|
HC NEEDLE LOC WIRE
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
HCPCS C1819
|
| Hospital Charge Code |
27200323
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.41
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: UMR Bronson Commercial |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC NEG PRES CANIST 1000CC
|
Facility
|
OP
|
$228.62
|
|
| Hospital Charge Code |
27200232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.59 |
| Max. Negotiated Rate |
$205.76 |
| Rate for Payer: Aetna American Axle |
$148.60
|
| Rate for Payer: Aetna Commercial |
$194.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.60
|
| Rate for Payer: BCBS Complete |
$91.45
|
| Rate for Payer: Cash Price |
$182.90
|
| Rate for Payer: Cofinity Commercial |
$160.03
|
| Rate for Payer: Cofinity Commercial |
$196.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.90
|
| Rate for Payer: Healthscope Commercial |
$205.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$194.33
|
| Rate for Payer: PHP Commercial |
$194.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.03
|
| Rate for Payer: Priority Health SBD |
$144.03
|
| Rate for Payer: UMR Bronson Commercial |
$84.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.46
|
|
|
HC NEG PRES CANIST 1000CC
|
Facility
|
IP
|
$228.62
|
|
| Hospital Charge Code |
27200232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.59 |
| Max. Negotiated Rate |
$205.76 |
| Rate for Payer: Aetna American Axle |
$148.60
|
| Rate for Payer: Aetna Commercial |
$194.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.60
|
| Rate for Payer: Cash Price |
$182.90
|
| Rate for Payer: Cofinity Commercial |
$160.03
|
| Rate for Payer: Cofinity Commercial |
$196.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.90
|
| Rate for Payer: Healthscope Commercial |
$205.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$194.33
|
| Rate for Payer: PHP Commercial |
$194.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.03
|
| Rate for Payer: Priority Health SBD |
$144.03
|
| Rate for Payer: UMR Bronson Commercial |
$100.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.46
|
|
|
HC NEG PRES CANIST 500CC
|
Facility
|
OP
|
$148.49
|
|
| Hospital Charge Code |
27200136
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.94 |
| Max. Negotiated Rate |
$133.64 |
| Rate for Payer: Aetna American Axle |
$96.52
|
| Rate for Payer: Aetna Commercial |
$126.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.52
|
| Rate for Payer: BCBS Complete |
$59.40
|
| Rate for Payer: Cash Price |
$118.79
|
| Rate for Payer: Cofinity Commercial |
$103.94
|
| Rate for Payer: Cofinity Commercial |
$127.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.79
|
| Rate for Payer: Healthscope Commercial |
$133.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$126.22
|
| Rate for Payer: PHP Commercial |
$126.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.94
|
| Rate for Payer: Priority Health SBD |
$93.55
|
| Rate for Payer: UMR Bronson Commercial |
$54.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.37
|
|
|
HC NEG PRES CANIST 500CC
|
Facility
|
IP
|
$148.49
|
|
| Hospital Charge Code |
27200136
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$65.34 |
| Max. Negotiated Rate |
$133.64 |
| Rate for Payer: Aetna American Axle |
$96.52
|
| Rate for Payer: Aetna Commercial |
$126.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.52
|
| Rate for Payer: Cash Price |
$118.79
|
| Rate for Payer: Cofinity Commercial |
$103.94
|
| Rate for Payer: Cofinity Commercial |
$127.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.79
|
| Rate for Payer: Healthscope Commercial |
$133.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$126.22
|
| Rate for Payer: PHP Commercial |
$126.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.94
|
| Rate for Payer: Priority Health SBD |
$93.55
|
| Rate for Payer: UMR Bronson Commercial |
$65.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.37
|
|
|
HC NEG PRES CLEANSE DRSG MED
|
Facility
|
IP
|
$500.88
|
|
| Hospital Charge Code |
27200229
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$220.39 |
| Max. Negotiated Rate |
$450.79 |
| Rate for Payer: Aetna American Axle |
$325.57
|
| Rate for Payer: Aetna Commercial |
$425.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.57
|
| Rate for Payer: Cash Price |
$400.70
|
| Rate for Payer: Cofinity Commercial |
$350.62
|
| Rate for Payer: Cofinity Commercial |
$430.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.70
|
| Rate for Payer: Healthscope Commercial |
$450.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.75
|
| Rate for Payer: PHP Commercial |
$425.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.62
|
| Rate for Payer: Priority Health SBD |
$315.55
|
| Rate for Payer: UMR Bronson Commercial |
