|
HC MYOMARKER 3 CMPT
|
Facility
|
OP
|
$26.04
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.63 |
| Max. Negotiated Rate |
$29.58 |
| Rate for Payer: Aetna American Axle |
$16.93
|
| Rate for Payer: Aetna Commercial |
$22.13
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.30
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$20.83
|
| Rate for Payer: Cash Price |
$20.83
|
| Rate for Payer: Cofinity Commercial |
$22.39
|
| Rate for Payer: Cofinity Commercial |
$18.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$23.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.53
|
| Rate for Payer: Mclaren Medicaid |
$9.81
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Medicaid |
$10.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.13
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$22.13
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.91
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$15.93
|
| Rate for Payer: Priority Health SBD |
$16.41
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| Rate for Payer: UHC Core |
$29.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$18.47
|
| Rate for Payer: UMR Bronson Commercial |
$9.63
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.53
|
|
|
HC MYOMARKER 3 PROFILE
|
Facility
|
IP
|
$19.52
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.59 |
| Max. Negotiated Rate |
$17.57 |
| Rate for Payer: Aetna American Axle |
$12.69
|
| Rate for Payer: Aetna Commercial |
$16.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.69
|
| Rate for Payer: Cash Price |
$15.62
|
| Rate for Payer: Cofinity Commercial |
$13.66
|
| Rate for Payer: Cofinity Commercial |
$16.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.62
|
| Rate for Payer: Healthscope Commercial |
$17.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.59
|
| Rate for Payer: PHP Commercial |
$16.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.66
|
| Rate for Payer: Priority Health SBD |
$12.30
|
| Rate for Payer: UMR Bronson Commercial |
$8.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.64
|
|
|
HC MYOMARKER 3 PROFILE
|
Facility
|
OP
|
$19.52
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.31 |
| Max. Negotiated Rate |
$19.03 |
| Rate for Payer: Aetna American Axle |
$12.69
|
| Rate for Payer: Aetna Commercial |
$16.59
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$10.37
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$15.62
|
| Rate for Payer: Cash Price |
$15.62
|
| Rate for Payer: Cofinity Commercial |
$13.66
|
| Rate for Payer: Cofinity Commercial |
$16.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$17.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.64
|
| Rate for Payer: Mclaren Medicaid |
$6.31
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Medicaid |
$6.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.59
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$16.59
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.82
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$12.66
|
| Rate for Payer: Priority Health SBD |
$12.30
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.84
|
| Rate for Payer: UHC Core |
$19.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$11.53
|
| Rate for Payer: UHC Medicare Advantage |
$11.88
|
| Rate for Payer: UMR Bronson Commercial |
$7.22
|
| Rate for Payer: VA VA |
$11.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.64
|
|
|
HC MYRINGOTOMY ASPIR&EUSTACHIAN TUBE NFLTJ
|
Facility
|
OP
|
$616.00
|
|
|
Service Code
|
CPT 69420
|
| Hospital Charge Code |
76100484
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.76 |
| Max. Negotiated Rate |
$683.51 |
| Rate for Payer: Aetna American Axle |
$400.40
|
| Rate for Payer: Aetna Commercial |
$523.60
|
| Rate for Payer: Aetna Medicare |
$225.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.40
|
| Rate for Payer: BCBS Complete |
$124.71
|
| Rate for Payer: BCBS MAPPO |
$217.12
|
| Rate for Payer: BCBS Trust/PPO |
$120.81
|
| Rate for Payer: BCN Medicare Advantage |
$217.12
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$529.76
|
| Rate for Payer: Cofinity Commercial |
$431.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$492.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.12
|
| Rate for Payer: Healthscope Commercial |
$554.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$431.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$462.00
|
| Rate for Payer: Mclaren Medicaid |
$118.76
|
| Rate for Payer: Mclaren Medicare |
$217.12
|
| Rate for Payer: Meridian Medicaid |
$124.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$227.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$523.60
|
| Rate for Payer: PACE Medicare |
