|
HC DEBRIDEMENT MUSCLE EACH ADDL 20 SQ CM
|
Facility
|
OP
|
$868.17
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
76100033
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$319.02 |
| Max. Negotiated Rate |
$781.35 |
| Rate for Payer: Aetna American Axle |
$564.31
|
| Rate for Payer: Aetna Commercial |
$737.94
|
| Rate for Payer: Aetna Medicare |
$434.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$564.31
|
| Rate for Payer: BCBS Complete |
$347.27
|
| Rate for Payer: BCBS Trust/PPO |
$319.02
|
| Rate for Payer: BCN Commercial |
$319.02
|
| Rate for Payer: Cash Price |
$694.54
|
| Rate for Payer: Cash Price |
$694.54
|
| Rate for Payer: Cash Price |
$694.54
|
| Rate for Payer: Cofinity Advantage |
$607.72
|
| Rate for Payer: Cofinity Commercial |
$746.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.54
|
| Rate for Payer: Healthscope Commercial |
$781.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$607.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$651.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$694.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$651.13
|
| Rate for Payer: PHP Commercial |
$737.94
|
| Rate for Payer: Priority Health SBD |
$546.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$564.31
|
| Rate for Payer: UHC Core |
$452.32
|
| Rate for Payer: UHC Exchange |
$341.19
|
| Rate for Payer: UMR Bronson Commercial |
$321.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$651.13
|
|
|
HC DEBRIDEMENT OF 1-5 NAILS
|
Facility
|
IP
|
$96.31
|
|
|
Service Code
|
CPT 11720
|
| Hospital Charge Code |
76100043
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$42.38 |
| Max. Negotiated Rate |
$86.68 |
| Rate for Payer: Aetna American Axle |
$62.60
|
| Rate for Payer: Aetna Commercial |
$81.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.60
|
| Rate for Payer: Cash Price |
$77.05
|
| Rate for Payer: Cofinity Advantage |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$82.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.05
|
| Rate for Payer: Healthscope Commercial |
$86.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.23
|
| Rate for Payer: PHP Commercial |
$81.86
|
| Rate for Payer: Priority Health SBD |
$60.68
|
| Rate for Payer: UMR Bronson Commercial |
$42.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.23
|
|
|
HC DEBRIDEMENT OF 1-5 NAILS
|
Facility
|
OP
|
$96.31
|
|
|
Service Code
|
CPT 11720
|
| Hospital Charge Code |
76100043
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$190.09 |
| Rate for Payer: Aetna American Axle |
$62.60
|
| Rate for Payer: Aetna Commercial |
$81.86
|
| Rate for Payer: Aetna Medicare |
$61.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$62.51
|
| Rate for Payer: BCN Commercial |
$62.51
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$77.05
|
| Rate for Payer: Cash Price |
$77.05
|
| Rate for Payer: Cash Price |
$77.05
|
| Rate for Payer: Cofinity Advantage |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$82.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$86.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.23
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$61.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.86
|
| Rate for Payer: Nomi Health Commercial |
$176.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.23
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$81.86
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.09
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health SBD |
$60.68
|
| Rate for Payer: Priority Health Tiered Network |
$152.07
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.60
|
| Rate for Payer: UHC Core |
$50.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$37.85
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: UMR Bronson Commercial |
$35.63
|
| Rate for Payer: VA VA |
$58.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.23
|
|
|
HC DEBRIDEMENT OF 6 OR MORE NAILS
|
Facility
|
OP
|
$116.75
|
|
|
Service Code
|
CPT 11721
|
| Hospital Charge Code |
76100044
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$190.09 |
| Rate for Payer: Aetna American Axle |
$75.89
|
| Rate for Payer: Aetna Commercial |
$99.24
|
| Rate for Payer: Aetna Medicare |
$61.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$101.98
|
| Rate for Payer: BCN Commercial |
$101.98
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$93.40
|
| Rate for Payer: Cash Price |
$93.40
|
| Rate for Payer: Cash Price |
$93.40
|
| Rate for Payer: Cofinity Advantage |
$81.72
|
| Rate for Payer: Cofinity Commercial |
$100.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$105.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.56
