|
HC INJ ONABOTULINUMTOXINA PER 1 UNIT
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
HCPCS J0585
|
| Hospital Charge Code |
63600114
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.52 |
| Max. Negotiated Rate |
$7.20 |
| Rate for Payer: Aetna American Axle |
$5.20
|
| Rate for Payer: Aetna Commercial |
$6.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.20
|
| Rate for Payer: Cash Price |
$6.40
|
| Rate for Payer: Cofinity Commercial |
$5.60
|
| Rate for Payer: Cofinity Commercial |
$6.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.40
|
| Rate for Payer: Healthscope Commercial |
$7.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6.80
|
| Rate for Payer: PHP Commercial |
$6.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.60
|
| Rate for Payer: Priority Health SBD |
$5.04
|
| Rate for Payer: UMR Bronson Commercial |
$3.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.00
|
|
|
HC INJ, PENICILLIN G BENZATHINE, 100,000 UNITS
|
Facility
|
OP
|
$16.84
|
|
|
Service Code
|
HCPCS J0561
|
| Hospital Charge Code |
63600162
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$70.22 |
| Rate for Payer: Aetna American Axle |
$10.95
|
| Rate for Payer: Aetna Commercial |
$14.31
|
| Rate for Payer: Aetna Medicare |
$22.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.16
|
| Rate for Payer: BCBS Complete |
$12.48
|
| Rate for Payer: BCBS MAPPO |
$21.73
|
| Rate for Payer: BCBS Trust/PPO |
$70.22
|
| Rate for Payer: BCN Medicare Advantage |
$21.73
|
| Rate for Payer: Cash Price |
$13.47
|
| Rate for Payer: Cash Price |
$13.47
|
| Rate for Payer: Cofinity Commercial |
$14.48
|
| Rate for Payer: Cofinity Commercial |
$11.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.73
|
| Rate for Payer: Healthscope Commercial |
$15.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.63
|
| Rate for Payer: Mclaren Medicaid |
$11.89
|
| Rate for Payer: Mclaren Medicare |
$21.73
|
| Rate for Payer: Meridian Medicaid |
$12.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.31
|
| Rate for Payer: PACE Medicare |
$20.64
|
| Rate for Payer: PACE SWMI |
$21.73
|
| Rate for Payer: PHP Commercial |
$14.31
|
| Rate for Payer: PHP Medicare Advantage |
$21.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.20
|
| Rate for Payer: Priority Health Medicare |
$21.73
|
| Rate for Payer: Priority Health Narrow Network |
$47.36
|
| Rate for Payer: Priority Health SBD |
$10.61
|
| Rate for Payer: Railroad Medicare Medicare |
$21.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.73
|
| Rate for Payer: UHC Medicare Advantage |
$22.38
|
| Rate for Payer: UMR Bronson Commercial |
$6.23
|
| Rate for Payer: VA VA |
$21.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.63
|
|
|
HC INJ, PENICILLIN G BENZATHINE, 100,000 UNITS
|
Facility
|
IP
|
$16.84
|
|
|
Service Code
|
HCPCS J0561
|
| Hospital Charge Code |
63600162
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.41 |
| Max. Negotiated Rate |
$15.16 |
| Rate for Payer: Aetna American Axle |
$10.95
|
| Rate for Payer: Aetna Commercial |
$14.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.95
|
| Rate for Payer: Cash Price |
$13.47
|
| Rate for Payer: Cofinity Commercial |
$11.79
|
| Rate for Payer: Cofinity Commercial |
$14.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.47
|
| Rate for Payer: Healthscope Commercial |
$15.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14.31
|
| Rate for Payer: PHP Commercial |
$14.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.79
|
| Rate for Payer: Priority Health SBD |
$10.61
|
| Rate for Payer: UMR Bronson Commercial |
$7.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.63
|
|
|
HC INJ SELECT R VENT/ATRIAL ANGIO HRT CATH
|
Facility
|
OP
|
$670.14
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
36000110
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$24.89 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$435.59
|
| Rate for Payer: Aetna Commercial |
$569.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$435.59
|
| Rate for Payer: BCBS Complete |
$268.06
|
| Rate for Payer: BCBS Trust/PPO |
$30.16
|
| Rate for Payer: Cash Price |
$536.11
|
| Rate for Payer: Cash Price |
$536.11
|
| Rate for Payer: Cofinity Commercial |
$469.10
|
| Rate for Payer: Cofinity Commercial |
$576.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$536.11
|
| Rate for Payer: Healthscope Commercial |
$603.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$469.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$502.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$569.62
|
| Rate for Payer: PHP Commercial |
$569.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.10
|
| Rate for Payer: Priority Health SBD |
