|
HC ENDOLUMINAL BIOPSY OF BILIARY TREE
|
Facility
|
IP
|
$675.66
|
|
|
Service Code
|
CPT 47543
|
| Hospital Charge Code |
36100500
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$297.29 |
| Max. Negotiated Rate |
$608.09 |
| Rate for Payer: Aetna American Axle |
$439.18
|
| Rate for Payer: Aetna Commercial |
$574.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.18
|
| Rate for Payer: Cash Price |
$540.53
|
| Rate for Payer: Cofinity Advantage |
$472.96
|
| Rate for Payer: Cofinity Commercial |
$581.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.53
|
| Rate for Payer: Healthscope Commercial |
$608.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$472.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$506.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$506.75
|
| Rate for Payer: PHP Commercial |
$574.31
|
| Rate for Payer: Priority Health SBD |
$425.67
|
| Rate for Payer: UMR Bronson Commercial |
$297.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$506.75
|
|
|
HC ENDOLUMINAL BIOPSY OF BILIARY TREE
|
Facility
|
OP
|
$675.66
|
|
|
Service Code
|
CPT 47543
|
| Hospital Charge Code |
36100500
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$249.99 |
| Max. Negotiated Rate |
$2,498.71 |
| Rate for Payer: Aetna American Axle |
$439.18
|
| Rate for Payer: Aetna Commercial |
$574.31
|
| Rate for Payer: Aetna Medicare |
$337.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.18
|
| Rate for Payer: BCBS Complete |
$270.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,498.71
|
| Rate for Payer: BCN Commercial |
$2,498.71
|
| Rate for Payer: Cash Price |
$540.53
|
| Rate for Payer: Cash Price |
$540.53
|
| Rate for Payer: Cash Price |
$540.53
|
| Rate for Payer: Cofinity Advantage |
$472.96
|
| Rate for Payer: Cofinity Commercial |
$581.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$540.53
|
| Rate for Payer: Healthscope Commercial |
$608.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$472.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$506.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$540.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$506.75
|
| Rate for Payer: PHP Commercial |
$574.31
|
| Rate for Payer: Priority Health SBD |
$425.67
|
| Rate for Payer: UMR Bronson Commercial |
$249.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$506.75
|
|
|
HC ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC
|
Facility
|
IP
|
$5,199.92
|
|
|
Service Code
|
CPT 50606
|
| Hospital Charge Code |
36100615
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,287.96 |
| Max. Negotiated Rate |
$4,679.93 |
| Rate for Payer: Aetna American Axle |
$3,379.95
|
| Rate for Payer: Aetna Commercial |
$4,419.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,379.95
|
| Rate for Payer: Cash Price |
$4,159.94
|
| Rate for Payer: Cofinity Advantage |
$3,639.94
|
| Rate for Payer: Cofinity Commercial |
$4,471.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,159.94
|
| Rate for Payer: Healthscope Commercial |
$4,679.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,639.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,899.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,419.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,899.94
|
| Rate for Payer: PHP Commercial |
$4,419.93
|
| Rate for Payer: Priority Health SBD |
$3,275.95
|
| Rate for Payer: UMR Bronson Commercial |
$2,287.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,899.94
|
|
|
HC ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC
|
Facility
|
OP
|
$5,199.92
|
|
|
Service Code
|
CPT 50606
|
| Hospital Charge Code |
36100615
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,923.97 |
| Max. Negotiated Rate |
$4,679.93 |
| Rate for Payer: Aetna American Axle |
$3,379.95
|
| Rate for Payer: Aetna Commercial |
$4,419.93
|
| Rate for Payer: Aetna Medicare |
$2,599.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,379.95
|
| Rate for Payer: BCBS Complete |
$2,079.97
|
| Rate for Payer: BCBS Trust/PPO |
$3,049.75
|
| Rate for Payer: BCN Commercial |
$3,049.75
|
| Rate for Payer: Cash Price |
$4,159.94
|
| Rate for Payer: Cash Price |
$4,159.94
|
| Rate for Payer: Cash Price |
$4,159.94
|
| Rate for Payer: Cofinity Advantage |
$3,639.94
|
| Rate for Payer: Cofinity Commercial |
$4,471.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,159.94
|
| Rate for Payer: Healthscope Commercial |
$4,679.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,639.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,899.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,159.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,419.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,899.94
