|
HC COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
IP
|
$871.25
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
76100332
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$383.35 |
| Max. Negotiated Rate |
$784.12 |
| Rate for Payer: Aetna American Axle |
$566.31
|
| Rate for Payer: Aetna Commercial |
$740.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.31
|
| Rate for Payer: Cash Price |
$697.00
|
| Rate for Payer: Cofinity Advantage |
$609.88
|
| Rate for Payer: Cofinity Commercial |
$749.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.00
|
| Rate for Payer: Healthscope Commercial |
$784.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$609.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$653.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$740.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$653.44
|
| Rate for Payer: PHP Commercial |
$740.56
|
| Rate for Payer: Priority Health SBD |
$548.89
|
| Rate for Payer: UMR Bronson Commercial |
$383.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$653.44
|
|
|
HC COLPOSCOPY VULVA W/BIOPSY
|
Facility
|
OP
|
$871.25
|
|
|
Service Code
|
CPT 56821
|
| Hospital Charge Code |
76100332
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$106.69 |
| Max. Negotiated Rate |
$981.93 |
| Rate for Payer: Aetna American Axle |
$566.31
|
| Rate for Payer: Aetna Commercial |
$740.56
|
| Rate for Payer: Aetna Medicare |
$315.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$106.69
|
| Rate for Payer: BCN Commercial |
$106.69
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$697.00
|
| Rate for Payer: Cash Price |
$697.00
|
| Rate for Payer: Cash Price |
$697.00
|
| Rate for Payer: Cofinity Advantage |
$609.88
|
| Rate for Payer: Cofinity Commercial |
$749.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$784.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$609.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$653.44
|
| Rate for Payer: Mclaren Medicaid |
$303.63
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$318.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$740.56
|
| Rate for Payer: Nomi Health Commercial |
$910.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$653.44
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$740.56
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$981.93
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health SBD |
$548.89
|
| Rate for Payer: Priority Health Tiered Network |
$785.54
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$566.31
|
| Rate for Payer: UHC Core |
$453.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Exchange |
$342.40
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: UMR Bronson Commercial |
$322.36
|
| Rate for Payer: VA VA |
$303.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$653.44
|
|
|
HC COMBI CATH SUPPLY
|
Facility
|
IP
|
$125.93
|
|
| Hospital Charge Code |
27200116
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.41 |
| Max. Negotiated Rate |
$113.34 |
| Rate for Payer: Aetna American Axle |
$81.85
|
| Rate for Payer: Aetna Commercial |
$107.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.85
|
| Rate for Payer: Cash Price |
$100.74
|
| Rate for Payer: Cofinity Advantage |
$88.15
|
| Rate for Payer: Cofinity Commercial |
$108.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.74
|
| Rate for Payer: Healthscope Commercial |
$113.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.45
|
| Rate for Payer: PHP Commercial |
$107.04
|
| Rate for Payer: Priority Health SBD |
$79.34
|
| Rate for Payer: UMR Bronson Commercial |
$55.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.45
|
|
|
HC COMBI CATH SUPPLY
|
Facility
|
OP
|
$125.93
|
|
| Hospital Charge Code |
27200116
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.59 |
| Max. Negotiated Rate |
$113.34 |
| Rate for Payer: Aetna American Axle |
$81.85
|
| Rate for Payer: Aetna Commercial |
$107.04
|
| Rate for Payer: Aetna Medicare |
$62.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.85
|
| Rate for Payer: BCBS Complete |
$50.37
|
| Rate for Payer: Cash Price |
$100.74
|
| Rate for Payer: Cofinity Advantage |
$88.15
|
| Rate for Payer: Cofinity Commercial |
$108.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.74
|
| Rate for Payer: Healthscope Commercial |
$113.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.45
|
| Rate for Payer: PHP Commercial |
$107.04
|
| Rate for Payer: Priority Health SBD |
$79.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.85
|
| Rate for Payer: UHC Core |
