63
|
|
|
HC CERULOPLASMIN
|
Facility
|
OP
|
$43.51
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
30100140
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.62 |
| Max. Negotiated Rate |
$39.16 |
| Rate for Payer: Aetna American Axle |
$28.28
|
| Rate for Payer: Aetna Commercial |
$36.98
|
| Rate for Payer: Aetna Medicare |
$11.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.43
|
| Rate for Payer: BCBS Complete |
$5.90
|
| Rate for Payer: BCBS MAPPO |
$10.74
|
| Rate for Payer: BCBS Trust/PPO |
$12.42
|
| Rate for Payer: BCN Commercial |
$12.42
|
| Rate for Payer: BCN Medicare Advantage |
$10.74
|
| Rate for Payer: Cash Price |
$34.81
|
| Rate for Payer: Cash Price |
$34.81
|
| Rate for Payer: Cofinity Advantage |
$30.46
|
| Rate for Payer: Cofinity Commercial |
$37.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.74
|
| Rate for Payer: Healthscope Commercial |
$39.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.63
|
| Rate for Payer: Mclaren Medicaid |
$10.74
|
| Rate for Payer: Mclaren Medicare |
$10.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.28
|
| Rate for Payer: Meridian Medicaid |
$11.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.98
|
| Rate for Payer: Nomi Health Commercial |
$16.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.63
|
| Rate for Payer: PACE Medicare |
$10.20
|
| Rate for Payer: PACE SWMI |
$10.74
|
| Rate for Payer: PHP Commercial |
$36.98
|
| Rate for Payer: PHP Medicare Advantage |
$10.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10.74
|
| Rate for Payer: Priority Health Medicare |
$10.74
|
| Rate for Payer: Priority Health SBD |
$27.41
|
| Rate for Payer: Priority Health Tiered Network |
$8.59
|
| Rate for Payer: Railroad Medicare Medicare |
$10.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.11
|
| Rate for Payer: UHC Core |
$16.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.74
|
| Rate for Payer: UHC Exchange |
$16.11
|
| Rate for Payer: UHC Medicaid |
$5.62
|
| Rate for Payer: UHCCP Medicaid |
$5.62
|
| Rate for Payer: UMR Bronson Commercial |
$16.10
|
| Rate for Payer: VA VA |
$10.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.63
|
|
|
HC CERVILENZ
|
Facility
|
OP
|
$174.10
|
|
| Hospital Charge Code |
27200171
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$64.42 |
| Max. Negotiated Rate |
$156.69 |
| Rate for Payer: Aetna American Axle |
$113.17
|
| Rate for Payer: Aetna Commercial |
$147.99
|
| Rate for Payer: Aetna Medicare |
$87.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.17
|
| Rate for Payer: BCBS Complete |
$69.64
|
| Rate for Payer: Cash Price |
$139.28
|
| Rate for Payer: Cofinity Advantage |
$121.87
|
| Rate for Payer: Cofinity Commercial |
$149.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.28
|
| Rate for Payer: Healthscope Commercial |
$156.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.57
|
| Rate for Payer: PHP Commercial |
$147.99
|
| Rate for Payer: Priority Health SBD |
$109.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.17
|
| Rate for Payer: UHC Core |
$90.71
|
| Rate for Payer: UHC Exchange |
$68.42
|
| Rate for Payer: UMR Bronson Commercial |
$64.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.57
|
|
|
HC CERVILENZ
|
Facility
|
IP
|
$174.10
|
|
| Hospital Charge Code |
27200171
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$76.60 |
| Max. Negotiated Rate |
$156.69 |
| Rate for Payer: Aetna American Axle |
$113.17
|
| Rate for Payer: Aetna Commercial |
$147.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.17
|
| Rate for Payer: Cash Price |
$139.28
|
| Rate for Payer: Cofinity Advantage |
$121.87
|
| Rate for Payer: Cofinity Commercial |
$149.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.28
|
| Rate for Payer: Healthscope Commercial |
$156.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.57
|
| Rate for Payer: PHP Commercial |
$147.99
|
| Rate for Payer: Priority Health SBD |
$109.68
|
| Rate for Payer: UMR Bronson Commercial |
$76.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.57
|
|
|
HC CERV OR VAG CA SCREEN PELVIC/BREAST EXAM
|
Facility
|
OP
|
$143.60
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
77000001
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$52.94 |
| Max. Negotiated Rate |
$327.36 |
| Rate for Payer: Aetna American Axle |
$93.34
|
| Rate for Payer: Aetna Commercial |
$122.06
|
| Rate for Payer: Aetna Medicare |
$105.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.53
|
| Rate for Payer: BCBS Complete |
$55.59
|
| Rate for Payer: BCBS MAPPO |
$101.22
|
| Rate for Payer: BCBS Trust/PPO |
