|
HC COMP BURN GARM LEG & PANTY
|
Facility
|
IP
|
$230.97
|
|
|
Service Code
|
HCPCS A6511
|
| Hospital Charge Code |
98300035
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$101.63 |
| Max. Negotiated Rate |
$207.87 |
| Rate for Payer: Aetna American Axle |
$150.13
|
| Rate for Payer: Aetna Commercial |
$196.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.13
|
| Rate for Payer: Cash Price |
$184.78
|
| Rate for Payer: Cofinity Advantage |
$161.68
|
| Rate for Payer: Cofinity Commercial |
$198.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.78
|
| Rate for Payer: Healthscope Commercial |
$207.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$161.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$173.23
|
| Rate for Payer: PHP Commercial |
$196.32
|
| Rate for Payer: Priority Health SBD |
$145.51
|
| Rate for Payer: UMR Bronson Commercial |
$101.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.23
|
|
|
HC COMP BURN GARM LINING,POCKET,F
|
Facility
|
OP
|
$12.48
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300037
|
|
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 LINING,POCKET,F
|
Facility
|
IP
|
$12.48
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300037
|
|
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 MITTEN TO WRIST
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300038
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna American Axle |
$45.99
|
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.99
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Advantage |
$49.52
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: Priority Health SBD |
$44.57
|
| Rate for Payer: UMR Bronson Commercial |
$31.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC COMP BURN GARM MITTEN TO WRIST
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300038
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.18 |
| Max. Negotiated Rate |
$414.25 |
| Rate for Payer: Aetna American Axle |
$45.99
|
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna Medicare |
$35.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.99
|
| Rate for Payer: BCBS Complete |
$28.30
|
| Rate for Payer: BCBS Trust/PPO |
$414.25
|
| Rate for Payer: BCN Commercial |
$414.25
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Advantage |
$49.52
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: Priority Health SBD |
$44.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.99
|
| Rate for Payer: UHC Core |
$36.86
|
| Rate for Payer: UHC Exchange |
$27.80
|
| Rate for Payer: UMR Bronson Commercial |
$26.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC COMP BURN GARM POCKET & PAD CO
|
Facility
|
OP
|
$14.57
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$414.25 |
| Rate for Payer: Aetna American Axle |
$9.47
|
| Rate for Payer: Aetna Commercial |
$12.38
|
| Rate for Payer: Aetna Medicare |
$7.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.47
|
| Rate for Payer: BCBS Complete |
$5.83
|
| Rate for Payer: BCBS Trust/PPO |
$414.25
|
| Rate for Payer: BCN Commercial |
$414.25
|
| Rate for Payer: Cash Price |
$11.66
|
| Rate for Payer: Cash Price |
$11.66
|
| Rate for Payer: Cofinity Advantage |
$10.20
|
| Rate for Payer: Cofinity Commercial |
$12.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.66
|
| Rate for Payer: Healthscope Commercial |
$13.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.93
|
| Rate for Payer: PHP Commercial |
$12.38
|
| Rate for Payer: Priority Health SBD |
$9.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.47
|
| Rate for Payer: UHC Core |
$7.59
|
| Rate for Payer: UHC Exchange |
$5.73
|
| Rate for Payer: UMR Bronson Commercial |
$5.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.93
|
|
|
HC COMP BURN GARM POCKET & PAD CO
|
Facility
|
IP
|
$14.57
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$13.11 |
| Rate for Payer: Aetna American Axle |
$9.47
|
| Rate for Payer: Aetna Commercial |
$12.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.47
|
| Rate for Payer: Cash Price |
$11.66
|
| Rate for Payer: Cofinity Advantage |
$10.20
|
| Rate for Payer: Cofinity Commercial |
$12.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.66
|
| Rate for Payer: Healthscope Commercial |
$13.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.93
|
| Rate for Payer: PHP Commercial |
$12.38
|
| Rate for Payer: Priority Health SBD |
$9.18
|
| Rate for Payer: UMR Bronson Commercial |
$6.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.93
|
|
|
HC COMP BURN GARM REINFORCEMENTS
|
Facility
|
IP
|
$12.48
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300041
|
|
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 REINFORCEMENTS
|
Facility
|
OP
|
$12.48
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300041
|
|
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 REINF SET HK&LO
|
Facility
|
OP
|
$10.40
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$414.25 |
| Rate for Payer: Aetna American Axle |
$6.76
|
| Rate for Payer: Aetna Commercial |
$8.84
|
| Rate for Payer: Aetna Medicare |
$5.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.76
|
| Rate for Payer: BCBS Complete |
$4.16
|
| Rate for Payer: BCBS Trust/PPO |
$414.25
|
| Rate for Payer: BCN Commercial |
$414.25
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cofinity Advantage |
$7.28
|
| Rate for Payer: Cofinity Commercial |
$8.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.32
|
| Rate for Payer: Healthscope Commercial |
$9.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.80
|
| Rate for Payer: PHP Commercial |
$8.84
|
| Rate for Payer: Priority Health SBD |
$6.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.76
|
| Rate for Payer: UHC Core |
$5.42
|
| Rate for Payer: UHC Exchange |
$4.09
|
| Rate for Payer: UMR Bronson Commercial |
