|
HC DAVITA OP HEMODIALYSIS
|
Facility
|
IP
|
$855.04
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100002
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$376.22 |
| Max. Negotiated Rate |
$769.54 |
| Rate for Payer: Aetna American Axle |
$555.78
|
| Rate for Payer: Aetna Commercial |
$726.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$555.78
|
| Rate for Payer: Cash Price |
$684.03
|
| Rate for Payer: Cofinity Commercial |
$598.53
|
| Rate for Payer: Cofinity Commercial |
$735.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$598.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.03
|
| Rate for Payer: Healthscope Commercial |
$769.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$598.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$641.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$726.78
|
| Rate for Payer: PHP Commercial |
$726.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$555.78
|
| Rate for Payer: Priority Health SBD |
$538.68
|
| Rate for Payer: UMR Bronson Commercial |
$376.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$641.28
|
|
|
HC DAVITA OP HEMODIALYSIS
|
Facility
|
OP
|
$855.04
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100002
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$316.36 |
| Max. Negotiated Rate |
$1,920.94 |
| Rate for Payer: Aetna American Axle |
$555.78
|
| Rate for Payer: Aetna Commercial |
$726.78
|
| Rate for Payer: Aetna Medicare |
$709.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$555.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$853.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$853.02
|
| Rate for Payer: BCBS Complete |
$384.07
|
| Rate for Payer: BCBS MAPPO |
$682.42
|
| Rate for Payer: BCN Medicare Advantage |
$682.42
|
| Rate for Payer: Cash Price |
$684.03
|
| Rate for Payer: Cash Price |
$684.03
|
| Rate for Payer: Cash Price |
$684.03
|
| Rate for Payer: Cofinity Commercial |
$598.53
|
| Rate for Payer: Cofinity Commercial |
$735.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$598.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$682.42
|
| Rate for Payer: Healthscope Commercial |
$769.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$598.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$641.28
|
| Rate for Payer: Mclaren Medicaid |
$365.78
|
| Rate for Payer: Mclaren Medicare |
$682.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$716.54
|
| Rate for Payer: Meridian Medicaid |
$384.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$784.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$726.78
|
| Rate for Payer: PACE Medicare |
$648.30
|
| Rate for Payer: PACE SWMI |
$682.42
|
| Rate for Payer: PHP Commercial |
$726.78
|
| Rate for Payer: PHP Medicare Advantage |
$682.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$555.78
|
| Rate for Payer: Priority Health Medicare |
$682.42
|
| Rate for Payer: Priority Health SBD |
$538.68
|
| Rate for Payer: Railroad Medicare Medicare |
$682.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,920.94
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$682.42
|
| Rate for Payer: UHC Exchange |
$1,304.17
|
| Rate for Payer: UHC Medicare Advantage |
$682.42
|
| Rate for Payer: UHCCP Medicaid |
$365.78
|
| Rate for Payer: UMR Bronson Commercial |
$316.36
|
| Rate for Payer: VA VA |
$682.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$641.28
|
|
|
HC DBL PIGTAIL BILIARY STENT
|
Facility
|
OP
|
$783.42
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800064
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$289.87 |
| Max. Negotiated Rate |
$705.08 |
| Rate for Payer: Aetna American Axle |
$509.22
|
| Rate for Payer: Aetna Commercial |
$665.91
|
| Rate for Payer: Aetna Medicare |
$391.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$509.22
|
| Rate for Payer: BCBS Complete |
$313.37
|
| Rate for Payer: Cash Price |
$626.74
|
| Rate for Payer: Cofinity Commercial |
$548.39
|
| Rate for Payer: Cofinity Commercial |
$673.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$548.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$626.74
|
| Rate for Payer: Healthscope Commercial |
$705.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$548.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$587.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$665.91
|
| Rate for Payer: PHP Commercial |
$665.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.22
|
| Rate for Payer: Priority Health SBD |
$493.55
|
| Rate for Payer: UMR Bronson Commercial |
$289.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$587.57
|
|
|
HC DBL PIGTAIL BILIARY STENT
|
Facility
|
IP
|
$783.42
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800064
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$344.70 |
| Max. Negotiated Rate |
$705.08 |
| Rate for Payer: Aetna American Axle |
$509.22
|
| Rate for Payer: Aetna Commercial |
$665.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$509.22
|
| Rate for Payer: Cash Price |
$626.74
|
| Rate for Payer: Cofinity Commercial |
$548.39
|
| Rate for Payer: Cofinity Commercial |
$673.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$548.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$626.74
|
| Rate for Payer: Healthscope Commercial |
