|
HC DPPX AB IFA TITER, S
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200461
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna American Axle |
$51.73
|
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$10.45
|
| Rate for Payer: BCN Commercial |
$10.45
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Advantage |
$55.71
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$50.14
|
| Rate for Payer: Priority Health Tiered Network |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.08
|
| Rate for Payer: UHC Core |
$18.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.08
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: UMR Bronson Commercial |
$29.45
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC DRAINAGE ABSC CST HEMAT DENTOALVEOLAR STRUX
|
Facility
|
OP
|
$378.42
|
|
|
Service Code
|
CPT 41800
|
| Hospital Charge Code |
76100529
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna American Axle |
$245.97
|
| Rate for Payer: Aetna Commercial |
$321.66
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$157.33
|
| Rate for Payer: BCN Commercial |
$157.33
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$302.74
|
| Rate for Payer: Cash Price |
$302.74
|
| Rate for Payer: Cash Price |
$302.74
|
| Rate for Payer: Cofinity Advantage |
$264.89
|
| Rate for Payer: Cofinity Commercial |
$325.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$340.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$264.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.81
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.66
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$283.81
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$321.66
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$238.40
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.97
|
| Rate for Payer: UHC Core |
$197.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$148.72
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$140.02
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.81
|
|
|
HC DRAINAGE ABSC CST HEMAT DENTOALVEOLAR STRUX
|
Facility
|
IP
|
$378.42
|
|
|
Service Code
|
CPT 41800
|
| Hospital Charge Code |
76100529
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$166.50 |
| Max. Negotiated Rate |
$340.58 |
| Rate for Payer: Aetna American Axle |
$245.97
|
| Rate for Payer: Aetna Commercial |
$321.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.97
|
| Rate for Payer: Cash Price |
$302.74
|
| Rate for Payer: Cofinity Advantage |
$264.89
|
| Rate for Payer: Cofinity Commercial |
$325.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.74
|
| Rate for Payer: Healthscope Commercial |
$340.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$264.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$283.81
|
| Rate for Payer: PHP Commercial |
$321.66
|
| Rate for Payer: Priority Health SBD |
$238.40
|
| Rate for Payer: UMR Bronson Commercial |
$166.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.81
|
|
|
HC DRAINAGE ABSCESS PALATE UVULA
|
Facility
|
IP
|
$653.51
|
|
|
Service Code
|
CPT 42000
|
| Hospital Charge Code |
76100559
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$287.54 |
| Max. Negotiated Rate |
$588.16 |
| Rate for Payer: Aetna American Axle |
$424.78
|
| Rate for Payer: Aetna Commercial |
$555.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$424.78
|
| Rate for Payer: Cash Price |
$522.81
|
| Rate for Payer: Cofinity Advantage |
$457.46
|
| Rate for Payer: Cofinity Commercial |
$562.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$522.81
|
| Rate for Payer: Healthscope Commercial |
$588.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$457.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$490.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$555.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$490.13
|
| Rate for Payer: PHP Commercial |
$555.48
|
| Rate for Payer: Priority Health SBD |
$411.71
|
| Rate for Payer: UMR Bronson Commercial |
$287.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$490.13
|
|
|
HC DRAINAGE ABSCESS PALATE UVULA
|
Facility
|
OP
|
$653.51
|
|
|
Service Code
|
CPT 42000
|
| Hospital Charge Code |
76100559
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.43 |
| Max. Negotiated Rate |
$763.21 |
| Rate for Payer: Aetna American Axle |
$424.78
|
| Rate for Payer: Aetna Commercial |
$555.48
|
| Rate for Payer: Aetna Medicare |
$245.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$424.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.00
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS Trust/PPO |
$320.86
|
| Rate for Payer: BCN Commercial |
$320.86
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: Cash Price |
