|
HC CHAMBER HOLDING OPTI CHAMBER
|
Facility
|
OP
|
$22.32
|
|
| Hospital Charge Code |
27000044
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.26 |
| Max. Negotiated Rate |
$20.09 |
| Rate for Payer: Aetna American Axle |
$14.51
|
| Rate for Payer: Aetna Commercial |
$18.97
|
| Rate for Payer: Aetna Medicare |
$11.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.51
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Cofinity Commercial |
$15.62
|
| Rate for Payer: Cofinity Commercial |
$19.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.86
|
| Rate for Payer: Healthscope Commercial |
$20.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.97
|
| Rate for Payer: PHP Commercial |
$18.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.51
|
| Rate for Payer: Priority Health SBD |
$14.06
|
| Rate for Payer: UMR Bronson Commercial |
$8.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.74
|
|
|
HC CHAMBER HOLDING OPTI CHAMBER
|
Facility
|
IP
|
$22.32
|
|
| Hospital Charge Code |
27000044
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.82 |
| Max. Negotiated Rate |
$20.09 |
| Rate for Payer: Aetna American Axle |
$14.51
|
| Rate for Payer: Aetna Commercial |
$18.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.51
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Cofinity Commercial |
$15.62
|
| Rate for Payer: Cofinity Commercial |
$19.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.86
|
| Rate for Payer: Healthscope Commercial |
$20.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.97
|
| Rate for Payer: PHP Commercial |
$18.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.51
|
| Rate for Payer: Priority Health SBD |
$14.06
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.74
|
|
|
HC CHANGE CYSTOSTOMY TUBE COMPLICATED
|
Facility
|
IP
|
$1,016.47
|
|
|
Service Code
|
CPT 51710
|
| Hospital Charge Code |
76100297
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$447.25 |
| Max. Negotiated Rate |
$914.82 |
| Rate for Payer: Aetna American Axle |
$660.71
|
| Rate for Payer: Aetna Commercial |
$864.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$660.71
|
| Rate for Payer: Cash Price |
$813.18
|
| Rate for Payer: Cofinity Commercial |
$711.53
|
| Rate for Payer: Cofinity Commercial |
$874.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$711.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$813.18
|
| Rate for Payer: Healthscope Commercial |
$914.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$711.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$762.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$864.00
|
| Rate for Payer: PHP Commercial |
$864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$660.71
|
| Rate for Payer: Priority Health SBD |
$640.38
|
| Rate for Payer: UMR Bronson Commercial |
$447.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$762.35
|
|
|
HC CHANGE CYSTOSTOMY TUBE COMPLICATED
|
Facility
|
OP
|
$1,016.47
|
|
|
Service Code
|
CPT 51710
|
| Hospital Charge Code |
76100297
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$348.92 |
| Max. Negotiated Rate |
$1,832.42 |
| Rate for Payer: Aetna American Axle |
$660.71
|
| Rate for Payer: Aetna Commercial |
$864.00
|
| Rate for Payer: Aetna Medicare |
$677.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$660.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$813.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$813.71
|
| Rate for Payer: BCBS Complete |
$366.37
|
| Rate for Payer: BCBS MAPPO |
$650.97
|
| Rate for Payer: BCN Medicare Advantage |
$650.97
|
| Rate for Payer: Cash Price |
$813.18
|
| Rate for Payer: Cash Price |
$813.18
|
| Rate for Payer: Cofinity Commercial |
$874.16
|
| Rate for Payer: Cofinity Commercial |
$711.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$711.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$813.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$650.97
|
| Rate for Payer: Healthscope Commercial |
$914.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$711.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$762.35
|
| Rate for Payer: Mclaren Medicaid |
$348.92
|
| Rate for Payer: Mclaren Medicare |
$650.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$683.52
|
| Rate for Payer: Meridian Medicaid |
$366.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$748.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$864.00