$206.26
|
| Rate for Payer: PACE SWMI |
$217.12
|
| Rate for Payer: PHP Commercial |
$523.60
|
| Rate for Payer: PHP Medicare Advantage |
$217.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$683.51
|
| Rate for Payer: Priority Health Medicare |
$217.12
|
| Rate for Payer: Priority Health Narrow Network |
$546.81
|
| Rate for Payer: Priority Health SBD |
$388.08
|
| Rate for Payer: Railroad Medicare Medicare |
$217.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.12
|
| Rate for Payer: UHC Exchange |
$119.84
|
| Rate for Payer: UHC Medicare Advantage |
$223.63
|
| Rate for Payer: UMR Bronson Commercial |
$227.92
|
| Rate for Payer: VA VA |
$217.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$462.00
|
|
|
HC MYRINGOTOMY ASPIR&EUSTACHIAN TUBE NFLTJ
|
Facility
|
IP
|
$616.00
|
|
|
Service Code
|
CPT 69420
|
| Hospital Charge Code |
76100484
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$271.04 |
| Max. Negotiated Rate |
$554.40 |
| Rate for Payer: Aetna American Axle |
$400.40
|
| Rate for Payer: Aetna Commercial |
$523.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$400.40
|
| Rate for Payer: Cash Price |
$492.80
|
| Rate for Payer: Cofinity Commercial |
$529.76
|
| Rate for Payer: Cofinity Commercial |
$431.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$492.80
|
| Rate for Payer: Healthscope Commercial |
$554.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$431.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$462.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$523.60
|
| Rate for Payer: PHP Commercial |
$523.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$431.20
|
| Rate for Payer: Priority Health SBD |
$388.08
|
| Rate for Payer: UMR Bronson Commercial |
$271.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$462.00
|
|
|
HC NAIL BED REPAIR
|
Facility
|
OP
|
$742.77
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
45000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$107.73 |
| Max. Negotiated Rate |
$1,757.43 |
| Rate for Payer: Aetna American Axle |
$482.80
|
| Rate for Payer: Aetna Commercial |
$631.35
|
| Rate for Payer: Aetna Medicare |
$580.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$482.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$697.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$697.82
|
| Rate for Payer: BCBS Complete |
$320.66
|
| Rate for Payer: BCBS MAPPO |
$558.26
|
| Rate for Payer: BCBS Trust/PPO |
$375.01
|
| Rate for Payer: BCN Medicare Advantage |
$558.26
|
| Rate for Payer: Cash Price |
$594.22
|
| Rate for Payer: Cash Price |
$594.22
|
| Rate for Payer: Cofinity Commercial |
$519.94
|
| Rate for Payer: Cofinity Commercial |
$638.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$594.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.26
|
| Rate for Payer: Healthscope Commercial |
$668.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$519.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$557.08
|
| Rate for Payer: Mclaren Medicaid |
$305.37
|
| Rate for Payer: Mclaren Medicare |
$558.26
|
| Rate for Payer: Meridian Medicaid |
$320.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$631.35
|
| Rate for Payer: PACE Medicare |
$530.35
|
| Rate for Payer: PACE SWMI |
$558.26
|
| Rate for Payer: PHP Commercial |
$631.35
|
| Rate for Payer: PHP Medicare Advantage |
$558.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$519.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,757.43
|
| Rate for Payer: Priority Health Medicare |
$558.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,405.94
|
| Rate for Payer: Priority Health SBD |
$467.95
|
| Rate for Payer: Railroad Medicare Medicare |
$558.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$558.26
|
| Rate for Payer: UHC Exchange |
$107.73
|
| Rate for Payer: UHC Medicare Advantage |
$575.01
|
| Rate for Payer: UMR Bronson Commercial |
$274.82
|
| Rate for Payer: VA VA |
$558.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$557.08
|
|
|
HC NAIL BED REPAIR
|
Facility
|
IP
|
$742.77
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
45000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$326.82 |
| Max. Negotiated Rate |
$668.49 |
| Rate for Payer: Aetna American Axle |
$482.80
|
| Rate for Payer: Aetna Commercial |
$631.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$482.80
|
| Rate for Payer: Cash Price |
$594.22
|
| Rate for Payer: Cofinity Commercial |
$519.94
|
| Rate for Payer: Cofinity Commercial |
$638.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$594.22
|
| Rate for Payer: Healthscope Commercial |
$668.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$519.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$557.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$631.35