|
| Rate for Payer: PHP Commercial |
$4,419.93
|
| Rate for Payer: Priority Health SBD |
$3,275.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,923.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,899.94
|
|
|
HC ENDOMETR ABLATE THERMAL
|
Facility
|
IP
|
$13,620.60
|
|
|
Service Code
|
CPT 58353
|
| Hospital Charge Code |
76100336
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,993.06 |
| Max. Negotiated Rate |
$12,258.54 |
| Rate for Payer: Aetna American Axle |
$8,853.39
|
| Rate for Payer: Aetna Commercial |
$11,577.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,853.39
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cofinity Advantage |
$9,534.42
|
| Rate for Payer: Cofinity Commercial |
$11,713.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,896.48
|
| Rate for Payer: Healthscope Commercial |
$12,258.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,534.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,215.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,577.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,215.45
|
| Rate for Payer: PHP Commercial |
$11,577.51
|
| Rate for Payer: Priority Health SBD |
$8,580.98
|
| Rate for Payer: UMR Bronson Commercial |
$5,993.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,215.45
|
|
|
HC ENDOMETR ABLATE THERMAL
|
Facility
|
OP
|
$13,620.60
|
|
|
Service Code
|
CPT 58353
|
| Hospital Charge Code |
76100336
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,606.87 |
| Max. Negotiated Rate |
$16,119.31 |
| Rate for Payer: Aetna American Axle |
$8,853.39
|
| Rate for Payer: Aetna Commercial |
$11,577.51
|
| Rate for Payer: Aetna Medicare |
$5,183.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,853.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,230.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,230.57
|
| Rate for Payer: BCBS Complete |
$2,737.47
|
| Rate for Payer: BCBS MAPPO |
$4,984.46
|
| Rate for Payer: BCBS Trust/PPO |
$4,357.29
|
| Rate for Payer: BCN Commercial |
$4,357.29
|
| Rate for Payer: BCN Medicare Advantage |
$4,984.46
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cofinity Advantage |
$9,534.42
|
| Rate for Payer: Cofinity Commercial |
$11,713.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,896.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,984.46
|
| Rate for Payer: Healthscope Commercial |
$12,258.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,534.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,215.45
|
| Rate for Payer: Mclaren Medicaid |
$4,984.46
|
| Rate for Payer: Mclaren Medicare |
$4,984.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,233.68
|
| Rate for Payer: Meridian Medicaid |
$5,233.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,732.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,482.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,577.51
|
| Rate for Payer: Nomi Health Commercial |
$14,953.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,215.45
|
| Rate for Payer: PACE Medicare |
$4,735.24
|
| Rate for Payer: PACE SWMI |
$4,984.46
|
| Rate for Payer: PHP Commercial |
$11,577.51
|
| Rate for Payer: PHP Medicare Advantage |
$4,984.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,606.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16,119.31
|
| Rate for Payer: Priority Health Medicare |
$4,984.46
|
| Rate for Payer: Priority Health SBD |
$8,580.98
|
| Rate for Payer: Priority Health Tiered Network |
$12,895.45
|
| Rate for Payer: Railroad Medicare Medicare |
$4,984.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,853.39
|
| Rate for Payer: UHC Core |
$7,096.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4,984.46
|
| Rate for Payer: UHC Exchange |
$5,352.90
|
| Rate for Payer: UHC Medicaid |
$2,606.87
|
| Rate for Payer: UHCCP Medicaid |
$2,606.87
|
| Rate for Payer: UMR Bronson Commercial |
$5,039.62
|
| Rate for Payer: VA VA |
$4,984.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,215.45
|
|
|
HC ENDOMETR BX CONJUNCT W/COLP
|
Facility
|
IP
|
$737.54
|
|
|
Service Code
|
CPT 58110
|
| Hospital Charge Code |
76100335
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$324.52 |
| Max. Negotiated Rate |
$663.79 |
| Rate for Payer: Aetna American Axle |
$479.40
|
| Rate for Payer: Aetna Commercial |
$626.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$479.40
|
| Rate for Payer: Cash Price |
$590.03
|
| Rate for Payer: Cofinity Advantage |
$516.28
|
| Rate for Payer: Cofinity Commercial |
$634.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$590.03
|
| Rate for Payer: Healthscope Commercial |