$422.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.38
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$24.89
|
| Rate for Payer: UMR Bronson Commercial |
$247.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$502.60
|
|
|
HC INJ SELECT R VENT/ATRIAL ANGIO HRT CATH
|
Facility
|
IP
|
$670.14
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
36000110
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$294.86 |
| Max. Negotiated Rate |
$603.13 |
| Rate for Payer: Aetna American Axle |
$435.59
|
| Rate for Payer: Aetna Commercial |
$569.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$435.59
|
| Rate for Payer: Cash Price |
$536.11
|
| Rate for Payer: Cofinity Commercial |
$469.10
|
| Rate for Payer: Cofinity Commercial |
$576.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$536.11
|
| Rate for Payer: Healthscope Commercial |
$603.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$469.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$502.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$569.62
|
| Rate for Payer: PHP Commercial |
$569.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.10
|
| Rate for Payer: Priority Health SBD |
$422.19
|
| Rate for Payer: UMR Bronson Commercial |
$294.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$502.60
|
|
|
HC INJ TIXAGEVIMAB AND CILGAVIMAB
|
Facility
|
IP
|
$204.00
|
|
|
Service Code
|
HCPCS M0220
|
| Hospital Charge Code |
77100033
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$89.76 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Aetna American Axle |
$132.60
|
| Rate for Payer: Aetna Commercial |
$173.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.60
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$142.80
|
| Rate for Payer: Cofinity Commercial |
$175.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.20
|
| Rate for Payer: Healthscope Commercial |
$183.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$142.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$173.40
|
| Rate for Payer: PHP Commercial |
$173.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.80
|
| Rate for Payer: Priority Health SBD |
$128.52
|
| Rate for Payer: UMR Bronson Commercial |
$89.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.00
|
|
|
HC INJ TIXAGEVIMAB AND CILGAVIMAB
|
Facility
|
OP
|
$204.00
|
|
|
Service Code
|
HCPCS M0220
|
| Hospital Charge Code |
77100033
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$47.00 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Aetna American Axle |
$132.60
|
| Rate for Payer: Aetna Commercial |
$173.40
|
| Rate for Payer: Aetna Medicare |
$146.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.50
|
| Rate for Payer: BCBS Complete |
$80.65
|
| Rate for Payer: BCBS MAPPO |
$140.40
|
| Rate for Payer: BCN Medicare Advantage |
$140.40
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$142.80
|
| Rate for Payer: Cofinity Commercial |
$175.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.40
|
| Rate for Payer: Healthscope Commercial |
$183.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$142.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.00
|
| Rate for Payer: Mclaren Medicaid |
$76.80
|
| Rate for Payer: Mclaren Medicare |
$140.40
|
| Rate for Payer: Meridian Medicaid |
$80.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$173.40
|
| Rate for Payer: PACE Medicare |
$133.38
|
| Rate for Payer: PACE SWMI |
$140.40
|
| Rate for Payer: PHP Commercial |
$173.40
|
| Rate for Payer: PHP Medicare Advantage |
$140.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.50
|
| Rate for Payer: Priority Health Medicare |
$140.40
|
| Rate for Payer: Priority Health Narrow Network |
$120.40
|
| Rate for Payer: Priority Health SBD |
$128.52
|
| Rate for Payer: Railroad Medicare Medicare |
$140.40
|
| Rate for Payer: UHC Core |
$47.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.40
|
| Rate for Payer: UHC Medicare Advantage |
$144.61
|
| Rate for Payer: UMR Bronson Commercial |
$75.48
|
| Rate for Payer: VA VA |
$140.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.00
|
|
|
HC INJ, TRIAMCINOLONE ACETONIDE, NOT SPECIFIED, 10 MG
|
Facility
|
OP
|
$10.20
|
|
|
Service Code
|
CPT J3301
|
| Hospital Charge Code |
63600103
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.04 |
| Max. Negotiated Rate |
$9.18 |
| Rate for Payer: Aetna American Axle |
$6.63
|
| Rate for Payer: Aetna Commercial |
$8.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.63
|
| Rate for Payer: BCBS Complete |
$4.08
|
| Rate for Payer: BCBS Trust/PPO |
$3.04
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cofinity Commercial |
$7.14
|
| Rate for Payer: Cofinity Commercial |