|
| Rate for Payer: PACE Medicare |
$618.42
|
| Rate for Payer: PACE SWMI |
$650.97
|
| Rate for Payer: PHP Commercial |
$864.00
|
| Rate for Payer: PHP Medicare Advantage |
$650.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$660.71
|
| Rate for Payer: Priority Health Medicare |
$650.97
|
| Rate for Payer: Priority Health SBD |
$640.38
|
| Rate for Payer: Railroad Medicare Medicare |
$650.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,832.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$650.97
|
| Rate for Payer: UHC Exchange |
$1,244.07
|
| Rate for Payer: UHC Medicare Advantage |
$650.97
|
| Rate for Payer: UHCCP Medicaid |
$348.92
|
| Rate for Payer: UMR Bronson Commercial |
$376.09
|
| Rate for Payer: VA VA |
$650.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$762.35
|
|
|
HC CHANNEL RFA ENDO CATHETER
|
Facility
|
IP
|
$3,721.58
|
|
| Hospital Charge Code |
27200289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,637.50 |
| Max. Negotiated Rate |
$3,349.42 |
| Rate for Payer: Aetna American Axle |
$2,419.03
|
| Rate for Payer: Aetna Commercial |
$3,163.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,419.03
|
| Rate for Payer: Cash Price |
$2,977.26
|
| Rate for Payer: Cofinity Commercial |
$2,605.11
|
| Rate for Payer: Cofinity Commercial |
$3,200.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,605.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,977.26
|
| Rate for Payer: Healthscope Commercial |
$3,349.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,605.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,791.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,163.34
|
| Rate for Payer: PHP Commercial |
$3,163.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,419.03
|
| Rate for Payer: Priority Health SBD |
$2,344.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,637.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,791.18
|
|
|
HC CHANNEL RFA ENDO CATHETER
|
Facility
|
OP
|
$3,721.58
|
|
| Hospital Charge Code |
27200289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,376.98 |
| Max. Negotiated Rate |
$3,349.42 |
| Rate for Payer: Aetna American Axle |
$2,419.03
|
| Rate for Payer: Aetna Commercial |
$3,163.34
|
| Rate for Payer: Aetna Medicare |
$1,860.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,419.03
|
| Rate for Payer: BCBS Complete |
$1,488.63
|
| Rate for Payer: Cash Price |
$2,977.26
|
| Rate for Payer: Cofinity Commercial |
$2,605.11
|
| Rate for Payer: Cofinity Commercial |
$3,200.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,605.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,977.26
|
| Rate for Payer: Healthscope Commercial |
$3,349.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,605.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,791.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,163.34
|
| Rate for Payer: PHP Commercial |
$3,163.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,419.03
|
| Rate for Payer: Priority Health SBD |
$2,344.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,376.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,791.18
|
|
|
HC CHEM CAUTERY GRANULATION TISSUE
|
Facility
|
OP
|
$296.74
|
|
|
Service Code
|
CPT 17250
|
| Hospital Charge Code |
76100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna American Axle |
$192.88
|
| Rate for Payer: Aetna Commercial |
$252.23
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$237.39
|
| Rate for Payer: Cash Price |
$237.39
|
| Rate for Payer: Cofinity Commercial |
$255.20
|
| Rate for Payer: Cofinity Commercial |
$207.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$207.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$267.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$207.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.56
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.23
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$252.23
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.88
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$186.95
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$370.35
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: UMR Bronson Commercial |
$109.79
|
| Rate for Payer: VA VA |
$193.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.56
|
|
|
HC CHEM CAUTERY GRANULATION TISSUE
|
Facility
|
IP
|
$296.74
|
|
|
Service Code