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$61.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.24
|
| Rate for Payer: Nomi Health Commercial |
$176.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.56
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$99.24
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.09
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health SBD |
$73.55
|
| Rate for Payer: Priority Health Tiered Network |
$152.07
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.89
|
| Rate for Payer: UHC Core |
$60.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$45.88
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: UMR Bronson Commercial |
$43.20
|
| Rate for Payer: VA VA |
$58.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.56
|
|
|
HC DEBRIDEMENT OF 6 OR MORE NAILS
|
Facility
|
IP
|
$116.75
|
|
|
Service Code
|
CPT 11721
|
| Hospital Charge Code |
76100044
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$51.37 |
| Max. Negotiated Rate |
$105.08 |
| Rate for Payer: Aetna American Axle |
$75.89
|
| Rate for Payer: Aetna Commercial |
$99.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.89
|
| Rate for Payer: Cash Price |
$93.40
|
| Rate for Payer: Cofinity Advantage |
$81.72
|
| Rate for Payer: Cofinity Commercial |
$100.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.40
|
| Rate for Payer: Healthscope Commercial |
$105.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.56
|
| Rate for Payer: PHP Commercial |
$99.24
|
| Rate for Payer: Priority Health SBD |
$73.55
|
| Rate for Payer: UMR Bronson Commercial |
$51.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.56
|
|
|
HC DEBRIDE MUSCLE FASCIA FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$1,135.66
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
76100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$385.14 |
| Max. Negotiated Rate |
$2,381.49 |
| Rate for Payer: Aetna American Axle |
$738.18
|
| Rate for Payer: Aetna Commercial |
$965.31
|
| Rate for Payer: Aetna Medicare |
$765.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$738.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$920.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$920.51
|
| Rate for Payer: BCBS Complete |
$404.44
|
| Rate for Payer: BCBS MAPPO |
$736.41
|
| Rate for Payer: BCBS Trust/PPO |
$905.59
|
| Rate for Payer: BCN Commercial |
$905.59
|
| Rate for Payer: BCN Medicare Advantage |
$736.41
|
| Rate for Payer: Cash Price |
$908.53
|
| Rate for Payer: Cash Price |
$908.53
|
| Rate for Payer: Cash Price |
$908.53
|
| Rate for Payer: Cofinity Advantage |
$794.96
|
| Rate for Payer: Cofinity Commercial |
$976.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.41
|
| Rate for Payer: Healthscope Commercial |
$1,022.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$794.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$851.75
|
| Rate for Payer: Mclaren Medicaid |
$736.41
|
| Rate for Payer: Mclaren Medicare |
$736.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.23
|
| Rate for Payer: Meridian Medicaid |
$773.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$846.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$810.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$965.31
|
| Rate for Payer: Nomi Health Commercial |
$2,209.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$851.75
|
| Rate for Payer: PACE Medicare |
$699.59
|
| Rate for Payer: PACE SWMI |
$736.41
|
| Rate for Payer: PHP Commercial |
$965.31
|
| Rate for Payer: PHP Medicare Advantage |
$736.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,381.49
|
| Rate for Payer: Priority Health Medicare |
$736.41
|
| Rate for Payer: Priority Health SBD |
$715.47
|
| Rate for Payer: Priority Health Tiered Network |
$1,905.19
|
| Rate for Payer: Railroad Medicare Medicare |
$736.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$738.18
|
| Rate for Payer: UHC Core |
$591.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$736.41
|
| Rate for Payer: UHC Exchange |
$446.31
|
| Rate for Payer: UHC Medicaid |
$385.14
|
| Rate for Payer: UHCCP Medicaid |
$385.14
|
| Rate for Payer: UMR Bronson Commercial |
$420.19
|
| Rate for Payer: VA VA |
$736.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$851.75
|
|
|
HC DEBRIDE MUSCLE FASCIA FIRST 20 SQ CM OR LESS
|
Facility
|
IP
|
$1,135.66
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
76100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$499.69 |
| Max. Negotiated Rate |
$1,022.09 |
| Rate for Payer: Aetna American Axle |
