|
HC MANIPULAT PALMAR FAC CORD POST INJ
|
Facility
|
OP
|
$484.50
|
|
|
Service Code
|
CPT 26341
|
| Hospital Charge Code |
76100318
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$77.93 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$314.92
|
| Rate for Payer: Aetna Commercial |
$411.82
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$314.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$78.32
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$387.60
|
| Rate for Payer: Cash Price |
$387.60
|
| Rate for Payer: Cofinity Commercial |
$339.15
|
| Rate for Payer: Cofinity Commercial |
$416.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$436.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$339.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.38
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$411.82
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$411.82
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$339.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$305.24
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$77.93
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$179.26
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.38
|
|
|
HC MANIPULAT PALMAR FAC CORD POST INJ
|
Facility
|
IP
|
$484.50
|
|
|
Service Code
|
CPT 26341
|
| Hospital Charge Code |
76100318
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$213.18 |
| Max. Negotiated Rate |
$436.05 |
| Rate for Payer: Aetna American Axle |
$314.92
|
| Rate for Payer: Aetna Commercial |
$411.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$314.92
|
| Rate for Payer: Cash Price |
$387.60
|
| Rate for Payer: Cofinity Commercial |
$339.15
|
| Rate for Payer: Cofinity Commercial |
$416.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.60
|
| Rate for Payer: Healthscope Commercial |
$436.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$339.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$411.82
|
| Rate for Payer: PHP Commercial |
$411.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$339.15
|
| Rate for Payer: Priority Health SBD |
$305.24
|
| Rate for Payer: UMR Bronson Commercial |
$213.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.38
|
|
|
HC MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH
|
Facility
|
OP
|
$1,463.70
|
|
|
Service Code
|
CPT 50396
|
| Hospital Charge Code |
36100614
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$111.66 |
| Max. Negotiated Rate |
$1,911.48 |
| Rate for Payer: Aetna American Axle |
$951.40
|
| Rate for Payer: Aetna Commercial |
$1,244.14
|
| Rate for Payer: Aetna Medicare |
$631.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$951.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$759.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$759.00
|
| Rate for Payer: BCBS Complete |
$348.78
|
| Rate for Payer: BCBS MAPPO |
$607.20
|
| Rate for Payer: BCBS Trust/PPO |
$440.95
|
| Rate for Payer: BCN Medicare Advantage |
$607.20
|
| Rate for Payer: Cash Price |
$1,170.96
|
| Rate for Payer: Cash Price |
$1,170.96
|
| Rate for Payer: Cofinity Commercial |
$1,024.59
|
| Rate for Payer: Cofinity Commercial |
$1,258.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,170.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.20
|
| Rate for Payer: Healthscope Commercial |
$1,317.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,024.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,097.78
|
| Rate for Payer: Mclaren Medicaid |
$332.14
|
| Rate for Payer: Mclaren Medicare |
$607.20
|
| Rate for Payer: Meridian Medicaid |
$348.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$637.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$698.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,244.14
|
| Rate for Payer: PACE Medicare |
$576.84
|
| Rate for Payer: PACE SWMI |
$607.20
|
| Rate for Payer: PHP Commercial |
$1,244.14
|
| Rate for Payer: PHP Medicare Advantage |
$607.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$332.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,024.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,911.48
|
| Rate for Payer: Priority Health Medicare |
$607.20
|
| Rate for Payer: Priority Health Narrow Network |
$1,529.18
|
| Rate for Payer: Priority Health SBD |
$922.13
|
| Rate for Payer: Railroad Medicare Medicare |
$607.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.83
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$607.20
|
| Rate for Payer: UHC Exchange |
$111.66
|
| Rate for Payer: UHC Medicare Advantage |
$625.42
|
| Rate for Payer: UMR Bronson Commercial |
$541.57
|
| Rate for Payer: VA VA |
$607.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,097.78
|
|
|
HC MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH
|
Facility
|
IP
|
$1,463.70
|
|
|
Service Code
|
CPT 50396
|
| Hospital Charge Code |
36100614
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$644.03 |
| Max. Negotiated Rate |
$1,317.33 |
| Rate for Payer: Aetna American Axle |
$951.40
|
| Rate for Payer: Aetna Commercial |
