|
HC DESTRUCT PREMALIGNANT LESIONS FIRST LESION
|
Facility
|
IP
|
$180.06
|
|
|
Service Code
|
CPT 17000
|
| Hospital Charge Code |
76100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$79.23 |
| Max. Negotiated Rate |
$162.05 |
| Rate for Payer: Aetna American Axle |
$117.04
|
| Rate for Payer: Aetna Commercial |
$153.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.04
|
| Rate for Payer: Cash Price |
$144.05
|
| Rate for Payer: Cofinity Advantage |
$126.04
|
| Rate for Payer: Cofinity Commercial |
$154.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.05
|
| Rate for Payer: Healthscope Commercial |
$162.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.04
|
| Rate for Payer: PHP Commercial |
$153.05
|
| Rate for Payer: Priority Health SBD |
$113.44
|
| Rate for Payer: UMR Bronson Commercial |
$79.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.04
|
|
|
HC DESTRUCT PREMALIGNANT LESIONS SECOND THRU 14 LESIONS EACH
|
Facility
|
IP
|
$36.19
|
|
|
Service Code
|
CPT 17003
|
| Hospital Charge Code |
76100121
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$15.92 |
| Max. Negotiated Rate |
$32.57 |
| Rate for Payer: Aetna American Axle |
$23.52
|
| Rate for Payer: Aetna Commercial |
$30.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.52
|
| Rate for Payer: Cash Price |
$28.95
|
| Rate for Payer: Cofinity Advantage |
$25.33
|
| Rate for Payer: Cofinity Commercial |
$31.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.95
|
| Rate for Payer: Healthscope Commercial |
$32.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.14
|
| Rate for Payer: PHP Commercial |
$30.76
|
| Rate for Payer: Priority Health SBD |
$22.80
|
| Rate for Payer: UMR Bronson Commercial |
$15.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.14
|
|
|
HC DESTRUCT PREMALIGNANT LESIONS SECOND THRU 14 LESIONS EACH
|
Facility
|
OP
|
$36.19
|
|
|
Service Code
|
CPT 17003
|
| Hospital Charge Code |
76100121
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$13.39 |
| Max. Negotiated Rate |
$32.57 |
| Rate for Payer: Aetna American Axle |
$23.52
|
| Rate for Payer: Aetna Commercial |
$30.76
|
| Rate for Payer: Aetna Medicare |
$18.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.52
|
| Rate for Payer: BCBS Complete |
$14.48
|
| Rate for Payer: BCBS Trust/PPO |
$24.43
|
| Rate for Payer: BCN Commercial |
$24.43
|
| Rate for Payer: Cash Price |
$28.95
|
| Rate for Payer: Cash Price |
$28.95
|
| Rate for Payer: Cash Price |
$28.95
|
| Rate for Payer: Cofinity Advantage |
$25.33
|
| Rate for Payer: Cofinity Commercial |
$31.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.95
|
| Rate for Payer: Healthscope Commercial |
$32.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.14
|
| Rate for Payer: PHP Commercial |
$30.76
|
| Rate for Payer: Priority Health SBD |
$22.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.52
|
| Rate for Payer: UHC Core |
$18.85
|
| Rate for Payer: UHC Exchange |
$14.22
|
| Rate for Payer: UMR Bronson Commercial |
$13.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.14
|
|
|
HC DESTRUCT VAGINAL LESION(S) SIMPLE
|
Facility
|
IP
|
$3,976.50
|
|
|
Service Code
|
CPT 57061
|
| Hospital Charge Code |
36100583
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,749.66 |
| Max. Negotiated Rate |
$3,578.85 |
| Rate for Payer: Aetna American Axle |
$2,584.72
|
| Rate for Payer: Aetna Commercial |
$3,380.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,584.72
|
| Rate for Payer: Cash Price |
$3,181.20
|
| Rate for Payer: Cofinity Advantage |
$2,783.55
|
| Rate for Payer: Cofinity Commercial |
$3,419.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,181.20
|
| Rate for Payer: Healthscope Commercial |
$3,578.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,783.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,982.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,380.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,982.38
|
| Rate for Payer: PHP Commercial |
$3,380.03
|
| Rate for Payer: Priority Health SBD |
$2,505.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,749.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,982.38
|
|
|
HC DESTRUCT VAGINAL LESION(S) SIMPLE
|
Facility
|
OP
|
$3,976.50
|
|
|
Service Code
|
CPT 57061
|
| Hospital Charge Code |
36100583
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$100.42 |
| Max. Negotiated Rate |
$10,430.93 |
| Rate for Payer: Aetna American Axle |
$2,584.72
|
| Rate for Payer: Aetna Commercial |
$3,380.03
|
| Rate for Payer: Aetna Medicare |
$3,354.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,584.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$100.42
|
| Rate for Payer: BCN Commercial |
$100.42
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$3,181.20
|
| Rate for Payer: Cash Price |
$3,181.20
|
| Rate for Payer: Cash Price |
$3,181.20
|
| Rate for Payer: Cofinity Advantage |
$2,783.55
|
| Rate for Payer: Cofinity Commercial |