$705.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$548.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$587.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$665.91
|
| Rate for Payer: PHP Commercial |
$665.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.22
|
| Rate for Payer: Priority Health SBD |
$493.55
|
| Rate for Payer: UMR Bronson Commercial |
$344.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$587.57
|
|
|
HC D & C
|
Facility
|
OP
|
$2,041.41
|
|
| Hospital Charge Code |
45000037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$755.32 |
| Max. Negotiated Rate |
$1,837.27 |
| Rate for Payer: Aetna American Axle |
$1,326.92
|
| Rate for Payer: Aetna Commercial |
$1,735.20
|
| Rate for Payer: Aetna Medicare |
$1,020.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,326.92
|
| Rate for Payer: BCBS Complete |
$816.56
|
| Rate for Payer: Cash Price |
$1,633.13
|
| Rate for Payer: Cofinity Commercial |
$1,428.99
|
| Rate for Payer: Cofinity Commercial |
$1,755.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,428.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,633.13
|
| Rate for Payer: Healthscope Commercial |
$1,837.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,428.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,531.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,735.20
|
| Rate for Payer: PHP Commercial |
$1,735.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.92
|
| Rate for Payer: Priority Health SBD |
$1,286.09
|
| Rate for Payer: UMR Bronson Commercial |
$755.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,531.06
|
|
|
HC D & C
|
Facility
|
IP
|
$2,041.41
|
|
| Hospital Charge Code |
45000037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$898.22 |
| Max. Negotiated Rate |
$1,837.27 |
| Rate for Payer: Aetna American Axle |
$1,326.92
|
| Rate for Payer: Aetna Commercial |
$1,735.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,326.92
|
| Rate for Payer: Cash Price |
$1,633.13
|
| Rate for Payer: Cofinity Commercial |
$1,428.99
|
| Rate for Payer: Cofinity Commercial |
$1,755.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,428.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,633.13
|
| Rate for Payer: Healthscope Commercial |
$1,837.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,428.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,531.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,735.20
|
| Rate for Payer: PHP Commercial |
$1,735.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.92
|
| Rate for Payer: Priority Health SBD |
$1,286.09
|
| Rate for Payer: UMR Bronson Commercial |
$898.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,531.06
|
|
|
HC D&C (OB SURGERY)
|
Facility
|
IP
|
$1,051.40
|
|
| Hospital Charge Code |
36000026
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$462.62 |
| Max. Negotiated Rate |
$946.26 |
| Rate for Payer: Aetna American Axle |
$683.41
|
| Rate for Payer: Aetna Commercial |
$893.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$683.41
|
| Rate for Payer: Cash Price |
$841.12
|
| Rate for Payer: Cofinity Commercial |
$735.98
|
| Rate for Payer: Cofinity Commercial |
$904.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$735.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.12
|
| Rate for Payer: Healthscope Commercial |
$946.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$735.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$788.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$893.69
|
| Rate for Payer: PHP Commercial |
$893.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.41
|
| Rate for Payer: Priority Health SBD |
$662.38
|
| Rate for Payer: UMR Bronson Commercial |
$462.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$788.55
|
|
|
HC D&C (OB SURGERY)
|
Facility
|
OP
|
$1,051.40
|
|
| Hospital Charge Code |
36000026
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$389.02 |
| Max. Negotiated Rate |
$946.26 |
| Rate for Payer: Aetna American Axle |
$683.41
|
| Rate for Payer: Aetna Commercial |
$893.69
|
| Rate for Payer: Aetna Medicare |
$525.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$683.41
|
| Rate for Payer: BCBS Complete |
$420.56
|
| Rate for Payer: Cash Price |
$841.12
|
| Rate for Payer: Cofinity Commercial |
$735.98
|
| Rate for Payer: Cofinity Commercial |
$904.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$735.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.12
|
| Rate for Payer: Healthscope Commercial |
$946.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$735.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$788.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$893.69
|
| Rate for Payer: PHP Commercial |
$893.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.41
|
| Rate for Payer: Priority Health SBD |
$662.38
|
| Rate for Payer: UMR Bronson Commercial |
$389.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$788.55
|
|
|
HC D & C POSTPARTUM
|
Facility
|
IP
|
$7,945.53
|
|
|
Service Code
|
CPT 59160
|
| Hospital Charge Code |
76100341
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,496.03 |
| Max. Negotiated Rate |
$7,150.98 |
| Rate for Payer: Aetna American Axle |
$5,164.59
|