$92.98
|
| Rate for Payer: BCN Commercial |
$92.98
|
| Rate for Payer: BCN Medicare Advantage |
$101.22
|
| Rate for Payer: Cash Price |
$114.88
|
| Rate for Payer: Cash Price |
$114.88
|
| Rate for Payer: Cofinity Advantage |
$100.52
|
| Rate for Payer: Cofinity Commercial |
$123.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.22
|
| Rate for Payer: Healthscope Commercial |
$129.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$100.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.70
|
| Rate for Payer: Mclaren Medicaid |
$101.22
|
| Rate for Payer: Mclaren Medicare |
$101.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.28
|
| Rate for Payer: Meridian Medicaid |
$106.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.06
|
| Rate for Payer: Nomi Health Commercial |
$303.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.70
|
| Rate for Payer: PACE Medicare |
$96.16
|
| Rate for Payer: PACE SWMI |
$101.22
|
| Rate for Payer: PHP Commercial |
$122.06
|
| Rate for Payer: PHP Medicare Advantage |
$101.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$327.36
|
| Rate for Payer: Priority Health Medicare |
$101.22
|
| Rate for Payer: Priority Health SBD |
$90.47
|
| Rate for Payer: Priority Health Tiered Network |
$261.89
|
| Rate for Payer: Railroad Medicare Medicare |
$101.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.34
|
| Rate for Payer: UHC Core |
$74.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.22
|
| Rate for Payer: UHC Exchange |
$56.43
|
| Rate for Payer: UHC Medicaid |
$52.94
|
| Rate for Payer: UHCCP Medicaid |
$52.94
|
| Rate for Payer: UMR Bronson Commercial |
$53.13
|
| Rate for Payer: VA VA |
$101.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.70
|
|
|
HC CERV OR VAG CA SCREEN PELVIC/BREAST EXAM
|
Facility
|
IP
|
$143.60
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
77000001
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$63.18 |
| Max. Negotiated Rate |
$129.24 |
| Rate for Payer: Aetna American Axle |
$93.34
|
| Rate for Payer: Aetna Commercial |
$122.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.34
|
| Rate for Payer: Cash Price |
$114.88
|
| Rate for Payer: Cofinity Advantage |
$100.52
|
| Rate for Payer: Cofinity Commercial |
$123.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.88
|
| Rate for Payer: Healthscope Commercial |
$129.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$100.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.70
|
| Rate for Payer: PHP Commercial |
$122.06
|
| Rate for Payer: Priority Health SBD |
$90.47
|
| Rate for Payer: UMR Bronson Commercial |
$63.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.70
|
|
|
HC CESIUM 137 PER SOURCE
|
Facility
|
OP
|
$793.26
|
|
| Hospital Charge Code |
34000001
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$293.51 |
| Max. Negotiated Rate |
$713.93 |
| Rate for Payer: Aetna American Axle |
$515.62
|
| Rate for Payer: Aetna Commercial |
$674.27
|
| Rate for Payer: Aetna Medicare |
$396.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.62
|
| Rate for Payer: BCBS Complete |
$317.30
|
| Rate for Payer: Cash Price |
$634.61
|
| Rate for Payer: Cofinity Advantage |
$555.28
|
| Rate for Payer: Cofinity Commercial |
$682.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.61
|
| Rate for Payer: Healthscope Commercial |
$713.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$555.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$594.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$634.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$674.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.95
|
| Rate for Payer: PHP Commercial |
$674.27
|
| Rate for Payer: Priority Health SBD |
$499.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$515.62
|
| Rate for Payer: UHC Core |
$413.29
|
| Rate for Payer: UHC Exchange |
$311.75
|
| Rate for Payer: UMR Bronson Commercial |
$293.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$594.95
|
|
|
HC CESIUM 137 PER SOURCE
|
Facility
|
IP
|
$793.26
|
|
| Hospital Charge Code |
34000001
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$349.03 |
| Max. Negotiated Rate |
$713.93 |
| Rate for Payer: Aetna American Axle |
$515.62
|
| Rate for Payer: Aetna Commercial |
$674.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.62
|
| Rate for Payer: Cash Price |
$634.61
|
| Rate for Payer: Cofinity Advantage |
$555.28
|
| Rate for Payer: Cofinity Commercial |
$682.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.61
|
| Rate for Payer: Healthscope Commercial |