$663.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$516.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$553.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$553.15
|
| Rate for Payer: PHP Commercial |
$626.91
|
| Rate for Payer: Priority Health SBD |
$464.65
|
| Rate for Payer: UMR Bronson Commercial |
$324.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$553.15
|
|
|
HC ENDOMETR BX CONJUNCT W/COLP
|
Facility
|
OP
|
$737.54
|
|
|
Service Code
|
CPT 58110
|
| Hospital Charge Code |
76100335
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.12 |
| Max. Negotiated Rate |
$663.79 |
| Rate for Payer: Aetna American Axle |
$479.40
|
| Rate for Payer: Aetna Commercial |
$626.91
|
| Rate for Payer: Aetna Medicare |
$368.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$479.40
|
| Rate for Payer: BCBS Complete |
$295.02
|
| Rate for Payer: BCBS Trust/PPO |
$207.57
|
| Rate for Payer: BCCCP Commercial |
$49.12
|
| Rate for Payer: BCN Commercial |
$207.57
|
| Rate for Payer: Cash Price |
$590.03
|
| Rate for Payer: Cash Price |
$590.03
|
| Rate for Payer: Cash Price |
$590.03
|
| Rate for Payer: Cofinity Advantage |
$516.28
|
| Rate for Payer: Cofinity Commercial |
$634.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$590.03
|
| Rate for Payer: Healthscope Commercial |
$663.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$516.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$553.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$590.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$553.15
|
| Rate for Payer: PHP Commercial |
$626.91
|
| Rate for Payer: Priority Health SBD |
$464.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$479.40
|
| Rate for Payer: UHC Core |
$384.26
|
| Rate for Payer: UHC Exchange |
$289.85
|
| Rate for Payer: UMR Bronson Commercial |
$272.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$553.15
|
|
|
HC ENDOMETRIAL SAMPLING
|
Facility
|
OP
|
$223.91
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
76100141
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$82.85 |
| Max. Negotiated Rate |
$651.46 |
| Rate for Payer: Aetna American Axle |
$145.54
|
| Rate for Payer: Aetna Commercial |
$190.32
|
| Rate for Payer: Aetna Medicare |
$209.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$251.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$251.80
|
| Rate for Payer: BCBS Complete |
$110.63
|
| Rate for Payer: BCBS MAPPO |
$201.44
|
| Rate for Payer: BCBS Trust/PPO |
$159.75
|
| Rate for Payer: BCCCP Commercial |
$97.15
|
| Rate for Payer: BCN Commercial |
$159.75
|
| Rate for Payer: BCN Medicare Advantage |
$201.44
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cofinity Advantage |
$156.74
|
| Rate for Payer: Cofinity Commercial |
$192.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.44
|
| Rate for Payer: Healthscope Commercial |
$201.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.93
|
| Rate for Payer: Mclaren Medicaid |
$201.44
|
| Rate for Payer: Mclaren Medicare |
$201.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.51
|
| Rate for Payer: Meridian Medicaid |
$211.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.32
|
| Rate for Payer: Nomi Health Commercial |
$604.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.93
|
| Rate for Payer: PACE Medicare |
$191.37
|
| Rate for Payer: PACE SWMI |
$201.44
|
| Rate for Payer: PHP Commercial |
$190.32
|
| Rate for Payer: PHP Medicare Advantage |
$201.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$651.46
|
| Rate for Payer: Priority Health Medicare |
$201.44
|
| Rate for Payer: Priority Health SBD |
$141.06
|
| Rate for Payer: Priority Health Tiered Network |
$521.17
|
| Rate for Payer: Railroad Medicare Medicare |
$201.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.54
|
| Rate for Payer: UHC Core |
$116.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$201.44
|
| Rate for Payer: UHC Exchange |
$88.00
|
| Rate for Payer: UHC Medicaid |
$105.35
|
| Rate for Payer: UHCCP Medicaid |
$105.35
|
| Rate for Payer: UMR Bronson Commercial |
$82.85
|
| Rate for Payer: VA VA |
$201.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.93
|
|
|
HC ENDOMETRIAL SAMPLING
|
Facility
|
IP
|
$223.91
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
76100141
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$98.52 |
| Max. Negotiated Rate |
$201.52 |
| Rate for Payer: Aetna American Axle |
$145.54
|
| Rate for Payer: Aetna Commercial |
$190.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.54
|
| Rate for Payer: Cash Price |
$179.13
|
| Rate for Payer: Cofinity Advantage |
$156.74
|