$8.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.16
|
| Rate for Payer: Healthscope Commercial |
$9.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.67
|
| Rate for Payer: PHP Commercial |
$8.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.14
|
| Rate for Payer: Priority Health SBD |
$6.43
|
| Rate for Payer: UMR Bronson Commercial |
$3.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.65
|
|
|
HC INJ, TRIAMCINOLONE ACETONIDE, NOT SPECIFIED, 10 MG
|
Facility
|
IP
|
$10.20
|
|
|
Service Code
|
CPT J3301
|
| Hospital Charge Code |
63600103
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.49 |
| Max. Negotiated Rate |
$9.18 |
| Rate for Payer: Aetna American Axle |
$6.63
|
| Rate for Payer: Aetna Commercial |
$8.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.63
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cofinity Commercial |
$7.14
|
| Rate for Payer: Cofinity Commercial |
$8.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.16
|
| Rate for Payer: Healthscope Commercial |
$9.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.67
|
| Rate for Payer: PHP Commercial |
$8.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.14
|
| Rate for Payer: Priority Health SBD |
$6.43
|
| Rate for Payer: UMR Bronson Commercial |
$4.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.65
|
|
|
HC INJ, VIT B12 CYANCOBALAMIN, UP TO 1000MCG
|
Facility
|
IP
|
$5.10
|
|
|
Service Code
|
CPT J3420
|
| Hospital Charge Code |
63600104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.24 |
| Max. Negotiated Rate |
$4.59 |
| Rate for Payer: Aetna American Axle |
$3.32
|
| Rate for Payer: Aetna Commercial |
$4.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.32
|
| Rate for Payer: Cash Price |
$4.08
|
| Rate for Payer: Cofinity Commercial |
$3.57
|
| Rate for Payer: Cofinity Commercial |
$4.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.08
|
| Rate for Payer: Healthscope Commercial |
$4.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.34
|
| Rate for Payer: PHP Commercial |
$4.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.57
|
| Rate for Payer: Priority Health SBD |
$3.21
|
| Rate for Payer: UMR Bronson Commercial |
$2.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.82
|
|
|
HC INJ, VIT B12 CYANCOBALAMIN, UP TO 1000MCG
|
Facility
|
OP
|
$5.10
|
|
|
Service Code
|
CPT J3420
|
| Hospital Charge Code |
63600104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.89 |
| Max. Negotiated Rate |
$4.66 |
| Rate for Payer: Aetna American Axle |
$3.32
|
| Rate for Payer: Aetna Commercial |
$4.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.32
|
| Rate for Payer: BCBS Complete |
$2.04
|
| Rate for Payer: BCBS Trust/PPO |
$4.66
|
| Rate for Payer: Cash Price |
$4.08
|
| Rate for Payer: Cash Price |
$4.08
|
| Rate for Payer: Cofinity Commercial |
$3.57
|
| Rate for Payer: Cofinity Commercial |
$4.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.08
|
| Rate for Payer: Healthscope Commercial |
$4.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4.34
|
| Rate for Payer: PHP Commercial |
$4.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.57
|
| Rate for Payer: Priority Health SBD |
$3.21
|
| Rate for Payer: UMR Bronson Commercial |
$1.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.82
|
|
|
HC INSECT VENOM ALLERGY PANEL
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200115
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: UMR Bronson Commercial |
$10.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC INSECT VENOM ALLERGY PANEL
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200115
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.70
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.16
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$5.73
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: UMR Bronson Commercial |
$9.21
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC INSERT CATH COMPLICATED
|
Facility
|
OP
|
$490.51
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
45000005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$74.00 |
| Max. Negotiated Rate |
$441.46 |
| Rate for Payer: Aetna American Axle |
$318.83
|
| Rate for Payer: Aetna Commercial |
$416.93
|
| Rate for Payer: Aetna Medicare |
$144.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$86.69
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$392.41
|
| Rate for Payer: Cash Price |
$392.41
|
| Rate for Payer: Cofinity Commercial |
$421.84
|
| Rate for Payer: Cofinity Commercial |
$343.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$441.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$343.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.88
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$416.93