$713.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$555.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$594.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$674.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.95
|
| Rate for Payer: PHP Commercial |
$674.27
|
| Rate for Payer: Priority Health SBD |
$499.75
|
| Rate for Payer: UMR Bronson Commercial |
$349.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$594.95
|
|
|
HC CHAMBER HOLDING OPTI CHAMBER
|
Facility
|
IP
|
$22.77
|
|
| Hospital Charge Code |
27000044
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.02 |
| Max. Negotiated Rate |
$20.49 |
| Rate for Payer: Aetna American Axle |
$14.80
|
| Rate for Payer: Aetna Commercial |
$19.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.80
|
| Rate for Payer: Cash Price |
$18.22
|
| Rate for Payer: Cofinity Advantage |
$15.94
|
| Rate for Payer: Cofinity Commercial |
$19.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.22
|
| Rate for Payer: Healthscope Commercial |
$20.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.08
|
| Rate for Payer: PHP Commercial |
$19.35
|
| Rate for Payer: Priority Health SBD |
$14.35
|
| Rate for Payer: UMR Bronson Commercial |
$10.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.08
|
|
|
HC CHAMBER HOLDING OPTI CHAMBER
|
Facility
|
OP
|
$22.77
|
|
| Hospital Charge Code |
27000044
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.42 |
| Max. Negotiated Rate |
$20.49 |
| Rate for Payer: Aetna American Axle |
$14.80
|
| Rate for Payer: Aetna Commercial |
$19.35
|
| Rate for Payer: Aetna Medicare |
$11.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.80
|
| Rate for Payer: BCBS Complete |
$9.11
|
| Rate for Payer: Cash Price |
$18.22
|
| Rate for Payer: Cofinity Advantage |
$15.94
|
| Rate for Payer: Cofinity Commercial |
$19.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.22
|
| Rate for Payer: Healthscope Commercial |
$20.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.08
|
| Rate for Payer: PHP Commercial |
$19.35
|
| Rate for Payer: Priority Health SBD |
$14.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.80
|
| Rate for Payer: UHC Core |
$11.86
|
| Rate for Payer: UHC Exchange |
$8.95
|
| Rate for Payer: UMR Bronson Commercial |
$8.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.08
|
|
|
HC CHANGE CYSTOSTOMY TUBE COMPLICATED
|
Facility
|
IP
|
$1,036.80
|
|
|
Service Code
|
CPT 51710
|
| Hospital Charge Code |
76100297
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$456.19 |
| Max. Negotiated Rate |
$933.12 |
| Rate for Payer: Aetna American Axle |
$673.92
|
| Rate for Payer: Aetna Commercial |
$881.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$673.92
|
| Rate for Payer: Cash Price |
$829.44
|
| Rate for Payer: Cofinity Advantage |
$725.76
|
| Rate for Payer: Cofinity Commercial |
$891.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$829.44
|
| Rate for Payer: Healthscope Commercial |
$933.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$725.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$777.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$881.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$777.60
|
| Rate for Payer: PHP Commercial |
$881.28
|
| Rate for Payer: Priority Health SBD |
$653.18
|
| Rate for Payer: UMR Bronson Commercial |
$456.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$777.60
|
|
|
HC CHANGE CYSTOSTOMY TUBE COMPLICATED
|
Facility
|
OP
|
$1,036.80
|
|
|
Service Code
|
CPT 51710
|
| Hospital Charge Code |
76100297
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$363.38 |
| Max. Negotiated Rate |
$2,246.88 |
| Rate for Payer: Aetna American Axle |
$673.92
|
| Rate for Payer: Aetna Commercial |
$881.28
|
| Rate for Payer: Aetna Medicare |
$722.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$673.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$868.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$868.49
|
| Rate for Payer: BCBS Complete |
$381.58
|
| Rate for Payer: BCBS MAPPO |
$694.79
|
| Rate for Payer: BCBS Trust/PPO |
$651.78
|
| Rate for Payer: BCN Commercial |
$651.78
|
| Rate for Payer: BCN Medicare Advantage |
$694.79
|
| Rate for Payer: Cash Price |
$829.44
|
| Rate for Payer: Cash Price |
$829.44
|
| Rate for Payer: Cash Price |
$829.44
|
| Rate for Payer: Cofinity Advantage |
$725.76
|
| Rate for Payer: Cofinity Commercial |
$891.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$829.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.79
|
| Rate for Payer: Healthscope Commercial |