$1,244.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$951.40
|
| Rate for Payer: Cash Price |
$1,170.96
|
| Rate for Payer: Cofinity Commercial |
$1,024.59
|
| Rate for Payer: Cofinity Commercial |
$1,258.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,170.96
|
| Rate for Payer: Healthscope Commercial |
$1,317.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,024.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,097.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,244.14
|
| Rate for Payer: PHP Commercial |
$1,244.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,024.59
|
| Rate for Payer: Priority Health SBD |
$922.13
|
| Rate for Payer: UMR Bronson Commercial |
$644.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,097.78
|
|
|
HC MANTIS CLIP
|
Facility
|
OP
|
$1,134.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27200356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$1,020.60 |
| Rate for Payer: Aetna American Axle |
$737.10
|
| Rate for Payer: Aetna Commercial |
$963.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.10
|
| Rate for Payer: BCBS Complete |
$453.60
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: Cash Price |
$907.20
|
| Rate for Payer: Cash Price |
$907.20
|
| Rate for Payer: Cofinity Commercial |
$793.80
|
| Rate for Payer: Cofinity Commercial |
$975.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$907.20
|
| Rate for Payer: Healthscope Commercial |
$1,020.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$793.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$850.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$963.90
|
| Rate for Payer: PHP Commercial |
$963.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$793.80
|
| Rate for Payer: Priority Health SBD |
$714.42
|
| Rate for Payer: UMR Bronson Commercial |
$419.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$850.50
|
|
|
HC MANTIS CLIP
|
Facility
|
IP
|
$1,134.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27200356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$498.96 |
| Max. Negotiated Rate |
$1,020.60 |
| Rate for Payer: Aetna American Axle |
$737.10
|
| Rate for Payer: Aetna Commercial |
$963.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.10
|
| Rate for Payer: Cash Price |
$907.20
|
| Rate for Payer: Cofinity Commercial |
$793.80
|
| Rate for Payer: Cofinity Commercial |
$975.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$907.20
|
| Rate for Payer: Healthscope Commercial |
$1,020.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$793.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$850.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$963.90
|
| Rate for Payer: PHP Commercial |
$963.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$793.80
|
| Rate for Payer: Priority Health SBD |
$714.42
|
| Rate for Payer: UMR Bronson Commercial |
$498.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$850.50
|
|
|
HC MANUAL DIFFERENTIAL
|
Facility
|
IP
|
$45.40
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
30500002
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.98 |
| Max. Negotiated Rate |
$40.86 |
| Rate for Payer: Aetna American Axle |
$29.51
|
| Rate for Payer: Aetna Commercial |
$38.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.51
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cofinity Commercial |
$31.78
|
| Rate for Payer: Cofinity Commercial |
$39.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.32
|
| Rate for Payer: Healthscope Commercial |
$40.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.59
|
| Rate for Payer: PHP Commercial |
$38.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health SBD |
$28.60
|
| Rate for Payer: UMR Bronson Commercial |
$19.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.05
|
|
|
HC MANUAL DIFFERENTIAL
|
Facility
|
OP
|
$45.40
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
30500002
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.08 |
| Max. Negotiated Rate |
$40.86 |
| Rate for Payer: Aetna American Axle |
$29.51
|
| Rate for Payer: Aetna Commercial |
$38.59
|
| Rate for Payer: Aetna Medicare |
$3.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.75
|
| Rate for Payer: BCBS Complete |
$2.18
|
| Rate for Payer: BCBS MAPPO |
$3.80
|
| Rate for Payer: BCBS Trust/PPO |
$3.42
|
| Rate for Payer: BCN Medicare Advantage |
$3.80
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cash Price |
$36.32
|
| Rate for Payer: Cofinity Commercial |
$39.04
|
| Rate for Payer: Cofinity Commercial |
$31.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.80
|
| Rate for Payer: Healthscope Commercial |
$40.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.05
|
| Rate for Payer: Mclaren Medicaid |
$2.08
|
| Rate for Payer: Mclaren Medicare |
$3.80
|
| Rate for Payer: Meridian Medicaid |
$2.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.59
|
| Rate for Payer: PACE Medicare |
$3.61
|
| Rate for Payer: PACE SWMI |
$3.80
|
| Rate for Payer: PHP Commercial |
$38.59
|
| Rate for Payer: PHP Medicare Advantage |