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,164.59
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$5,561.87
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,561.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,561.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health SBD |
$5,005.68
|
| Rate for Payer: UMR Bronson Commercial |
$3,496.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC D & C POSTPARTUM
|
Facility
|
OP
|
$7,945.53
|
|
|
Service Code
|
CPT 59160
|
| Hospital Charge Code |
76100341
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,662.10 |
| Max. Negotiated Rate |
$8,728.81 |
| Rate for Payer: Aetna American Axle |
$5,164.59
|
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: Aetna Medicare |
$3,224.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,164.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,876.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,876.16
|
| Rate for Payer: BCBS Complete |
$1,745.20
|
| Rate for Payer: BCBS MAPPO |
$3,100.93
|
| Rate for Payer: BCN Medicare Advantage |
$3,100.93
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Cofinity Commercial |
$5,561.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,561.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,100.93
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,561.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Mclaren Medicaid |
$1,662.10
|
| Rate for Payer: Mclaren Medicare |
$3,100.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,255.98
|
| Rate for Payer: Meridian Medicaid |
$1,745.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,566.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: PACE Medicare |
$2,945.88
|
| Rate for Payer: PACE SWMI |
$3,100.93
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,100.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,662.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health Medicare |
$3,100.93
|
| Rate for Payer: Priority Health SBD |
$5,005.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,100.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,728.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,100.93
|
| Rate for Payer: UHC Exchange |
$5,926.19
|
| Rate for Payer: UHC Medicare Advantage |
$3,100.93
|
| Rate for Payer: UHCCP Medicaid |
$1,662.10
|
| Rate for Payer: UMR Bronson Commercial |
$2,939.85
|
| Rate for Payer: VA VA |
$3,100.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC DDAVP CMPT1
|
Facility
|
OP
|
$38.49
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500024
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.30 |
| Max. Negotiated Rate |
$64.57 |
| Rate for Payer: Aetna American Axle |
$25.02
|
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: Aetna Medicare |
$23.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: BCBS Complete |
$12.91
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Cofinity Commercial |
$26.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.87
|
| Rate for Payer: Mclaren Medicaid |
$12.30
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health SBD |
$24.25
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.94
|
| Rate for Payer: UHC Exchange |
$43.84
|
| Rate for Payer: UHC Medicare Advantage |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.30
|
| Rate for Payer: UMR Bronson Commercial |
$14.24
|
| Rate for Payer: VA VA |
$22.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.87
|
|
|
HC DDAVP CMPT1
|
Facility
|
IP
|
$38.49
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500024
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.94 |
| Max. Negotiated Rate |
$34.64 |
| Rate for Payer: Aetna American Axle |
$25.02
|
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.02
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$26.94
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: Priority Health SBD |
$24.25
|
| Rate for Payer: UMR Bronson Commercial |
$16.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.87
|
|
|
HC DDAVP CMPT2
|
Facility
|
OP
|
$38.49
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500027
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.30 |
| Max. Negotiated Rate |
$64.57 |
| Rate for Payer: Aetna American Axle |
$25.02
|
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: Aetna Medicare |
$23.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: BCBS Complete |
$12.91
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Cofinity Commercial |
$26.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.87
|
| Rate for Payer: Mclaren Medicaid |
$12.30
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health SBD |
$24.25
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.94
|
| Rate for Payer: UHC Exchange |
$43.84
|
| Rate for Payer: UHC Medicare Advantage |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.30
|
| Rate for Payer: UMR Bronson Commercial |
$14.24
|
| Rate for Payer: VA VA |
$22.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.87
|
|
|
HC DDAVP CMPT2
|
Facility
|
IP
|
$38.49
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500027
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.94 |
| Max. Negotiated Rate |
$34.64 |
| Rate for Payer: Aetna American Axle |
$25.02
|
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.02