$933.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$725.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$777.60
|
| Rate for Payer: Mclaren Medicaid |
$694.79
|
| Rate for Payer: Mclaren Medicare |
$694.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.53
|
| Rate for Payer: Meridian Medicaid |
$729.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$799.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$764.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$881.28
|
| Rate for Payer: Nomi Health Commercial |
$2,084.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$777.60
|
| Rate for Payer: PACE Medicare |
$660.05
|
| Rate for Payer: PACE SWMI |
$694.79
|
| Rate for Payer: PHP Commercial |
$881.28
|
| Rate for Payer: PHP Medicare Advantage |
$694.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,246.88
|
| Rate for Payer: Priority Health Medicare |
$694.79
|
| Rate for Payer: Priority Health SBD |
$653.18
|
| Rate for Payer: Priority Health Tiered Network |
$1,797.50
|
| Rate for Payer: Railroad Medicare Medicare |
$694.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$673.92
|
| Rate for Payer: UHC Core |
$540.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$694.79
|
| Rate for Payer: UHC Exchange |
$407.46
|
| Rate for Payer: UHC Medicaid |
$363.38
|
| Rate for Payer: UHCCP Medicaid |
$363.38
|
| Rate for Payer: UMR Bronson Commercial |
$383.62
|
| Rate for Payer: VA VA |
$694.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$777.60
|
|
|
HC CHANNEL RFA ENDO CATHETER
|
Facility
|
OP
|
$3,796.01
|
|
| Hospital Charge Code |
27200289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,404.52 |
| Max. Negotiated Rate |
$3,416.41 |
| Rate for Payer: Aetna American Axle |
$2,467.41
|
| Rate for Payer: Aetna Commercial |
$3,226.61
|
| Rate for Payer: Aetna Medicare |
$1,898.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,467.41
|
| Rate for Payer: BCBS Complete |
$1,518.40
|
| Rate for Payer: Cash Price |
$3,036.81
|
| Rate for Payer: Cofinity Advantage |
$2,657.21
|
| Rate for Payer: Cofinity Commercial |
$3,264.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,036.81
|
| Rate for Payer: Healthscope Commercial |
$3,416.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,657.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,847.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,036.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,226.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,847.01
|
| Rate for Payer: PHP Commercial |
$3,226.61
|
| Rate for Payer: Priority Health SBD |
$2,391.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,467.41
|
| Rate for Payer: UHC Core |
$1,977.72
|
| Rate for Payer: UHC Exchange |
$1,491.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,404.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,847.01
|
|
|
HC CHANNEL RFA ENDO CATHETER
|
Facility
|
IP
|
$3,796.01
|
|
| Hospital Charge Code |
27200289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,670.24 |
| Max. Negotiated Rate |
$3,416.41 |
| Rate for Payer: Aetna American Axle |
$2,467.41
|
| Rate for Payer: Aetna Commercial |
$3,226.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,467.41
|
| Rate for Payer: Cash Price |
$3,036.81
|
| Rate for Payer: Cofinity Advantage |
$2,657.21
|
| Rate for Payer: Cofinity Commercial |
$3,264.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,036.81
|
| Rate for Payer: Healthscope Commercial |
$3,416.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,657.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,847.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,226.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,847.01
|
| Rate for Payer: PHP Commercial |
$3,226.61
|
| Rate for Payer: Priority Health SBD |
$2,391.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,670.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,847.01
|
|
|
HC CHEM CAUTERY GRANULATION TISSUE
|
Facility
|
OP
|
$302.67
|
|
|
Service Code
|
CPT 17250
|
| Hospital Charge Code |
76100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna American Axle |
$196.74
|
| Rate for Payer: Aetna Commercial |
$257.27
|
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$155.99
|
| Rate for Payer: BCN Commercial |
$155.99
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$242.14
|
| Rate for Payer: Cash Price |
$242.14
|
| Rate for Payer: Cash Price |
$242.14
|
| Rate for Payer: Cofinity Advantage |
$211.87
|
| Rate for Payer: Cofinity Commercial |
$260.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$272.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$211.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.00
