|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$109.14
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$29.80 |
| Max. Negotiated Rate |
$275.31 |
| Rate for Payer: Aetna American Axle |
$70.94
|
| Rate for Payer: Aetna Commercial |
$92.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.94
|
| Rate for Payer: BCBS Complete |
$43.66
|
| Rate for Payer: BCBS Trust/PPO |
$275.31
|
| Rate for Payer: Cash Price |
$87.31
|
| Rate for Payer: Cash Price |
$87.31
|
| Rate for Payer: Cofinity Commercial |
$76.40
|
| Rate for Payer: Cofinity Commercial |
$93.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.31
|
| Rate for Payer: Healthscope Commercial |
$98.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$92.77
|
| Rate for Payer: PHP Commercial |
$92.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.40
|
| Rate for Payer: Priority Health SBD |
$68.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.78
|
| Rate for Payer: UHC Exchange |
$29.80
|
| Rate for Payer: UMR Bronson Commercial |
$40.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.86
|
|
|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$109.14
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$48.02 |
| Max. Negotiated Rate |
$98.23 |
| Rate for Payer: Aetna American Axle |
$70.94
|
| Rate for Payer: Aetna Commercial |
$92.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.94
|
| Rate for Payer: Cash Price |
$87.31
|
| Rate for Payer: Cofinity Commercial |
$76.40
|
| Rate for Payer: Cofinity Commercial |
$93.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.31
|
| Rate for Payer: Healthscope Commercial |
$98.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$92.77
|
| Rate for Payer: PHP Commercial |
$92.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.40
|
| Rate for Payer: Priority Health SBD |
$68.76
|
| Rate for Payer: UMR Bronson Commercial |
$48.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.86
|
|
|
HC INCISIONAL BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$480.42
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.38 |
| Max. Negotiated Rate |
$432.38 |
| Rate for Payer: Aetna American Axle |
$312.27
|
| Rate for Payer: Aetna Commercial |
$408.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.27
|
| Rate for Payer: Cash Price |
$384.34
|
| Rate for Payer: Cofinity Commercial |
$336.29
|
| Rate for Payer: Cofinity Commercial |
$413.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.34
|
| Rate for Payer: Healthscope Commercial |
$432.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$336.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.36
|
| Rate for Payer: PHP Commercial |
$408.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.29
|
| Rate for Payer: Priority Health SBD |
$302.66
|
| Rate for Payer: UMR Bronson Commercial |
$211.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.32
|
|
|
HC INCISIONAL BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$480.42
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.01 |
| Max. Negotiated Rate |
$1,757.43 |
| Rate for Payer: Aetna American Axle |
$312.27
|
| Rate for Payer: Aetna Commercial |
$408.36
|
| Rate for Payer: Aetna Medicare |
$580.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$697.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$697.82
|
| Rate for Payer: BCBS Complete |
$320.66
|
| Rate for Payer: BCBS MAPPO |
$558.26
|
| Rate for Payer: BCBS Trust/PPO |
$155.27
|
| Rate for Payer: BCN Medicare Advantage |
$558.26
|
| Rate for Payer: Cash Price |
$384.34
|
| Rate for Payer: Cash Price |
$384.34
|
| Rate for Payer: Cofinity Commercial |
$413.16
|
| Rate for Payer: Cofinity Commercial |
$336.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.26
|
| Rate for Payer: Healthscope Commercial |
$432.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$336.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.32
|
| Rate for Payer: Mclaren Medicaid |
$305.37
|
| Rate for Payer: Mclaren Medicare |
$558.26
|
| Rate for Payer: Meridian Medicaid |
$320.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$408.36
|
| Rate for Payer: PACE Medicare |
$530.35
|
| Rate for Payer: PACE SWMI |
$558.26
|
| Rate for Payer: PHP Commercial |
$408.36
|
| Rate for Payer: PHP Medicare Advantage |
$558.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,757.43
|
| Rate for Payer: Priority Health Medicare |
$558.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,405.94
|
| Rate for Payer: Priority Health SBD |
$302.66
|
| Rate for Payer: Railroad Medicare Medicare |
$558.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$558.26
|
| Rate for Payer: UHC Exchange |
$55.01
|
| Rate for Payer: UHC Medicare Advantage |
$575.01
|
| Rate for Payer: UMR Bronson Commercial |
$177.76
|
| Rate for Payer: VA VA |
$558.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.32
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
OP
|
$1,964.82
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$726.98 |
| Max. Negotiated Rate |
$1,768.34 |
| Rate for Payer: Aetna American Axle |
$1,277.13
|
| Rate for Payer: Aetna Commercial |
$1,670.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,277.13
|
| Rate for Payer: BCBS Complete |
$785.93
|
| Rate for Payer: Cash Price |
$1,571.86
|
| Rate for Payer: Cofinity Commercial |