$220.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.66
|
|
|
HC NEG PRES CLEANSE DRSG MED
|
Facility
|
OP
|
$500.88
|
|
| Hospital Charge Code |
27200229
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$185.33 |
| Max. Negotiated Rate |
$450.79 |
| Rate for Payer: Aetna American Axle |
$325.57
|
| Rate for Payer: Aetna Commercial |
$425.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.57
|
| Rate for Payer: BCBS Complete |
$200.35
|
| Rate for Payer: Cash Price |
$400.70
|
| Rate for Payer: Cofinity Commercial |
$350.62
|
| Rate for Payer: Cofinity Commercial |
$430.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.70
|
| Rate for Payer: Healthscope Commercial |
$450.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.75
|
| Rate for Payer: PHP Commercial |
$425.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.62
|
| Rate for Payer: Priority Health SBD |
$315.55
|
| Rate for Payer: UMR Bronson Commercial |
$185.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.66
|
|
|
HC NEG PRESSURE WND TX DME GT 50 SQ CM
|
Facility
|
OP
|
$530.23
|
|
|
Service Code
|
CPT 97606
|
| Hospital Charge Code |
76100009
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$22.10 |
| Max. Negotiated Rate |
$477.21 |
| Rate for Payer: Aetna American Axle |
$344.65
|
| Rate for Payer: Aetna Commercial |
$450.70
|
| Rate for Payer: Aetna Medicare |
$368.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$424.18
|
| Rate for Payer: Cash Price |
$424.18
|
| Rate for Payer: Cofinity Commercial |
$456.00
|
| Rate for Payer: Cofinity Commercial |
$371.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$477.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$371.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.67
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$450.70
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$450.70
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.63
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$22.10
|
| Rate for Payer: Priority Health SBD |
$334.04
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.43
|
| Rate for Payer: UHC Exchange |
$25.87
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: UMR Bronson Commercial |
$196.19
|
| Rate for Payer: VA VA |
$354.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.67
|
|
|
HC NEG PRESSURE WND TX DME GT 50 SQ CM
|
Facility
|
IP
|
$530.23
|
|
|
Service Code
|
CPT 97606
|
| Hospital Charge Code |
76100009
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$233.30 |
| Max. Negotiated Rate |
$477.21 |
| Rate for Payer: Aetna American Axle |
$344.65
|
| Rate for Payer: Aetna Commercial |
$450.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.65
|
| Rate for Payer: Cash Price |
$424.18
|
| Rate for Payer: Cofinity Commercial |
$371.16
|
| Rate for Payer: Cofinity Commercial |
$456.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.18
|
| Rate for Payer: Healthscope Commercial |
$477.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$371.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$450.70
|
| Rate for Payer: PHP Commercial |
$450.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.16
|
| Rate for Payer: Priority Health SBD |
$334.04
|
| Rate for Payer: UMR Bronson Commercial |
$233.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.67
|
|
|
HC NEG PRESSURE WND TX DME UP TO 50 SQ CM
|
Facility
|
OP
|
$419.92
|
|
|
Service Code
|
CPT 97605
|
| Hospital Charge Code |
76100008
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$20.38 |
| Max. Negotiated Rate |
$377.93 |
| Rate for Payer: Aetna American Axle |
$272.95
|
| Rate for Payer: Aetna Commercial |
$356.93
|
| Rate for Payer: Aetna Medicare |
$185.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$81.42
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$335.94
|
| Rate for Payer: Cash Price |
$335.94
|
| Rate for Payer: Cofinity Commercial |
$293.94
|
| Rate for Payer: Cofinity Commercial |
$361.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$377.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$293.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.94
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$356.93
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$356.93
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.48
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$20.38
|
| Rate for Payer: Priority Health SBD |
$264.55
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.95
|
| Rate for Payer: UHC Exchange |
$23.58
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: UMR Bronson Commercial |
$155.37
|
| Rate for Payer: VA VA |
$177.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.94
|
|
|
HC NEG PRESSURE WND TX DME UP TO 50 SQ CM
|
Facility
|
IP
|
$419.92
|
|
|
Service Code
|
CPT 97605
|
| Hospital Charge Code |
76100008
