|
HC DEBRIDEMENT BONE EACH ADDL 20 SQ CM
|
Facility
|
IP
|
$1,657.20
|
|
|
Service Code
|
CPT 11047
|
| Hospital Charge Code |
76100034
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$729.17 |
| 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 New Business (MI Preferred) |
$1,077.18
|
| 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 |
$729.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,242.90
|
|
|
HC DEBRIDEMENT EA ADDL GT 20 SQ CM
|
Facility
|
OP
|
$375.36
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
42000036
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$138.88 |
| Max. Negotiated Rate |
$337.82 |
| Rate for Payer: Aetna American Axle |
$243.98
|
| Rate for Payer: Aetna Commercial |
$319.06
|
| Rate for Payer: Aetna Medicare |
$187.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.98
|
| Rate for Payer: BCBS Complete |
$150.14
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Commercial |
$262.75
|
| Rate for Payer: Cofinity Commercial |
$322.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$262.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Healthscope Commercial |
$337.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$262.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.06
|
| Rate for Payer: PHP Commercial |
$319.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.98
|
| Rate for Payer: Priority Health SBD |
$236.48
|
| Rate for Payer: UMR Bronson Commercial |
$138.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.52
|
|
|
HC DEBRIDEMENT EA ADDL GT 20 SQ CM
|
Facility
|
IP
|
$375.36
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
42000036
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$165.16 |
| Max. Negotiated Rate |
$337.82 |
| Rate for Payer: Aetna American Axle |
$243.98
|
| Rate for Payer: Aetna Commercial |
$319.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.98
|
| Rate for Payer: Cash Price |
$300.29
|
| Rate for Payer: Cofinity Commercial |
$262.75
|
| Rate for Payer: Cofinity Commercial |
$322.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$262.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.29
|
| Rate for Payer: Healthscope Commercial |
$337.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$262.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.06
|
| Rate for Payer: PHP Commercial |
$319.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$243.98
|
| Rate for Payer: Priority Health SBD |
$236.48
|
| Rate for Payer: UMR Bronson Commercial |
$165.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.52
|
|
|
HC DEBRIDEMENT FIRST 20 SQ CM
|
Facility
|
IP
|
$382.87
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
42000035
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$168.46 |
| Max. Negotiated Rate |
$344.58 |
| Rate for Payer: Aetna American Axle |
$248.87
|
| Rate for Payer: Aetna Commercial |
$325.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.87
|
| Rate for Payer: Cash Price |
$306.30
|
| Rate for Payer: Cofinity Commercial |
$268.01
|
| Rate for Payer: Cofinity Commercial |
$329.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$268.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.30
|
| Rate for Payer: Healthscope Commercial |
$344.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$268.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.44
|
| Rate for Payer: PHP Commercial |
$325.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.87
|
| Rate for Payer: Priority Health SBD |
$241.21
|
| Rate for Payer: UMR Bronson Commercial |
$168.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.15
|
|
|
HC DEBRIDEMENT FIRST 20 SQ CM
|
Facility
|
OP
|
$382.87
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
42000035
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna American Axle |
$248.87
|
| Rate for Payer: Aetna Commercial |
$325.44
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$306.30
|
| Rate for Payer: Cash Price |
$306.30
|
| Rate for Payer: Cofinity Commercial |
$329.27
|
| Rate for Payer: Cofinity Commercial |
$268.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$268.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$344.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$268.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.15
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.44
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$325.44
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.87
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$241.21
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$370.35
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: UMR Bronson Commercial |
$141.66
|
| Rate for Payer: VA VA |
$193.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.15
|
|
|
HC DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE
|
Facility
|
OP
|
$520.20
|
|
|
Service Code
|
CPT 69220
|
| Hospital Charge Code |
76100376
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna American Axle |
$338.13
|
| Rate for Payer: Aetna Commercial |
$442.17
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cofinity Commercial |
$447.37
|
| Rate for Payer: Cofinity Commercial |
$364.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$364.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$468.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.15