$65.61
|
| Rate for Payer: UHC Exchange |
$49.49
|
| Rate for Payer: UMR Bronson Commercial |
$46.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.45
|
|
|
HC COMBINED VACCINE, MMR+VARICELLA, SUBQ
|
Facility
|
IP
|
$217.55
|
|
|
Service Code
|
CPT 90710
|
| Hospital Charge Code |
63600206
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$95.72 |
| Max. Negotiated Rate |
$195.79 |
| Rate for Payer: Aetna American Axle |
$141.41
|
| Rate for Payer: Aetna Commercial |
$184.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.41
|
| Rate for Payer: Cash Price |
$174.04
|
| Rate for Payer: Cofinity Advantage |
$152.28
|
| Rate for Payer: Cofinity Commercial |
$187.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.04
|
| Rate for Payer: Healthscope Commercial |
$195.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.16
|
| Rate for Payer: PHP Commercial |
$184.92
|
| Rate for Payer: Priority Health SBD |
$137.06
|
| Rate for Payer: UMR Bronson Commercial |
$95.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.16
|
|
|
HC COMBINED VACCINE, MMR+VARICELLA, SUBQ
|
Facility
|
OP
|
$217.55
|
|
|
Service Code
|
CPT 90710
|
| Hospital Charge Code |
63600206
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$80.49 |
| Max. Negotiated Rate |
$920.31 |
| Rate for Payer: Aetna American Axle |
$141.41
|
| Rate for Payer: Aetna Commercial |
$184.92
|
| Rate for Payer: Aetna Medicare |
$108.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.41
|
| Rate for Payer: BCBS Complete |
$87.02
|
| Rate for Payer: BCBS Trust/PPO |
$920.31
|
| Rate for Payer: BCN Commercial |
$920.31
|
| Rate for Payer: Cash Price |
$174.04
|
| Rate for Payer: Cash Price |
$174.04
|
| Rate for Payer: Cofinity Advantage |
$152.28
|
| Rate for Payer: Cofinity Commercial |
$187.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.04
|
| Rate for Payer: Healthscope Commercial |
$195.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.16
|
| Rate for Payer: PHP Commercial |
$184.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$329.08
|
| Rate for Payer: Priority Health SBD |
$137.06
|
| Rate for Payer: Priority Health Tiered Network |
$263.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$571.56
|
| Rate for Payer: UHC Core |
$571.56
|
| Rate for Payer: UHC Exchange |
$571.56
|
| Rate for Payer: UMR Bronson Commercial |
$80.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.16
|
|
|
HC COMMON REED IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200080
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC COMMON REED IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200080
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC COMM WORK REINTEGRATION EA 15 MIN
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
42000031
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$64.25
|
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna Medicare |
$49.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.25
|
| Rate for Payer: BCBS Complete |
$39.54
|
| Rate for Payer: BCBS Trust/PPO |
$29.63
|
| Rate for Payer: BCN Commercial |
$29.63
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Advantage |
$69.19
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$27.00
|
| Rate for Payer: Priority Health SBD |
$62.27
|
| Rate for Payer: Priority Health Tiered Network |
$21.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.25
|
| Rate for Payer: UHC Core |
$51.50
|
| Rate for Payer: UHC Exchange |
$38.84
|
| Rate for Payer: UMR Bronson Commercial |
$36.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC COMM WORK REINTEGRATION EA 15 MIN
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 97537
|
| Hospital Charge Code |
42000031
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$43.49 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna American Axle |
$64.25
|
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.25
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Advantage |
$69.19
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: Priority Health SBD |
$62.27
|
| Rate for Payer: UMR Bronson Commercial |
$43.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC COMPARTMENT PRESSURE CHECK
|
Facility
|
OP
|
$671.79
|
|
| Hospital Charge Code |
27000045
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$248.56 |
| Max. Negotiated Rate |
$604.61 |
| Rate for Payer: Aetna American Axle |
$436.66
|
| Rate for Payer: Aetna Commercial |
$571.02
|
| Rate for Payer: Aetna Medicare |
$335.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.66
|
| Rate for Payer: BCBS Complete |