$522.81
|
| Rate for Payer: Cash Price |
$522.81
|
| Rate for Payer: Cash Price |
$522.81
|
| Rate for Payer: Cofinity Advantage |
$457.46
|
| Rate for Payer: Cofinity Commercial |
$562.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$522.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$588.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$457.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$490.13
|
| Rate for Payer: Mclaren Medicaid |
$236.00
|
| Rate for Payer: Mclaren Medicare |
$236.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.80
|
| Rate for Payer: Meridian Medicaid |
$247.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$555.48
|
| Rate for Payer: Nomi Health Commercial |
$708.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$490.13
|
| Rate for Payer: PACE Medicare |
$224.20
|
| Rate for Payer: PACE SWMI |
$236.00
|
| Rate for Payer: PHP Commercial |
$555.48
|
| Rate for Payer: PHP Medicare Advantage |
$236.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$763.21
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health SBD |
$411.71
|
| Rate for Payer: Priority Health Tiered Network |
$610.57
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$424.78
|
| Rate for Payer: UHC Core |
$340.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.00
|
| Rate for Payer: UHC Exchange |
$256.83
|
| Rate for Payer: UHC Medicaid |
$123.43
|
| Rate for Payer: UHCCP Medicaid |
$123.43
|
| Rate for Payer: UMR Bronson Commercial |
$241.80
|
| Rate for Payer: VA VA |
$236.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$490.13
|
|
|
HC DRAINAGE CATHETER LVL 1
|
Facility
|
OP
|
$21.85
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna American Axle |
$14.20
|
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna Medicare |
$10.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.20
|
| Rate for Payer: BCBS Complete |
$8.74
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Advantage |
$15.29
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.39
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: Priority Health SBD |
$13.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.20
|
| Rate for Payer: UHC Core |
$11.38
|
| Rate for Payer: UHC Exchange |
$8.59
|
| Rate for Payer: UMR Bronson Commercial |
$8.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.39
|
|
|
HC DRAINAGE CATHETER LVL 1
|
Facility
|
IP
|
$21.85
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$19.66 |
| Rate for Payer: Aetna American Axle |
$14.20
|
| Rate for Payer: Aetna Commercial |
$18.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.20
|
| Rate for Payer: Cash Price |
$17.48
|
| Rate for Payer: Cofinity Advantage |
$15.29
|
| Rate for Payer: Cofinity Commercial |
$18.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.48
|
| Rate for Payer: Healthscope Commercial |
$19.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.39
|
| Rate for Payer: PHP Commercial |
$18.57
|
| Rate for Payer: Priority Health SBD |
$13.77
|
| Rate for Payer: UMR Bronson Commercial |
$9.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.39
|
|
|
HC DRAINAGE CATHETER LVL 15
|
Facility
|
OP
|
$1,590.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200348
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$1,431.00 |
| Rate for Payer: Aetna American Axle |
$1,033.50
|
| Rate for Payer: Aetna Commercial |
$1,351.50
|
| Rate for Payer: Aetna Medicare |
$795.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.50
|
| Rate for Payer: BCBS Complete |
$636.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cofinity Advantage |
$1,113.00
|
| Rate for Payer: Cofinity Commercial |
$1,367.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,272.00
|
| Rate for Payer: Healthscope Commercial |
$1,431.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,113.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,192.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,272.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,351.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,192.50
|
| Rate for Payer: PHP Commercial |
$1,351.50
|
| Rate for Payer: Priority Health SBD |
$1,001.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,033.50
|
| Rate for Payer: UHC Core |
$828.39
|
| Rate for Payer: UHC Exchange |
$624.87
|
| Rate for Payer: UMR Bronson Commercial |
$588.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,192.50
|
|
|
HC DRAINAGE CATHETER LVL 15
|
Facility
|
IP
|
$1,590.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200348
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$699.60 |
| Max. Negotiated Rate |
$1,431.00 |
| Rate for Payer: Aetna American Axle |
$1,033.50
|