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.17
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$442.17
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.13
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$327.73
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$370.35
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: UMR Bronson Commercial |
$192.47
|
| Rate for Payer: VA VA |
$193.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.15
|
|
|
HC DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE
|
Facility
|
IP
|
$520.20
|
|
|
Service Code
|
CPT 69220
|
| Hospital Charge Code |
76100376
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$228.89 |
| Max. Negotiated Rate |
$468.18 |
| Rate for Payer: Aetna American Axle |
$338.13
|
| Rate for Payer: Aetna Commercial |
$442.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.13
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cofinity Commercial |
$364.14
|
| Rate for Payer: Cofinity Commercial |
$447.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$364.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.16
|
| Rate for Payer: Healthscope Commercial |
$468.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.17
|
| Rate for Payer: PHP Commercial |
$442.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$338.13
|
| Rate for Payer: Priority Health SBD |
$327.73
|
| Rate for Payer: UMR Bronson Commercial |
$228.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.15
|
|
|
HC DEBRIDEMENT MUSCLE EACH ADDL 20 SQ CM
|
Facility
|
OP
|
$851.15
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
76100033
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$314.93 |
| Max. Negotiated Rate |
$766.03 |
| Rate for Payer: Aetna American Axle |
$553.25
|
| Rate for Payer: Aetna Commercial |
$723.48
|
| Rate for Payer: Aetna Medicare |
$425.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.25
|
| Rate for Payer: BCBS Complete |
$340.46
|
| Rate for Payer: Cash Price |
$680.92
|
| Rate for Payer: Cofinity Commercial |
$595.80
|
| Rate for Payer: Cofinity Commercial |
$731.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$595.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$680.92
|
| Rate for Payer: Healthscope Commercial |
$766.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$595.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$638.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$723.48
|
| Rate for Payer: PHP Commercial |
$723.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.25
|
| Rate for Payer: Priority Health SBD |
$536.22
|
| Rate for Payer: UMR Bronson Commercial |
$314.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$638.36
|
|
|
HC DEBRIDEMENT MUSCLE EACH ADDL 20 SQ CM
|
Facility
|
IP
|
$851.15
|
|
|
Service Code
|
CPT 11046
|
| Hospital Charge Code |
76100033
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$374.51 |
| Max. Negotiated Rate |
$766.03 |
| Rate for Payer: Aetna American Axle |
$553.25
|
| Rate for Payer: Aetna Commercial |
$723.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$553.25
|
| Rate for Payer: Cash Price |
$680.92
|
| Rate for Payer: Cofinity Commercial |
$595.80
|
| Rate for Payer: Cofinity Commercial |
$731.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$595.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$680.92
|
| Rate for Payer: Healthscope Commercial |
$766.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$595.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$638.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$723.48
|
| Rate for Payer: PHP Commercial |
$723.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.25
|
| Rate for Payer: Priority Health SBD |
$536.22
|
| Rate for Payer: UMR Bronson Commercial |
$374.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$638.36
|
|
|
HC DEBRIDEMENT OF 1-5 NAILS
|
Facility
|
IP
|
$94.42
|
|
|
Service Code
|
CPT 11720
|
| Hospital Charge Code |
76100043
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$41.54 |
| Max. Negotiated Rate |
$84.98 |
| Rate for Payer: Aetna American Axle |
$61.37
|
| Rate for Payer: Aetna Commercial |
$80.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.37
|
| Rate for Payer: Cash Price |
$75.54
|
| Rate for Payer: Cofinity Commercial |
$66.09
|
| Rate for Payer: Cofinity Commercial |
$81.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.54
|
| Rate for Payer: Healthscope Commercial |
$84.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.26
|
| Rate for Payer: PHP Commercial |
$80.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.37
|
| Rate for Payer: Priority Health SBD |
$59.48
|
| Rate for Payer: UMR Bronson Commercial |
$41.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.81
|
|
|
HC DEBRIDEMENT OF 1-5 NAILS
|
Facility
|
OP
|
$94.42
|
|
|
Service Code
|
CPT 11720
|
| Hospital Charge Code |
76100043
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$163.07 |
| Rate for Payer: Aetna American Axle |
$61.37
|
| Rate for Payer: Aetna Commercial |
$80.26
|
| Rate for Payer: Aetna Medicare |
$60.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$75.54
|
| Rate for Payer: Cash Price |
$75.54
|
| Rate for Payer: Cofinity Commercial |
$81.20
|
| Rate for Payer: Cofinity Commercial |