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$184.76 |
| Max. Negotiated Rate |
$377.93 |
| Rate for Payer: Aetna American Axle |
$272.95
|
| Rate for Payer: Aetna Commercial |
$356.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.95
|
| Rate for Payer: Cash Price |
$335.94
|
| Rate for Payer: Cofinity Commercial |
$293.94
|
| Rate for Payer: Cofinity Commercial |
$361.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$335.94
|
| Rate for Payer: Healthscope Commercial |
$377.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$293.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$314.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$356.93
|
| Rate for Payer: PHP Commercial |
$356.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$293.94
|
| Rate for Payer: Priority Health SBD |
$264.55
|
| Rate for Payer: UMR Bronson Commercial |
$184.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$314.94
|
|
|
HC NEG PRES TRAC PAD
|
Facility
|
IP
|
$72.36
|
|
| Hospital Charge Code |
27000158
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.84 |
| Max. Negotiated Rate |
$65.12 |
| Rate for Payer: Aetna American Axle |
$47.03
|
| Rate for Payer: Aetna Commercial |
$61.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.03
|
| Rate for Payer: Cash Price |
$57.89
|
| Rate for Payer: Cofinity Commercial |
$50.65
|
| Rate for Payer: Cofinity Commercial |
$62.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.89
|
| Rate for Payer: Healthscope Commercial |
$65.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.51
|
| Rate for Payer: PHP Commercial |
$61.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.65
|
| Rate for Payer: Priority Health SBD |
$45.59
|
| Rate for Payer: UMR Bronson Commercial |
$31.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.27
|
|
|
HC NEG PRES TRAC PAD
|
Facility
|
OP
|
$72.36
|
|
| Hospital Charge Code |
27000158
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.77 |
| Max. Negotiated Rate |
$65.12 |
| Rate for Payer: Aetna American Axle |
$47.03
|
| Rate for Payer: Aetna Commercial |
$61.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.03
|
| Rate for Payer: BCBS Complete |
$28.94
|
| Rate for Payer: Cash Price |
$57.89
|
| Rate for Payer: Cofinity Commercial |
$50.65
|
| Rate for Payer: Cofinity Commercial |
$62.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.89
|
| Rate for Payer: Healthscope Commercial |
$65.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.51
|
| Rate for Payer: PHP Commercial |
$61.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.65
|
| Rate for Payer: Priority Health SBD |
$45.59
|
| Rate for Payer: UMR Bronson Commercial |
$26.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.27
|
|
|
HC NEG PRES VF CASSETTE
|
Facility
|
IP
|
$208.70
|
|
| Hospital Charge Code |
27200230
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$91.83 |
| Max. Negotiated Rate |
$187.83 |
| Rate for Payer: Aetna American Axle |
$135.66
|
| Rate for Payer: Aetna Commercial |
$177.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.66
|
| Rate for Payer: Cash Price |
$166.96
|
| Rate for Payer: Cofinity Commercial |
$146.09
|
| Rate for Payer: Cofinity Commercial |
$179.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.96
|
| Rate for Payer: Healthscope Commercial |
$187.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$146.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.40
|
| Rate for Payer: PHP Commercial |
$177.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.09
|
| Rate for Payer: Priority Health SBD |
$131.48
|
| Rate for Payer: UMR Bronson Commercial |
$91.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.52
|
|
|
HC NEG PRES VF CASSETTE
|
Facility
|
OP
|
$208.70
|
|
| Hospital Charge Code |
27200230
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$77.22 |
| Max. Negotiated Rate |
$187.83 |
| Rate for Payer: Aetna American Axle |
$135.66
|
| Rate for Payer: Aetna Commercial |
$177.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.66
|
| Rate for Payer: BCBS Complete |
$83.48
|
| Rate for Payer: Cash Price |
$166.96
|
| Rate for Payer: Cofinity Commercial |
$146.09
|
| Rate for Payer: Cofinity Commercial |
$179.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.96
|
| Rate for Payer: Healthscope Commercial |
$187.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$146.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.40
|
| Rate for Payer: PHP Commercial |
$177.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.09
|
| Rate for Payer: Priority Health SBD |
$131.48
|
| Rate for Payer: UMR Bronson Commercial |
$77.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.52
|
|
|
HC NEG PRES VF DRSG MED
|
Facility
|
OP
|
$436.37
|
|
| Hospital Charge Code |
27200228
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.46 |
| Max. Negotiated Rate |