$268.72
|
| Rate for Payer: Cash Price |
$537.43
|
| Rate for Payer: Cofinity Advantage |
$470.25
|
| Rate for Payer: Cofinity Commercial |
$577.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.43
|
| Rate for Payer: Healthscope Commercial |
$604.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$470.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$537.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$571.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$503.84
|
| Rate for Payer: PHP Commercial |
$571.02
|
| Rate for Payer: Priority Health SBD |
$423.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$436.66
|
| Rate for Payer: UHC Core |
$350.00
|
| Rate for Payer: UHC Exchange |
$264.01
|
| Rate for Payer: UMR Bronson Commercial |
$248.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.84
|
|
|
HC COMPARTMENT PRESSURE CHECK
|
Facility
|
IP
|
$671.79
|
|
| Hospital Charge Code |
27000045
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$295.59 |
| Max. Negotiated Rate |
$604.61 |
| Rate for Payer: Aetna American Axle |
$436.66
|
| Rate for Payer: Aetna Commercial |
$571.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.66
|
| Rate for Payer: Cash Price |
$537.43
|
| Rate for Payer: Cofinity Advantage |
$470.25
|
| Rate for Payer: Cofinity Commercial |
$577.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.43
|
| Rate for Payer: Healthscope Commercial |
$604.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$470.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$571.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$503.84
|
| Rate for Payer: PHP Commercial |
$571.02
|
| Rate for Payer: Priority Health SBD |
$423.23
|
| Rate for Payer: UMR Bronson Commercial |
$295.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.84
|
|
|
HC COMP BURN GARM 2 LEGS-WAIST
|
Facility
|
IP
|
$243.45
|
|
|
Service Code
|
HCPCS A6511
|
| Hospital Charge Code |
98300142
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$107.12 |
| Max. Negotiated Rate |
$219.10 |
| Rate for Payer: Aetna American Axle |
$158.24
|
| Rate for Payer: Aetna Commercial |
$206.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.24
|
| Rate for Payer: Cash Price |
$194.76
|
| Rate for Payer: Cofinity Advantage |
$170.41
|
| Rate for Payer: Cofinity Commercial |
$209.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.76
|
| Rate for Payer: Healthscope Commercial |
$219.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.59
|
| Rate for Payer: PHP Commercial |
$206.93
|
| Rate for Payer: Priority Health SBD |
$153.37
|
| Rate for Payer: UMR Bronson Commercial |
$107.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.59
|
|
|
HC COMP BURN GARM 2 LEGS-WAIST
|
Facility
|
OP
|
$243.45
|
|
|
Service Code
|
HCPCS A6511
|
| Hospital Charge Code |
98300142
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$90.08 |
| Max. Negotiated Rate |
$285.69 |
| Rate for Payer: Aetna American Axle |
$158.24
|
| Rate for Payer: Aetna Commercial |
$206.93
|
| Rate for Payer: Aetna Medicare |
$121.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.24
|
| Rate for Payer: BCBS Complete |
$97.38
|
| Rate for Payer: BCBS Trust/PPO |
$285.69
|
| Rate for Payer: BCN Commercial |
$285.69
|
| Rate for Payer: Cash Price |
$194.76
|
| Rate for Payer: Cash Price |
$194.76
|
| Rate for Payer: Cofinity Advantage |
$170.41
|
| Rate for Payer: Cofinity Commercial |
$209.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.76
|
| Rate for Payer: Healthscope Commercial |
$219.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$194.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.59
|
| Rate for Payer: PHP Commercial |
$206.93
|
| Rate for Payer: Priority Health SBD |
$153.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.24
|
| Rate for Payer: UHC Core |
$126.84
|
| Rate for Payer: UHC Exchange |
$95.68
|
| Rate for Payer: UMR Bronson Commercial |
$90.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.59
|
|
|
HC COMP BURN GARM 2 OR MORE FAB/C
|
Facility
|
OP
|
$12.48
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.62 |
| Max. Negotiated Rate |
$414.25 |
| Rate for Payer: Aetna American Axle |
$8.11
|
| Rate for Payer: Aetna Commercial |
$10.61
|
| Rate for Payer: Aetna Medicare |
$6.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.11
|
| Rate for Payer: BCBS Complete |
$4.99
|
| Rate for Payer: BCBS Trust/PPO |
$414.25
|
| Rate for Payer: BCN Commercial |
$414.25
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Advantage |
$8.74
|
| Rate for Payer: Cofinity Commercial |