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$26.94
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: Priority Health SBD |
$24.25
|
| Rate for Payer: UMR Bronson Commercial |
$16.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.87
|
|
|
HC DDAVP FACTOR VIII RISTOCETIN V
|
Facility
|
IP
|
$38.49
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500021
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.94 |
| Max. Negotiated Rate |
$34.64 |
| Rate for Payer: Aetna American Axle |
$25.02
|
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.02
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$26.94
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: Priority Health SBD |
$24.25
|
| Rate for Payer: UMR Bronson Commercial |
$16.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.87
|
|
|
HC DDAVP FACTOR VIII RISTOCETIN V
|
Facility
|
OP
|
$38.49
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500021
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$50.39 |
| Rate for Payer: Aetna American Axle |
$25.02
|
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: Aetna Medicare |
$18.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.38
|
| Rate for Payer: BCBS Complete |
$10.07
|
| Rate for Payer: BCBS MAPPO |
$17.90
|
| Rate for Payer: BCN Medicare Advantage |
$17.90
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Cofinity Commercial |
$26.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.90
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.87
|
| Rate for Payer: Mclaren Medicaid |
$9.59
|
| Rate for Payer: Mclaren Medicare |
$17.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.80
|
| Rate for Payer: Meridian Medicaid |
$10.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: PACE Medicare |
$17.00
|
| Rate for Payer: PACE SWMI |
$17.90
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: PHP Medicare Advantage |
$17.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: Priority Health Medicare |
$17.90
|
| Rate for Payer: Priority Health SBD |
$24.25
|
| Rate for Payer: Railroad Medicare Medicare |
$17.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.90
|
| Rate for Payer: UHC Exchange |
$34.21
|
| Rate for Payer: UHC Medicare Advantage |
$17.90
|
| Rate for Payer: UHCCP Medicaid |
$9.59
|
| Rate for Payer: UMR Bronson Commercial |
$14.24
|
| Rate for Payer: VA VA |
$17.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.87
|
|
|
HC D-DIMER QUANTITATIVE
|
Facility
|
OP
|
$124.64
|
|
|
Service Code
|
CPT 85380
|
| Hospital Charge Code |
30500081
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.46 |
| Max. Negotiated Rate |
$112.18 |
| Rate for Payer: Aetna American Axle |
$81.02
|
| Rate for Payer: Aetna Commercial |
$105.94
|
| Rate for Payer: Aetna Medicare |
$10.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.72
|
| Rate for Payer: BCBS Complete |
$5.73
|
| Rate for Payer: BCBS MAPPO |
$10.18
|
| Rate for Payer: BCN Medicare Advantage |
$10.18
|
| Rate for Payer: Cash Price |
$99.71
|
| Rate for Payer: Cash Price |
$99.71
|
| Rate for Payer: Cofinity Commercial |
$87.25
|
| Rate for Payer: Cofinity Commercial |
$107.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$87.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$112.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.48
|
| Rate for Payer: Mclaren Medicaid |
$5.46
|
| Rate for Payer: Mclaren Medicare |
$10.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.69
|
| Rate for Payer: Meridian Medicaid |
$5.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.94
|
| Rate for Payer: PACE Medicare |
$9.67
|
| Rate for Payer: PACE SWMI |
$10.18
|
| Rate for Payer: PHP Commercial |
$105.94
|
| Rate for Payer: PHP Medicare Advantage |
$10.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.02
|
| Rate for Payer: Priority Health Medicare |
$10.18
|
| Rate for Payer: Priority Health SBD |
$78.52
|
| Rate for Payer: Railroad Medicare Medicare |
$10.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.18
|
| Rate for Payer: UHC Exchange |
$19.45
|
| Rate for Payer: UHC Medicare Advantage |
$10.18
|
| Rate for Payer: UHCCP Medicaid |
$5.46
|
| Rate for Payer: UMR Bronson Commercial |
$46.12
|
| Rate for Payer: VA VA |
$10.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.48
|
|
|
HC D-DIMER QUANTITATIVE
|
Facility
|
IP
|
$124.64
|
|
|
Service Code
|
CPT 85380
|
| Hospital Charge Code |
30500081
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$54.84 |
| Max. Negotiated Rate |
$112.18 |
| Rate for Payer: Aetna American Axle |
$81.02
|
| Rate for Payer: Aetna Commercial |
$105.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.02
|
| Rate for Payer: Cash Price |
$99.71
|
| Rate for Payer: Cofinity Commercial |
$107.19
|
| Rate for Payer: Cofinity Commercial |
$87.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$87.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.71
|
| Rate for Payer: Healthscope Commercial |
$112.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.94
|
| Rate for Payer: PHP Commercial |
$105.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.02
|
| Rate for Payer: Priority Health SBD |
$78.52
|
| Rate for Payer: UMR Bronson Commercial |
$54.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.48
