|
HC EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV EA ADDL 15
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 92627
|
| Hospital Charge Code |
47100018
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$27.52 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna American Axle |
$49.73
|
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: Aetna Medicare |
$38.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.73
|
| Rate for Payer: BCBS Complete |
$30.60
|
| Rate for Payer: BCBS Trust/PPO |
$27.52
|
| Rate for Payer: BCN Commercial |
$27.52
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Advantage |
$53.55
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.38
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: Priority Health SBD |
$48.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.73
|
| Rate for Payer: UHC Core |
$39.86
|
| Rate for Payer: UHC Exchange |
$30.06
|
| Rate for Payer: UMR Bronson Commercial |
$28.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC EVAL CENTRAL AUDITORY FUNCJ W/REPRT EA 15 MIN
|
Facility
|
OP
|
$40.58
|
|
|
Service Code
|
CPT 92621
|
| Hospital Charge Code |
76100496
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$15.01 |
| Max. Negotiated Rate |
$36.52 |
| Rate for Payer: Aetna American Axle |
$26.38
|
| Rate for Payer: Aetna Commercial |
$34.49
|
| Rate for Payer: Aetna Medicare |
$20.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.38
|
| Rate for Payer: BCBS Complete |
$16.23
|
| Rate for Payer: Cash Price |
$32.46
|
| Rate for Payer: Cofinity Advantage |
$28.41
|
| Rate for Payer: Cofinity Commercial |
$34.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.46
|
| Rate for Payer: Healthscope Commercial |
$36.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.43
|
| Rate for Payer: PHP Commercial |
$34.49
|
| Rate for Payer: Priority Health SBD |
$25.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.38
|
| Rate for Payer: UHC Core |
$21.14
|
| Rate for Payer: UHC Exchange |
$15.95
|
| Rate for Payer: UMR Bronson Commercial |
$15.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.43
|
|
|
HC EVAL CENTRAL AUDITORY FUNCJ W/REPRT EA 15 MIN
|
Facility
|
IP
|
$40.58
|
|
|
Service Code
|
CPT 92621
|
| Hospital Charge Code |
76100496
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$17.86 |
| Max. Negotiated Rate |
$36.52 |
| Rate for Payer: Aetna American Axle |
$26.38
|
| Rate for Payer: Aetna Commercial |
$34.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.38
|
| Rate for Payer: Cash Price |
$32.46
|
| Rate for Payer: Cofinity Advantage |
$28.41
|
| Rate for Payer: Cofinity Commercial |
$34.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.46
|
| Rate for Payer: Healthscope Commercial |
$36.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.43
|
| Rate for Payer: PHP Commercial |
$34.49
|
| Rate for Payer: Priority Health SBD |
$25.57
|
| Rate for Payer: UMR Bronson Commercial |
$17.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.43
|
|
|
HC EVAL ORAL SPEECH ADDL 30 MIN
|
Facility
|
IP
|
$119.02
|
|
|
Service Code
|
CPT 92608
|
| Hospital Charge Code |
44400015
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$52.37 |
| Max. Negotiated Rate |
$107.12 |
| Rate for Payer: Aetna American Axle |
$77.36
|
| Rate for Payer: Aetna Commercial |
$101.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.36
|
| Rate for Payer: Cash Price |
$95.22
|
| Rate for Payer: Cofinity Advantage |
$83.31
|
| Rate for Payer: Cofinity Commercial |
$102.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.22
|
| Rate for Payer: Healthscope Commercial |
$107.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.27
|
| Rate for Payer: PHP Commercial |
$101.17
|
| Rate for Payer: Priority Health SBD |
$74.98
|
| Rate for Payer: UMR Bronson Commercial |
$52.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.27
|
|
|
HC EVAL ORAL SPEECH ADDL 30 MIN
|
Facility
|
OP
|
$119.02
|
|
|
Service Code
|
CPT 92608
|
| Hospital Charge Code |
44400015
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$77.36
|
| Rate for Payer: Aetna Commercial |
$101.17
|
| Rate for Payer: Aetna Medicare |
$59.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.36
|
| Rate for Payer: BCBS Complete |
$47.61
|
| Rate for Payer: BCBS Trust/PPO |
$66.30
|
| Rate for Payer: BCN Commercial |
$66.30
|
| Rate for Payer: Cash Price |
$95.22
|
| Rate for Payer: Cash Price |
$95.22
|
| Rate for Payer: Cash Price |
$95.22
|
| Rate for Payer: Cofinity Advantage |
$83.31
|
| Rate for Payer: Cofinity Commercial |
$102.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.22
|
| Rate for Payer: Healthscope Commercial |
$107.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.17