$3.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.95
|
| Rate for Payer: Priority Health Medicare |
$3.80
|
| Rate for Payer: Priority Health Narrow Network |
$3.16
|
| Rate for Payer: Priority Health SBD |
$28.60
|
| Rate for Payer: Railroad Medicare Medicare |
$3.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.56
|
| Rate for Payer: UHC Core |
$5.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.80
|
| Rate for Payer: UHC Exchange |
$3.80
|
| Rate for Payer: UHC Medicare Advantage |
$3.91
|
| Rate for Payer: UMR Bronson Commercial |
$16.80
|
| Rate for Payer: VA VA |
$3.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.05
|
|
|
HC MAPLE IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200046
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: UMR Bronson Commercial |
$10.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC MAPLE IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200046
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.70
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.16
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$5.73
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: UMR Bronson Commercial |
$9.21
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC MAPPING W/INTRACARDIAC 3D
|
Facility
|
OP
|
$6,048.60
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
48100035
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$278.98 |
| Max. Negotiated Rate |
$5,443.74 |
| Rate for Payer: Aetna American Axle |
$3,931.59
|
| Rate for Payer: Aetna Commercial |
$5,141.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,931.59
|
| Rate for Payer: BCBS Complete |
$2,419.44
|
| Rate for Payer: BCBS Trust/PPO |
$371.98
|
| Rate for Payer: Cash Price |
$4,838.88
|
| Rate for Payer: Cash Price |
$4,838.88
|
| Rate for Payer: Cofinity Commercial |
$4,234.02
|
| Rate for Payer: Cofinity Commercial |
$5,201.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,838.88
|
| Rate for Payer: Healthscope Commercial |
$5,443.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,234.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,536.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,141.31
|
| Rate for Payer: PHP Commercial |
$5,141.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,234.02
|
| Rate for Payer: Priority Health SBD |
$3,810.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.88
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$278.98
|
| Rate for Payer: UMR Bronson Commercial |
$2,237.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,536.45
|
|
|
HC MAPPING W/INTRACARDIAC 3D
|
Facility
|
IP
|
$6,048.60
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
48100035
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,661.38 |
| Max. Negotiated Rate |
$5,443.74 |
| Rate for Payer: Aetna American Axle |
$3,931.59
|
| Rate for Payer: Aetna Commercial |
$5,141.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,931.59
|
| Rate for Payer: Cash Price |
$4,838.88
|
| Rate for Payer: Cofinity Commercial |
$4,234.02
|
| Rate for Payer: Cofinity Commercial |
$5,201.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,838.88
|
| Rate for Payer: Healthscope Commercial |
$5,443.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,234.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,536.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,141.31
|
| Rate for Payer: PHP Commercial |
$5,141.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,234.02
|
| Rate for Payer: Priority Health SBD |
$3,810.62
|
| Rate for Payer: UMR Bronson Commercial |
$2,661.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,536.45
|
|
|
HC MAPPING W/OUT INTRACARDIAC 3D
|
Facility
|
OP
|
$4,311.84
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
48100032
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$521.11 |
| Max. Negotiated Rate |
$3,880.66 |
| Rate for Payer: Aetna American Axle |
$2,802.70
|
| Rate for Payer: Aetna Commercial |
$3,665.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,802.70
|
| Rate for Payer: BCBS Complete |
$1,724.74
|
| Rate for Payer: BCBS Trust/PPO |
$521.11
|
| Rate for Payer: Cash Price |
$3,449.47
|
| Rate for Payer: Cash Price |
$3,449.47
|
| Rate for Payer: Cofinity Commercial |
$3,018.29
|
| Rate for Payer: Cofinity Commercial |
$3,708.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,449.47
|
| Rate for Payer: Healthscope Commercial |
$3,880.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,018.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,233.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,665.06
|
| Rate for Payer: PHP Commercial |
$3,665.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.29
|
| Rate for Payer: Priority Health SBD |
$2,716.46
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,595.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,233.88
|
|
|
HC MAPPING W/OUT INTRACARDIAC 3D
|
Facility
|
IP
|
$4,311.84
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
48100032
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,897.21 |