| Rate for Payer: Cofinity Commercial |
$192.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.13
|
| Rate for Payer: Healthscope Commercial |
$201.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.93
|
| Rate for Payer: PHP Commercial |
$190.32
|
| Rate for Payer: Priority Health SBD |
$141.06
|
| Rate for Payer: UMR Bronson Commercial |
$98.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.93
|
|
|
HC ENDOMYOCARDIAL BIOPSY
|
Facility
|
IP
|
$2,923.12
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
48100025
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,286.17 |
| Max. Negotiated Rate |
$2,630.81 |
| Rate for Payer: Aetna American Axle |
$1,900.03
|
| Rate for Payer: Aetna Commercial |
$2,484.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,900.03
|
| Rate for Payer: Cash Price |
$2,338.50
|
| Rate for Payer: Cofinity Advantage |
$2,046.18
|
| Rate for Payer: Cofinity Commercial |
$2,513.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,338.50
|
| Rate for Payer: Healthscope Commercial |
$2,630.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,046.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,192.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,484.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,192.34
|
| Rate for Payer: PHP Commercial |
$2,484.65
|
| Rate for Payer: Priority Health SBD |
$1,841.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,286.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,192.34
|
|
|
HC ENDOMYOCARDIAL BIOPSY
|
Facility
|
OP
|
$2,923.12
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
48100025
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,081.55 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$1,900.03
|
| Rate for Payer: Aetna Commercial |
$2,484.65
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,900.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,676.56
|
| Rate for Payer: BCN Commercial |
$1,676.56
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,338.50
|
| Rate for Payer: Cash Price |
$2,338.50
|
| Rate for Payer: Cofinity Advantage |
$2,046.18
|
| Rate for Payer: Cofinity Commercial |
$2,513.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,338.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,630.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,046.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,192.34
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,484.65
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,192.34
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$2,484.65
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$1,841.57
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,081.55
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,192.34
|
|
|
HC ENDOMYSIAL IGA ANTIBODY.
|
Facility
|
OP
|
$81.71
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200426
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$73.54 |
| Rate for Payer: Aetna American Axle |
$53.11
|
| Rate for Payer: Aetna Commercial |
$69.45
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.11
|
| 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 |
$65.37
|
| Rate for Payer: Cash Price |
$65.37
|
| Rate for Payer: Cofinity Advantage |
$57.20
|
| Rate for Payer: Cofinity Commercial |
$70.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$73.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.28
|
| 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 |
$69.45
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.28
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$69.45
|
| 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 |
$51.48
|
| 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 |
$30.23
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.28
|
|
|
HC ENDOMYSIAL IGA ANTIBODY.
|
Facility
|
IP
|
$81.71
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200426
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.95 |
| Max. Negotiated Rate |
$73.54 |
| Rate for Payer: Aetna American Axle |
$53.11
|
| Rate for Payer: Aetna Commercial |
$69.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.11
|
| Rate for Payer: Cash Price |
$65.37
|
| Rate for Payer: Cofinity Advantage |
$57.20
|
| Rate for Payer: Cofinity Commercial |
$70.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.37
|
| Rate for Payer: Healthscope Commercial |
$73.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.28
|
| Rate for Payer: PHP Commercial |
$69.45
|
| Rate for Payer: Priority Health SBD |
$51.48
|
| Rate for Payer: UMR Bronson Commercial |
$35.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.28
|
|
|
HC ENDOMYSIAL IGA TITER.