$392.73 |
| Rate for Payer: Aetna American Axle |
$283.64
|
| Rate for Payer: Aetna Commercial |
$370.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.64
|
| Rate for Payer: BCBS Complete |
$174.55
|
| Rate for Payer: Cash Price |
$349.10
|
| Rate for Payer: Cofinity Commercial |
$305.46
|
| Rate for Payer: Cofinity Commercial |
$375.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.10
|
| Rate for Payer: Healthscope Commercial |
$392.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$305.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$370.91
|
| Rate for Payer: PHP Commercial |
$370.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.46
|
| Rate for Payer: Priority Health SBD |
$274.91
|
| Rate for Payer: UMR Bronson Commercial |
$161.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.28
|
|
|
HC NEG PRES VF DRSG MED
|
Facility
|
IP
|
$436.37
|
|
| Hospital Charge Code |
27200228
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$192.00 |
| Max. Negotiated Rate |
$392.73 |
| Rate for Payer: Aetna American Axle |
$283.64
|
| Rate for Payer: Aetna Commercial |
$370.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.64
|
| Rate for Payer: Cash Price |
$349.10
|
| Rate for Payer: Cofinity Commercial |
$305.46
|
| Rate for Payer: Cofinity Commercial |
$375.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.10
|
| Rate for Payer: Healthscope Commercial |
$392.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$305.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$370.91
|
| Rate for Payer: PHP Commercial |
$370.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$305.46
|
| Rate for Payer: Priority Health SBD |
$274.91
|
| Rate for Payer: UMR Bronson Commercial |
$192.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.28
|
|
|
HC NEG PRES VF DRSG SMA
|
Facility
|
IP
|
$371.86
|
|
| Hospital Charge Code |
27200227
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$163.62 |
| Max. Negotiated Rate |
$334.67 |
| Rate for Payer: Aetna American Axle |
$241.71
|
| Rate for Payer: Aetna Commercial |
$316.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.71
|
| Rate for Payer: Cash Price |
$297.49
|
| Rate for Payer: Cofinity Commercial |
$260.30
|
| Rate for Payer: Cofinity Commercial |
$319.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.49
|
| Rate for Payer: Healthscope Commercial |
$334.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$278.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$316.08
|
| Rate for Payer: PHP Commercial |
$316.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.30
|
| Rate for Payer: Priority Health SBD |
$234.27
|
| Rate for Payer: UMR Bronson Commercial |
$163.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$278.90
|
|
|
HC NEG PRES VF DRSG SMA
|
Facility
|
OP
|
$371.86
|
|
| Hospital Charge Code |
27200227
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$137.59 |
| Max. Negotiated Rate |
$334.67 |
| Rate for Payer: Aetna American Axle |
$241.71
|
| Rate for Payer: Aetna Commercial |
$316.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.71
|
| Rate for Payer: BCBS Complete |
$148.74
|
| Rate for Payer: Cash Price |
$297.49
|
| Rate for Payer: Cofinity Commercial |
$260.30
|
| Rate for Payer: Cofinity Commercial |
$319.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.49
|
| Rate for Payer: Healthscope Commercial |
$334.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$278.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$316.08
|
| Rate for Payer: PHP Commercial |
$316.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.30
|
| Rate for Payer: Priority Health SBD |
$234.27
|
| Rate for Payer: UMR Bronson Commercial |
$137.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$278.90
|
|
|
HC NEG PRES VF DUO TRAC PAD
|
Facility
|
OP
|
$284.59
|
|
| Hospital Charge Code |
27200231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.30 |
| Max. Negotiated Rate |
$256.13 |
| Rate for Payer: Aetna American Axle |
$184.98
|
| Rate for Payer: Aetna Commercial |
$241.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.98
|
| Rate for Payer: BCBS Complete |
$113.84
|
| Rate for Payer: Cash Price |
$227.67
|
| Rate for Payer: Cofinity Commercial |
$199.21
|
| Rate for Payer: Cofinity Commercial |
$244.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.67
|
| Rate for Payer: Healthscope Commercial |
$256.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$241.90
|
| Rate for Payer: PHP Commercial |
$241.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.21
|
| Rate for Payer: Priority Health SBD |
$179.29
|
| Rate for Payer: UMR Bronson Commercial |
$105.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.44
|
|
|
HC NEG PRES VF DUO TRAC PAD
|
Facility
|
IP
|
$284.59
|
|
| Hospital Charge Code |
27200231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$125.22 |