$738.18
|
| Rate for Payer: Aetna Commercial |
$965.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$738.18
|
| Rate for Payer: Cash Price |
$908.53
|
| Rate for Payer: Cofinity Advantage |
$794.96
|
| Rate for Payer: Cofinity Commercial |
$976.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.53
|
| Rate for Payer: Healthscope Commercial |
$1,022.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$794.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$851.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$965.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$851.75
|
| Rate for Payer: PHP Commercial |
$965.31
|
| Rate for Payer: Priority Health SBD |
$715.47
|
| Rate for Payer: UMR Bronson Commercial |
$499.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$851.75
|
|
|
HC DEBRIDE SKIN AT FX SITE
|
Facility
|
IP
|
$1,924.74
|
|
|
Service Code
|
CPT 11010
|
| Hospital Charge Code |
76100390
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.89 |
| Max. Negotiated Rate |
$1,732.27 |
| Rate for Payer: Aetna American Axle |
$1,251.08
|
| Rate for Payer: Aetna Commercial |
$1,636.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.08
|
| Rate for Payer: Cash Price |
$1,539.79
|
| Rate for Payer: Cofinity Advantage |
$1,347.32
|
| Rate for Payer: Cofinity Commercial |
$1,655.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,539.79
|
| Rate for Payer: Healthscope Commercial |
$1,732.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,347.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,443.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,636.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,443.56
|
| Rate for Payer: PHP Commercial |
$1,636.03
|
| Rate for Payer: Priority Health SBD |
$1,212.59
|
| Rate for Payer: UMR Bronson Commercial |
$846.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,443.56
|
|
|
HC DEBRIDE SKIN AT FX SITE
|
Facility
|
OP
|
$1,924.74
|
|
|
Service Code
|
CPT 11010
|
| Hospital Charge Code |
76100390
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna American Axle |
$1,251.08
|
| Rate for Payer: Aetna Commercial |
$1,636.03
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$742.95
|
| Rate for Payer: BCN Commercial |
$742.95
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$1,539.79
|
| Rate for Payer: Cash Price |
$1,539.79
|
| Rate for Payer: Cash Price |
$1,539.79
|
| Rate for Payer: Cofinity Advantage |
$1,347.32
|
| Rate for Payer: Cofinity Commercial |
$1,655.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,539.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$1,732.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,347.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,443.56
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,636.03
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,443.56
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$1,636.03
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$1,212.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,251.08
|
| Rate for Payer: UHC Core |
$1,002.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$756.42
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: UMR Bronson Commercial |
$712.15
|
| Rate for Payer: VA VA |
$705.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,443.56
|
|
|
HC DEBRIDE SKIN BONE AT FX SITE
|
Facility
|
OP
|
$4,161.60
|
|
|
Service Code
|
CPT 11012
|
| Hospital Charge Code |
76100391
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna American Axle |
$2,705.04
|
| Rate for Payer: Aetna Commercial |
$3,537.36
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,705.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,940.82
|
| Rate for Payer: BCN Commercial |
$1,940.82
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cofinity Advantage |
$2,913.12
|
| Rate for Payer: Cofinity Commercial |
$3,578.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,329.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$3,745.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,913.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,121.20
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,537.36
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,121.20
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$3,537.36
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$2,621.81
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,705.04
|
| Rate for Payer: UHC Core |
$2,168.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$1,635.51
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,539.79
|
| Rate for Payer: VA VA |