|
| Rate for Payer: PHP Commercial |
$631.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$519.94
|
| Rate for Payer: Priority Health SBD |
$467.95
|
| Rate for Payer: UMR Bronson Commercial |
$326.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$557.08
|
|
|
HC NAIL PROCEDURE
|
Facility
|
IP
|
$266.48
|
|
| Hospital Charge Code |
45000047
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$117.25 |
| Max. Negotiated Rate |
$239.83 |
| Rate for Payer: Aetna American Axle |
$173.21
|
| Rate for Payer: Aetna Commercial |
$226.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.21
|
| Rate for Payer: Cash Price |
$213.18
|
| Rate for Payer: Cofinity Commercial |
$186.54
|
| Rate for Payer: Cofinity Commercial |
$229.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.18
|
| Rate for Payer: Healthscope Commercial |
$239.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$186.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$226.51
|
| Rate for Payer: PHP Commercial |
$226.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.54
|
| Rate for Payer: Priority Health SBD |
$167.88
|
| Rate for Payer: UMR Bronson Commercial |
$117.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.86
|
|
|
HC NAIL PROCEDURE
|
Facility
|
OP
|
$266.48
|
|
| Hospital Charge Code |
45000047
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$98.60 |
| Max. Negotiated Rate |
$239.83 |
| Rate for Payer: Aetna American Axle |
$173.21
|
| Rate for Payer: Aetna Commercial |
$226.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.21
|
| Rate for Payer: BCBS Complete |
$106.59
|
| Rate for Payer: Cash Price |
$213.18
|
| Rate for Payer: Cofinity Commercial |
$186.54
|
| Rate for Payer: Cofinity Commercial |
$229.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$213.18
|
| Rate for Payer: Healthscope Commercial |
$239.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$186.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$226.51
|
| Rate for Payer: PHP Commercial |
$226.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.54
|
| Rate for Payer: Priority Health SBD |
$167.88
|
| Rate for Payer: UMR Bronson Commercial |
$98.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.86
|
|
|
HC NA PHOSPHATE PER MCI
|
Facility
|
OP
|
$321.66
|
|
|
Service Code
|
HCPCS A9563
|
| Hospital Charge Code |
34400004
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$44.29 |
| Max. Negotiated Rate |
$289.49 |
| Rate for Payer: Aetna American Axle |
$209.08
|
| Rate for Payer: Aetna Commercial |
$273.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.08
|
| Rate for Payer: BCBS Complete |
$128.66
|
| Rate for Payer: BCBS Trust/PPO |
$44.29
|
| Rate for Payer: Cash Price |
$257.33
|
| Rate for Payer: Cash Price |
$257.33
|
| Rate for Payer: Cofinity Commercial |
$225.16
|
| Rate for Payer: Cofinity Commercial |
$276.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.33
|
| Rate for Payer: Healthscope Commercial |
$289.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$225.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$273.41
|
| Rate for Payer: PHP Commercial |
$273.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.16
|
| Rate for Payer: Priority Health SBD |
$202.65
|
| Rate for Payer: UMR Bronson Commercial |
$119.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.24
|
|
|
HC NA PHOSPHATE PER MCI
|
Facility
|
IP
|
$321.66
|
|
|
Service Code
|
HCPCS A9563
|
| Hospital Charge Code |
34400004
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$141.53 |
| Max. Negotiated Rate |
$289.49 |
| Rate for Payer: Aetna American Axle |
$209.08
|
| Rate for Payer: Aetna Commercial |
$273.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.08
|
| Rate for Payer: Cash Price |
$257.33
|
| Rate for Payer: Cofinity Commercial |
$225.16
|
| Rate for Payer: Cofinity Commercial |
$276.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.33
|
| Rate for Payer: Healthscope Commercial |
$289.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$225.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$273.41
|
| Rate for Payer: PHP Commercial |
$273.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.16
|
| Rate for Payer: Priority Health SBD |
$202.65
|
| Rate for Payer: UMR Bronson Commercial |
$141.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.24
|
|
|
HC NASAL BONES COMP MIN 3 VW
|
Facility
|
IP
|
$194.91
|
|
|
Service Code
|
CPT 70160
|
| Hospital Charge Code |
32000011
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$85.76 |
| Max. Negotiated Rate |
$175.42 |
| Rate for Payer: Aetna American Axle |
$126.69
|
| Rate for Payer: Aetna Commercial |