$3,419.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,181.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$3,578.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,783.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,982.38
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$3,386.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,380.03
|
| Rate for Payer: Nomi Health Commercial |
$9,676.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,982.38
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$3,380.03
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,430.93
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health SBD |
$2,505.20
|
| Rate for Payer: Priority Health Tiered Network |
$8,344.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,584.72
|
| Rate for Payer: UHC Core |
$2,071.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Exchange |
$1,562.76
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,471.31
|
| Rate for Payer: VA VA |
$3,225.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,982.38
|
|
|
HC DES VESSEL/BRANCH
|
Facility
|
IP
|
$25,160.93
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
48100075
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,070.81 |
| Max. Negotiated Rate |
$22,644.84 |
| Rate for Payer: Aetna American Axle |
$16,354.60
|
| Rate for Payer: Aetna Commercial |
$21,386.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16,354.60
|
| Rate for Payer: Cash Price |
$20,128.74
|
| Rate for Payer: Cofinity Advantage |
$17,612.65
|
| Rate for Payer: Cofinity Commercial |
$21,638.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,128.74
|
| Rate for Payer: Healthscope Commercial |
$22,644.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,612.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,870.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,386.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,870.70
|
| Rate for Payer: PHP Commercial |
$21,386.79
|
| Rate for Payer: Priority Health SBD |
$15,851.39
|
| Rate for Payer: UMR Bronson Commercial |
$11,070.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,870.70
|
|
|
HC DES VESSEL/BRANCH
|
Facility
|
OP
|
$25,160.93
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
48100075
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$37,198.61 |
| Rate for Payer: Aetna American Axle |
$16,354.60
|
| Rate for Payer: Aetna Commercial |
$21,386.79
|
| Rate for Payer: Aetna Medicare |
$11,962.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16,354.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$11,004.10
|
| Rate for Payer: BCN Commercial |
$11,004.10
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$20,128.74
|
| Rate for Payer: Cash Price |
$20,128.74
|
| Rate for Payer: Cash Price |
$20,128.74
|
| Rate for Payer: Cofinity Advantage |
$17,612.65
|
| Rate for Payer: Cofinity Commercial |
$21,638.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,128.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$22,644.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,612.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,870.70
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$12,077.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,386.79
|
| Rate for Payer: Nomi Health Commercial |
$34,508.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,870.70
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$21,386.79
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,198.61
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health SBD |
$15,851.39
|
| Rate for Payer: Priority Health Tiered Network |
$29,758.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: UMR Bronson Commercial |
$9,309.54
|
| Rate for Payer: VA VA |
$11,502.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,870.70
|
|
|
HC DEVELOPMENTAL TESTING
|
Facility
|
IP
|
$386.77
|
|
|
Service Code
|
CPT 96110
|
| Hospital Charge Code |
51000057
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$170.18 |
| Max. Negotiated Rate |
$348.09 |
| Rate for Payer: Aetna American Axle |
$251.40
|
| Rate for Payer: Aetna Commercial |
$328.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.40
|
| Rate for Payer: Cash Price |
$309.42
|
| Rate for Payer: Cofinity Advantage |
$270.74
|
| Rate for Payer: Cofinity Commercial |
$332.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$309.42
|
| Rate for Payer: Healthscope Commercial |
$348.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$270.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.08
|
| Rate for Payer: PHP Commercial |
$328.75
|
| Rate for Payer: Priority Health SBD |
$243.67
|
| Rate for Payer: UMR Bronson Commercial |
$170.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.08
|
|
|
HC DEVELOPMENTAL TESTING
|
Facility
|
OP
|
$386.77
|
|
|
Service Code
|
CPT 96110
|
| Hospital Charge Code |
51000057
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$15.79 |