| Max. Negotiated Rate |
$256.13 |
| Rate for Payer: Aetna American Axle |
$184.98
|
| Rate for Payer: Aetna Commercial |
$241.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.98
|
| Rate for Payer: Cash Price |
$227.67
|
| Rate for Payer: Cofinity Commercial |
$199.21
|
| Rate for Payer: Cofinity Commercial |
$244.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.67
|
| Rate for Payer: Healthscope Commercial |
$256.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$241.90
|
| Rate for Payer: PHP Commercial |
$241.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.21
|
| Rate for Payer: Priority Health SBD |
$179.29
|
| Rate for Payer: UMR Bronson Commercial |
$125.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.44
|
|
|
HC NEG PRES WHT FOAM DRSG
|
Facility
|
IP
|
$176.57
|
|
| Hospital Charge Code |
27200158
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$77.69 |
| Max. Negotiated Rate |
$158.91 |
| Rate for Payer: Aetna American Axle |
$114.77
|
| Rate for Payer: Aetna Commercial |
$150.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.77
|
| Rate for Payer: Cash Price |
$141.26
|
| Rate for Payer: Cofinity Commercial |
$123.60
|
| Rate for Payer: Cofinity Commercial |
$151.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.26
|
| Rate for Payer: Healthscope Commercial |
$158.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$123.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$150.08
|
| Rate for Payer: PHP Commercial |
$150.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.60
|
| Rate for Payer: Priority Health SBD |
$111.24
|
| Rate for Payer: UMR Bronson Commercial |
$77.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.43
|
|
|
HC NEG PRES WHT FOAM DRSG
|
Facility
|
OP
|
$176.57
|
|
| Hospital Charge Code |
27200158
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$65.33 |
| Max. Negotiated Rate |
$158.91 |
| Rate for Payer: Aetna American Axle |
$114.77
|
| Rate for Payer: Aetna Commercial |
$150.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.77
|
| Rate for Payer: BCBS Complete |
$70.63
|
| Rate for Payer: Cash Price |
$141.26
|
| Rate for Payer: Cofinity Commercial |
$123.60
|
| Rate for Payer: Cofinity Commercial |
$151.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.26
|
| Rate for Payer: Healthscope Commercial |
$158.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$123.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$150.08
|
| Rate for Payer: PHP Commercial |
$150.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.60
|
| Rate for Payer: Priority Health SBD |
$111.24
|
| Rate for Payer: UMR Bronson Commercial |
$65.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.43
|
|
|
HC NEG PRES WND THRPY DSG EXLGE
|
Facility
|
IP
|
$373.77
|
|
| Hospital Charge Code |
27200137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$164.46 |
| Max. Negotiated Rate |
$336.39 |
| Rate for Payer: Aetna American Axle |
$242.95
|
| Rate for Payer: Aetna Commercial |
$317.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.95
|
| Rate for Payer: Cash Price |
$299.02
|
| Rate for Payer: Cofinity Commercial |
$261.64
|
| Rate for Payer: Cofinity Commercial |
$321.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.02
|
| Rate for Payer: Healthscope Commercial |
$336.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$261.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$280.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$317.70
|
| Rate for Payer: PHP Commercial |
$317.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.64
|
| Rate for Payer: Priority Health SBD |
$235.48
|
| Rate for Payer: UMR Bronson Commercial |
$164.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$280.33
|
|
|
HC NEG PRES WND THRPY DSG EXLGE
|
Facility
|
OP
|
$373.77
|
|
| Hospital Charge Code |
27200137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$138.29 |
| Max. Negotiated Rate |
$336.39 |
| Rate for Payer: Aetna American Axle |
$242.95
|
| Rate for Payer: Aetna Commercial |
$317.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.95
|
| Rate for Payer: BCBS Complete |
$149.51
|
| Rate for Payer: Cash Price |
$299.02
|
| Rate for Payer: Cofinity Commercial |
$261.64
|
| Rate for Payer: Cofinity Commercial |
$321.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.02
|
| Rate for Payer: Healthscope Commercial |
$336.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$261.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$280.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$317.70
|
| Rate for Payer: PHP Commercial |
$317.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.64
|
| Rate for Payer: Priority Health SBD |
$235.48
|
| Rate for Payer: UMR Bronson Commercial |
$138.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$280.33
|
|