|
|
|
HC DEBRIDE BONE FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$2,208.87
|
|
|
Service Code
|
CPT 11044
|
| Hospital Charge Code |
45000070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$817.28 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna American Axle |
$1,435.77
|
| Rate for Payer: Aetna Commercial |
$1,877.54
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,435.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$1,767.10
|
| Rate for Payer: Cash Price |
$1,767.10
|
| Rate for Payer: Cofinity Commercial |
$1,899.63
|
| Rate for Payer: Cofinity Commercial |
$1,546.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,546.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,767.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$1,987.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,546.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,656.65
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,877.54
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,877.54
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,435.77
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$1,391.59
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$3,019.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: UMR Bronson Commercial |
$817.28
|
| Rate for Payer: VA VA |
$1,580.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,656.65
|
|
|
HC DEBRIDE BONE FIRST 20 SQ CM OR LESS
|
Facility
|
IP
|
$2,208.87
|
|
|
Service Code
|
CPT 11044
|
| Hospital Charge Code |
45000070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$971.90 |
| Max. Negotiated Rate |
$1,987.98 |
| Rate for Payer: Aetna American Axle |
$1,435.77
|
| Rate for Payer: Aetna Commercial |
$1,877.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,435.77
|
| Rate for Payer: Cash Price |
$1,767.10
|
| Rate for Payer: Cofinity Commercial |
$1,546.21
|
| Rate for Payer: Cofinity Commercial |
$1,899.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,546.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,767.10
|
| Rate for Payer: Healthscope Commercial |
$1,987.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,546.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,656.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,877.54
|
| Rate for Payer: PHP Commercial |
$1,877.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,435.77
|
| Rate for Payer: Priority Health SBD |
$1,391.59
|
| Rate for Payer: UMR Bronson Commercial |
$971.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,656.65
|
|
|
HC DEBRIDE ECZEMTOUS/INFECT SKIN UP TO 10%
|
Facility
|
IP
|
$535.18
|
|
|
Service Code
|
CPT 11000
|
| Hospital Charge Code |
76100078
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$235.48 |
| Max. Negotiated Rate |
$481.66 |
| Rate for Payer: Aetna American Axle |
$347.87
|
| Rate for Payer: Aetna Commercial |
$454.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$347.87
|
| Rate for Payer: Cash Price |
$428.14
|
| Rate for Payer: Cofinity Commercial |
$374.63
|
| Rate for Payer: Cofinity Commercial |
$460.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$374.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.14
|
| Rate for Payer: Healthscope Commercial |
$481.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$374.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.90
|
| Rate for Payer: PHP Commercial |
$454.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.87
|
| Rate for Payer: Priority Health SBD |
$337.16
|
| Rate for Payer: UMR Bronson Commercial |
$235.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.38
|
|
|
HC DEBRIDE ECZEMTOUS/INFECT SKIN UP TO 10%
|
Facility
|
OP
|
$535.18
|
|
|
Service Code
|
CPT 11000
|
| Hospital Charge Code |
76100078
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$198.02 |
| Max. Negotiated Rate |
$1,680.50 |
| Rate for Payer: Aetna American Axle |
$347.87
|
| Rate for Payer: Aetna Commercial |
$454.90
|
| Rate for Payer: Aetna Medicare |
$620.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$347.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$746.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$746.25
|
| Rate for Payer: BCBS Complete |
$335.99
|
| Rate for Payer: BCBS MAPPO |
$597.00
|
| Rate for Payer: BCN Medicare Advantage |
$597.00
|
| Rate for Payer: Cash Price |
$428.14
|
| Rate for Payer: Cash Price |
$428.14
|
| Rate for Payer: Cofinity Commercial |
$460.25
|
| Rate for Payer: Cofinity Commercial |
$374.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$374.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.00
|
| Rate for Payer: Healthscope Commercial |
$481.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$374.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.38
|
| Rate for Payer: Mclaren Medicaid |
$319.99
|
| Rate for Payer: Mclaren Medicare |
$597.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$626.85
|
| Rate for Payer: Meridian Medicaid |
$335.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$686.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.90
|
| Rate for Payer: PACE Medicare |
$567.15
|
| Rate for Payer: PACE SWMI |
$597.00
|
| Rate for Payer: PHP Commercial |
$454.90
|
| Rate for Payer: PHP Medicare Advantage |