| Max. Negotiated Rate |
$348.09 |
| Rate for Payer: Aetna American Axle |
$251.40
|
| Rate for Payer: Aetna Commercial |
$328.75
|
| Rate for Payer: Aetna Medicare |
$193.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.40
|
| Rate for Payer: BCBS Complete |
$154.71
|
| Rate for Payer: BCBS Trust/PPO |
$15.79
|
| Rate for Payer: BCN Commercial |
$15.79
|
| Rate for Payer: Cash Price |
$309.42
|
| Rate for Payer: Cash Price |
$309.42
|
| Rate for Payer: Cofinity Advantage |
$270.74
|
| Rate for Payer: Cofinity Commercial |
$332.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$309.42
|
| Rate for Payer: Healthscope Commercial |
$348.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$270.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$309.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.08
|
| Rate for Payer: PHP Commercial |
$328.75
|
| Rate for Payer: Priority Health SBD |
$243.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.40
|
| Rate for Payer: UHC Core |
$201.51
|
| Rate for Payer: UHC Exchange |
$152.00
|
| Rate for Payer: UMR Bronson Commercial |
$143.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.08
|
|
|
HC DEVICE NOT RETURNED ACTIWATCH
|
Facility
|
OP
|
$949.00
|
|
| Hospital Charge Code |
27000615
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$351.13 |
| Max. Negotiated Rate |
$854.10 |
| Rate for Payer: Aetna American Axle |
$616.85
|
| Rate for Payer: Aetna Commercial |
$806.65
|
| Rate for Payer: Aetna Medicare |
$474.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.85
|
| Rate for Payer: BCBS Complete |
$379.60
|
| Rate for Payer: Cash Price |
$759.20
|
| Rate for Payer: Cofinity Advantage |
$664.30
|
| Rate for Payer: Cofinity Commercial |
$816.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$759.20
|
| Rate for Payer: Healthscope Commercial |
$854.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$664.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$711.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$759.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$806.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$711.75
|
| Rate for Payer: PHP Commercial |
$806.65
|
| Rate for Payer: Priority Health SBD |
$597.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$616.85
|
| Rate for Payer: UHC Core |
$494.43
|
| Rate for Payer: UHC Exchange |
$372.96
|
| Rate for Payer: UMR Bronson Commercial |
$351.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$711.75
|
|
|
HC DEVICE NOT RETURNED ACTIWATCH
|
Professional
|
Both
|
$997.00
|
|
| Hospital Charge Code |
27000615
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$398.80 |
| Max. Negotiated Rate |
$747.75 |
| Rate for Payer: Aetna Medicare |
$498.50
|
| Rate for Payer: BCBS Complete |
$398.80
|
| Rate for Payer: Cash Price |
$797.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$747.75
|
| Rate for Payer: UMR Bronson Commercial |
$458.62
|
|
|
HC DEVICE NOT RETURNED ACTIWATCH
|
Facility
|
IP
|
$949.00
|
|
| Hospital Charge Code |
27000615
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$417.56 |
| Max. Negotiated Rate |
$854.10 |
| Rate for Payer: Aetna American Axle |
$616.85
|
| Rate for Payer: Aetna Commercial |
$806.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.85
|
| Rate for Payer: Cash Price |
$759.20
|
| Rate for Payer: Cofinity Advantage |
$664.30
|
| Rate for Payer: Cofinity Commercial |
$816.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$759.20
|
| Rate for Payer: Healthscope Commercial |
$854.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$664.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$711.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$806.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$711.75
|
| Rate for Payer: PHP Commercial |
$806.65
|
| Rate for Payer: Priority Health SBD |
$597.87
|
| Rate for Payer: UMR Bronson Commercial |
$417.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$711.75
|
|
|
HC DEVICE NOT RETURNED ACTIWATCH
|
Professional
|
Both
|
$997.00
|
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$398.80 |
| Max. Negotiated Rate |
$747.75 |
| Rate for Payer: Aetna Medicare |
$498.50
|
| Rate for Payer: BCBS Complete |
$398.80
|
| Rate for Payer: Cash Price |
$797.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$747.75
|
| Rate for Payer: UMR Bronson Commercial |
$458.62
|
|
|
HC DEVICE NOT RETURNED AIR 10 OXIMETRY
|
Facility
|
IP
|
$310.00
|
|
| Hospital Charge Code |
27000616
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$136.40 |
| Max. Negotiated Rate |
$279.00 |
| Rate for Payer: Aetna American Axle |
$201.50
|
| Rate for Payer: Aetna Commercial |
$263.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.50
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cofinity Advantage |
$217.00
|
| Rate for Payer: Cofinity Commercial |
$266.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.00
|
| Rate for Payer: Healthscope Commercial |