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$416.93
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.09
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$349.67
|
| Rate for Payer: Priority Health SBD |
$309.02
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
| Rate for Payer: UHC Exchange |
$74.00
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: UMR Bronson Commercial |
$181.49
|
| Rate for Payer: VA VA |
$138.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.88
|
|
|
HC INSERT CATH COMPLICATED
|
Facility
|
IP
|
$490.51
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
45000005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$215.82 |
| Max. Negotiated Rate |
$441.46 |
| Rate for Payer: Aetna American Axle |
$318.83
|
| Rate for Payer: Aetna Commercial |
$416.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.83
|
| Rate for Payer: Cash Price |
$392.41
|
| Rate for Payer: Cofinity Commercial |
$343.36
|
| Rate for Payer: Cofinity Commercial |
$421.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.41
|
| Rate for Payer: Healthscope Commercial |
$441.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$343.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$416.93
|
| Rate for Payer: PHP Commercial |
$416.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.36
|
| Rate for Payer: Priority Health SBD |
$309.02
|
| Rate for Payer: UMR Bronson Commercial |
$215.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.88
|
|
|
HC INSERT CERVICAL DILATOR
|
Facility
|
IP
|
$414.94
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
36100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$182.57 |
| Max. Negotiated Rate |
$373.45 |
| Rate for Payer: Aetna American Axle |
$269.71
|
| Rate for Payer: Aetna Commercial |
$352.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.71
|
| Rate for Payer: Cash Price |
$331.95
|
| Rate for Payer: Cofinity Commercial |
$290.46
|
| Rate for Payer: Cofinity Commercial |
$356.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.95
|
| Rate for Payer: Healthscope Commercial |
$373.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$290.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$311.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$352.70
|
| Rate for Payer: PHP Commercial |
$352.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.46
|
| Rate for Payer: Priority Health SBD |
$261.41
|
| Rate for Payer: UMR Bronson Commercial |
$182.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$311.20
|
|
|
HC INSERT CERVICAL DILATOR
|
Facility
|
OP
|
$414.94
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
36100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.55 |
| Max. Negotiated Rate |
$897.69 |
| Rate for Payer: Aetna American Axle |
$269.71
|
| Rate for Payer: Aetna Commercial |
$352.70
|
| Rate for Payer: Aetna Medicare |
$296.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$356.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$356.45
|
| Rate for Payer: BCBS Complete |
$163.80
|
| Rate for Payer: BCBS MAPPO |
$285.16
|
| Rate for Payer: BCBS Trust/PPO |
$312.22
|
| Rate for Payer: BCN Medicare Advantage |
$285.16
|
| Rate for Payer: Cash Price |
$331.95
|
| Rate for Payer: Cash Price |
$331.95
|
| Rate for Payer: Cofinity Commercial |
$356.85
|
| Rate for Payer: Cofinity Commercial |
$290.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.16
|
| Rate for Payer: Healthscope Commercial |
$373.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$290.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$311.20
|
| Rate for Payer: Mclaren Medicaid |
$155.98
|
| Rate for Payer: Mclaren Medicare |
$285.16
|
| Rate for Payer: Meridian Medicaid |
$163.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$299.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$327.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$352.70
|
| Rate for Payer: PACE Medicare |
$270.90
|
| Rate for Payer: PACE SWMI |
$285.16
|
| Rate for Payer: PHP Commercial |
$352.70
|
| Rate for Payer: PHP Medicare Advantage |
$285.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$897.69
|
| Rate for Payer: Priority Health Medicare |
$285.16
|
| Rate for Payer: Priority Health Narrow Network |
$718.15
|
| Rate for Payer: Priority Health SBD |
$261.41
|
| Rate for Payer: Railroad Medicare Medicare |
$285.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$285.16
|
| Rate for Payer: UHC Exchange |
$43.55
|
| Rate for Payer: UHC Medicare Advantage |
$293.71
|
| Rate for Payer: UMR Bronson Commercial |
$153.53
|
| Rate for Payer: VA VA |
$285.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$311.20
|
|
|
HC INSERT EMERGENCY AIRWAY
|