|
CPT 17250
|
| Hospital Charge Code |
76100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$130.57 |
| Max. Negotiated Rate |
$267.07 |
| Rate for Payer: Aetna American Axle |
$192.88
|
| Rate for Payer: Aetna Commercial |
$252.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.88
|
| Rate for Payer: Cash Price |
$237.39
|
| Rate for Payer: Cofinity Commercial |
$207.72
|
| Rate for Payer: Cofinity Commercial |
$255.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$207.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.39
|
| Rate for Payer: Healthscope Commercial |
$267.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$207.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.23
|
| Rate for Payer: PHP Commercial |
$252.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.88
|
| Rate for Payer: Priority Health SBD |
$186.95
|
| Rate for Payer: UMR Bronson Commercial |
$130.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.56
|
|
|
HC CHEMO ADMIN INTO CNS
|
Facility
|
IP
|
$1,126.02
|
|
|
Service Code
|
CPT 96450
|
| Hospital Charge Code |
33100005
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$495.45 |
| Max. Negotiated Rate |
$1,013.42 |
| Rate for Payer: Aetna American Axle |
$731.91
|
| Rate for Payer: Aetna Commercial |
$957.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.91
|
| Rate for Payer: Cash Price |
$900.82
|
| Rate for Payer: Cofinity Commercial |
$788.21
|
| Rate for Payer: Cofinity Commercial |
$968.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$788.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.82
|
| Rate for Payer: Healthscope Commercial |
$1,013.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$788.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$844.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$957.12
|
| Rate for Payer: PHP Commercial |
$957.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.91
|
| Rate for Payer: Priority Health SBD |
$709.39
|
| Rate for Payer: UMR Bronson Commercial |
$495.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$844.51
|
|
|
HC CHEMO ADMIN INTO CNS
|
Facility
|
OP
|
$1,126.02
|
|
|
Service Code
|
CPT 96450
|
| Hospital Charge Code |
33100005
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$173.39 |
| Max. Negotiated Rate |
$1,013.42 |
| Rate for Payer: Aetna American Axle |
$731.91
|
| Rate for Payer: Aetna Commercial |
$957.12
|
| Rate for Payer: Aetna Medicare |
$336.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$404.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$404.36
|
| Rate for Payer: BCBS Complete |
$182.06
|
| Rate for Payer: BCBS MAPPO |
$323.49
|
| Rate for Payer: BCN Medicare Advantage |
$323.49
|
| Rate for Payer: Cash Price |
$900.82
|
| Rate for Payer: Cash Price |
$900.82
|
| Rate for Payer: Cofinity Commercial |
$968.38
|
| Rate for Payer: Cofinity Commercial |
$788.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$788.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$323.49
|
| Rate for Payer: Healthscope Commercial |
$1,013.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$788.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$844.51
|
| Rate for Payer: Mclaren Medicaid |
$173.39
|
| Rate for Payer: Mclaren Medicare |
$323.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$339.66
|
| Rate for Payer: Meridian Medicaid |
$182.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$372.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$957.12
|
| Rate for Payer: PACE Medicare |
$307.32
|
| Rate for Payer: PACE SWMI |
$323.49
|
| Rate for Payer: PHP Commercial |
$957.12
|
| Rate for Payer: PHP Medicare Advantage |
$323.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$173.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.91
|
| Rate for Payer: Priority Health Medicare |
$323.49
|
| Rate for Payer: Priority Health SBD |
$709.39
|
| Rate for Payer: Railroad Medicare Medicare |
$323.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$910.59
|
| Rate for Payer: UHC Core |
$284.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$323.49
|
| Rate for Payer: UHC Exchange |
$618.22
|
| Rate for Payer: UHC Medicare Advantage |
$323.49
|
| Rate for Payer: UHCCP Medicaid |
$173.39
|
| Rate for Payer: UMR Bronson Commercial |
$416.63
|
| Rate for Payer: VA VA |
$323.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$844.51
|
|
|