$279.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$232.50
|
| Rate for Payer: PHP Commercial |
$263.50
|
| Rate for Payer: Priority Health SBD |
$195.30
|
| Rate for Payer: UMR Bronson Commercial |
$136.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.50
|
|
|
HC DEVICE NOT RETURNED AIR 10 OXIMETRY
|
Facility
|
OP
|
$310.00
|
|
| Hospital Charge Code |
27000616
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$114.70 |
| Max. Negotiated Rate |
$279.00 |
| Rate for Payer: Aetna American Axle |
$201.50
|
| Rate for Payer: Aetna Commercial |
$263.50
|
| Rate for Payer: Aetna Medicare |
$155.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.50
|
| Rate for Payer: BCBS Complete |
$124.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cofinity Advantage |
$217.00
|
| Rate for Payer: Cofinity Commercial |
$266.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.00
|
| Rate for Payer: Healthscope Commercial |
$279.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$248.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$263.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$232.50
|
| Rate for Payer: PHP Commercial |
$263.50
|
| Rate for Payer: Priority Health SBD |
$195.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.50
|
| Rate for Payer: UHC Core |
$161.51
|
| Rate for Payer: UHC Exchange |
$121.83
|
| Rate for Payer: UMR Bronson Commercial |
$114.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.50
|
|
|
HC DEVICE NOT RETURNED AIR 10 OXIMETRY
|
Professional
|
Both
|
$325.00
|
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$130.00 |
| Max. Negotiated Rate |
$243.75 |
| Rate for Payer: Aetna Medicare |
$162.50
|
| Rate for Payer: BCBS Complete |
$130.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: UMR Bronson Commercial |
$149.50
|
|
|
HC DEVICE NOT RETURNED AIR 10 OXIMETRY
|
Professional
|
Both
|
$325.00
|
|
| Hospital Charge Code |
27000616
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$130.00 |
| Max. Negotiated Rate |
$243.75 |
| Rate for Payer: Aetna Medicare |
$162.50
|
| Rate for Payer: BCBS Complete |
$130.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: UMR Bronson Commercial |
$149.50
|
|
|
HC DEVICE NOT RETURNED APNEALINK
|
Professional
|
Both
|
$870.00
|
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$348.00 |
| Max. Negotiated Rate |
$652.50 |
| Rate for Payer: Aetna Medicare |
$435.00
|
| Rate for Payer: BCBS Complete |
$348.00
|
| Rate for Payer: Cash Price |
$696.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$652.50
|
| Rate for Payer: UMR Bronson Commercial |
$400.20
|
|
|
HC DEVICE NOT RETURNED CADD PUMP
|
Facility
|
OP
|
$3,723.00
|
|
| Hospital Charge Code |
27000642
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,377.51 |
| Max. Negotiated Rate |
$3,350.70 |
| Rate for Payer: Aetna American Axle |
$2,419.95
|
| Rate for Payer: Aetna Commercial |
$3,164.55
|
| Rate for Payer: Aetna Medicare |
$1,861.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,419.95
|
| Rate for Payer: BCBS Complete |
$1,489.20
|
| Rate for Payer: Cash Price |
$2,978.40
|
| Rate for Payer: Cofinity Advantage |
$2,606.10
|
| Rate for Payer: Cofinity Commercial |
$3,201.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,978.40
|
| Rate for Payer: Healthscope Commercial |
$3,350.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,606.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,792.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,978.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,164.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,792.25
|
| Rate for Payer: PHP Commercial |
$3,164.55
|
| Rate for Payer: Priority Health SBD |
$2,345.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,419.95
|
| Rate for Payer: UHC Core |
$1,939.68
|
| Rate for Payer: UHC Exchange |
$1,463.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,377.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,792.25
|
|
|
HC DEVICE NOT RETURNED CADD PUMP
|
Facility
|
IP
|
$3,723.00
|
|
| Hospital Charge Code |
27000642
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,638.12 |
| Max. Negotiated Rate |
$3,350.70 |
| Rate for Payer: Aetna American Axle |
$2,419.95
|
| Rate for Payer: Aetna Commercial |
$3,164.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,419.95
|
| Rate for Payer: Cash Price |
$2,978.40
|
| Rate for Payer: Cofinity Advantage |
$2,606.10
|
| Rate for Payer: Cofinity Commercial |
$3,201.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,978.40
|
| Rate for Payer: Healthscope Commercial |
$3,350.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,606.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,792.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,164.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,792.25
|
| Rate for Payer: PHP Commercial |
$3,164.55
|
| Rate for Payer: Priority Health SBD |