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.27
|
| Rate for Payer: PHP Commercial |
$101.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$39.00
|
| Rate for Payer: Priority Health SBD |
$74.98
|
| Rate for Payer: Priority Health Tiered Network |
$31.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.36
|
| Rate for Payer: UHC Core |
$62.01
|
| Rate for Payer: UHC Exchange |
$46.77
|
| Rate for Payer: UMR Bronson Commercial |
$44.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.27
|
|
|
HC EVAL ORAL SPEECH DEVICE
|
Facility
|
IP
|
$309.02
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
44400014
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$135.97 |
| Max. Negotiated Rate |
$278.12 |
| Rate for Payer: Aetna American Axle |
$200.86
|
| Rate for Payer: Aetna Commercial |
$262.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.86
|
| Rate for Payer: Cash Price |
$247.22
|
| Rate for Payer: Cofinity Advantage |
$216.31
|
| Rate for Payer: Cofinity Commercial |
$265.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.22
|
| Rate for Payer: Healthscope Commercial |
$278.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$216.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.76
|
| Rate for Payer: PHP Commercial |
$262.67
|
| Rate for Payer: Priority Health SBD |
$194.68
|
| Rate for Payer: UMR Bronson Commercial |
$135.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.76
|
|
|
HC EVAL ORAL SPEECH DEVICE
|
Facility
|
OP
|
$309.02
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
44400014
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$114.34 |
| Max. Negotiated Rate |
$278.12 |
| Rate for Payer: Aetna American Axle |
$200.86
|
| Rate for Payer: Aetna Commercial |
$262.67
|
| Rate for Payer: Aetna Medicare |
$154.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.86
|
| Rate for Payer: BCBS Complete |
$123.61
|
| Rate for Payer: BCBS Trust/PPO |
$168.69
|
| Rate for Payer: BCN Commercial |
$168.69
|
| Rate for Payer: Cash Price |
$247.22
|
| Rate for Payer: Cash Price |
$247.22
|
| Rate for Payer: Cash Price |
$247.22
|
| Rate for Payer: Cofinity Advantage |
$216.31
|
| Rate for Payer: Cofinity Commercial |
$265.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.22
|
| Rate for Payer: Healthscope Commercial |
$278.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$216.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.67
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.76
|
| Rate for Payer: PHP Commercial |
$262.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$203.00
|
| Rate for Payer: Priority Health SBD |
$194.68
|
| Rate for Payer: Priority Health Tiered Network |
$162.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.86
|
| Rate for Payer: UHC Core |
$161.00
|
| Rate for Payer: UHC Exchange |
$121.44
|
| Rate for Payer: UMR Bronson Commercial |
$114.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.76
|
|
|
HC EVENT MONITOR
|
Facility
|
OP
|
$520.44
|
|
|
Service Code
|
CPT 93270
|
| Hospital Charge Code |
48000003
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$19.45 |
| Max. Negotiated Rate |
$468.40 |
| Rate for Payer: Aetna American Axle |
$338.29
|
| Rate for Payer: Aetna Commercial |
$442.37
|
| Rate for Payer: Aetna Medicare |
$38.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.49
|
| Rate for Payer: BCBS Complete |
$20.42
|
| Rate for Payer: BCBS MAPPO |
$37.19
|
| Rate for Payer: BCBS Trust/PPO |
$32.40
|
| Rate for Payer: BCN Commercial |
$32.40
|
| Rate for Payer: BCN Medicare Advantage |
$37.19
|
| Rate for Payer: Cash Price |
$416.35
|
| Rate for Payer: Cash Price |
$416.35
|
| Rate for Payer: Cofinity Advantage |
$364.31
|
| Rate for Payer: Cofinity Commercial |
$447.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.19
|
| Rate for Payer: Healthscope Commercial |
$468.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.33
|
| Rate for Payer: Mclaren Medicaid |
$37.19
|
| Rate for Payer: Mclaren Medicare |
$37.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.05
|
| Rate for Payer: Meridian Medicaid |
$39.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.37
|
| Rate for Payer: Nomi Health Commercial |
$111.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.33
|
| Rate for Payer: PACE Medicare |
$35.33
|
| Rate for Payer: PACE SWMI |
$37.19
|
| Rate for Payer: PHP Commercial |
$442.37
|
| Rate for Payer: PHP Medicare Advantage |
$37.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$120.26
|
| Rate for Payer: Priority Health Medicare |
$37.19
|
| Rate for Payer: Priority Health SBD |
$327.88
|
| Rate for Payer: Priority Health Tiered Network |
$96.21
|
| Rate for Payer: Railroad Medicare Medicare |
$37.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.29
|