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$209.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.27
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$227.00
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$257.27
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.50
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health SBD |
$190.68
|
| Rate for Payer: Priority Health Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.74
|
| Rate for Payer: UHC Core |
$157.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$118.95
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: UMR Bronson Commercial |
$111.99
|
| Rate for Payer: VA VA |
$199.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.00
|
|
|
HC CHEM CAUTERY GRANULATION TISSUE
|
Facility
|
IP
|
$302.67
|
|
|
Service Code
|
CPT 17250
|
| Hospital Charge Code |
76100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$133.17 |
| Max. Negotiated Rate |
$272.40 |
| Rate for Payer: Aetna American Axle |
$196.74
|
| Rate for Payer: Aetna Commercial |
$257.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.74
|
| Rate for Payer: Cash Price |
$242.14
|
| Rate for Payer: Cofinity Advantage |
$211.87
|
| Rate for Payer: Cofinity Commercial |
$260.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.14
|
| Rate for Payer: Healthscope Commercial |
$272.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$211.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$227.00
|
| Rate for Payer: PHP Commercial |
$257.27
|
| Rate for Payer: Priority Health SBD |
$190.68
|
| Rate for Payer: UMR Bronson Commercial |
$133.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.00
|
|
|
HC CHEMO ADMIN INTO CNS
|
Facility
|
OP
|
$1,148.54
|
|
|
Service Code
|
CPT 96450
|
| Hospital Charge Code |
33100005
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$172.13 |
| Max. Negotiated Rate |
$1,064.33 |
| Rate for Payer: Aetna American Axle |
$746.55
|
| Rate for Payer: Aetna Commercial |
$976.26
|
| Rate for Payer: Aetna Medicare |
$342.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$746.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$411.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$411.40
|
| Rate for Payer: BCBS Complete |
$180.75
|
| Rate for Payer: BCBS MAPPO |
$329.12
|
| Rate for Payer: BCBS Trust/PPO |
$806.85
|
| Rate for Payer: BCN Commercial |
$806.85
|
| Rate for Payer: BCN Medicare Advantage |
$329.12
|
| Rate for Payer: Cash Price |
$918.83
|
| Rate for Payer: Cash Price |
$918.83
|
| Rate for Payer: Cofinity Advantage |
$803.98
|
| Rate for Payer: Cofinity Commercial |
$987.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$918.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.12
|
| Rate for Payer: Healthscope Commercial |
$1,033.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$803.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$861.40
|
| Rate for Payer: Mclaren Medicaid |
$329.12
|
| Rate for Payer: Mclaren Medicare |
$329.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$345.58
|
| Rate for Payer: Meridian Medicaid |
$345.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$378.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$362.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$976.26
|
| Rate for Payer: Nomi Health Commercial |
$987.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$861.40
|
| Rate for Payer: PACE Medicare |
$312.66
|
| Rate for Payer: PACE SWMI |
$329.12
|
| Rate for Payer: PHP Commercial |
$976.26
|
| Rate for Payer: PHP Medicare Advantage |
$329.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,064.33
|
| Rate for Payer: Priority Health Medicare |
$329.12
|
| Rate for Payer: Priority Health SBD |
$723.58
|
| Rate for Payer: Priority Health Tiered Network |
$851.46
|
| Rate for Payer: Railroad Medicare Medicare |
$329.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$746.55
|
| Rate for Payer: UHC Core |
$598.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$329.12
|
| Rate for Payer: UHC Exchange |
$451.38
|
| Rate for Payer: UHC Medicaid |
$172.13
|
| Rate for Payer: UHCCP Medicaid |
$172.13
|
| Rate for Payer: UMR Bronson Commercial |
$424.96
|
| Rate for Payer: VA VA |
$329.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$861.40
|
|
|
HC CHEMO ADMIN INTO CNS
|
Facility
|
IP
|
$1,148.54
|
|
|
Service Code
|
CPT 96450
|
| Hospital Charge Code |
33100005
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$505.36 |
| Max. Negotiated Rate |
$1,033.69 |
| Rate for Payer: Aetna American Axle |