$1,375.37
|
| Rate for Payer: Cofinity Commercial |
$1,689.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,571.86
|
| Rate for Payer: Healthscope Commercial |
$1,768.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,375.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,473.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,670.10
|
| Rate for Payer: PHP Commercial |
$1,670.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,375.37
|
| Rate for Payer: Priority Health SBD |
$1,237.84
|
| Rate for Payer: UMR Bronson Commercial |
$726.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,473.62
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
IP
|
$1,964.82
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$864.52 |
| Max. Negotiated Rate |
$1,768.34 |
| Rate for Payer: Aetna American Axle |
$1,277.13
|
| Rate for Payer: Aetna Commercial |
$1,670.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,277.13
|
| Rate for Payer: Cash Price |
$1,571.86
|
| Rate for Payer: Cofinity Commercial |
$1,375.37
|
| Rate for Payer: Cofinity Commercial |
$1,689.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,571.86
|
| Rate for Payer: Healthscope Commercial |
$1,768.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,375.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,473.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,670.10
|
| Rate for Payer: PHP Commercial |
$1,670.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,375.37
|
| Rate for Payer: Priority Health SBD |
$1,237.84
|
| Rate for Payer: UMR Bronson Commercial |
$864.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,473.62
|
|
|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
IP
|
$616.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$271.04 |
| Max. Negotiated Rate |
$554.40 |
| Rate for Payer: Aetna American Axle |
$400.40
|
| Rate for Payer: Aetna Commercial |
$523.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.40
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$431.20
|
| Rate for Payer: Cofinity Commercial |
$529.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$492.80
|
| Rate for Payer: Healthscope Commercial |
$554.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$431.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$462.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$523.60
|
| Rate for Payer: PHP Commercial |
$523.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.20
|
| Rate for Payer: Priority Health SBD |
$388.08
|
| Rate for Payer: UMR Bronson Commercial |
$271.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$462.00
|
|
|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
OP
|
$616.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.76 |
| Max. Negotiated Rate |
$734.01 |
| Rate for Payer: Aetna American Axle |
$400.40
|
| Rate for Payer: Aetna Commercial |
$523.60
|
| Rate for Payer: Aetna Medicare |
$225.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.40
|
| Rate for Payer: BCBS Complete |
$124.71
|
| Rate for Payer: BCBS MAPPO |
$217.12
|
| Rate for Payer: BCBS Trust/PPO |
$734.01
|
| Rate for Payer: BCN Medicare Advantage |
$217.12
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$431.20
|
| Rate for Payer: Cofinity Commercial |
$529.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$492.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.12
|
| Rate for Payer: Healthscope Commercial |
$554.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$431.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$462.00
|
| Rate for Payer: Mclaren Medicaid |
$118.76
|
| Rate for Payer: Mclaren Medicare |
$217.12
|
| Rate for Payer: Meridian Medicaid |
$124.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$227.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$523.60
|
| Rate for Payer: PACE Medicare |
$206.26
|
| Rate for Payer: PACE SWMI |
$217.12
|
| Rate for Payer: PHP Commercial |
$523.60
|
| Rate for Payer: PHP Medicare Advantage |
$217.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$683.51
|
| Rate for Payer: Priority Health Medicare |
$217.12
|
| Rate for Payer: Priority Health Narrow Network |
$546.81
|
| Rate for Payer: Priority Health SBD |
$388.08
|
| Rate for Payer: Railroad Medicare Medicare |
$217.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.12
|
| Rate for Payer: UHC Exchange |
$134.91
|
| Rate for Payer: UHC Medicare Advantage |
$223.63
|
| Rate for Payer: UMR Bronson Commercial |
$227.92
|
| Rate for Payer: VA VA |
$217.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$462.00
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
IP
|
$650.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$286.00 |
| Max. Negotiated Rate |
$585.00 |
| Rate for Payer: Aetna American Axle |
$422.50
|
| Rate for Payer: Aetna Commercial |
$552.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.50
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$455.00
|
| Rate for Payer: Cofinity Commercial |
$559.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Healthscope Commercial |
$585.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$455.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.50
|
| Rate for Payer: PHP Commercial |
$552.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.00
|