$2,894.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,121.20
|
|
|
HC DEBRIDE SKIN BONE AT FX SITE
|
Facility
|
IP
|
$4,161.60
|
|
|
Service Code
|
CPT 11012
|
| Hospital Charge Code |
76100391
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,831.10 |
| Max. Negotiated Rate |
$3,745.44 |
| Rate for Payer: Aetna American Axle |
$2,705.04
|
| Rate for Payer: Aetna Commercial |
$3,537.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,705.04
|
| Rate for Payer: Cash Price |
$3,329.28
|
| Rate for Payer: Cofinity Advantage |
$2,913.12
|
| Rate for Payer: Cofinity Commercial |
$3,578.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,329.28
|
| Rate for Payer: Healthscope Commercial |
$3,745.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,913.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,121.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,537.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,121.20
|
| Rate for Payer: PHP Commercial |
$3,537.36
|
| Rate for Payer: Priority Health SBD |
$2,621.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,831.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,121.20
|
|
|
HC DEBRIDE SQ TISSUE EACH ADDL 20SQ CM
|
Facility
|
OP
|
$519.25
|
|
|
Service Code
|
CPT 11045
|
| Hospital Charge Code |
36100405
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$177.07 |
| Max. Negotiated Rate |
$467.32 |
| Rate for Payer: Aetna American Axle |
$337.51
|
| Rate for Payer: Aetna Commercial |
$441.36
|
| Rate for Payer: Aetna Medicare |
$259.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.51
|
| Rate for Payer: BCBS Complete |
$207.70
|
| Rate for Payer: BCBS Trust/PPO |
$177.07
|
| Rate for Payer: BCN Commercial |
$177.07
|
| Rate for Payer: Cash Price |
$415.40
|
| Rate for Payer: Cash Price |
$415.40
|
| Rate for Payer: Cash Price |
$415.40
|
| Rate for Payer: Cofinity Advantage |
$363.48
|
| Rate for Payer: Cofinity Commercial |
$446.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$415.40
|
| Rate for Payer: Healthscope Commercial |
$467.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$363.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$389.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$415.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$441.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$389.44
|
| Rate for Payer: PHP Commercial |
$441.36
|
| Rate for Payer: Priority Health SBD |
$327.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$337.51
|
| Rate for Payer: UHC Core |
$270.53
|
| Rate for Payer: UHC Exchange |
$204.07
|
| Rate for Payer: UMR Bronson Commercial |
$192.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$389.44
|
|
|
HC DEBRIDE SQ TISSUE EACH ADDL 20SQ CM
|
Facility
|
IP
|
$519.25
|
|
|
Service Code
|
CPT 11045
|
| Hospital Charge Code |
36100405
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$228.47 |
| Max. Negotiated Rate |
$467.32 |
| Rate for Payer: Aetna American Axle |
$337.51
|
| Rate for Payer: Aetna Commercial |
$441.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.51
|
| Rate for Payer: Cash Price |
$415.40
|
| Rate for Payer: Cofinity Advantage |
$363.48
|
| Rate for Payer: Cofinity Commercial |
$446.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$415.40
|
| Rate for Payer: Healthscope Commercial |
$467.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$363.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$389.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$441.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$389.44
|
| Rate for Payer: PHP Commercial |
$441.36
|
| Rate for Payer: Priority Health SBD |
$327.13
|
| Rate for Payer: UMR Bronson Commercial |
$228.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$389.44
|
|
|
HC DEBRIDE SQ TISSUE FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$657.98
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
76100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna American Axle |
$427.69
|
| Rate for Payer: Aetna Commercial |
$559.28
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$427.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$388.22
|
| Rate for Payer: BCN Commercial |
$388.22
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$526.38
|
| Rate for Payer: Cash Price |
$526.38
|
| Rate for Payer: Cash Price |
$526.38
|
| Rate for Payer: Cofinity Advantage |
$460.59
|
| Rate for Payer: Cofinity Commercial |
$565.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$592.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$460.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$493.49
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$559.28