|
Facility
|
OP
|
$163.24
|
|
|
Service Code
|
CPT 86231
|
| Hospital Charge Code |
30200494
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$146.92 |
| Rate for Payer: Aetna American Axle |
$106.11
|
| Rate for Payer: Aetna Commercial |
$138.75
|
| Rate for Payer: Aetna Medicare |
$12.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.11
|
| Rate for Payer: BCBS Complete |
$6.64
|
| Rate for Payer: BCBS MAPPO |
$12.09
|
| Rate for Payer: BCBS Trust/PPO |
$13.98
|
| Rate for Payer: BCN Commercial |
$13.98
|
| Rate for Payer: BCN Medicare Advantage |
$12.09
|
| Rate for Payer: Cash Price |
$130.59
|
| Rate for Payer: Cash Price |
$130.59
|
| Rate for Payer: Cofinity Advantage |
$114.27
|
| Rate for Payer: Cofinity Commercial |
$140.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.09
|
| Rate for Payer: Healthscope Commercial |
$146.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.43
|
| Rate for Payer: Mclaren Medicaid |
$12.09
|
| Rate for Payer: Mclaren Medicare |
$12.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.69
|
| Rate for Payer: Meridian Medicaid |
$12.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.75
|
| Rate for Payer: Nomi Health Commercial |
$18.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.43
|
| Rate for Payer: PACE Medicare |
$11.49
|
| Rate for Payer: PACE SWMI |
$12.09
|
| Rate for Payer: PHP Commercial |
$138.75
|
| Rate for Payer: PHP Medicare Advantage |
$12.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.09
|
| Rate for Payer: Priority Health Medicare |
$12.09
|
| Rate for Payer: Priority Health SBD |
$102.84
|
| Rate for Payer: Priority Health Tiered Network |
$9.67
|
| Rate for Payer: Railroad Medicare Medicare |
$12.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.14
|
| Rate for Payer: UHC Core |
$18.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.09
|
| Rate for Payer: UHC Exchange |
$18.14
|
| Rate for Payer: UHC Medicaid |
$6.32
|
| Rate for Payer: UHCCP Medicaid |
$6.32
|
| Rate for Payer: UMR Bronson Commercial |
$60.40
|
| Rate for Payer: VA VA |
$12.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.43
|
|
|
HC ENDOMYSIAL IGA TITER.
|
Facility
|
IP
|
$163.24
|
|
|
Service Code
|
CPT 86231
|
| Hospital Charge Code |
30200494
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$71.83 |
| Max. Negotiated Rate |
$146.92 |
| Rate for Payer: Aetna American Axle |
$106.11
|
| Rate for Payer: Aetna Commercial |
$138.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.11
|
| Rate for Payer: Cash Price |
$130.59
|
| Rate for Payer: Cofinity Advantage |
$114.27
|
| Rate for Payer: Cofinity Commercial |
$140.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.59
|
| Rate for Payer: Healthscope Commercial |
$146.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.43
|
| Rate for Payer: PHP Commercial |
$138.75
|
| Rate for Payer: Priority Health SBD |
$102.84
|
| Rate for Payer: UMR Bronson Commercial |
$71.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.43
|
|
|
HC ENDOPLEGE
|
Facility
|
IP
|
$5,404.70
|
|
| Hospital Charge Code |
27000098
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,378.07 |
| Max. Negotiated Rate |
$4,864.23 |
| Rate for Payer: Aetna American Axle |
$3,513.05
|
| Rate for Payer: Aetna Commercial |
$4,593.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,513.05
|
| Rate for Payer: Cash Price |
$4,323.76
|
| Rate for Payer: Cofinity Advantage |
$3,783.29
|
| Rate for Payer: Cofinity Commercial |
$4,648.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,323.76
|
| Rate for Payer: Healthscope Commercial |
$4,864.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,783.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,053.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,593.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,053.53
|
| Rate for Payer: PHP Commercial |
$4,593.99
|
| Rate for Payer: Priority Health SBD |
$3,404.96
|
| Rate for Payer: UMR Bronson Commercial |
$2,378.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,053.53
|
|
|
HC ENDOPLEGE
|
Facility
|
OP
|
$5,404.70
|
|
| Hospital Charge Code |
27000098
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,999.74 |
| Max. Negotiated Rate |
$4,864.23 |
| Rate for Payer: Aetna American Axle |
$3,513.05
|
| Rate for Payer: Aetna Commercial |
$4,593.99
|
| Rate for Payer: Aetna Medicare |
$2,702.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,513.05
|
| Rate for Payer: BCBS Complete |
$2,161.88
|
| Rate for Payer: Cash Price |
$4,323.76
|
| Rate for Payer: Cofinity Advantage |
$3,783.29
|
| Rate for Payer: Cofinity Commercial |
$4,648.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,323.76
|
| Rate for Payer: Healthscope Commercial |