Facility
|
IP
|
$565.01
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
45000012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$248.60 |
| Max. Negotiated Rate |
$508.51 |
| Rate for Payer: Aetna American Axle |
$367.26
|
| Rate for Payer: Aetna Commercial |
$480.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$367.26
|
| Rate for Payer: Cash Price |
$452.01
|
| Rate for Payer: Cofinity Commercial |
$395.51
|
| Rate for Payer: Cofinity Commercial |
$485.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.01
|
| Rate for Payer: Healthscope Commercial |
$508.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$395.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$480.26
|
| Rate for Payer: PHP Commercial |
$480.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$395.51
|
| Rate for Payer: Priority Health SBD |
$355.96
|
| Rate for Payer: UMR Bronson Commercial |
$248.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.76
|
|
|
HC INSERT EMERGENCY AIRWAY
|
Facility
|
OP
|
$565.01
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
45000012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$118.76 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$367.26
|
| Rate for Payer: Aetna Commercial |
$480.26
|
| Rate for Payer: Aetna Medicare |
$225.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$367.26
|
| 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 |
$222.25
|
| Rate for Payer: BCN Medicare Advantage |
$217.12
|
| Rate for Payer: Cash Price |
$452.01
|
| Rate for Payer: Cash Price |
$452.01
|
| Rate for Payer: Cofinity Commercial |
$485.91
|
| Rate for Payer: Cofinity Commercial |
$395.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.12
|
| Rate for Payer: Healthscope Commercial |
$508.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$395.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.76
|
| 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 |
$480.26
|
| Rate for Payer: PACE Medicare |
$206.26
|
| Rate for Payer: PACE SWMI |
$217.12
|
| Rate for Payer: PHP Commercial |
$480.26
|
| 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 |
$395.51
|
| 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 |
$355.96
|
| Rate for Payer: Railroad Medicare Medicare |
$217.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.19
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.12
|
| Rate for Payer: UHC Exchange |
$136.54
|
| Rate for Payer: UHC Medicare Advantage |
$223.63
|
| Rate for Payer: UMR Bronson Commercial |
$209.05
|
| Rate for Payer: VA VA |
$217.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.76
|
|
|
HC INSERT INDWELLING CATH
|
Facility
|
IP
|
$195.34
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
45000004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$85.95 |
| Max. Negotiated Rate |
$175.81 |
| Rate for Payer: Aetna American Axle |
$126.97
|
| Rate for Payer: Aetna Commercial |
$166.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.97
|
| Rate for Payer: Cash Price |
$156.27
|
| Rate for Payer: Cofinity Commercial |
$136.74
|
| Rate for Payer: Cofinity Commercial |
$167.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.27
|
| Rate for Payer: Healthscope Commercial |
$175.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$166.04
|
| Rate for Payer: PHP Commercial |
$166.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.74
|
| Rate for Payer: Priority Health SBD |
$123.06
|
| Rate for Payer: UMR Bronson Commercial |
$85.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.50
|
|
|
HC INSERT INDWELLING CATH
|
Facility
|
OP
|
$195.34
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
45000004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$357.43 |
| Rate for Payer: Aetna American Axle |
$126.97
|
| Rate for Payer: Aetna Commercial |
$166.04
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$242.13
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$156.27
|
| Rate for Payer: Cash Price |
$156.27
|
| Rate for Payer: Cofinity Commercial |
$136.74
|
| Rate for Payer: Cofinity Commercial |
$167.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$175.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.50
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$166.04
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$166.04
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.43
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$285.94
|
| Rate for Payer: Priority Health SBD |
$123.06
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$24.56
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$72.28
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.50
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
IP
|
$1,052.40