HC CHEMODENERVATION INTERNAL ANAL SPHINCTER
|
Facility
|
OP
|
$3,203.25
|
|
|
Service Code
|
CPT 46505
|
| Hospital Charge Code |
76100384
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$616.36 |
| Max. Negotiated Rate |
$3,236.94 |
| Rate for Payer: Aetna American Axle |
$2,082.11
|
| Rate for Payer: Aetna Commercial |
$2,722.76
|
| Rate for Payer: Aetna Medicare |
$1,195.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,082.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,437.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,437.41
|
| Rate for Payer: BCBS Complete |
$647.18
|
| Rate for Payer: BCBS MAPPO |
$1,149.93
|
| Rate for Payer: BCN Medicare Advantage |
$1,149.93
|
| Rate for Payer: Cash Price |
$2,562.60
|
| Rate for Payer: Cash Price |
$2,562.60
|
| Rate for Payer: Cofinity Commercial |
$2,754.80
|
| Rate for Payer: Cofinity Commercial |
$2,242.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,242.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,562.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,149.93
|
| Rate for Payer: Healthscope Commercial |
$2,882.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,242.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,402.44
|
| Rate for Payer: Mclaren Medicaid |
$616.36
|
| Rate for Payer: Mclaren Medicare |
$1,149.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,207.43
|
| Rate for Payer: Meridian Medicaid |
$647.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,322.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,722.76
|
| Rate for Payer: PACE Medicare |
$1,092.43
|
| Rate for Payer: PACE SWMI |
$1,149.93
|
| Rate for Payer: PHP Commercial |
$2,722.76
|
| Rate for Payer: PHP Medicare Advantage |
$1,149.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$616.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,082.11
|
| Rate for Payer: Priority Health Medicare |
$1,149.93
|
| Rate for Payer: Priority Health SBD |
$2,018.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,149.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,236.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,149.93
|
| Rate for Payer: UHC Exchange |
$2,197.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,149.93
|
| Rate for Payer: UHCCP Medicaid |
$616.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,185.20
|
| Rate for Payer: VA VA |
$1,149.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,402.44
|
|
|
HC CHEMODENERVATION INTERNAL ANAL SPHINCTER
|
Facility
|
IP
|
$3,203.25
|
|
|
Service Code
|
CPT 46505
|
| Hospital Charge Code |
76100384
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,409.43 |
| Max. Negotiated Rate |
$2,882.93 |
| Rate for Payer: Aetna American Axle |
$2,082.11
|
| Rate for Payer: Aetna Commercial |
$2,722.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,082.11
|
| Rate for Payer: Cash Price |
$2,562.60
|
| Rate for Payer: Cofinity Commercial |
$2,242.28
|
| Rate for Payer: Cofinity Commercial |
$2,754.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,242.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,562.60
|
| Rate for Payer: Healthscope Commercial |
$2,882.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,242.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,402.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,722.76
|
| Rate for Payer: PHP Commercial |
$2,722.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,082.11
|
| Rate for Payer: Priority Health SBD |
$2,018.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,409.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,402.44
|
|
|
HC CHEMODENERVATION TRUNK 6 OR > MUSCLES
|
Facility
|
OP
|
$1,955.95
|
|
|
Service Code
|
CPT 64647
|
| Hospital Charge Code |
36000374
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$362.01 |
| Max. Negotiated Rate |
$1,901.18 |
| Rate for Payer: Aetna American Axle |
$1,271.37
|
| Rate for Payer: Aetna Commercial |
$1,662.56
|
| Rate for Payer: Aetna Medicare |
$702.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,271.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$844.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$844.25
|
| Rate for Payer: BCBS Complete |
$380.12
|
| Rate for Payer: BCBS MAPPO |
$675.40
|
| Rate for Payer: BCN Medicare Advantage |
$675.40
|
| Rate for Payer: Cash Price |
$1,564.76
|
| Rate for Payer: Cash Price |
$1,564.76
|
| Rate for Payer: Cofinity Commercial |