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$493.49
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$559.28
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$414.53
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$427.69
|
| Rate for Payer: UHC Core |
$342.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$258.59
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: UMR Bronson Commercial |
$243.45
|
| Rate for Payer: VA VA |
$405.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$493.49
|
|
|
HC DEBRIDE SQ TISSUE FIRST 20 SQ CM OR LESS
|
Facility
|
IP
|
$657.98
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
76100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$289.51 |
| Max. Negotiated Rate |
$592.18 |
| Rate for Payer: Aetna American Axle |
$427.69
|
| Rate for Payer: Aetna Commercial |
$559.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$427.69
|
| Rate for Payer: Cash Price |
$526.38
|
| Rate for Payer: Cofinity Advantage |
$460.59
|
| Rate for Payer: Cofinity Commercial |
$565.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.38
|
| Rate for Payer: Healthscope Commercial |
$592.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$460.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$493.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$559.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$493.49
|
| Rate for Payer: PHP Commercial |
$559.28
|
| Rate for Payer: Priority Health SBD |
$414.53
|
| Rate for Payer: UMR Bronson Commercial |
$289.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$493.49
|
|
|
HC DECALCIFICATION
|
Facility
|
OP
|
$38.31
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
31000051
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.14 |
| Max. Negotiated Rate |
$34.48 |
| Rate for Payer: Aetna American Axle |
$24.90
|
| Rate for Payer: Aetna Commercial |
$32.56
|
| Rate for Payer: Aetna Medicare |
$19.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.90
|
| Rate for Payer: BCBS Complete |
$15.32
|
| Rate for Payer: BCBS Trust/PPO |
$15.40
|
| Rate for Payer: BCN Commercial |
$15.40
|
| Rate for Payer: Cash Price |
$30.65
|
| Rate for Payer: Cash Price |
$30.65
|
| Rate for Payer: Cofinity Advantage |
$26.82
|
| Rate for Payer: Cofinity Commercial |
$32.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.65
|
| Rate for Payer: Healthscope Commercial |
$34.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.73
|
| Rate for Payer: PHP Commercial |
$32.56
|
| Rate for Payer: Priority Health SBD |
$24.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.14
|
| Rate for Payer: UHC Core |
$12.14
|
| Rate for Payer: UHC Exchange |
$12.14
|
| Rate for Payer: UMR Bronson Commercial |
$14.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.73
|
|
|
HC DECALCIFICATION
|
Facility
|
IP
|
$38.31
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
31000051
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$16.86 |
| Max. Negotiated Rate |
$34.48 |
| Rate for Payer: Aetna American Axle |
$24.90
|
| Rate for Payer: Aetna Commercial |
$32.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.90
|
| Rate for Payer: Cash Price |
$30.65
|
| Rate for Payer: Cofinity Advantage |
$26.82
|
| Rate for Payer: Cofinity Commercial |
$32.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.65
|
| Rate for Payer: Healthscope Commercial |
$34.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.73
|
| Rate for Payer: PHP Commercial |
$32.56
|
| Rate for Payer: Priority Health SBD |
$24.14
|
| Rate for Payer: UMR Bronson Commercial |
$16.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.73
|
|
|
HC DECLOT BY THROMBOLYTIC
|
Facility
|
OP
|
$492.82
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
76100005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$172.13 |
| Max. Negotiated Rate |
$1,064.33 |
| Rate for Payer: Aetna American Axle |
$320.33
|
| Rate for Payer: Aetna Commercial |
$418.90
|
| Rate for Payer: Aetna Medicare |
$342.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$411.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$411.40
|
| Rate for Payer: BCBS Complete |
$180.75
|
| Rate for Payer: BCBS MAPPO |
$329.12
|
| Rate for Payer: BCBS Trust/PPO |
$450.70
|
| Rate for Payer: BCN Commercial |
$450.70
|
| Rate for Payer: BCN Medicare Advantage |
$329.12
|
| Rate for Payer: Cash Price |
$394.26
|
| Rate for Payer: Cash Price |
$394.26
|
| Rate for Payer: Cash Price |
$394.26
|
| Rate for Payer: Cofinity Advantage |
$344.97
|
| Rate for Payer: Cofinity Commercial |
$423.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.12