| Rate for Payer: Aetna Commercial |
$1,351.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,033.50
|
| Rate for Payer: Cash Price |
$1,272.00
|
| Rate for Payer: Cofinity Advantage |
$1,113.00
|
| Rate for Payer: Cofinity Commercial |
$1,367.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,272.00
|
| Rate for Payer: Healthscope Commercial |
$1,431.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,113.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,192.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,351.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,192.50
|
| Rate for Payer: PHP Commercial |
$1,351.50
|
| Rate for Payer: Priority Health SBD |
$1,001.70
|
| Rate for Payer: UMR Bronson Commercial |
$699.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,192.50
|
|
|
HC DRAINAGE CATHETER LVL 2
|
Facility
|
OP
|
$232.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$209.30 |
| Rate for Payer: Aetna American Axle |
$151.16
|
| Rate for Payer: Aetna Commercial |
$197.68
|
| Rate for Payer: Aetna Medicare |
$116.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.16
|
| Rate for Payer: BCBS Complete |
$93.02
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$186.05
|
| Rate for Payer: Cash Price |
$186.05
|
| Rate for Payer: Cofinity Advantage |
$162.79
|
| Rate for Payer: Cofinity Commercial |
$200.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.05
|
| Rate for Payer: Healthscope Commercial |
$209.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$162.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.42
|
| Rate for Payer: PHP Commercial |
$197.68
|
| Rate for Payer: Priority Health SBD |
$146.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.16
|
| Rate for Payer: UHC Core |
$121.16
|
| Rate for Payer: UHC Exchange |
$91.40
|
| Rate for Payer: UMR Bronson Commercial |
$86.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.42
|
|
|
HC DRAINAGE CATHETER LVL 2
|
Facility
|
IP
|
$232.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$102.33 |
| Max. Negotiated Rate |
$209.30 |
| Rate for Payer: Aetna American Axle |
$151.16
|
| Rate for Payer: Aetna Commercial |
$197.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.16
|
| Rate for Payer: Cash Price |
$186.05
|
| Rate for Payer: Cofinity Advantage |
$162.79
|
| Rate for Payer: Cofinity Commercial |
$200.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.05
|
| Rate for Payer: Healthscope Commercial |
$209.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$162.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$197.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.42
|
| Rate for Payer: PHP Commercial |
$197.68
|
| Rate for Payer: Priority Health SBD |
$146.51
|
| Rate for Payer: UMR Bronson Commercial |
$102.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.42
|
|
|
HC DRAINAGE CATHETER LVL 3
|
Facility
|
OP
|
$385.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$347.00 |
| Rate for Payer: Aetna American Axle |
$250.61
|
| Rate for Payer: Aetna Commercial |
$327.73
|
| Rate for Payer: Aetna Medicare |
$192.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.61
|
| Rate for Payer: BCBS Complete |
$154.22
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$308.45
|
| Rate for Payer: Cash Price |
$308.45
|
| Rate for Payer: Cofinity Advantage |
$269.89
|
| Rate for Payer: Cofinity Commercial |
$331.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.45
|
| Rate for Payer: Healthscope Commercial |
$347.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.17
|
| Rate for Payer: PHP Commercial |
$327.73
|
| Rate for Payer: Priority Health SBD |
$242.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.61
|
| Rate for Payer: UHC Core |
$200.88
|
| Rate for Payer: UHC Exchange |
$151.53
|
| Rate for Payer: UMR Bronson Commercial |
$142.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.17
|
|
|
HC DRAINAGE CATHETER LVL 3
|
Facility
|
IP
|
$385.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$169.65 |
| Max. Negotiated Rate |
$347.00 |
| Rate for Payer: Aetna American Axle |
$250.61
|
| Rate for Payer: Aetna Commercial |
$327.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.61
|
| Rate for Payer: Cash Price |
$308.45
|
| Rate for Payer: Cofinity Advantage |
$269.89
|
| Rate for Payer: Cofinity Commercial |
$331.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.45
|
| Rate for Payer: Healthscope Commercial |
$347.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.17
|
| Rate for Payer: PHP Commercial |
$327.73
|
| Rate for Payer: Priority Health SBD |
$242.90
|
| Rate for Payer: UMR Bronson Commercial |
$169.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.17
|
|
|
HC DRAINAGE CATHETER LVL 34
|
Facility