$165.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.69
|
| Rate for Payer: Cash Price |
$155.93
|
| Rate for Payer: Cofinity Commercial |
$136.44
|
| Rate for Payer: Cofinity Commercial |
$167.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.93
|
| Rate for Payer: Healthscope Commercial |
$175.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$165.67
|
| Rate for Payer: PHP Commercial |
$165.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.44
|
| Rate for Payer: Priority Health SBD |
$122.79
|
| Rate for Payer: UMR Bronson Commercial |
$85.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.18
|
|
|
HC NASAL BONES COMP MIN 3 VW
|
Facility
|
OP
|
$194.91
|
|
|
Service Code
|
CPT 70160
|
| Hospital Charge Code |
32000011
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.00 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$126.69
|
| Rate for Payer: Aetna Commercial |
$165.67
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$57.02
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$155.93
|
| Rate for Payer: Cash Price |
$155.93
|
| Rate for Payer: Cofinity Commercial |
$167.62
|
| Rate for Payer: Cofinity Commercial |
$136.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$175.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.18
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$165.67
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$165.67
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$122.79
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.70
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$37.00
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$72.12
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.18
|
|
|
HC NASAL ENDOSCOPY DX
|
Facility
|
OP
|
$250.88
|
|
|
Service Code
|
CPT 31231
|
| Hospital Charge Code |
76100183
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$63.20 |
| Max. Negotiated Rate |
$554.27 |
| Rate for Payer: Aetna American Axle |
$163.07
|
| Rate for Payer: Aetna Commercial |
$213.25
|
| Rate for Payer: Aetna Medicare |
$183.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.09
|
| Rate for Payer: BCBS Complete |
$101.13
|
| Rate for Payer: BCBS MAPPO |
$176.07
|
| Rate for Payer: BCBS Trust/PPO |
$95.11
|
| Rate for Payer: BCN Medicare Advantage |
$176.07
|
| Rate for Payer: Cash Price |
$200.70
|
| Rate for Payer: Cash Price |
$200.70
|
| Rate for Payer: Cofinity Commercial |
$215.76
|
| Rate for Payer: Cofinity Commercial |
$175.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.07
|
| Rate for Payer: Healthscope Commercial |
$225.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.16
|
| Rate for Payer: Mclaren Medicaid |
$96.31
|
| Rate for Payer: Mclaren Medicare |
$176.07
|
| Rate for Payer: Meridian Medicaid |
$101.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$184.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$213.25
|
| Rate for Payer: PACE Medicare |
$167.27
|
| Rate for Payer: PACE SWMI |
$176.07
|
| Rate for Payer: PHP Commercial |
$213.25
|
| Rate for Payer: PHP Medicare Advantage |
$176.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$554.27
|
| Rate for Payer: Priority Health Medicare |
$176.07
|
| Rate for Payer: Priority Health Narrow Network |
$443.42
|
| Rate for Payer: Priority Health SBD |
$158.05
|
| Rate for Payer: Railroad Medicare Medicare |
$176.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.07
|
| Rate for Payer: UHC Exchange |
$63.20
|
| Rate for Payer: UHC Medicare Advantage |
$181.35
|
| Rate for Payer: UMR Bronson Commercial |
$92.83
|
| Rate for Payer: VA VA |
$176.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.16
|
|
|
HC NASAL ENDOSCOPY DX
|
Facility
|
IP
|
$250.88
|
|
|
Service Code
|
CPT 31231
|
| Hospital Charge Code |
76100183
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$110.39 |
| Max. Negotiated Rate |
$225.79 |
| Rate for Payer: Aetna American Axle |
$163.07
|
| Rate for Payer: Aetna Commercial |
$213.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.07
|
| Rate for Payer: Cash Price |
$200.70
|
| Rate for Payer: Cofinity Commercial |
$175.62
|
| Rate for Payer: Cofinity Commercial |
$215.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.70
|
| Rate for Payer: Healthscope Commercial |
$225.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$213.25
|
| Rate for Payer: PHP Commercial |
$213.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.62
|
| Rate for Payer: Priority Health SBD |
$158.05
|
| Rate for Payer: UMR Bronson Commercial |
$110.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.16
|
|
|
HC NASAL/SINUS ENDSC SURG W/BX POLYPEC/DBRD SPX
|
Facility
|
IP
|
$4,350.00
|
|
|
Service Code
|
CPT 31237
|
| Hospital Charge Code |
76100454