|
| Rate for Payer: Healthscope Commercial |
$443.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$344.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$369.62
|
| Rate for Payer: Mclaren Medicaid |
$329.12
|
| Rate for Payer: Mclaren Medicare |
$329.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$345.58
|
| Rate for Payer: Meridian Medicaid |
$345.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$378.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$362.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$418.90
|
| Rate for Payer: Nomi Health Commercial |
$987.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$369.62
|
| Rate for Payer: PACE Medicare |
$312.66
|
| Rate for Payer: PACE SWMI |
$329.12
|
| Rate for Payer: PHP Commercial |
$418.90
|
| Rate for Payer: PHP Medicare Advantage |
$329.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,064.33
|
| Rate for Payer: Priority Health Medicare |
$329.12
|
| Rate for Payer: Priority Health SBD |
$310.48
|
| Rate for Payer: Priority Health Tiered Network |
$851.46
|
| Rate for Payer: Railroad Medicare Medicare |
$329.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.33
|
| Rate for Payer: UHC Core |
$256.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$329.12
|
| Rate for Payer: UHC Exchange |
$193.68
|
| Rate for Payer: UHC Medicaid |
$172.13
|
| Rate for Payer: UHCCP Medicaid |
$172.13
|
| Rate for Payer: UMR Bronson Commercial |
$182.34
|
| Rate for Payer: VA VA |
$329.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$369.62
|
|
|
HC DECLOT BY THROMBOLYTIC
|
Facility
|
IP
|
$492.82
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
76100005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$216.84 |
| Max. Negotiated Rate |
$443.54 |
| Rate for Payer: Aetna American Axle |
$320.33
|
| Rate for Payer: Aetna Commercial |
$418.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.33
|
| Rate for Payer: Cash Price |
$394.26
|
| Rate for Payer: Cofinity Advantage |
$344.97
|
| Rate for Payer: Cofinity Commercial |
$423.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.26
|
| Rate for Payer: Healthscope Commercial |
$443.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$344.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$369.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$418.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$369.62
|
| Rate for Payer: PHP Commercial |
$418.90
|
| Rate for Payer: Priority Health SBD |
$310.48
|
| Rate for Payer: UMR Bronson Commercial |
$216.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$369.62
|
|
|
HC DECONTAMINATION AMB/SELF-DIRECTED
|
Facility
|
IP
|
$146.25
|
|
| Hospital Charge Code |
27000613
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$64.35 |
| Max. Negotiated Rate |
$131.62 |
| Rate for Payer: Aetna American Axle |
$95.06
|
| Rate for Payer: Aetna Commercial |
$124.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.06
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Cofinity Advantage |
$102.38
|
| Rate for Payer: Cofinity Commercial |
$125.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.00
|
| Rate for Payer: Healthscope Commercial |
$131.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.69
|
| Rate for Payer: PHP Commercial |
$124.31
|
| Rate for Payer: Priority Health SBD |
$92.14
|
| Rate for Payer: UMR Bronson Commercial |
$64.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.69
|
|
|
HC DECONTAMINATION AMB/SELF-DIRECTED
|
Facility
|
OP
|
$146.25
|
|
| Hospital Charge Code |
27000613
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.11 |
| Max. Negotiated Rate |
$131.62 |
| Rate for Payer: Aetna American Axle |
$95.06
|
| Rate for Payer: Aetna Commercial |
$124.31
|
| Rate for Payer: Aetna Medicare |
$73.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.06
|
| Rate for Payer: BCBS Complete |
$58.50
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Cofinity Advantage |
$102.38
|
| Rate for Payer: Cofinity Commercial |
$125.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.00
|
| Rate for Payer: Healthscope Commercial |
$131.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.69
|
| Rate for Payer: PHP Commercial |
$124.31
|
| Rate for Payer: Priority Health SBD |
$92.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.06
|
| Rate for Payer: UHC Core |
$76.20
|
| Rate for Payer: UHC Exchange |
$57.48
|
| Rate for Payer: UMR Bronson Commercial |
$54.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.69
|
|
|
HC DECONTAMINATION AMB W/ASSIST
|
Facility
|
OP
|
$839.72
|
|
| Hospital Charge Code |
27000026
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$310.70 |