$10.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Healthscope Commercial |
$11.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.36
|
| Rate for Payer: PHP Commercial |
$10.61
|
| Rate for Payer: Priority Health SBD |
$7.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.11
|
| Rate for Payer: UHC Core |
$6.50
|
| Rate for Payer: UHC Exchange |
$4.90
|
| Rate for Payer: UMR Bronson Commercial |
$4.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.36
|
|
|
HC COMP BURN GARM 2 OR MORE FAB/C
|
Facility
|
IP
|
$12.48
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300143
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.49 |
| Max. Negotiated Rate |
$11.23 |
| Rate for Payer: Aetna American Axle |
$8.11
|
| Rate for Payer: Aetna Commercial |
$10.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.11
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Advantage |
$8.74
|
| Rate for Payer: Cofinity Commercial |
$10.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Healthscope Commercial |
$11.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.36
|
| Rate for Payer: PHP Commercial |
$10.61
|
| Rate for Payer: Priority Health SBD |
$7.86
|
| Rate for Payer: UMR Bronson Commercial |
$5.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.36
|
|
|
HC COMP BURN GARM ABD REINFOR DBL
|
Facility
|
OP
|
$16.65
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300144
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.16 |
| Max. Negotiated Rate |
$414.25 |
| Rate for Payer: Aetna American Axle |
$10.82
|
| Rate for Payer: Aetna Commercial |
$14.15
|
| Rate for Payer: Aetna Medicare |
$8.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.82
|
| Rate for Payer: BCBS Complete |
$6.66
|
| Rate for Payer: BCBS Trust/PPO |
$414.25
|
| Rate for Payer: BCN Commercial |
$414.25
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cofinity Advantage |
$11.65
|
| Rate for Payer: Cofinity Commercial |
$14.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Healthscope Commercial |
$14.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.49
|
| Rate for Payer: PHP Commercial |
$14.15
|
| Rate for Payer: Priority Health SBD |
$10.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.82
|
| Rate for Payer: UHC Core |
$8.67
|
| Rate for Payer: UHC Exchange |
$6.54
|
| Rate for Payer: UMR Bronson Commercial |
$6.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.49
|
|
|
HC COMP BURN GARM ABD REINFOR DBL
|
Facility
|
IP
|
$16.65
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300144
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$14.98 |
| Rate for Payer: Aetna American Axle |
$10.82
|
| Rate for Payer: Aetna Commercial |
$14.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.82
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cofinity Advantage |
$11.65
|
| Rate for Payer: Cofinity Commercial |
$14.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.32
|
| Rate for Payer: Healthscope Commercial |
$14.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.49
|
| Rate for Payer: PHP Commercial |
$14.15
|
| Rate for Payer: Priority Health SBD |
$10.49
|
| Rate for Payer: UMR Bronson Commercial |
$7.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.49
|
|
|
HC COMP BURN GARM ANKLET
|
Facility
|
IP
|
$64.50
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.38 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna American Axle |
$41.92
|
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.92
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Advantage |
$45.15
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: Priority Health SBD |
$40.63
|
| Rate for Payer: UMR Bronson Commercial |
$28.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.38
|
|
|
HC COMP BURN GARM ANKLET
|
Facility
|
OP
|
$64.50
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$414.25 |
| Rate for Payer: Aetna American Axle |
$41.92
|
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: Aetna Medicare |
$32.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.92
|
| Rate for Payer: BCBS Complete |
$25.80
|
| Rate for Payer: BCBS Trust/PPO |
$414.25
|
| Rate for Payer: BCN Commercial |
$414.25
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Advantage |
$45.15
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: Priority Health SBD |
$40.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.92
|
| Rate for Payer: UHC Core |
$33.60
|
| Rate for Payer: UHC Exchange |
$25.35
|
| Rate for Payer: UMR Bronson Commercial |