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,914.00 |
| Max. Negotiated Rate |
$3,915.00 |
| Rate for Payer: Aetna American Axle |
$2,827.50
|
| Rate for Payer: Aetna Commercial |
$3,697.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,827.50
|
| Rate for Payer: Cash Price |
$3,480.00
|
| Rate for Payer: Cofinity Commercial |
$3,045.00
|
| Rate for Payer: Cofinity Commercial |
$3,741.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,480.00
|
| Rate for Payer: Healthscope Commercial |
$3,915.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,045.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,262.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,697.50
|
| Rate for Payer: PHP Commercial |
$3,697.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,045.00
|
| Rate for Payer: Priority Health SBD |
$2,740.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,914.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,262.50
|
|
|
HC NASAL/SINUS ENDSC SURG W/BX POLYPEC/DBRD SPX
|
Facility
|
OP
|
$4,350.00
|
|
|
Service Code
|
CPT 31237
|
| Hospital Charge Code |
76100454
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$156.84 |
| Max. Negotiated Rate |
$4,749.35 |
| Rate for Payer: Aetna American Axle |
$2,827.50
|
| Rate for Payer: Aetna Commercial |
$3,697.50
|
| Rate for Payer: Aetna Medicare |
$1,569.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,827.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,885.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,885.82
|
| Rate for Payer: BCBS Complete |
$866.57
|
| Rate for Payer: BCBS MAPPO |
$1,508.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,299.08
|
| Rate for Payer: BCN Medicare Advantage |
$1,508.66
|
| Rate for Payer: Cash Price |
$3,480.00
|
| Rate for Payer: Cash Price |
$3,480.00
|
| Rate for Payer: Cofinity Commercial |
$3,045.00
|
| Rate for Payer: Cofinity Commercial |
$3,741.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,480.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,508.66
|
| Rate for Payer: Healthscope Commercial |
$3,915.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,045.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,262.50
|
| Rate for Payer: Mclaren Medicaid |
$825.24
|
| Rate for Payer: Mclaren Medicare |
$1,508.66
|
| Rate for Payer: Meridian Medicaid |
$866.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,584.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,734.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,697.50
|
| Rate for Payer: PACE Medicare |
$1,433.23
|
| Rate for Payer: PACE SWMI |
$1,508.66
|
| Rate for Payer: PHP Commercial |
$3,697.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,508.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$825.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,045.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,749.35
|
| Rate for Payer: Priority Health Medicare |
$1,508.66
|
| Rate for Payer: Priority Health Narrow Network |
$3,799.48
|
| Rate for Payer: Priority Health SBD |
$2,740.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,508.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,508.66
|
| Rate for Payer: UHC Exchange |
$156.84
|
| Rate for Payer: UHC Medicare Advantage |
$1,553.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,609.50
|
| Rate for Payer: VA VA |
$1,508.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,262.50
|
|
|
HC NASOPHARYNGOSCOPY
|
Facility
|
OP
|
$250.88
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
76100177
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$37.00 |
| Max. Negotiated Rate |
$554.27 |
| Rate for Payer: Aetna American Axle |
$163.07
|
| Rate for Payer: Aetna Commercial |
$213.25
|
| Rate for Payer: Aetna Medicare |
$183.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$220.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$220.09
|
| Rate for Payer: BCBS Complete |
$101.13
|
| Rate for Payer: BCBS MAPPO |
$176.07
|
| Rate for Payer: BCBS Trust/PPO |
$389.10
|
| Rate for Payer: BCN Medicare Advantage |
$176.07
|
| Rate for Payer: Cash Price |
$200.70
|
| Rate for Payer: Cash Price |
$200.70
|
| Rate for Payer: Cofinity Commercial |
$175.62
|
| Rate for Payer: Cofinity Commercial |
$215.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.07
|
| Rate for Payer: Healthscope Commercial |
$225.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.16
|
| Rate for Payer: Mclaren Medicaid |
$96.31
|
| Rate for Payer: Mclaren Medicare |
$176.07
|
| Rate for Payer: Meridian Medicaid |
$101.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$184.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$202.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$213.25