| Max. Negotiated Rate |
$755.75 |
| Rate for Payer: Aetna American Axle |
$545.82
|
| Rate for Payer: Aetna Commercial |
$713.76
|
| Rate for Payer: Aetna Medicare |
$419.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.82
|
| Rate for Payer: BCBS Complete |
$335.89
|
| Rate for Payer: Cash Price |
$671.78
|
| Rate for Payer: Cofinity Advantage |
$587.80
|
| Rate for Payer: Cofinity Commercial |
$722.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$671.78
|
| Rate for Payer: Healthscope Commercial |
$755.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$587.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$629.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$671.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$713.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$629.79
|
| Rate for Payer: PHP Commercial |
$713.76
|
| Rate for Payer: Priority Health SBD |
$529.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.82
|
| Rate for Payer: UHC Core |
$437.49
|
| Rate for Payer: UHC Exchange |
$330.01
|
| Rate for Payer: UMR Bronson Commercial |
$310.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$629.79
|
|
|
HC DECONTAMINATION AMB W/ASSIST
|
Facility
|
IP
|
$839.72
|
|
| Hospital Charge Code |
27000026
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$369.48 |
| Max. Negotiated Rate |
$755.75 |
| Rate for Payer: Aetna American Axle |
$545.82
|
| Rate for Payer: Aetna Commercial |
$713.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.82
|
| Rate for Payer: Cash Price |
$671.78
|
| Rate for Payer: Cofinity Advantage |
$587.80
|
| Rate for Payer: Cofinity Commercial |
$722.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$671.78
|
| Rate for Payer: Healthscope Commercial |
$755.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$587.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$629.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$713.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$629.79
|
| Rate for Payer: PHP Commercial |
$713.76
|
| Rate for Payer: Priority Health SBD |
$529.02
|
| Rate for Payer: UMR Bronson Commercial |
$369.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$629.79
|
|
|
HC DECONTAMINATION NON AMBULATORY
|
Facility
|
OP
|
$1,679.41
|
|
| Hospital Charge Code |
27000126
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$621.38 |
| Max. Negotiated Rate |
$1,511.47 |
| Rate for Payer: Aetna American Axle |
$1,091.62
|
| Rate for Payer: Aetna Commercial |
$1,427.50
|
| Rate for Payer: Aetna Medicare |
$839.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,091.62
|
| Rate for Payer: BCBS Complete |
$671.76
|
| Rate for Payer: Cash Price |
$1,343.53
|
| Rate for Payer: Cofinity Advantage |
$1,175.59
|
| Rate for Payer: Cofinity Commercial |
$1,444.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,343.53
|
| Rate for Payer: Healthscope Commercial |
$1,511.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,175.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,259.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,343.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,427.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,259.56
|
| Rate for Payer: PHP Commercial |
$1,427.50
|
| Rate for Payer: Priority Health SBD |
$1,058.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,091.62
|
| Rate for Payer: UHC Core |
$874.97
|
| Rate for Payer: UHC Exchange |
$660.01
|
| Rate for Payer: UMR Bronson Commercial |
$621.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,259.56
|
|
|
HC DECONTAMINATION NON AMBULATORY
|
Facility
|
IP
|
$1,679.41
|
|
| Hospital Charge Code |
27000126
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$738.94 |
| Max. Negotiated Rate |
$1,511.47 |
| Rate for Payer: Aetna American Axle |
$1,091.62
|
| Rate for Payer: Aetna Commercial |
$1,427.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,091.62
|
| Rate for Payer: Cash Price |
$1,343.53
|
| Rate for Payer: Cofinity Advantage |
$1,175.59
|
| Rate for Payer: Cofinity Commercial |
$1,444.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,343.53
|
| Rate for Payer: Healthscope Commercial |
$1,511.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,175.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,259.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,427.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,259.56
|
| Rate for Payer: PHP Commercial |
$1,427.50
|
| Rate for Payer: Priority Health SBD |
$1,058.03
|
| Rate for Payer: UMR Bronson Commercial |
$738.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,259.56
|
|