$4,864.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,783.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,053.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,323.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,593.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,053.53
|
| Rate for Payer: PHP Commercial |
$4,593.99
|
| Rate for Payer: Priority Health SBD |
$3,404.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,513.05
|
| Rate for Payer: UHC Core |
$2,815.85
|
| Rate for Payer: UHC Exchange |
$2,124.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,999.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,053.53
|
|
|
HC ENDOSC INJ IMPLT MATRL URT &/BLDR NECK
|
Facility
|
OP
|
$9,663.48
|
|
|
Service Code
|
CPT 51715
|
| Hospital Charge Code |
76100356
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,836.94 |
| Max. Negotiated Rate |
$11,358.48 |
| Rate for Payer: Aetna American Axle |
$6,281.26
|
| Rate for Payer: Aetna Commercial |
$8,213.96
|
| Rate for Payer: Aetna Medicare |
$3,652.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,281.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$3,772.36
|
| Rate for Payer: BCN Commercial |
$3,772.36
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Cash Price |
$7,730.78
|
| Rate for Payer: Cash Price |
$7,730.78
|
| Rate for Payer: Cash Price |
$7,730.78
|
| Rate for Payer: Cofinity Advantage |
$6,764.44
|
| Rate for Payer: Cofinity Commercial |
$8,310.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,730.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Healthscope Commercial |
$8,697.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,764.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,247.61
|
| Rate for Payer: Mclaren Medicaid |
$3,512.31
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$3,687.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,213.96
|
| Rate for Payer: Nomi Health Commercial |
$10,536.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,247.61
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Commercial |
$8,213.96
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,358.48
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health SBD |
$6,087.99
|
| Rate for Payer: Priority Health Tiered Network |
$9,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,281.26
|
| Rate for Payer: UHC Core |
$5,034.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Exchange |
$3,797.75
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: UMR Bronson Commercial |
$3,575.49
|
| Rate for Payer: VA VA |
$3,512.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,247.61
|
|
|
HC ENDOSC INJ IMPLT MATRL URT &/BLDR NECK
|
Facility
|
IP
|
$9,663.48
|
|
|
Service Code
|
CPT 51715
|
| Hospital Charge Code |
76100356
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,251.93 |
| Max. Negotiated Rate |
$8,697.13 |
| Rate for Payer: Aetna American Axle |
$6,281.26
|
| Rate for Payer: Aetna Commercial |
$8,213.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,281.26
|
| Rate for Payer: Cash Price |
$7,730.78
|
| Rate for Payer: Cofinity Advantage |
$6,764.44
|
| Rate for Payer: Cofinity Commercial |
$8,310.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,730.78
|
| Rate for Payer: Healthscope Commercial |
$8,697.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,764.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,247.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,213.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,247.61
|
| Rate for Payer: PHP Commercial |
$8,213.96
|
| Rate for Payer: Priority Health SBD |
$6,087.99
|
| Rate for Payer: UMR Bronson Commercial |
$4,251.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,247.61
|
|
|
HC ENDOSCOPE SINGLE USE URINARY TRACT
|
Facility
|
OP
|
$504.90
|
|
|
Service Code
|
HCPCS C1747
|
| Hospital Charge Code |
27200351
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$454.41 |
| Rate for Payer: Aetna American Axle |
$328.19
|
| Rate for Payer: Aetna Commercial |
$429.17
|
| Rate for Payer: Aetna Medicare |
$252.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$328.19
|
| Rate for Payer: BCBS Complete |
$201.96
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$403.92
|
| Rate for Payer: Cash Price |
$403.92
|
| Rate for Payer: Cofinity Advantage |
$353.43
|
| Rate for Payer: Cofinity Commercial |
$434.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$403.92
|
| Rate for Payer: Healthscope Commercial |
$454.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$353.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$378.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$403.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.68
|
| Rate for Payer: PHP Commercial |
$429.17
|
| Rate for Payer: Priority Health SBD |
$318.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.19
|
| Rate for Payer: UHC Core |