|
| Rate for Payer: PACE Medicare |
$167.27
|
| Rate for Payer: PACE SWMI |
$176.07
|
| Rate for Payer: PHP Commercial |
$213.25
|
| Rate for Payer: PHP Medicare Advantage |
$176.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$554.27
|
| Rate for Payer: Priority Health Medicare |
$176.07
|
| Rate for Payer: Priority Health Narrow Network |
$443.42
|
| Rate for Payer: Priority Health SBD |
$158.05
|
| Rate for Payer: Railroad Medicare Medicare |
$176.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.07
|
| Rate for Payer: UHC Exchange |
$37.00
|
| Rate for Payer: UHC Medicare Advantage |
$181.35
|
| Rate for Payer: UMR Bronson Commercial |
$92.83
|
| Rate for Payer: VA VA |
$176.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.16
|
|
|
HC NASOPHARYNGOSCOPY
|
Facility
|
IP
|
$250.88
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
76100177
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$110.39 |
| Max. Negotiated Rate |
$225.79 |
| Rate for Payer: Aetna American Axle |
$163.07
|
| Rate for Payer: Aetna Commercial |
$213.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.07
|
| Rate for Payer: Cash Price |
$200.70
|
| Rate for Payer: Cofinity Commercial |
$215.76
|
| Rate for Payer: Cofinity Commercial |
$175.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.70
|
| Rate for Payer: Healthscope Commercial |
$225.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$213.25
|
| Rate for Payer: PHP Commercial |
$213.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.62
|
| Rate for Payer: Priority Health SBD |
$158.05
|
| Rate for Payer: UMR Bronson Commercial |
$110.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.16
|
|
|
HC NASOTRACHEAL SUCTION
|
Facility
|
IP
|
$243.69
|
|
|
Service Code
|
CPT 31720
|
| Hospital Charge Code |
41000001
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$107.22 |
| Max. Negotiated Rate |
$219.32 |
| Rate for Payer: Aetna American Axle |
$158.40
|
| Rate for Payer: Aetna Commercial |
$207.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.40
|
| Rate for Payer: Cash Price |
$194.95
|
| Rate for Payer: Cofinity Commercial |
$209.57
|
| Rate for Payer: Cofinity Commercial |
$170.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.95
|
| Rate for Payer: Healthscope Commercial |
$219.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.14
|
| Rate for Payer: PHP Commercial |
$207.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.58
|
| Rate for Payer: Priority Health SBD |
$153.52
|
| Rate for Payer: UMR Bronson Commercial |
$107.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.77
|
|
|
HC NASOTRACHEAL SUCTION
|
Facility
|
OP
|
$243.69
|
|
|
Service Code
|
CPT 31720
|
| Hospital Charge Code |
41000001
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$46.82 |
| Max. Negotiated Rate |
$596.84 |
| Rate for Payer: Aetna American Axle |
$158.40
|
| Rate for Payer: Aetna Commercial |
$207.14
|
| Rate for Payer: Aetna Medicare |
$197.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.99
|
| Rate for Payer: BCBS Complete |
$108.90
|
| Rate for Payer: BCBS MAPPO |
$189.59
|
| Rate for Payer: BCBS Trust/PPO |
$144.34
|
| Rate for Payer: BCN Medicare Advantage |
$189.59
|
| Rate for Payer: Cash Price |
$194.95
|
| Rate for Payer: Cash Price |
$194.95
|
| Rate for Payer: Cash Price |
$194.95
|
| Rate for Payer: Cofinity Commercial |
$170.58
|
| Rate for Payer: Cofinity Commercial |
$209.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.59
|
| Rate for Payer: Healthscope Commercial |
$219.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.77
|
| Rate for Payer: Mclaren Medicaid |
$103.71
|
| Rate for Payer: Mclaren Medicare |
$189.59
|
| Rate for Payer: Meridian Medicaid |
$108.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.14
|
| Rate for Payer: PACE Medicare |
$180.11
|
| Rate for Payer: PACE SWMI |
$189.59
|
| Rate for Payer: PHP Commercial |
$207.14
|
| Rate for Payer: PHP Medicare Advantage |
$189.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$596.84
|
| Rate for Payer: Priority Health Medicare |
$189.59
|
| Rate for Payer: Priority Health Narrow Network |
$477.47
|
| Rate for Payer: Priority Health SBD |
$153.52
|
| Rate for Payer: Railroad Medicare Medicare |
$189.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.50
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.59
|
| Rate for Payer: UHC Exchange |
$46.82
|
| Rate for Payer: UHC Medicare Advantage |
$195.28
|
| Rate for Payer: UMR Bronson Commercial |
$90.17
|
| Rate for Payer: VA VA |
$189.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.77
|
|
|
HC NCCU OBSERVATION PER HOUR
|
Facility
|
OP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200021