$597.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.87
|
| Rate for Payer: Priority Health Medicare |
$597.00
|
| Rate for Payer: Priority Health SBD |
$337.16
|
| Rate for Payer: Railroad Medicare Medicare |
$597.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,680.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$597.00
|
| Rate for Payer: UHC Exchange |
$1,140.93
|
| Rate for Payer: UHC Medicare Advantage |
$597.00
|
| Rate for Payer: UHCCP Medicaid |
$319.99
|
| Rate for Payer: UMR Bronson Commercial |
$198.02
|
| Rate for Payer: VA VA |
$597.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.38
|
|
|
HC DEBRIDE MASTOIDECTOMY CAVITY CMPLX
|
Facility
|
IP
|
$1,342.32
|
|
|
Service Code
|
CPT 69222
|
| Hospital Charge Code |
76100483
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$590.62 |
| Max. Negotiated Rate |
$1,208.09 |
| Rate for Payer: Aetna American Axle |
$872.51
|
| Rate for Payer: Aetna Commercial |
$1,140.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.51
|
| Rate for Payer: Cash Price |
$1,073.86
|
| Rate for Payer: Cofinity Commercial |
$1,154.40
|
| Rate for Payer: Cofinity Commercial |
$939.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$939.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,073.86
|
| Rate for Payer: Healthscope Commercial |
$1,208.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$939.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,006.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,140.97
|
| Rate for Payer: PHP Commercial |
$1,140.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.51
|
| Rate for Payer: Priority Health SBD |
$845.66
|
| Rate for Payer: UMR Bronson Commercial |
$590.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,006.74
|
|
|
HC DEBRIDE MASTOIDECTOMY CAVITY CMPLX
|
Facility
|
OP
|
$1,342.32
|
|
|
Service Code
|
CPT 69222
|
| Hospital Charge Code |
76100483
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$266.21 |
| Max. Negotiated Rate |
$1,398.05 |
| Rate for Payer: Aetna American Axle |
$872.51
|
| Rate for Payer: Aetna Commercial |
$1,140.97
|
| Rate for Payer: Aetna Medicare |
$516.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$620.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$620.83
|
| Rate for Payer: BCBS Complete |
$279.52
|
| Rate for Payer: BCBS MAPPO |
$496.66
|
| Rate for Payer: BCN Medicare Advantage |
$496.66
|
| Rate for Payer: Cash Price |
$1,073.86
|
| Rate for Payer: Cash Price |
$1,073.86
|
| Rate for Payer: Cofinity Commercial |
$939.62
|
| Rate for Payer: Cofinity Commercial |
$1,154.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$939.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,073.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.66
|
| Rate for Payer: Healthscope Commercial |
$1,208.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$939.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,006.74
|
| Rate for Payer: Mclaren Medicaid |
$266.21
|
| Rate for Payer: Mclaren Medicare |
$496.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.49
|
| Rate for Payer: Meridian Medicaid |
$279.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$571.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,140.97
|
| Rate for Payer: PACE Medicare |
$471.83
|
| Rate for Payer: PACE SWMI |
$496.66
|
| Rate for Payer: PHP Commercial |
$1,140.97
|
| Rate for Payer: PHP Medicare Advantage |
$496.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.51
|
| Rate for Payer: Priority Health Medicare |
$496.66
|
| Rate for Payer: Priority Health SBD |
$845.66
|
| Rate for Payer: Railroad Medicare Medicare |
$496.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,398.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.66
|
| Rate for Payer: UHC Exchange |
$949.17
|
| Rate for Payer: UHC Medicare Advantage |
$496.66
|
| Rate for Payer: UHCCP Medicaid |
$266.21
|
| Rate for Payer: UMR Bronson Commercial |
$496.66
|
| Rate for Payer: VA VA |
$496.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,006.74
|
|
|
HC DEBRIDEMENT BONE EACH ADDL 20 SQ CM
|
Facility
|
OP
|
$1,657.20
|
|
|
Service Code
|
CPT 11047
|
| Hospital Charge Code |
76100034
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$613.16 |
| Max. Negotiated Rate |
$1,491.48 |
| Rate for Payer: Aetna American Axle |
$1,077.18
|
| Rate for Payer: Aetna Commercial |
$1,408.62
|
| Rate for Payer: Aetna Medicare |
$828.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,077.18
|
| Rate for Payer: BCBS Complete |
$662.88
|
| Rate for Payer: Cash Price |
$1,325.76
|
| Rate for Payer: Cofinity Commercial |
$1,160.04
|
| Rate for Payer: Cofinity Commercial |
$1,425.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,160.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,325.76
|
| Rate for Payer: Healthscope Commercial |
$1,491.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,160.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,242.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,408.62
|
| Rate for Payer: PHP Commercial |
$1,408.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,077.18
|
| Rate for Payer: Priority Health SBD |
$1,044.04
|
| Rate for Payer: UMR Bronson Commercial |
$613.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,242.90
|
|