$23.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.38
|
|
|
HC COMP BURN GARM BDY BRF SLVD LE
|
Facility
|
OP
|
$345.41
|
|
|
Service Code
|
HCPCS A6510
|
| Hospital Charge Code |
98300146
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$127.80 |
| Max. Negotiated Rate |
$523.77 |
| Rate for Payer: Aetna American Axle |
$224.52
|
| Rate for Payer: Aetna Commercial |
$293.60
|
| Rate for Payer: Aetna Medicare |
$172.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.52
|
| Rate for Payer: BCBS Complete |
$138.16
|
| Rate for Payer: BCBS Trust/PPO |
$523.77
|
| Rate for Payer: BCN Commercial |
$523.77
|
| Rate for Payer: Cash Price |
$276.33
|
| Rate for Payer: Cash Price |
$276.33
|
| Rate for Payer: Cofinity Advantage |
$241.79
|
| Rate for Payer: Cofinity Commercial |
$297.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.33
|
| Rate for Payer: Healthscope Commercial |
$310.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$276.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.06
|
| Rate for Payer: PHP Commercial |
$293.60
|
| Rate for Payer: Priority Health SBD |
$217.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.52
|
| Rate for Payer: UHC Core |
$179.96
|
| Rate for Payer: UHC Exchange |
$135.75
|
| Rate for Payer: UMR Bronson Commercial |
$127.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.06
|
|
|
HC COMP BURN GARM BDY BRF SLVD LE
|
Facility
|
IP
|
$345.41
|
|
|
Service Code
|
HCPCS A6510
|
| Hospital Charge Code |
98300146
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$151.98 |
| Max. Negotiated Rate |
$310.87 |
| Rate for Payer: Aetna American Axle |
$224.52
|
| Rate for Payer: Aetna Commercial |
$293.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.52
|
| Rate for Payer: Cash Price |
$276.33
|
| Rate for Payer: Cofinity Advantage |
$241.79
|
| Rate for Payer: Cofinity Commercial |
$297.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.33
|
| Rate for Payer: Healthscope Commercial |
$310.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.06
|
| Rate for Payer: PHP Commercial |
$293.60
|
| Rate for Payer: Priority Health SBD |
$217.61
|
| Rate for Payer: UMR Bronson Commercial |
$151.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.06
|
|
|
HC COMP BURN GARM BELLY BAND
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300147
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Advantage |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: UMR Bronson Commercial |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC COMP BURN GARM BELLY BAND
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300147
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.40 |
| Max. Negotiated Rate |
$414.25 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$20.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: BCBS Complete |
$16.65
|
| Rate for Payer: BCBS Trust/PPO |
$414.25
|
| Rate for Payer: BCN Commercial |
$414.25
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Advantage |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.05
|
| Rate for Payer: UHC Core |
$21.68
|
| Rate for Payer: UHC Exchange |
$16.36
|
| Rate for Payer: UMR Bronson Commercial |
$15.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC COMP BURN GARM BODY BRF SLEEVE
|
Facility
|
OP
|
$245.53
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300148
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$90.85 |
| Max. Negotiated Rate |
$414.25 |
| Rate for Payer: Aetna American Axle |
$159.59
|
| Rate for Payer: Aetna Commercial |
$208.70
|
| Rate for Payer: Aetna Medicare |
$122.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.59
|
| Rate for Payer: BCBS Complete |
$98.21
|
| Rate for Payer: BCBS Trust/PPO |
$414.25
|
| Rate for Payer: BCN Commercial |
$414.25
|
| Rate for Payer: Cash Price |
$196.42
|
| Rate for Payer: Cash Price |
$196.42
|
| Rate for Payer: Cofinity Advantage |
$171.87
|
| Rate for Payer: Cofinity Commercial |
$211.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.42
|
| Rate for Payer: Healthscope Commercial |
$220.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$184.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$196.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.15
|
| Rate for Payer: PHP Commercial |
$208.70
|
| Rate for Payer: Priority Health SBD |
$154.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.59
|
| Rate for Payer: UHC Core |
$127.92
|
| Rate for Payer: UHC Exchange |
$96.49
|
| Rate for Payer: UMR Bronson Commercial |
$90.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$184.15
|
|