| Rate for Payer: Priority Health SBD |
$409.50
|
| Rate for Payer: UMR Bronson Commercial |
$286.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.50
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
OP
|
$650.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.76 |
| Max. Negotiated Rate |
$734.01 |
| Rate for Payer: Aetna American Axle |
$422.50
|
| Rate for Payer: Aetna Commercial |
$552.50
|
| Rate for Payer: Aetna Medicare |
$225.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.40
|
| Rate for Payer: BCBS Complete |
$124.71
|
| Rate for Payer: BCBS MAPPO |
$217.12
|
| Rate for Payer: BCBS Trust/PPO |
$734.01
|
| Rate for Payer: BCN Medicare Advantage |
$217.12
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$455.00
|
| Rate for Payer: Cofinity Commercial |
$559.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.12
|
| Rate for Payer: Healthscope Commercial |
$585.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$455.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.50
|
| Rate for Payer: Mclaren Medicaid |
$118.76
|
| Rate for Payer: Mclaren Medicare |
$217.12
|
| Rate for Payer: Meridian Medicaid |
$124.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$227.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.50
|
| Rate for Payer: PACE Medicare |
$206.26
|
| Rate for Payer: PACE SWMI |
$217.12
|
| Rate for Payer: PHP Commercial |
$552.50
|
| Rate for Payer: PHP Medicare Advantage |
$217.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$683.51
|
| Rate for Payer: Priority Health Medicare |
$217.12
|
| Rate for Payer: Priority Health Narrow Network |
$546.81
|
| Rate for Payer: Priority Health SBD |
$409.50
|
| Rate for Payer: Railroad Medicare Medicare |
$217.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.12
|
| Rate for Payer: UHC Exchange |
$134.91
|
| Rate for Payer: UHC Medicare Advantage |
$223.63
|
| Rate for Payer: UMR Bronson Commercial |
$240.50
|
| Rate for Payer: VA VA |
$217.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.50
|
|
|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
IP
|
$1,772.43
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$779.87 |
| Max. Negotiated Rate |
$1,595.19 |
| Rate for Payer: Aetna American Axle |
$1,152.08
|
| Rate for Payer: Aetna Commercial |
$1,506.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,152.08
|
| Rate for Payer: Cash Price |
$1,417.94
|
| Rate for Payer: Cofinity Commercial |
$1,240.70
|
| Rate for Payer: Cofinity Commercial |
$1,524.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,417.94
|
| Rate for Payer: Healthscope Commercial |
$1,595.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,240.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,329.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,506.57
|
| Rate for Payer: PHP Commercial |
$1,506.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,240.70
|
| Rate for Payer: Priority Health SBD |
$1,116.63
|
| Rate for Payer: UMR Bronson Commercial |
$779.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,329.32
|
|
|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
OP
|
$1,772.43
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.90 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$1,152.08
|
| Rate for Payer: Aetna Commercial |
$1,506.57
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,152.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,603.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,417.94
|
| Rate for Payer: Cash Price |
$1,417.94
|
| Rate for Payer: Cofinity Commercial |
$1,240.70
|
| Rate for Payer: Cofinity Commercial |
$1,524.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,417.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,595.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,240.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,329.32
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,506.57
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,506.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,240.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$1,116.63
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$116.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$655.80
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,329.32
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
OP
|
$951.66
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$168.63 |
| Max. Negotiated Rate |
$1,968.76 |
| Rate for Payer: Aetna American Axle |
$618.58
|
| Rate for Payer: Aetna Commercial |
$808.91
|
| Rate for Payer: Aetna Medicare |
$650.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$618.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$694.01
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$761.33
|
| Rate for Payer: Cash Price |
$761.33
|
| Rate for Payer: Cofinity Commercial |
$666.16
|
| Rate for Payer: Cofinity Commercial |
$818.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$856.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$666.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.74
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$808.91
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$808.91
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$666.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.76