| Rate for Payer: UHC Core |
$271.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.19
|
| Rate for Payer: UHC Exchange |
$204.53
|
| Rate for Payer: UHC Medicaid |
$19.45
|
| Rate for Payer: UHCCP Medicaid |
$19.45
|
| Rate for Payer: UMR Bronson Commercial |
$192.56
|
| Rate for Payer: VA VA |
$37.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.33
|
|
|
HC EVENT MONITOR
|
Facility
|
IP
|
$520.44
|
|
|
Service Code
|
CPT 93270
|
| Hospital Charge Code |
48000003
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$228.99 |
| Max. Negotiated Rate |
$468.40 |
| Rate for Payer: Aetna American Axle |
$338.29
|
| Rate for Payer: Aetna Commercial |
$442.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.29
|
| Rate for Payer: Cash Price |
$416.35
|
| Rate for Payer: Cofinity Advantage |
$364.31
|
| Rate for Payer: Cofinity Commercial |
$447.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.35
|
| Rate for Payer: Healthscope Commercial |
$468.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.33
|
| Rate for Payer: PHP Commercial |
$442.37
|
| Rate for Payer: Priority Health SBD |
$327.88
|
| Rate for Payer: UMR Bronson Commercial |
$228.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.33
|
|
|
HC EVEROLIMUS
|
Facility
|
OP
|
$71.10
|
|
|
Service Code
|
CPT 80169
|
| Hospital Charge Code |
30100626
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.18 |
| Max. Negotiated Rate |
$63.99 |
| Rate for Payer: Aetna American Axle |
$46.22
|
| Rate for Payer: Aetna Commercial |
$60.44
|
| Rate for Payer: Aetna Medicare |
$14.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.16
|
| Rate for Payer: BCBS Complete |
$7.54
|
| Rate for Payer: BCBS MAPPO |
$13.73
|
| Rate for Payer: BCBS Trust/PPO |
$15.88
|
| Rate for Payer: BCN Commercial |
$15.88
|
| Rate for Payer: BCN Medicare Advantage |
$13.73
|
| Rate for Payer: Cash Price |
$56.88
|
| Rate for Payer: Cash Price |
$56.88
|
| Rate for Payer: Cofinity Advantage |
$49.77
|
| Rate for Payer: Cofinity Commercial |
$61.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.73
|
| Rate for Payer: Healthscope Commercial |
$63.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.33
|
| Rate for Payer: Mclaren Medicaid |
$13.73
|
| Rate for Payer: Mclaren Medicare |
$13.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.42
|
| Rate for Payer: Meridian Medicaid |
$14.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.44
|
| Rate for Payer: Nomi Health Commercial |
$20.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.33
|
| Rate for Payer: PACE Medicare |
$13.04
|
| Rate for Payer: PACE SWMI |
$13.73
|
| Rate for Payer: PHP Commercial |
$60.44
|
| Rate for Payer: PHP Medicare Advantage |
$13.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.73
|
| Rate for Payer: Priority Health Medicare |
$13.73
|
| Rate for Payer: Priority Health SBD |
$44.79
|
| Rate for Payer: Priority Health Tiered Network |
$10.98
|
| Rate for Payer: Railroad Medicare Medicare |
$13.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.60
|
| Rate for Payer: UHC Core |
$20.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.73
|
| Rate for Payer: UHC Exchange |
$20.60
|
| Rate for Payer: UHC Medicaid |
$7.18
|
| Rate for Payer: UHCCP Medicaid |
$7.18
|
| Rate for Payer: UMR Bronson Commercial |
$26.31
|
| Rate for Payer: VA VA |
$13.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.33
|
|
|
HC EVEROLIMUS
|
Facility
|
IP
|
$71.10
|
|
|
Service Code
|
CPT 80169
|
| Hospital Charge Code |
30100626
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.28 |
| Max. Negotiated Rate |
$63.99 |
| Rate for Payer: Aetna American Axle |
$46.22
|
| Rate for Payer: Aetna Commercial |
$60.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.22
|
| Rate for Payer: Cash Price |
$56.88
|
| Rate for Payer: Cofinity Advantage |
$49.77
|
| Rate for Payer: Cofinity Commercial |
$61.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.88
|
| Rate for Payer: Healthscope Commercial |
$63.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.33
|
| Rate for Payer: PHP Commercial |
$60.44
|
| Rate for Payer: Priority Health SBD |
$44.79
|
| Rate for Payer: UMR Bronson Commercial |
$31.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.33
|
|
|
HC EVOKED AUDITORY TEST COMPLETE
|
Facility
|
OP
|
$292.35
|
|
|
Service Code
|
CPT 92588
|
| Hospital Charge Code |
76100506
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$21.14 |
| Max. Negotiated Rate |
$1,202.41 |
| Rate for Payer: Aetna American Axle |
$190.03
|
| Rate for Payer: Aetna Commercial |
$248.50
|
| Rate for Payer: Aetna Medicare |
$386.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$21.14
|
| Rate for Payer: BCN Commercial |
$21.14
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cofinity Advantage |