$263.05
|
| Rate for Payer: UHC Exchange |
$198.43
|
| Rate for Payer: UMR Bronson Commercial |
$186.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$378.68
|
|
|
HC ENDOSCOPE SINGLE USE URINARY TRACT
|
Facility
|
IP
|
$504.90
|
|
|
Service Code
|
HCPCS C1747
|
| Hospital Charge Code |
27200351
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$222.16 |
| Max. Negotiated Rate |
$454.41 |
| Rate for Payer: Aetna American Axle |
$328.19
|
| Rate for Payer: Aetna Commercial |
$429.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$328.19
|
| Rate for Payer: Cash Price |
$403.92
|
| Rate for Payer: Cofinity Advantage |
$353.43
|
| Rate for Payer: Cofinity Commercial |
$434.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$403.92
|
| Rate for Payer: Healthscope Commercial |
$454.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$353.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$378.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$429.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$378.68
|
| Rate for Payer: PHP Commercial |
$429.17
|
| Rate for Payer: Priority Health SBD |
$318.09
|
| Rate for Payer: UMR Bronson Commercial |
$222.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$378.68
|
|
|
HC ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS
|
Facility
|
IP
|
$303.82
|
|
|
Service Code
|
CPT 74329
|
| Hospital Charge Code |
32000342
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$133.68 |
| Max. Negotiated Rate |
$273.44 |
| Rate for Payer: Aetna American Axle |
$197.48
|
| Rate for Payer: Aetna Commercial |
$258.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.48
|
| Rate for Payer: Cash Price |
$243.06
|
| Rate for Payer: Cofinity Advantage |
$212.67
|
| Rate for Payer: Cofinity Commercial |
$261.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.06
|
| Rate for Payer: Healthscope Commercial |
$273.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$212.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$227.87
|
| Rate for Payer: PHP Commercial |
$258.25
|
| Rate for Payer: Priority Health SBD |
$191.41
|
| Rate for Payer: UMR Bronson Commercial |
$133.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.87
|
|
|
HC ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS
|
Facility
|
OP
|
$303.82
|
|
|
Service Code
|
CPT 74329
|
| Hospital Charge Code |
32000342
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$112.41 |
| Max. Negotiated Rate |
$273.44 |
| Rate for Payer: Aetna American Axle |
$197.48
|
| Rate for Payer: Aetna Commercial |
$258.25
|
| Rate for Payer: Aetna Medicare |
$151.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.48
|
| Rate for Payer: BCBS Complete |
$121.53
|
| Rate for Payer: BCBS Trust/PPO |
$196.19
|
| Rate for Payer: BCN Commercial |
$196.19
|
| Rate for Payer: Cash Price |
$243.06
|
| Rate for Payer: Cash Price |
$243.06
|
| Rate for Payer: Cofinity Advantage |
$212.67
|
| Rate for Payer: Cofinity Commercial |
$261.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.06
|
| Rate for Payer: Healthscope Commercial |
$273.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$212.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$243.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$227.87
|
| Rate for Payer: PHP Commercial |
$258.25
|
| Rate for Payer: Priority Health SBD |
$191.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.48
|
| Rate for Payer: UHC Core |
$158.29
|
| Rate for Payer: UHC Exchange |
$119.40
|
| Rate for Payer: UMR Bronson Commercial |
$112.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.87
|
|
|
HC ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
OP
|
$2,826.77
|
|
| Hospital Charge Code |
36000118
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,045.90 |
| Max. Negotiated Rate |
$2,544.09 |
| Rate for Payer: Aetna American Axle |
$1,837.40
|
| Rate for Payer: Aetna Commercial |
$2,402.75
|
| Rate for Payer: Aetna Medicare |
$1,413.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,837.40
|
| Rate for Payer: BCBS Complete |
$1,130.71
|
| Rate for Payer: Cash Price |
$2,261.42
|
| Rate for Payer: Cofinity Advantage |
$1,978.74
|
| Rate for Payer: Cofinity Commercial |
$2,431.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,261.42
|
| Rate for Payer: Healthscope Commercial |
$2,544.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,978.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,120.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,261.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,402.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,120.08
|
| Rate for Payer: PHP Commercial |
$2,402.75
|
| Rate for Payer: Priority Health SBD |
$1,780.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,045.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,120.08
|
|