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.01
|
| Rate for Payer: Priority Health SBD |
$599.55
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.39
|
| Rate for Payer: UHC Exchange |
$168.63
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: UMR Bronson Commercial |
$352.11
|
| Rate for Payer: VA VA |
$625.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.74
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
IP
|
$951.66
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$418.73 |
| Max. Negotiated Rate |
$856.49 |
| Rate for Payer: Aetna American Axle |
$618.58
|
| Rate for Payer: Aetna Commercial |
$808.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$618.58
|
| Rate for Payer: Cash Price |
$761.33
|
| Rate for Payer: Cofinity Commercial |
$666.16
|
| Rate for Payer: Cofinity Commercial |
$818.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.33
|
| Rate for Payer: Healthscope Commercial |
$856.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$666.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$808.91
|
| Rate for Payer: PHP Commercial |
$808.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$666.16
|
| Rate for Payer: Priority Health SBD |
$599.55
|
| Rate for Payer: UMR Bronson Commercial |
$418.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.74
|
|
|
HC INCISION EXT THROMBOSED HEMORRHOID
|
Facility
|
IP
|
$292.09
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
45000066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.52 |
| Max. Negotiated Rate |
$262.88 |
| Rate for Payer: Aetna American Axle |
$189.86
|
| Rate for Payer: Aetna Commercial |
$248.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.86
|
| Rate for Payer: Cash Price |
$233.67
|
| Rate for Payer: Cofinity Commercial |
$204.46
|
| Rate for Payer: Cofinity Commercial |
$251.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.67
|
| Rate for Payer: Healthscope Commercial |
$262.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$248.28
|
| Rate for Payer: PHP Commercial |
$248.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$204.46
|
| Rate for Payer: Priority Health SBD |
$184.02
|
| Rate for Payer: UMR Bronson Commercial |
$128.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.07
|
|
|
HC INCISION EXT THROMBOSED HEMORRHOID
|
Facility
|
OP
|
$292.09
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
45000066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$108.07 |
| Max. Negotiated Rate |
$691.57 |
| Rate for Payer: Aetna American Axle |
$189.86
|
| Rate for Payer: Aetna Commercial |
$248.28
|
| Rate for Payer: Aetna Medicare |
$228.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.60
|
| Rate for Payer: BCBS Complete |
$126.18
|
| Rate for Payer: BCBS MAPPO |
$219.68
|
| Rate for Payer: BCBS Trust/PPO |
$198.14
|
| Rate for Payer: BCN Medicare Advantage |
$219.68
|
| Rate for Payer: Cash Price |
$233.67
|
| Rate for Payer: Cash Price |
$233.67
|
| Rate for Payer: Cofinity Commercial |
$251.20
|
| Rate for Payer: Cofinity Commercial |
$204.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.68
|
| Rate for Payer: Healthscope Commercial |
$262.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.07
|
| Rate for Payer: Mclaren Medicaid |
$120.16
|
| Rate for Payer: Mclaren Medicare |
$219.68
|
| Rate for Payer: Meridian Medicaid |
$126.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$248.28
|
| Rate for Payer: PACE Medicare |
$208.70
|
| Rate for Payer: PACE SWMI |
$219.68
|
| Rate for Payer: PHP Commercial |
$248.28
|
| Rate for Payer: PHP Medicare Advantage |
$219.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$204.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$691.57
|
| Rate for Payer: Priority Health Medicare |
$219.68
|
| Rate for Payer: Priority Health Narrow Network |
$553.26
|
| Rate for Payer: Priority Health SBD |
$184.02
|
| Rate for Payer: Railroad Medicare Medicare |
$219.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.68
|
| Rate for Payer: UHC Exchange |
$109.04
|
| Rate for Payer: UHC Medicare Advantage |
$226.27
|
| Rate for Payer: UMR Bronson Commercial |
$108.07
|
| Rate for Payer: VA VA |
$219.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.07
|
|
|
HC INCISION OF LABIAL FRENUM FRENOTOMY
|
Facility
|
IP
|
$1,350.00
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
76100459
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$594.00 |
| Max. Negotiated Rate |
$1,215.00 |
| Rate for Payer: Aetna American Axle |
$877.50
|
| Rate for Payer: Aetna Commercial |
$1,147.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$877.50
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cofinity Commercial |
$1,161.00
|
| Rate for Payer: Cofinity Commercial |
$945.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,080.00
|
| Rate for Payer: Healthscope Commercial |
$1,215.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$945.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,012.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,147.50
|
| Rate for Payer: PHP Commercial |
$1,147.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$945.00
|
| Rate for Payer: Priority Health SBD |
$850.50
|
| Rate for Payer: UMR Bronson Commercial |
$594.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,012.50
|
|