| Max. Negotiated Rate |
$3,880.66 |
| Rate for Payer: Aetna American Axle |
$2,802.70
|
| Rate for Payer: Aetna Commercial |
$3,665.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,802.70
|
| Rate for Payer: Cash Price |
$3,449.47
|
| Rate for Payer: Cofinity Commercial |
$3,018.29
|
| Rate for Payer: Cofinity Commercial |
$3,708.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,449.47
|
| Rate for Payer: Healthscope Commercial |
$3,880.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,018.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,233.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,665.06
|
| Rate for Payer: PHP Commercial |
$3,665.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.29
|
| Rate for Payer: Priority Health SBD |
$2,716.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,897.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,233.88
|
|
|
HC MARS BARTHOLINS GLAND CYST
|
Facility
|
OP
|
$7,789.74
|
|
|
Service Code
|
CPT 56440
|
| Hospital Charge Code |
76100331
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$179.77 |
| Max. Negotiated Rate |
$8,748.29 |
| Rate for Payer: Aetna American Axle |
$5,063.33
|
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: Aetna Medicare |
$2,890.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,063.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,374.68
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$5,452.82
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,452.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,748.29
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$6,998.63
|
| Rate for Payer: Priority Health SBD |
$4,907.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,778.95
|
| Rate for Payer: UHC Exchange |
$179.77
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: UMR Bronson Commercial |
$2,882.20
|
| Rate for Payer: VA VA |
$2,778.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC MARS BARTHOLINS GLAND CYST
|
Facility
|
IP
|
$7,789.74
|
|
|
Service Code
|
CPT 56440
|
| Hospital Charge Code |
76100331
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,427.49 |
| Max. Negotiated Rate |
$7,010.77 |
| Rate for Payer: Aetna American Axle |
$5,063.33
|
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,063.33
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$5,452.82
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,452.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health SBD |
$4,907.54
|
| Rate for Payer: UMR Bronson Commercial |
$3,427.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC MARSUPIALIZ SUBLNGL SALIVARY CYST RANULA
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 42409
|
| Hospital Charge Code |
76100472
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,476.00 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna American Axle |
$5,135.00
|
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,135.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Cofinity Commercial |
$5,530.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,530.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,925.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health SBD |
$4,977.00
|
| Rate for Payer: UMR Bronson Commercial |
$3,476.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,925.00
|
|
|
HC MARSUPIALIZ SUBLNGL SALIVARY CYST RANULA
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 42409
|
| Hospital Charge Code |
76100472
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$231.17 |
| Max. Negotiated Rate |
$9,009.23 |
| Rate for Payer: Aetna American Axle |
$5,135.00
|
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: Aetna Medicare |
$2,976.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,135.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,396.54
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$5,530.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,530.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,925.00
|
| Rate for Payer: Mclaren Medicaid |
$1,565.43
|
| Rate for Payer: Mclaren Medicare |
$2,861.84
|
| Rate for Payer: Meridian Medicaid |
$1,643.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PACE Medicare |
$2,718.75
|
| Rate for Payer: PACE SWMI |
$2,861.84
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,009.23
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$7,207.38
|
| Rate for Payer: Priority Health SBD |
$4,977.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,861.84
|
| Rate for Payer: UHC Exchange |
$231.17
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: UMR Bronson Commercial |
$2,923.00
|
| Rate for Payer: VA VA |
$2,861.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,925.00
|
|
|
HC MASSAGE THERAPY
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 97124
|
| Hospital Charge Code |
42000024
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$10.23 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$19.50
|
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.50
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS Trust/PPO |