$3.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.80
|
|
|
HC COMP BURN GARM REINF SET HK&LO
|
Facility
|
IP
|
$10.40
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300040
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.58 |
| Max. Negotiated Rate |
$9.36 |
| Rate for Payer: Aetna American Axle |
$6.76
|
| Rate for Payer: Aetna Commercial |
$8.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.76
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cofinity Advantage |
$7.28
|
| Rate for Payer: Cofinity Commercial |
$8.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.32
|
| Rate for Payer: Healthscope Commercial |
$9.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.80
|
| Rate for Payer: PHP Commercial |
$8.84
|
| Rate for Payer: Priority Health SBD |
$6.55
|
| Rate for Payer: UMR Bronson Commercial |
$4.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.80
|
|
|
HC COMP BURN GARM SHOULD FLAP REG
|
Facility
|
IP
|
$35.37
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300042
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.56 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna American Axle |
$22.99
|
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.99
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Advantage |
$24.76
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.53
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: Priority Health SBD |
$22.28
|
| Rate for Payer: UMR Bronson Commercial |
$15.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC COMP BURN GARM SHOULD FLAP REG
|
Facility
|
OP
|
$35.37
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300042
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.09 |
| Max. Negotiated Rate |
$414.25 |
| Rate for Payer: Aetna American Axle |
$22.99
|
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: Aetna Medicare |
$17.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.99
|
| Rate for Payer: BCBS Complete |
$14.15
|
| Rate for Payer: BCBS Trust/PPO |
$414.25
|
| Rate for Payer: BCN Commercial |
$414.25
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Advantage |
$24.76
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.53
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: Priority Health SBD |
$22.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.99
|
| Rate for Payer: UHC Core |
$18.43
|
| Rate for Payer: UHC Exchange |
$13.90
|
| Rate for Payer: UMR Bronson Commercial |
$13.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC COMP BURN GARM SILON-TEX P/D-G
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300044
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.46 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna American Axle |
$40.57
|
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Advantage |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: UMR Bronson Commercial |
$27.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC COMP BURN GARM SILON-TEX P/D-G
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300044
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.10 |
| Max. Negotiated Rate |
$414.25 |
| Rate for Payer: Aetna American Axle |
$40.57
|
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$31.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: BCBS Complete |
$24.97
|
| Rate for Payer: BCBS Trust/PPO |
$414.25
|
| Rate for Payer: BCN Commercial |
$414.25
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Advantage |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.57
|
| Rate for Payer: UHC Core |
$32.52
|
| Rate for Payer: UHC Exchange |
$24.53
|
| Rate for Payer: UMR Bronson Commercial |
$23.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC COMP BURN GARM SILON-TEX UP TO
|
Facility
|
OP
|
$37.45
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300045
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.86 |
| Max. Negotiated Rate |
$414.25 |
| Rate for Payer: Aetna American Axle |
$24.34
|
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna Medicare |
$18.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.34
|
| Rate for Payer: BCBS Complete |
$14.98
|
| Rate for Payer: BCBS Trust/PPO |
$414.25
|
| Rate for Payer: BCN Commercial |
$414.25
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Advantage |
$26.21
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.09
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: Priority Health SBD |
$23.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.34
|
| Rate for Payer: UHC Core |
$19.51
|
| Rate for Payer: UHC Exchange |
$14.72
|
| Rate for Payer: UMR Bronson Commercial |
$13.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC COMP BURN GARM SILON-TEX UP TO
|
Facility
|
IP
|
$37.45
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300045
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.48 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna American Axle |
$24.34
|
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.34
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Advantage |
$26.21
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.09
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: Priority Health SBD |
$23.59
|
| Rate for Payer: UMR Bronson Commercial |
$16.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC COMP BURN GARM SILON-TEX WHOL
|
Facility
|
IP
|
$87.39
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300046
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.45 |
| Max. Negotiated Rate |
$78.65 |
| Rate for Payer: Aetna American Axle |
$56.80
|
| Rate for Payer: Aetna Commercial |
$74.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.80
|
| Rate for Payer: Cash Price |
$69.91
|
| Rate for Payer: Cofinity Advantage |
$61.17
|
| Rate for Payer: Cofinity Commercial |
$75.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.91
|
| Rate for Payer: Healthscope Commercial |