$204.65
|
| Rate for Payer: Cofinity Commercial |
$251.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$263.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.26
|
| Rate for Payer: Mclaren Medicaid |
$371.82
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$390.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.50
|
| Rate for Payer: Nomi Health Commercial |
$1,115.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.26
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$248.50
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,202.41
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health SBD |
$184.18
|
| Rate for Payer: Priority Health Tiered Network |
$961.93
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.03
|
| Rate for Payer: UHC Core |
$152.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Exchange |
$114.89
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: UMR Bronson Commercial |
$108.17
|
| Rate for Payer: VA VA |
$371.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.26
|
|
|
HC EVOKED AUDITORY TEST COMPLETE
|
Facility
|
IP
|
$292.35
|
|
|
Service Code
|
CPT 92588
|
| Hospital Charge Code |
76100506
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$128.63 |
| Max. Negotiated Rate |
$263.12 |
| Rate for Payer: Aetna American Axle |
$190.03
|
| Rate for Payer: Aetna Commercial |
$248.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.03
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cofinity Advantage |
$204.65
|
| Rate for Payer: Cofinity Commercial |
$251.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.88
|
| Rate for Payer: Healthscope Commercial |
$263.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.26
|
| Rate for Payer: PHP Commercial |
$248.50
|
| Rate for Payer: Priority Health SBD |
$184.18
|
| Rate for Payer: UMR Bronson Commercial |
$128.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.26
|
|
|
HC EVOKED AUDITORY TEST LIMITED
|
Facility
|
IP
|
$292.35
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100507
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$128.63 |
| Max. Negotiated Rate |
$263.12 |
| Rate for Payer: Aetna American Axle |
$190.03
|
| Rate for Payer: Aetna Commercial |
$248.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.03
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cofinity Advantage |
$204.65
|
| Rate for Payer: Cofinity Commercial |
$251.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.88
|
| Rate for Payer: Healthscope Commercial |
$263.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.26
|
| Rate for Payer: PHP Commercial |
$248.50
|
| Rate for Payer: Priority Health SBD |
$184.18
|
| Rate for Payer: UMR Bronson Commercial |
$128.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.26
|
|
|
HC EVOKED AUDITORY TEST LIMITED
|
Facility
|
OP
|
$292.35
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100507
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$15.50 |
| Max. Negotiated Rate |
$695.77 |
| Rate for Payer: Aetna American Axle |
$190.03
|
| Rate for Payer: Aetna Commercial |
$248.50
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$15.50
|
| Rate for Payer: BCN Commercial |
$15.50
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cash Price |
$233.88
|
| Rate for Payer: Cofinity Advantage |
$204.65
|
| Rate for Payer: Cofinity Commercial |
$251.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$263.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.26
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.50
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.26
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$248.50
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$184.18
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.03
|
| Rate for Payer: UHC Core |
$152.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$114.89
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: UMR Bronson Commercial |
$108.17
|
| Rate for Payer: VA VA |
$215.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.26
|
|
|
HC EVOKED OTOACOUSTIC EMISNS LIMITD
|
Facility
|
IP
|
$801.11
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100489
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$352.49 |
| Max. Negotiated Rate |
$721.00 |
| Rate for Payer: Aetna American Axle |
$520.72
|
| Rate for Payer: Aetna Commercial |
$680.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$520.72
|
| Rate for Payer: Cash Price |
$640.89
|
| Rate for Payer: Cofinity Advantage |
$560.78
|
| Rate for Payer: Cofinity Commercial |
$688.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.89
|
| Rate for Payer: Healthscope Commercial |