$1,682.12
|
| Rate for Payer: Cofinity Commercial |
$1,369.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,369.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,564.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.40
|
| Rate for Payer: Healthscope Commercial |
$1,760.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,369.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,466.96
|
| Rate for Payer: Mclaren Medicaid |
$362.01
|
| Rate for Payer: Mclaren Medicare |
$675.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.17
|
| Rate for Payer: Meridian Medicaid |
$380.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$776.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,662.56
|
| Rate for Payer: PACE Medicare |
$641.63
|
| Rate for Payer: PACE SWMI |
$675.40
|
| Rate for Payer: PHP Commercial |
$1,662.56
|
| Rate for Payer: PHP Medicare Advantage |
$675.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,271.37
|
| Rate for Payer: Priority Health Medicare |
$675.40
|
| Rate for Payer: Priority Health SBD |
$1,232.25
|
| Rate for Payer: Railroad Medicare Medicare |
$675.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,901.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.40
|
| Rate for Payer: UHC Exchange |
$1,290.76
|
| Rate for Payer: UHC Medicare Advantage |
$675.40
|
| Rate for Payer: UHCCP Medicaid |
$362.01
|
| Rate for Payer: UMR Bronson Commercial |
$723.70
|
| Rate for Payer: VA VA |
$675.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,466.96
|
|
|
HC CHEMODENERVATION TRUNK 6 OR > MUSCLES
|
Facility
|
IP
|
$1,955.95
|
|
|
Service Code
|
CPT 64647
|
| Hospital Charge Code |
36000374
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$860.62 |
| Max. Negotiated Rate |
$1,760.36 |
| Rate for Payer: Aetna American Axle |
$1,271.37
|
| Rate for Payer: Aetna Commercial |
$1,662.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,271.37
|
| Rate for Payer: Cash Price |
$1,564.76
|
| Rate for Payer: Cofinity Commercial |
$1,369.16
|
| Rate for Payer: Cofinity Commercial |
$1,682.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,369.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,564.76
|
| Rate for Payer: Healthscope Commercial |
$1,760.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,369.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,466.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,662.56
|
| Rate for Payer: PHP Commercial |
$1,662.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,271.37
|
| Rate for Payer: Priority Health SBD |
$1,232.25
|
| Rate for Payer: UMR Bronson Commercial |
$860.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,466.96
|
|
|
HC CHEMODENERV SALIV GLANDS
|
Facility
|
IP
|
$386.21
|
|
|
Service Code
|
CPT 64611
|
| Hospital Charge Code |
76100210
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$169.93 |
| Max. Negotiated Rate |
$347.59 |
| Rate for Payer: Aetna American Axle |
$251.04
|
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.04
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cofinity Commercial |
$270.35
|
| Rate for Payer: Cofinity Commercial |
$332.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$270.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.97
|
| Rate for Payer: Healthscope Commercial |
$347.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$270.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.28
|
| Rate for Payer: PHP Commercial |
$328.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.04
|
| Rate for Payer: Priority Health SBD |
$243.31
|
| Rate for Payer: UMR Bronson Commercial |
$169.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.66
|
|
|
HC CHEMODENERV SALIV GLANDS
|
Facility
|
OP
|
$386.21
|
|
|
Service Code
|
CPT 64611
|
| Hospital Charge Code |
76100210
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$142.90 |
| Max. Negotiated Rate |
$810.38 |
| Rate for Payer: Aetna American Axle |
$251.04
|
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare |
$299.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$359.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$359.86
|
| Rate for Payer: BCBS Complete |
$162.02
|
| Rate for Payer: BCBS MAPPO |
$287.89
|
| Rate for Payer: BCN Medicare Advantage |
$287.89
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cofinity Commercial |
$332.14
|
| Rate for Payer: Cofinity Commercial |