|
HC INCISION OF LABIAL FRENUM FRENOTOMY
|
Facility
|
OP
|
$1,350.00
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
76100459
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$29.14 |
| Max. Negotiated Rate |
$1,539.60 |
| Rate for Payer: Aetna American Axle |
$877.50
|
| Rate for Payer: Aetna Commercial |
$1,147.50
|
| Rate for Payer: Aetna Medicare |
$508.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$877.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$611.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$611.32
|
| Rate for Payer: BCBS Complete |
$280.92
|
| Rate for Payer: BCBS MAPPO |
$489.06
|
| Rate for Payer: BCBS Trust/PPO |
$119.98
|
| Rate for Payer: BCN Medicare Advantage |
$489.06
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cash Price |
$1,080.00
|
| Rate for Payer: Cofinity Commercial |
$1,161.00
|
| Rate for Payer: Cofinity Commercial |
$945.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,080.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.06
|
| Rate for Payer: Healthscope Commercial |
$1,215.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$945.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,012.50
|
| Rate for Payer: Mclaren Medicaid |
$267.52
|
| Rate for Payer: Mclaren Medicare |
$489.06
|
| Rate for Payer: Meridian Medicaid |
$280.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$513.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,147.50
|
| Rate for Payer: PACE Medicare |
$464.61
|
| Rate for Payer: PACE SWMI |
$489.06
|
| Rate for Payer: PHP Commercial |
$1,147.50
|
| Rate for Payer: PHP Medicare Advantage |
$489.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$945.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,539.60
|
| Rate for Payer: Priority Health Medicare |
$489.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,231.68
|
| Rate for Payer: Priority Health SBD |
$850.50
|
| Rate for Payer: Railroad Medicare Medicare |
$489.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$489.06
|
| Rate for Payer: UHC Exchange |
$29.14
|
| Rate for Payer: UHC Medicare Advantage |
$503.73
|
| Rate for Payer: UMR Bronson Commercial |
$499.50
|
| Rate for Payer: VA VA |
$489.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,012.50
|
|
|
HC INCISION OF URETHRA
|
Facility
|
OP
|
$2,742.78
|
|
|
Service Code
|
CPT 53020
|
| Hospital Charge Code |
76100296
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.98 |
| Max. Negotiated Rate |
$5,699.47 |
| Rate for Payer: Aetna American Axle |
$1,782.81
|
| Rate for Payer: Aetna Commercial |
$2,331.36
|
| Rate for Payer: Aetna Medicare |
$1,882.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,782.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,372.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,194.22
|
| Rate for Payer: Cash Price |
$2,194.22
|
| Rate for Payer: Cofinity Commercial |
$1,919.95
|
| Rate for Payer: Cofinity Commercial |
$2,358.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,194.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$2,468.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,919.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,057.08
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,331.36
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$2,331.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,919.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,699.47
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$4,559.58
|
| Rate for Payer: Priority Health SBD |
$1,727.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,810.48
|
| Rate for Payer: UHC Exchange |
$93.98
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,014.83
|
| Rate for Payer: VA VA |
$1,810.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,057.08
|
|
|
HC INCISION OF URETHRA
|
Facility
|
IP
|
$2,742.78
|
|
|
Service Code
|
CPT 53020
|
| Hospital Charge Code |
76100296
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,206.82 |
| Max. Negotiated Rate |
$2,468.50 |
| Rate for Payer: Aetna American Axle |
$1,782.81
|
| Rate for Payer: Aetna Commercial |
$2,331.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,782.81
|
| Rate for Payer: Cash Price |
$2,194.22
|
| Rate for Payer: Cofinity Commercial |
$1,919.95
|
| Rate for Payer: Cofinity Commercial |
$2,358.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,194.22
|
| Rate for Payer: Healthscope Commercial |
$2,468.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,919.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,057.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,331.36
|
| Rate for Payer: PHP Commercial |
$2,331.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,919.95
|
| Rate for Payer: Priority Health SBD |
$1,727.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,206.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,057.08
|
|
|
HC INDIRECT CALORIMETRY
|
Facility
|
OP
|
$1,143.42
|
|
|
Service Code
|
CPT 94690
|
| Hospital Charge Code |
46000008
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$29.74 |
| Max. Negotiated Rate |
$1,029.08 |
| Rate for Payer: Aetna American Axle |
$743.22
|
| Rate for Payer: Aetna Commercial |
$971.91
|
| Rate for Payer: Aetna Medicare |
$56.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$743.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$219.51