|
IP
|
$3,491.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,536.04 |
| Max. Negotiated Rate |
$3,141.90 |
| Rate for Payer: Aetna American Axle |
$2,269.15
|
| Rate for Payer: Aetna Commercial |
$2,967.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,269.15
|
| Rate for Payer: Cash Price |
$2,792.80
|
| Rate for Payer: Cofinity Advantage |
$2,443.70
|
| Rate for Payer: Cofinity Commercial |
$3,002.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,792.80
|
| Rate for Payer: Healthscope Commercial |
$3,141.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,443.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,618.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,967.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,618.25
|
| Rate for Payer: PHP Commercial |
$2,967.35
|
| Rate for Payer: Priority Health SBD |
$2,199.33
|
| Rate for Payer: UMR Bronson Commercial |
$1,536.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,618.25
|
|
|
HC DRAINAGE CATHETER LVL 34
|
Facility
|
OP
|
$3,491.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$3,141.90 |
| Rate for Payer: Aetna American Axle |
$2,269.15
|
| Rate for Payer: Aetna Commercial |
$2,967.35
|
| Rate for Payer: Aetna Medicare |
$1,745.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,269.15
|
| Rate for Payer: BCBS Complete |
$1,396.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$2,792.80
|
| Rate for Payer: Cash Price |
$2,792.80
|
| Rate for Payer: Cofinity Advantage |
$2,443.70
|
| Rate for Payer: Cofinity Commercial |
$3,002.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,792.80
|
| Rate for Payer: Healthscope Commercial |
$3,141.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,443.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,618.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,792.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,967.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,618.25
|
| Rate for Payer: PHP Commercial |
$2,967.35
|
| Rate for Payer: Priority Health SBD |
$2,199.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,269.15
|
| Rate for Payer: UHC Core |
$1,818.81
|
| Rate for Payer: UHC Exchange |
$1,371.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,291.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,618.25
|
|
|
HC DRAINAGE CATHETER LVL 4
|
Facility
|
IP
|
$538.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$236.97 |
| Max. Negotiated Rate |
$484.70 |
| Rate for Payer: Aetna American Axle |
$350.06
|
| Rate for Payer: Aetna Commercial |
$457.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$350.06
|
| Rate for Payer: Cash Price |
$430.85
|
| Rate for Payer: Cofinity Advantage |
$376.99
|
| Rate for Payer: Cofinity Commercial |
$463.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$430.85
|
| Rate for Payer: Healthscope Commercial |
$484.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$376.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$403.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$457.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.92
|
| Rate for Payer: PHP Commercial |
$457.78
|
| Rate for Payer: Priority Health SBD |
$339.29
|
| Rate for Payer: UMR Bronson Commercial |
$236.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$403.92
|
|
|
HC DRAINAGE CATHETER LVL 4
|
Facility
|
OP
|
$538.56
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$484.70 |
| Rate for Payer: Aetna American Axle |
$350.06
|
| Rate for Payer: Aetna Commercial |
$457.78
|
| Rate for Payer: Aetna Medicare |
$269.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$350.06
|
| Rate for Payer: BCBS Complete |
$215.42
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$430.85
|
| Rate for Payer: Cash Price |
$430.85
|
| Rate for Payer: Cofinity Advantage |
$376.99
|
| Rate for Payer: Cofinity Commercial |
$463.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$430.85
|
| Rate for Payer: Healthscope Commercial |
$484.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$376.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$403.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$430.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$457.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.92
|
| Rate for Payer: PHP Commercial |
$457.78
|
| Rate for Payer: Priority Health SBD |
$339.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.06
|
| Rate for Payer: UHC Core |
$280.59
|
| Rate for Payer: UHC Exchange |
$211.65
|
| Rate for Payer: UMR Bronson Commercial |
$199.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$403.92
|
|
|
HC DRAINAGE CATHETER LVL 9
|
Facility
|
IP
|
$919.13
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$404.42 |