$270.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$270.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.89
|
| Rate for Payer: Healthscope Commercial |
$347.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$270.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.66
|
| Rate for Payer: Mclaren Medicaid |
$154.31
|
| Rate for Payer: Mclaren Medicare |
$287.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.28
|
| Rate for Payer: Meridian Medicaid |
$162.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.28
|
| Rate for Payer: PACE Medicare |
$273.50
|
| Rate for Payer: PACE SWMI |
$287.89
|
| Rate for Payer: PHP Commercial |
$328.28
|
| Rate for Payer: PHP Medicare Advantage |
$287.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.04
|
| Rate for Payer: Priority Health Medicare |
$287.89
|
| Rate for Payer: Priority Health SBD |
$243.31
|
| Rate for Payer: Railroad Medicare Medicare |
$287.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$810.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.89
|
| Rate for Payer: UHC Exchange |
$550.19
|
| Rate for Payer: UHC Medicare Advantage |
$287.89
|
| Rate for Payer: UHCCP Medicaid |
$154.31
|
| Rate for Payer: UMR Bronson Commercial |
$142.90
|
| Rate for Payer: VA VA |
$287.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.66
|
|
|
HC CHEMODNRV EA ADD EXT 1-4 MUSC
|
Facility
|
IP
|
$696.44
|
|
|
Service Code
|
CPT 64643
|
| Hospital Charge Code |
36100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$306.43 |
| Max. Negotiated Rate |
$626.80 |
| Rate for Payer: Aetna American Axle |
$452.69
|
| Rate for Payer: Aetna Commercial |
$591.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.69
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cofinity Commercial |
$487.51
|
| Rate for Payer: Cofinity Commercial |
$598.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$487.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.15
|
| Rate for Payer: Healthscope Commercial |
$626.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$487.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$591.97
|
| Rate for Payer: PHP Commercial |
$591.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$452.69
|
| Rate for Payer: Priority Health SBD |
$438.76
|
| Rate for Payer: UMR Bronson Commercial |
$306.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.33
|
|
|
HC CHEMODNRV EA ADD EXT 1-4 MUSC
|
Facility
|
OP
|
$696.44
|
|
|
Service Code
|
CPT 64643
|
| Hospital Charge Code |
36100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$257.68 |
| Max. Negotiated Rate |
$626.80 |
| Rate for Payer: Aetna American Axle |
$452.69
|
| Rate for Payer: Aetna Commercial |
$591.97
|
| Rate for Payer: Aetna Medicare |
$348.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.69
|
| Rate for Payer: BCBS Complete |
$278.58
|
| Rate for Payer: Cash Price |
$557.15
|
| Rate for Payer: Cofinity Commercial |
$487.51
|
| Rate for Payer: Cofinity Commercial |
$598.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$487.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.15
|
| Rate for Payer: Healthscope Commercial |
$626.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$487.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$591.97
|
| Rate for Payer: PHP Commercial |
$591.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$452.69
|
| Rate for Payer: Priority Health SBD |
$438.76
|
| Rate for Payer: UMR Bronson Commercial |
$257.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.33
|
|
|
HC CHEMODNRV EXT1-4 MUSC
|
Facility
|
OP
|
$671.38
|
|
|
Service Code
|
CPT 64642
|
| Hospital Charge Code |
36100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$248.41 |
| Max. Negotiated Rate |
$1,901.18 |
| Rate for Payer: Aetna American Axle |
$436.40
|
| Rate for Payer: Aetna Commercial |
$570.67
|
| Rate for Payer: Aetna Medicare |
$702.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$844.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$844.25
|
| Rate for Payer: BCBS Complete |
$380.12
|
| Rate for Payer: BCBS MAPPO |
$675.40
|
| Rate for Payer: BCN Medicare Advantage |
$675.40
|
| Rate for Payer: Cash Price |
$537.10
|
| Rate for Payer: Cash Price |
$537.10
|
| Rate for Payer: Cofinity Commercial |
$577.39
|
| Rate for Payer: Cofinity Commercial |
$469.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$469.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.40