$78.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.54
|
| Rate for Payer: PHP Commercial |
$74.28
|
| Rate for Payer: Priority Health SBD |
$55.06
|
| Rate for Payer: UMR Bronson Commercial |
$38.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.54
|
|
|
HC COMP BURN GARM SILON-TEX WHOL
|
Facility
|
OP
|
$87.39
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300046
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$32.33 |
| Max. Negotiated Rate |
$414.25 |
| Rate for Payer: Aetna American Axle |
$56.80
|
| Rate for Payer: Aetna Commercial |
$74.28
|
| Rate for Payer: Aetna Medicare |
$43.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.80
|
| Rate for Payer: BCBS Complete |
$34.96
|
| Rate for Payer: BCBS Trust/PPO |
$414.25
|
| Rate for Payer: BCN Commercial |
$414.25
|
| Rate for Payer: Cash Price |
$69.91
|
| Rate for Payer: Cash Price |
$69.91
|
| Rate for Payer: Cofinity Advantage |
$61.17
|
| Rate for Payer: Cofinity Commercial |
$75.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.91
|
| Rate for Payer: Healthscope Commercial |
$78.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.54
|
| Rate for Payer: PHP Commercial |
$74.28
|
| Rate for Payer: Priority Health SBD |
$55.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.80
|
| Rate for Payer: UHC Core |
$45.53
|
| Rate for Payer: UHC Exchange |
$34.34
|
| Rate for Payer: UMR Bronson Commercial |
$32.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.54
|
|
|
HC COMP BURN GARM SLEEVE WRIST/AX
|
Facility
|
IP
|
$72.83
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300047
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$32.05 |
| Max. Negotiated Rate |
$65.55 |
| Rate for Payer: Aetna American Axle |
$47.34
|
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.34
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Advantage |
$50.98
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: Priority Health SBD |
$45.88
|
| Rate for Payer: UMR Bronson Commercial |
$32.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.62
|
|
|
HC COMP BURN GARM SLEEVE WRIST/AX
|
Facility
|
OP
|
$72.83
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300047
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.95 |
| Max. Negotiated Rate |
$414.25 |
| Rate for Payer: Aetna American Axle |
$47.34
|
| Rate for Payer: Aetna Commercial |
$61.91
|
| Rate for Payer: Aetna Medicare |
$36.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.34
|
| Rate for Payer: BCBS Complete |
$29.13
|
| Rate for Payer: BCBS Trust/PPO |
$414.25
|
| Rate for Payer: BCN Commercial |
$414.25
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cash Price |
$58.26
|
| Rate for Payer: Cofinity Advantage |
$50.98
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.26
|
| Rate for Payer: Healthscope Commercial |
$65.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.62
|
| Rate for Payer: PHP Commercial |
$61.91
|
| Rate for Payer: Priority Health SBD |
$45.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.34
|
| Rate for Payer: UHC Core |
$37.94
|
| Rate for Payer: UHC Exchange |
$28.62
|
| Rate for Payer: UMR Bronson Commercial |
$26.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.62
|
|
|
HC COMP BURN GARM SLV WRST-ELB/EL
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300048
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.10 |
| Max. Negotiated Rate |
$414.25 |
| Rate for Payer: Aetna American Axle |
$40.57
|
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$31.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: BCBS Complete |
$24.97
|
| Rate for Payer: BCBS Trust/PPO |
$414.25
|
| Rate for Payer: BCN Commercial |
$414.25
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Advantage |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.57
|
| Rate for Payer: UHC Core |
$32.52
|
| Rate for Payer: UHC Exchange |
$24.53
|
| Rate for Payer: UMR Bronson Commercial |
$23.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC COMP BURN GARM SLV WRST-ELB/EL
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300048
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.46 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna American Axle |
$40.57
|
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Advantage |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: UMR Bronson Commercial |
$27.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC COMP BURN GARM STERNAL STRAP
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300049
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.18 |
| Max. Negotiated Rate |
$414.25 |
| Rate for Payer: Aetna American Axle |
$45.99
|
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna Medicare |
$35.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.99
|
| Rate for Payer: BCBS Complete |
$28.30
|
| Rate for Payer: BCBS Trust/PPO |
$414.25
|
| Rate for Payer: BCN Commercial |
$414.25
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Advantage |
$49.52
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: Priority Health SBD |
$44.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.99
|
| Rate for Payer: UHC Core |
$36.86
|
| Rate for Payer: UHC Exchange |
$27.80
|
| Rate for Payer: UMR Bronson Commercial |
$26.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC COMP BURN GARM STERNAL STRAP
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
HCPCS A6512
|
| Hospital Charge Code |
98300049
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna American Axle |
$45.99
|
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.99
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Advantage |
$49.52
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: Priority Health SBD |
$44.57
|
| Rate for Payer: UMR Bronson Commercial |
$31.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