$746.55
|
| Rate for Payer: Aetna Commercial |
$976.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$746.55
|
| Rate for Payer: Cash Price |
$918.83
|
| Rate for Payer: Cofinity Advantage |
$803.98
|
| Rate for Payer: Cofinity Commercial |
$987.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$918.83
|
| Rate for Payer: Healthscope Commercial |
$1,033.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$803.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$861.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$976.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$861.40
|
| Rate for Payer: PHP Commercial |
$976.26
|
| Rate for Payer: Priority Health SBD |
$723.58
|
| Rate for Payer: UMR Bronson Commercial |
$505.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$861.40
|
|
|
HC CHEMODENERVATION INTERNAL ANAL SPHINCTER
|
Facility
|
OP
|
$3,267.32
|
|
|
Service Code
|
CPT 46505
|
| Hospital Charge Code |
76100384
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$623.59 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna American Axle |
$2,123.76
|
| Rate for Payer: Aetna Commercial |
$2,777.22
|
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,123.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,525.56
|
| Rate for Payer: BCN Commercial |
$2,525.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Cash Price |
$2,613.86
|
| Rate for Payer: Cash Price |
$2,613.86
|
| Rate for Payer: Cash Price |
$2,613.86
|
| Rate for Payer: Cofinity Advantage |
$2,287.12
|
| Rate for Payer: Cofinity Commercial |
$2,809.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,613.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Healthscope Commercial |
$2,940.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,287.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,450.49
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,777.22
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,450.49
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Commercial |
$2,777.22
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health SBD |
$2,058.41
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,123.76
|
| Rate for Payer: UHC Core |
$1,702.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Exchange |
$1,284.06
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: UMR Bronson Commercial |
$1,208.91
|
| Rate for Payer: VA VA |
$1,192.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,450.49
|
|
|
HC CHEMODENERVATION INTERNAL ANAL SPHINCTER
|
Facility
|
IP
|
$3,267.32
|
|
|
Service Code
|
CPT 46505
|
| Hospital Charge Code |
76100384
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,437.62 |
| Max. Negotiated Rate |
$2,940.59 |
| Rate for Payer: Aetna American Axle |
$2,123.76
|
| Rate for Payer: Aetna Commercial |
$2,777.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,123.76
|
| Rate for Payer: Cash Price |
$2,613.86
|
| Rate for Payer: Cofinity Advantage |
$2,287.12
|
| Rate for Payer: Cofinity Commercial |
$2,809.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,613.86
|
| Rate for Payer: Healthscope Commercial |
$2,940.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,287.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,450.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,777.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,450.49
|
| Rate for Payer: PHP Commercial |
$2,777.22
|
| Rate for Payer: Priority Health SBD |
$2,058.41
|
| Rate for Payer: UMR Bronson Commercial |
$1,437.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,450.49
|
|
|
HC CHEMODENERVATION TRUNK 6 OR > MUSCLES
|
Facility
|
IP
|
$1,995.07
|
|
|
Service Code
|
CPT 64647
|
| Hospital Charge Code |
36000374
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$877.83 |
| Max. Negotiated Rate |
$1,795.56 |
| Rate for Payer: Aetna American Axle |
$1,296.80
|
| Rate for Payer: Aetna Commercial |
$1,695.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,296.80
|
| Rate for Payer: Cash Price |
$1,596.06
|
| Rate for Payer: Cofinity Advantage |
$1,396.55
|
| Rate for Payer: Cofinity Commercial |
$1,715.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.06
|
| Rate for Payer: Healthscope Commercial |
$1,795.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,396.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,695.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,496.30
|
| Rate for Payer: PHP Commercial |
$1,695.81
|
| Rate for Payer: Priority Health SBD |
$1,256.89
|
| Rate for Payer: UMR Bronson Commercial |
$877.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.30
|
|