| Max. Negotiated Rate |
$827.22 |
| Rate for Payer: Aetna American Axle |
$597.43
|
| Rate for Payer: Aetna Commercial |
$781.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.43
|
| Rate for Payer: Cash Price |
$735.30
|
| Rate for Payer: Cofinity Advantage |
$643.39
|
| Rate for Payer: Cofinity Commercial |
$790.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.30
|
| Rate for Payer: Healthscope Commercial |
$827.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$643.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$689.35
|
| Rate for Payer: PHP Commercial |
$781.26
|
| Rate for Payer: Priority Health SBD |
$579.05
|
| Rate for Payer: UMR Bronson Commercial |
$404.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.35
|
|
|
HC DRAINAGE CATHETER LVL 9
|
Facility
|
OP
|
$919.13
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$827.22 |
| Rate for Payer: Aetna American Axle |
$597.43
|
| Rate for Payer: Aetna Commercial |
$781.26
|
| Rate for Payer: Aetna Medicare |
$459.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$597.43
|
| Rate for Payer: BCBS Complete |
$367.65
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$735.30
|
| Rate for Payer: Cash Price |
$735.30
|
| Rate for Payer: Cofinity Advantage |
$643.39
|
| Rate for Payer: Cofinity Commercial |
$790.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$735.30
|
| Rate for Payer: Healthscope Commercial |
$827.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$643.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$689.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$735.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$781.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$689.35
|
| Rate for Payer: PHP Commercial |
$781.26
|
| Rate for Payer: Priority Health SBD |
$579.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$597.43
|
| Rate for Payer: UHC Core |
$478.87
|
| Rate for Payer: UHC Exchange |
$361.22
|
| Rate for Payer: UMR Bronson Commercial |
$340.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$689.35
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
IP
|
$4,368.36
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,922.08 |
| Max. Negotiated Rate |
$3,931.52 |
| Rate for Payer: Aetna American Axle |
$2,839.43
|
| Rate for Payer: Aetna Commercial |
$3,713.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,839.43
|
| Rate for Payer: Cash Price |
$3,494.69
|
| Rate for Payer: Cofinity Advantage |
$3,057.85
|
| Rate for Payer: Cofinity Commercial |
$3,756.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,494.69
|
| Rate for Payer: Healthscope Commercial |
$3,931.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,057.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,276.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,713.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,276.27
|
| Rate for Payer: PHP Commercial |
$3,713.11
|
| Rate for Payer: Priority Health SBD |
$2,752.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,922.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,276.27
|
|
|
HC DRAINAGE FINGER ABSCESS COMPLICATED
|
Facility
|
OP
|
$4,368.36
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
76100514
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$2,839.43
|
| Rate for Payer: Aetna Commercial |
$3,713.11
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,839.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,114.61
|
| Rate for Payer: BCN Commercial |
$1,114.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,494.69
|
| Rate for Payer: Cash Price |
$3,494.69
|
| Rate for Payer: Cash Price |
$3,494.69
|
| Rate for Payer: Cofinity Advantage |
$3,057.85
|
| Rate for Payer: Cofinity Commercial |
$3,756.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,494.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$3,931.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,057.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,276.27
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,713.11
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,276.27
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$3,713.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$2,752.07
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,839.43
|
| Rate for Payer: UHC Core |
$2,275.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$1,716.77
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,616.29
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,276.27
|
|
|
HC DRAINAGE OF FINGER ABSCESS
|
Facility
|
IP
|
$530.60
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
76100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$233.46 |
| Max. Negotiated Rate |