|
| Rate for Payer: Healthscope Commercial |
$604.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$469.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.54
|
| Rate for Payer: Mclaren Medicaid |
$362.01
|
| Rate for Payer: Mclaren Medicare |
$675.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.17
|
| Rate for Payer: Meridian Medicaid |
$380.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$776.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.67
|
| Rate for Payer: PACE Medicare |
$641.63
|
| Rate for Payer: PACE SWMI |
$675.40
|
| Rate for Payer: PHP Commercial |
$570.67
|
| Rate for Payer: PHP Medicare Advantage |
$675.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.40
|
| Rate for Payer: Priority Health Medicare |
$675.40
|
| Rate for Payer: Priority Health SBD |
$422.97
|
| Rate for Payer: Railroad Medicare Medicare |
$675.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,901.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.40
|
| Rate for Payer: UHC Exchange |
$1,290.76
|
| Rate for Payer: UHC Medicare Advantage |
$675.40
|
| Rate for Payer: UHCCP Medicaid |
$362.01
|
| Rate for Payer: UMR Bronson Commercial |
$248.41
|
| Rate for Payer: VA VA |
$675.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.54
|
|
|
HC CHEMODNRV EXT1-4 MUSC
|
Facility
|
IP
|
$671.38
|
|
|
Service Code
|
CPT 64642
|
| Hospital Charge Code |
36100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$295.41 |
| Max. Negotiated Rate |
$604.24 |
| Rate for Payer: Aetna American Axle |
$436.40
|
| Rate for Payer: Aetna Commercial |
$570.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.40
|
| Rate for Payer: Cash Price |
$537.10
|
| Rate for Payer: Cofinity Commercial |
$469.97
|
| Rate for Payer: Cofinity Commercial |
$577.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$469.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$537.10
|
| Rate for Payer: Healthscope Commercial |
$604.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$469.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$570.67
|
| Rate for Payer: PHP Commercial |
$570.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$436.40
|
| Rate for Payer: Priority Health SBD |
$422.97
|
| Rate for Payer: UMR Bronson Commercial |
$295.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.54
|
|
|
HC CHEMODNRV EXTREMITY 5/< MUSCLES
|
Facility
|
OP
|
$115.59
|
|
|
Service Code
|
CPT 64645
|
| Hospital Charge Code |
36100550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$42.77 |
| Max. Negotiated Rate |
$104.03 |
| Rate for Payer: Aetna American Axle |
$75.13
|
| Rate for Payer: Aetna Commercial |
$98.25
|
| Rate for Payer: Aetna Medicare |
$57.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.13
|
| Rate for Payer: BCBS Complete |
$46.24
|
| Rate for Payer: Cash Price |
$92.47
|
| Rate for Payer: Cofinity Commercial |
$80.91
|
| Rate for Payer: Cofinity Commercial |
$99.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.47
|
| Rate for Payer: Healthscope Commercial |
$104.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.25
|
| Rate for Payer: PHP Commercial |
$98.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.13
|
| Rate for Payer: Priority Health SBD |
$72.82
|
| Rate for Payer: UMR Bronson Commercial |
$42.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.69
|
|
|
HC CHEMODNRV EXTREMITY 5/< MUSCLES
|
Facility
|
IP
|
$115.59
|
|
|
Service Code
|
CPT 64645
|
| Hospital Charge Code |
36100550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$50.86 |
| Max. Negotiated Rate |
$104.03 |
| Rate for Payer: Aetna American Axle |
$75.13
|
| Rate for Payer: Aetna Commercial |
$98.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.13
|
| Rate for Payer: Cash Price |
$92.47
|
| Rate for Payer: Cofinity Commercial |
$80.91
|
| Rate for Payer: Cofinity Commercial |
$99.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.47
|
| Rate for Payer: Healthscope Commercial |
$104.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.25
|
| Rate for Payer: PHP Commercial |
$98.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.13
|
| Rate for Payer: Priority Health SBD |
$72.82
|
| Rate for Payer: UMR Bronson Commercial |
$50.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.69
|
|
|
HC CHEMODNRV EXTREMITY 5 OR MORE MUSCLES
|
Facility
|
IP
|
$527.48
|
|
|
Service Code
|
CPT 64644
|