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$463.06 |
| Max. Negotiated Rate |
$947.16 |
| Rate for Payer: Aetna American Axle |
$684.06
|
| Rate for Payer: Aetna Commercial |
$894.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.06
|
| Rate for Payer: Cash Price |
$841.92
|
| Rate for Payer: Cofinity Commercial |
$736.68
|
| Rate for Payer: Cofinity Commercial |
$905.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.92
|
| Rate for Payer: Healthscope Commercial |
$947.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$736.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$894.54
|
| Rate for Payer: PHP Commercial |
$894.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.68
|
| Rate for Payer: Priority Health SBD |
$663.01
|
| Rate for Payer: UMR Bronson Commercial |
$463.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.30
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
OP
|
$1,052.40
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$389.39 |
| Max. Negotiated Rate |
$947.16 |
| Rate for Payer: Aetna American Axle |
$684.06
|
| Rate for Payer: Aetna Commercial |
$894.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.06
|
| Rate for Payer: BCBS Complete |
$420.96
|
| Rate for Payer: Cash Price |
$841.92
|
| Rate for Payer: Cofinity Commercial |
$905.06
|
| Rate for Payer: Cofinity Commercial |
$736.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.92
|
| Rate for Payer: Healthscope Commercial |
$947.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$736.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$894.54
|
| Rate for Payer: PHP Commercial |
$894.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.68
|
| Rate for Payer: Priority Health SBD |
$663.01
|
| Rate for Payer: UMR Bronson Commercial |
$389.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.30
|
|
|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
OP
|
$1,441.32
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$198.43 |
| Max. Negotiated Rate |
$3,302.11 |
| Rate for Payer: Aetna American Axle |
$936.86
|
| Rate for Payer: Aetna Commercial |
$1,225.12
|
| Rate for Payer: Aetna Medicare |
$1,090.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$936.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,311.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,311.18
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,034.21
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$1,153.06
|
| Rate for Payer: Cash Price |
$1,153.06
|
| Rate for Payer: Cofinity Commercial |
$1,008.92
|
| Rate for Payer: Cofinity Commercial |
$1,239.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,153.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$1,297.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,008.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,080.99
|
| Rate for Payer: Mclaren Medicaid |
$573.77
|
| Rate for Payer: Mclaren Medicare |
$1,048.94
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,206.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,225.12
|
| Rate for Payer: PACE Medicare |
$996.49
|
| Rate for Payer: PACE SWMI |
$1,048.94
|
| Rate for Payer: PHP Commercial |
$1,225.12
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,302.11
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,641.69
|
| Rate for Payer: Priority Health SBD |
$908.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.27
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.94
|
| Rate for Payer: UHC Exchange |
$198.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: UMR Bronson Commercial |
$533.29
|
| Rate for Payer: VA VA |
$1,048.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,080.99
|
|
|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
IP
|
$1,441.32
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$634.18 |
| Max. Negotiated Rate |
$1,297.19 |
| Rate for Payer: Aetna American Axle |
$936.86
|
| Rate for Payer: Aetna Commercial |
$1,225.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$936.86
|
| Rate for Payer: Cash Price |
$1,153.06
|
| Rate for Payer: Cofinity Commercial |
$1,008.92
|
| Rate for Payer: Cofinity Commercial |
$1,239.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,153.06
|
| Rate for Payer: Healthscope Commercial |
$1,297.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,008.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,080.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,225.12
|
| Rate for Payer: PHP Commercial |
$1,225.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,008.92
|
| Rate for Payer: Priority Health SBD |
$908.03
|
| Rate for Payer: UMR Bronson Commercial |
$634.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,080.99
|
|