$2,345.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,638.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,792.25
|
|
|
HC DEVICE NOT RETURNED HOLTER MONITOR
|
Facility
|
IP
|
$652.00
|
|
| Hospital Charge Code |
27000705
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$286.88 |
| Max. Negotiated Rate |
$586.80 |
| Rate for Payer: Aetna American Axle |
$423.80
|
| Rate for Payer: Aetna Commercial |
$554.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.80
|
| Rate for Payer: Cash Price |
$521.60
|
| Rate for Payer: Cofinity Advantage |
$456.40
|
| Rate for Payer: Cofinity Commercial |
$560.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$521.60
|
| Rate for Payer: Healthscope Commercial |
$586.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$456.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$489.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$554.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$489.00
|
| Rate for Payer: PHP Commercial |
$554.20
|
| Rate for Payer: Priority Health SBD |
$410.76
|
| Rate for Payer: UMR Bronson Commercial |
$286.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$489.00
|
|
|
HC DEVICE NOT RETURNED HOLTER MONITOR
|
Facility
|
OP
|
$652.00
|
|
| Hospital Charge Code |
27000705
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$241.24 |
| Max. Negotiated Rate |
$586.80 |
| Rate for Payer: Aetna American Axle |
$423.80
|
| Rate for Payer: Aetna Commercial |
$554.20
|
| Rate for Payer: Aetna Medicare |
$326.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.80
|
| Rate for Payer: BCBS Complete |
$260.80
|
| Rate for Payer: Cash Price |
$521.60
|
| Rate for Payer: Cofinity Advantage |
$456.40
|
| Rate for Payer: Cofinity Commercial |
$560.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$521.60
|
| Rate for Payer: Healthscope Commercial |
$586.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$456.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$489.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$521.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$554.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$489.00
|
| Rate for Payer: PHP Commercial |
$554.20
|
| Rate for Payer: Priority Health SBD |
$410.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.80
|
| Rate for Payer: UHC Core |
$339.69
|
| Rate for Payer: UHC Exchange |
$256.24
|
| Rate for Payer: UMR Bronson Commercial |
$241.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$489.00
|
|
|
HC DEVICE NOT RETURNED RU SLEEPING
|
Facility
|
OP
|
$495.00
|
|
| Hospital Charge Code |
27000614
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$183.15 |
| Max. Negotiated Rate |
$445.50 |
| Rate for Payer: Aetna American Axle |
$321.75
|
| Rate for Payer: Aetna Commercial |
$420.75
|
| Rate for Payer: Aetna Medicare |
$247.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.75
|
| Rate for Payer: BCBS Complete |
$198.00
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cofinity Advantage |
$346.50
|
| Rate for Payer: Cofinity Commercial |
$425.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.00
|
| Rate for Payer: Healthscope Commercial |
$445.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$346.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$396.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$371.25
|
| Rate for Payer: PHP Commercial |
$420.75
|
| Rate for Payer: Priority Health SBD |
$311.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.75
|
| Rate for Payer: UHC Core |
$257.89
|
| Rate for Payer: UHC Exchange |
$194.53
|
| Rate for Payer: UMR Bronson Commercial |
$183.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.25
|
|
|
HC DEVICE NOT RETURNED RU SLEEPING
|
Facility
|
IP
|
$495.00
|
|
| Hospital Charge Code |
27000614
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$217.80 |
| Max. Negotiated Rate |
$445.50 |
| Rate for Payer: Aetna American Axle |
$321.75
|
| Rate for Payer: Aetna Commercial |
$420.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.75
|
| Rate for Payer: Cash Price |
$396.00
|
| Rate for Payer: Cofinity Advantage |
$346.50
|
| Rate for Payer: Cofinity Commercial |
$425.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.00
|
| Rate for Payer: Healthscope Commercial |
$445.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$346.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$371.25
|
| Rate for Payer: PHP Commercial |
$420.75
|
| Rate for Payer: Priority Health SBD |
$311.85
|
| Rate for Payer: UMR Bronson Commercial |
$217.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.25
|
|
|
HC DEVICE NOT RETURNED RU SLEEPING
|
Professional
|
Both
|
$520.00
|
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$208.00 |
| Max. Negotiated Rate |
$390.00 |
| Rate for Payer: Aetna Medicare |
$260.00
|
| Rate for Payer: BCBS Complete |
$208.00
|
| Rate for Payer: Cash Price |
$416.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.00
|
| Rate for Payer: UMR Bronson Commercial |
$239.20
|
|