$721.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$560.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$680.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$600.83
|
| Rate for Payer: PHP Commercial |
$680.94
|
| Rate for Payer: Priority Health SBD |
$504.70
|
| Rate for Payer: UMR Bronson Commercial |
$352.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.83
|
|
|
HC EVOKED OTOACOUSTIC EMISNS LIMITD
|
Facility
|
OP
|
$801.11
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
76100489
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$15.50 |
| Max. Negotiated Rate |
$721.00 |
| Rate for Payer: Aetna American Axle |
$520.72
|
| Rate for Payer: Aetna Commercial |
$680.94
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$520.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$15.50
|
| Rate for Payer: BCN Commercial |
$15.50
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$640.89
|
| Rate for Payer: Cash Price |
$640.89
|
| Rate for Payer: Cofinity Advantage |
$560.78
|
| Rate for Payer: Cofinity Commercial |
$688.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$721.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$560.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.83
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$680.94
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$600.83
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$680.94
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$504.70
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$520.72
|
| Rate for Payer: UHC Core |
$417.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$314.84
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: UMR Bronson Commercial |
$296.41
|
| Rate for Payer: VA VA |
$215.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.83
|
|
|
HC EXAM AND SELECT ARCHIVE RETRIEVED
|
Facility
|
OP
|
$66.73
|
|
|
Service Code
|
CPT 88363
|
| Hospital Charge Code |
31000059
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.07 |
| Max. Negotiated Rate |
$93.19 |
| Rate for Payer: Aetna American Axle |
$43.37
|
| Rate for Payer: Aetna Commercial |
$56.72
|
| Rate for Payer: Aetna Medicare |
$29.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCBS Trust/PPO |
$43.09
|
| Rate for Payer: BCN Commercial |
$43.09
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$53.38
|
| Rate for Payer: Cash Price |
$53.38
|
| Rate for Payer: Cofinity Advantage |
$46.71
|
| Rate for Payer: Cofinity Commercial |
$57.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$60.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.05
|
| Rate for Payer: Mclaren Medicaid |
$28.82
|
| Rate for Payer: Mclaren Medicare |
$28.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$30.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.72
|
| Rate for Payer: Nomi Health Commercial |
$86.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.05
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$56.72
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$93.19
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health SBD |
$42.04
|
| Rate for Payer: Priority Health Tiered Network |
$74.55
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.74
|
| Rate for Payer: UHC Core |
$36.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$36.74
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: UMR Bronson Commercial |
$24.69
|
| Rate for Payer: VA VA |
$28.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.05
|
|
|
HC EXAM AND SELECT ARCHIVE RETRIEVED
|
Facility
|
IP
|
$66.73
|
|
|
Service Code
|
CPT 88363
|
| Hospital Charge Code |
31000059
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$29.36 |
| Max. Negotiated Rate |
$60.06 |
| Rate for Payer: Aetna American Axle |
$43.37
|
| Rate for Payer: Aetna Commercial |
$56.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.37
|
| Rate for Payer: Cash Price |
$53.38
|
| Rate for Payer: Cofinity Advantage |
$46.71
|
| Rate for Payer: Cofinity Commercial |
$57.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.38
|
| Rate for Payer: Healthscope Commercial |
$60.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.05
|
| Rate for Payer: PHP Commercial |
$56.72
|
| Rate for Payer: Priority Health SBD |
$42.04
|
| Rate for Payer: UMR Bronson Commercial |
$29.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.05
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.5 OF LESS
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
76100101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$226.47 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna American Axle |
$397.85
|
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$879.35
|
| Rate for Payer: BCN Commercial |
$879.35
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Advantage |