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$914.74
|
| Rate for Payer: Cash Price |
$914.74
|
| Rate for Payer: Cash Price |
$914.74
|
| Rate for Payer: Cofinity Commercial |
$800.39
|
| Rate for Payer: Cofinity Commercial |
$983.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$914.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$1,029.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$800.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$857.56
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$971.91
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$971.91
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.15
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$136.92
|
| Rate for Payer: Priority Health SBD |
$720.35
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.59
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.37
|
| Rate for Payer: UHC Exchange |
$47.81
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: UMR Bronson Commercial |
$423.07
|
| Rate for Payer: VA VA |
$54.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$857.56
|
|
|
HC INDIRECT CALORIMETRY
|
Facility
|
IP
|
$1,143.42
|
|
|
Service Code
|
CPT 94690
|
| Hospital Charge Code |
46000008
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$503.10 |
| Max. Negotiated Rate |
$1,029.08 |
| Rate for Payer: Aetna American Axle |
$743.22
|
| Rate for Payer: Aetna Commercial |
$971.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$743.22
|
| Rate for Payer: Cash Price |
$914.74
|
| Rate for Payer: Cofinity Commercial |
$800.39
|
| Rate for Payer: Cofinity Commercial |
$983.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$914.74
|
| Rate for Payer: Healthscope Commercial |
$1,029.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$800.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$857.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$971.91
|
| Rate for Payer: PHP Commercial |
$971.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.39
|
| Rate for Payer: Priority Health SBD |
$720.35
|
| Rate for Payer: UMR Bronson Commercial |
$503.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$857.56
|
|
|
HC INDIUM 111 DTPA PER MCI
|
Facility
|
IP
|
$571.84
|
|
|
Service Code
|
HCPCS A9548
|
| Hospital Charge Code |
34300015
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$251.61 |
| Max. Negotiated Rate |
$514.66 |
| Rate for Payer: Aetna American Axle |
$371.70
|
| Rate for Payer: Aetna Commercial |
$486.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$371.70
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$491.78
|
| Rate for Payer: Cofinity Commercial |
$400.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Healthscope Commercial |
$514.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$400.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$428.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PHP Commercial |
$486.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health SBD |
$360.26
|
| Rate for Payer: UMR Bronson Commercial |
$251.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$428.88
|
|
|
HC INDIUM 111 DTPA PER MCI
|
Facility
|
OP
|
$571.84
|
|
|
Service Code
|
HCPCS A9548
|
| Hospital Charge Code |
34300015
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$211.58 |
| Max. Negotiated Rate |
$736.15 |
| Rate for Payer: Aetna American Axle |
$371.70
|
| Rate for Payer: Aetna Commercial |
$486.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$371.70
|
| Rate for Payer: BCBS Complete |
$228.74
|
| Rate for Payer: BCBS Trust/PPO |
$736.15
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$400.29
|
| Rate for Payer: Cofinity Commercial |
$491.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Healthscope Commercial |
$514.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$400.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$428.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PHP Commercial |
$486.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health SBD |
$360.26
|
| Rate for Payer: UMR Bronson Commercial |
$211.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$428.88
|
|
|
HC INDIUM 111 PER 0.5 MCI
|
Facility
|
IP
|
$2,608.96
|
|
|
Service Code
|
HCPCS A9547
|
| Hospital Charge Code |
63600040
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,147.94 |
| Max. Negotiated Rate |
$2,348.06 |
| Rate for Payer: Aetna American Axle |
$1,695.82
|
| Rate for Payer: Aetna Commercial |
$2,217.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,695.82
|
| Rate for Payer: Cash Price |
$2,087.17
|
| Rate for Payer: Cofinity Commercial |
$1,826.27
|
| Rate for Payer: Cofinity Commercial |
$2,243.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,087.17
|
| Rate for Payer: Healthscope Commercial |
$2,348.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,826.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,956.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,217.62
|
| Rate for Payer: PHP Commercial |
$2,217.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,826.27
|
| Rate for Payer: Priority Health SBD |
$1,643.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,147.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,956.72
|
|