$10.23
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.00
|
| Rate for Payer: Priority Health Narrow Network |
$17.60
|
| Rate for Payer: Priority Health SBD |
$18.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.78
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$29.80
|
| Rate for Payer: UMR Bronson Commercial |
$11.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC MASSAGE THERAPY
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
CPT 97124
|
| Hospital Charge Code |
42000024
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna American Axle |
$19.50
|
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.50
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health SBD |
$18.90
|
| Rate for Payer: UMR Bronson Commercial |
$13.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC MASTECTOMY SLEEVE EA $100
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
HCPCS L8010
|
| Hospital Charge Code |
96000004
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$44.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna American Axle |
$65.00
|
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$70.00
|
| Rate for Payer: Cofinity Commercial |
$86.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.00
|
| Rate for Payer: PHP Commercial |
$85.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.00
|
| Rate for Payer: Priority Health SBD |
$63.00
|
| Rate for Payer: UMR Bronson Commercial |
$44.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.00
|
|
|
HC MASTECTOMY SLEEVE EA $100
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
HCPCS L8010
|
| Hospital Charge Code |
96000004
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.00 |
| Max. Negotiated Rate |
$161.76 |
| Rate for Payer: Aetna American Axle |
$65.00
|
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.00
|
| Rate for Payer: BCBS Complete |
$40.00
|
| Rate for Payer: BCBS Trust/PPO |
$161.76
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$70.00
|
| Rate for Payer: Cofinity Commercial |
$86.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.00
|
| Rate for Payer: PHP Commercial |
$85.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.00
|
| Rate for Payer: Priority Health SBD |
$63.00
|
| Rate for Payer: UMR Bronson Commercial |
$37.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.00
|
|
|
HC MASTECTOMY SLEEVE EA $125
|
Facility
|
OP
|
$125.00
|
|
|
Service Code
|
HCPCS L8010
|
| Hospital Charge Code |
96000005
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$46.25 |
| Max. Negotiated Rate |
$161.76 |
| Rate for Payer: Aetna American Axle |
$81.25
|
| Rate for Payer: Aetna Commercial |
$106.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.25
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS Trust/PPO |
$161.76
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$107.50
|
| Rate for Payer: Cofinity Commercial |
$87.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Healthscope Commercial |
$112.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$106.25
|
| Rate for Payer: PHP Commercial |
$106.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.50
|
| Rate for Payer: Priority Health SBD |
$78.75
|
| Rate for Payer: UMR Bronson Commercial |
$46.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.75
|
|
|
HC MASTECTOMY SLEEVE EA $125
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
HCPCS L8010
|
| Hospital Charge Code |
96000005
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.00 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna American Axle |
$81.25
|
| Rate for Payer: Aetna Commercial |
$106.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.25
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$107.50
|
| Rate for Payer: Cofinity Commercial |
$87.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Healthscope Commercial |
$112.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$106.25
|
| Rate for Payer: PHP Commercial |
$106.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.50
|
| Rate for Payer: Priority Health SBD |
$78.75
|
| Rate for Payer: UMR Bronson Commercial |
$55.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.75
|
|
|
HC MASTECTOMY SLEEVE EA $150
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
HCPCS L8010
|
| Hospital Charge Code |
96000006
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.50 |
| Max. Negotiated Rate |
$161.76 |
| Rate for Payer: Aetna American Axle |
$97.50
|
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.50
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: BCBS Trust/PPO |
$161.76
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$105.00
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.00
|
| Rate for Payer: Healthscope Commercial |
$135.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.50
|
| Rate for Payer: PHP Commercial |
$127.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health SBD |
$94.50
|
| Rate for Payer: UMR Bronson Commercial |
$55.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.50
|
|