$428.46
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.06
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$385.61
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.85
|
| Rate for Payer: UHC Core |
$318.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$240.55
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: UMR Bronson Commercial |
$226.47
|
| Rate for Payer: VA VA |
$705.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.06
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.5 OF LESS
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
76100101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$269.32 |
| Max. Negotiated Rate |
$550.87 |
| Rate for Payer: Aetna American Axle |
$397.85
|
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.85
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Advantage |
$428.46
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: Priority Health SBD |
$385.61
|
| Rate for Payer: UMR Bronson Commercial |
$269.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.06
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.6 TO 1.0 CM
|
Facility
|
OP
|
$612.08
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
76100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$226.47 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna American Axle |
$397.85
|
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$879.35
|
| Rate for Payer: BCN Commercial |
$879.35
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Advantage |
$428.46
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.06
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$385.61
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$397.85
|
| Rate for Payer: UHC Core |
$318.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$240.55
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: UMR Bronson Commercial |
$226.47
|
| Rate for Payer: VA VA |
$705.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.06
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.6 TO 1.0 CM
|
Facility
|
IP
|
$612.08
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
76100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$269.32 |
| Max. Negotiated Rate |
$550.87 |
| Rate for Payer: Aetna American Axle |
$397.85
|
| Rate for Payer: Aetna Commercial |
$520.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.85
|
| Rate for Payer: Cash Price |
$489.66
|
| Rate for Payer: Cofinity Advantage |
$428.46
|
| Rate for Payer: Cofinity Commercial |
$526.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.66
|
| Rate for Payer: Healthscope Commercial |
$550.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$459.06
|
| Rate for Payer: PHP Commercial |
$520.27
|
| Rate for Payer: Priority Health SBD |
$385.61
|
| Rate for Payer: UMR Bronson Commercial |
$269.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.06
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
76100103
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$527.81 |
| Max. Negotiated Rate |
$1,079.61 |
| Rate for Payer: Aetna American Axle |
$779.72
|
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.72
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Advantage |
$839.70
|
| Rate for Payer: Cofinity Commercial |
$1,031.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Healthscope Commercial |
$1,079.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$839.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| Rate for Payer: Priority Health SBD |
$755.73
|
| Rate for Payer: UMR Bronson Commercial |
$527.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.68
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
76100103
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$369.02 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna American Axle |
$779.72
|
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$879.35
|
| Rate for Payer: BCN Commercial |
$879.35
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cash Price |
$959.66
|
| Rate for Payer: Cofinity Advantage |
$839.70
|
| Rate for Payer: Cofinity Commercial |
$1,031.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$959.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$1,079.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$839.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.68
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$755.73
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$779.72
|
| Rate for Payer: UHC Core |
$624.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$471.43
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: UMR Bronson Commercial |
$443.84
|
| Rate for Payer: VA VA |
$705.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.68
|
|