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$49.70 |
| Max. Negotiated Rate |
$4,092.00 |
| Rate for Payer: Aetna American Axle |
$87.31
|
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.31
|
| Rate for Payer: BCBS Complete |
$53.73
|
| Rate for Payer: BCBS Trust/PPO |
$118.88
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Cofinity Commercial |
$94.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Meridian Medicaid |
$1,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health SBD |
$84.63
|
| Rate for Payer: UHC Core |
$4,092.00
|
| Rate for Payer: UMR Bronson Commercial |
$49.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC NCCU OBSERVATION PER HOUR
|
Facility
|
IP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200021
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$59.11 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna American Axle |
$87.31
|
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.31
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Cofinity Commercial |
$94.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health SBD |
$84.63
|
| Rate for Payer: UMR Bronson Commercial |
$59.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC NCS 11-12 STUDIES INCL F&H WAVES
|
Facility
|
OP
|
$2,232.45
|
|
|
Service Code
|
CPT 95912
|
| Hospital Charge Code |
92200032
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$242.31 |
| Max. Negotiated Rate |
$2,009.20 |
| Rate for Payer: Aetna American Axle |
$1,451.09
|
| Rate for Payer: Aetna Commercial |
$1,897.58
|
| Rate for Payer: Aetna Medicare |
$495.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,451.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$595.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$595.52
|
| Rate for Payer: BCBS Complete |
$273.66
|
| Rate for Payer: BCBS MAPPO |
$476.42
|
| Rate for Payer: BCBS Trust/PPO |
$465.83
|
| Rate for Payer: BCN Medicare Advantage |
$476.42
|
| Rate for Payer: Cash Price |
$1,785.96
|
| Rate for Payer: Cash Price |
$1,785.96
|
| Rate for Payer: Cash Price |
$1,785.96
|
| Rate for Payer: Cofinity Commercial |
$1,919.91
|
| Rate for Payer: Cofinity Commercial |
$1,562.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,785.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.42
|
| Rate for Payer: Healthscope Commercial |
$2,009.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,562.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,674.34
|
| Rate for Payer: Mclaren Medicaid |
$260.60
|
| Rate for Payer: Mclaren Medicare |
$476.42
|
| Rate for Payer: Meridian Medicaid |
$273.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$500.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,897.58
|
| Rate for Payer: PACE Medicare |
$452.60
|
| Rate for Payer: PACE SWMI |
$476.42
|
| Rate for Payer: PHP Commercial |
$1,897.58
|
| Rate for Payer: PHP Medicare Advantage |
$476.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,562.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,499.80
|
| Rate for Payer: Priority Health Medicare |
$476.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,199.84
|
| Rate for Payer: Priority Health SBD |
$1,406.44
|
| Rate for Payer: Railroad Medicare Medicare |
$476.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.54
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$476.42
|
| Rate for Payer: UHC Exchange |
$242.31
|
| Rate for Payer: UHC Medicare Advantage |
$490.71
|
| Rate for Payer: UMR Bronson Commercial |
$826.01
|
| Rate for Payer: VA VA |
$476.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,674.34
|
|
|
HC NCS 11-12 STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$2,232.45
|
|
|
Service Code
|
CPT 95912
|
| Hospital Charge Code |
92200032
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$982.28 |
| Max. Negotiated Rate |
$2,009.20 |
| Rate for Payer: Aetna American Axle |
$1,451.09
|
| Rate for Payer: Aetna Commercial |
$1,897.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,451.09
|
| Rate for Payer: Cash Price |
$1,785.96
|
| Rate for Payer: Cofinity Commercial |
$1,562.72
|
| Rate for Payer: Cofinity Commercial |
$1,919.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,785.96
|
| Rate for Payer: Healthscope Commercial |
$2,009.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,562.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,674.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,897.58
|
| Rate for Payer: PHP Commercial |
$1,897.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,562.72
|
| Rate for Payer: Priority Health SBD |
$1,406.44
|
| Rate for Payer: UMR Bronson Commercial |
$982.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,674.34
|
|