| Hospital Charge Code |
36100547
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$232.09 |
| Max. Negotiated Rate |
$474.73 |
| Rate for Payer: Aetna American Axle |
$342.86
|
| Rate for Payer: Aetna Commercial |
$448.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$342.86
|
| Rate for Payer: Cash Price |
$421.98
|
| Rate for Payer: Cofinity Commercial |
$369.24
|
| Rate for Payer: Cofinity Commercial |
$453.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$369.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$421.98
|
| Rate for Payer: Healthscope Commercial |
$474.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$369.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$395.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$448.36
|
| Rate for Payer: PHP Commercial |
$448.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.86
|
| Rate for Payer: Priority Health SBD |
$332.31
|
| Rate for Payer: UMR Bronson Commercial |
$232.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$395.61
|
|
|
HC CHEMODNRV EXTREMITY 5 OR MORE MUSCLES
|
Facility
|
OP
|
$527.48
|
|
|
Service Code
|
CPT 64644
|
| Hospital Charge Code |
36100547
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$195.17 |
| Max. Negotiated Rate |
$1,901.18 |
| Rate for Payer: Aetna American Axle |
$342.86
|
| Rate for Payer: Aetna Commercial |
$448.36
|
| Rate for Payer: Aetna Medicare |
$702.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$342.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$844.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$844.25
|
| Rate for Payer: BCBS Complete |
$380.12
|
| Rate for Payer: BCBS MAPPO |
$675.40
|
| Rate for Payer: BCN Medicare Advantage |
$675.40
|
| Rate for Payer: Cash Price |
$421.98
|
| Rate for Payer: Cash Price |
$421.98
|
| Rate for Payer: Cofinity Commercial |
$453.63
|
| Rate for Payer: Cofinity Commercial |
$369.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$369.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$421.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.40
|
| Rate for Payer: Healthscope Commercial |
$474.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$369.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$395.61
|
| Rate for Payer: Mclaren Medicaid |
$362.01
|
| Rate for Payer: Mclaren Medicare |
$675.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.17
|
| Rate for Payer: Meridian Medicaid |
$380.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$776.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$448.36
|
| Rate for Payer: PACE Medicare |
$641.63
|
| Rate for Payer: PACE SWMI |
$675.40
|
| Rate for Payer: PHP Commercial |
$448.36
|
| Rate for Payer: PHP Medicare Advantage |
$675.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.86
|
| Rate for Payer: Priority Health Medicare |
$675.40
|
| Rate for Payer: Priority Health SBD |
$332.31
|
| Rate for Payer: Railroad Medicare Medicare |
$675.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,901.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.40
|
| Rate for Payer: UHC Exchange |
$1,290.76
|
| Rate for Payer: UHC Medicare Advantage |
$675.40
|
| Rate for Payer: UHCCP Medicaid |
$362.01
|
| Rate for Payer: UMR Bronson Commercial |
$195.17
|
| Rate for Payer: VA VA |
$675.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$395.61
|
|
|
HC CHEMODNRV MUSC FACIAL
|
Facility
|
IP
|
$541.99
|
|
|
Service Code
|
CPT 64612
|
| Hospital Charge Code |
36100472
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$238.48 |
| Max. Negotiated Rate |
$487.79 |
| Rate for Payer: Aetna American Axle |
$352.29
|
| Rate for Payer: Aetna Commercial |
$460.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.29
|
| Rate for Payer: Cash Price |
$433.59
|
| Rate for Payer: Cofinity Commercial |
$379.39
|
| Rate for Payer: Cofinity Commercial |
$466.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$379.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.59
|
| Rate for Payer: Healthscope Commercial |
$487.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$379.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$460.69
|
| Rate for Payer: PHP Commercial |
$460.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$352.29
|
| Rate for Payer: Priority Health SBD |
$341.45
|
| Rate for Payer: UMR Bronson Commercial |
$238.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.49
|
|