$477.54 |
| Rate for Payer: Aetna American Axle |
$344.89
|
| Rate for Payer: Aetna Commercial |
$451.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.89
|
| Rate for Payer: Cash Price |
$424.48
|
| Rate for Payer: Cofinity Advantage |
$371.42
|
| Rate for Payer: Cofinity Commercial |
$456.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.48
|
| Rate for Payer: Healthscope Commercial |
$477.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$371.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$397.95
|
| Rate for Payer: PHP Commercial |
$451.01
|
| Rate for Payer: Priority Health SBD |
$334.28
|
| Rate for Payer: UMR Bronson Commercial |
$233.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.95
|
|
|
HC DRAINAGE OF FINGER ABSCESS
|
Facility
|
OP
|
$530.60
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
76100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna American Axle |
$344.89
|
| Rate for Payer: Aetna Commercial |
$451.01
|
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$288.28
|
| Rate for Payer: BCN Commercial |
$288.28
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$424.48
|
| Rate for Payer: Cash Price |
$424.48
|
| Rate for Payer: Cash Price |
$424.48
|
| Rate for Payer: Cofinity Advantage |
$371.42
|
| Rate for Payer: Cofinity Commercial |
$456.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$477.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$371.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.95
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$209.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.01
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$397.95
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$451.01
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.50
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health SBD |
$334.28
|
| Rate for Payer: Priority Health Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$344.89
|
| Rate for Payer: UHC Core |
$276.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$208.53
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: UMR Bronson Commercial |
$196.32
|
| Rate for Payer: VA VA |
$199.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.95
|
|
|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
OP
|
$2,136.37
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$790.46 |
| Max. Negotiated Rate |
$3,025.34 |
| Rate for Payer: Aetna American Axle |
$1,388.64
|
| Rate for Payer: Aetna Commercial |
$1,815.91
|
| Rate for Payer: Aetna Medicare |
$1,068.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,388.64
|
| Rate for Payer: BCBS Complete |
$854.55
|
| Rate for Payer: BCBS Trust/PPO |
$3,025.34
|
| Rate for Payer: BCN Commercial |
$3,025.34
|
| Rate for Payer: Cash Price |
$1,709.10
|
| Rate for Payer: Cash Price |
$1,709.10
|
| Rate for Payer: Cash Price |
$1,709.10
|
| Rate for Payer: Cofinity Advantage |
$1,495.46
|
| Rate for Payer: Cofinity Commercial |
$1,837.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,709.10
|
| Rate for Payer: Healthscope Commercial |
$1,922.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,495.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,602.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,709.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,815.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,602.28
|
| Rate for Payer: PHP Commercial |
$1,815.91
|
| Rate for Payer: Priority Health SBD |
$1,345.91
|
| Rate for Payer: UMR Bronson Commercial |
$790.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,602.28
|
|
|
HC DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH
|
Facility
|
IP
|
$2,136.37
|
|
|
Service Code
|
CPT 58822
|
| Hospital Charge Code |
36100259
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$940.00 |
| Max. Negotiated Rate |
$1,922.73 |
| Rate for Payer: Aetna American Axle |
$1,388.64
|
| Rate for Payer: Aetna Commercial |
$1,815.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,388.64
|
| Rate for Payer: Cash Price |
$1,709.10
|
| Rate for Payer: Cofinity Advantage |
$1,495.46
|
| Rate for Payer: Cofinity Commercial |
$1,837.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,709.10
|
| Rate for Payer: Healthscope Commercial |
$1,922.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,495.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,602.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,815.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,602.28
|
| Rate for Payer: PHP Commercial |
$1,815.91
|
| Rate for Payer: Priority Health SBD |
$1,345.91
|
| Rate for Payer: UMR Bronson Commercial |
$940.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,602.28
|
|