$66.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$84.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.81
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.26
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$80.26
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.37
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health SBD |
$59.48
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$110.71
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: UMR Bronson Commercial |
$34.94
|
| Rate for Payer: VA VA |
$57.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.81
|
|
|
HC DEBRIDEMENT OF 6 OR MORE NAILS
|
Facility
|
IP
|
$114.46
|
|
|
Service Code
|
CPT 11721
|
| Hospital Charge Code |
76100044
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$50.36 |
| Max. Negotiated Rate |
$103.01 |
| Rate for Payer: Aetna American Axle |
$74.40
|
| Rate for Payer: Aetna Commercial |
$97.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.40
|
| Rate for Payer: Cash Price |
$91.57
|
| Rate for Payer: Cofinity Commercial |
$80.12
|
| Rate for Payer: Cofinity Commercial |
$98.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.57
|
| Rate for Payer: Healthscope Commercial |
$103.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.29
|
| Rate for Payer: PHP Commercial |
$97.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.40
|
| Rate for Payer: Priority Health SBD |
$72.11
|
| Rate for Payer: UMR Bronson Commercial |
$50.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.84
|
|
|
HC DEBRIDEMENT OF 6 OR MORE NAILS
|
Facility
|
OP
|
$114.46
|
|
|
Service Code
|
CPT 11721
|
| Hospital Charge Code |
76100044
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$163.07 |
| Rate for Payer: Aetna American Axle |
$74.40
|
| Rate for Payer: Aetna Commercial |
$97.29
|
| Rate for Payer: Aetna Medicare |
$60.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$91.57
|
| Rate for Payer: Cash Price |
$91.57
|
| Rate for Payer: Cofinity Commercial |
$98.44
|
| Rate for Payer: Cofinity Commercial |
$80.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$103.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.84
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.29
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$97.29
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.40
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health SBD |
$72.11
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$110.71
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: UMR Bronson Commercial |
$42.35
|
| Rate for Payer: VA VA |
$57.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.84
|
|
|
HC DEBRIDE MUSCLE FASCIA FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$1,113.39
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
76100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$319.99 |
| Max. Negotiated Rate |
$1,680.50 |
| Rate for Payer: Aetna American Axle |
$723.70
|
| Rate for Payer: Aetna Commercial |
$946.38
|
| Rate for Payer: Aetna Medicare |
$620.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$723.70
|
| 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 |
$890.71
|
| Rate for Payer: Cash Price |
$890.71
|
| Rate for Payer: Cofinity Commercial |
$957.52
|
| Rate for Payer: Cofinity Commercial |
$779.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$779.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$890.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.00
|
| Rate for Payer: Healthscope Commercial |
$1,002.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$779.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$835.04
|
| 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 |
$946.38
|
| Rate for Payer: PACE Medicare |
$567.15
|
| Rate for Payer: PACE SWMI |
$597.00
|
| Rate for Payer: PHP Commercial |
$946.38
|
| 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 |
$723.70
|
| Rate for Payer: Priority Health Medicare |
$597.00
|
| Rate for Payer: Priority Health SBD |
$701.44
|
| 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 |
$411.95
|
| Rate for Payer: VA VA |
$597.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$835.04
|
|
|
HC DEBRIDE MUSCLE FASCIA FIRST 20 SQ CM OR LESS
|
Facility
|
IP
|
$1,113.39
|
|
|
Service Code
|
CPT 11043
|
| Hospital Charge Code |
76100026
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$489.89 |
| Max. Negotiated Rate |
$1,002.05 |
| Rate for Payer: Aetna American Axle |
$723.70
|
| Rate for Payer: Aetna Commercial |
$946.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$723.70
|
| Rate for Payer: Cash Price |
$890.71
|
| Rate for Payer: Cofinity Commercial |
$779.37
|
| Rate for Payer: Cofinity Commercial |
$957.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$779.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$890.71
|
| Rate for Payer: Healthscope Commercial |
$1,002.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$779.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$835.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$946.38
|
| Rate for Payer: PHP Commercial |
$946.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$723.70
|
| Rate for Payer: Priority Health SBD |
$701.44
|
| Rate for Payer: UMR Bronson Commercial |
$489.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$835.04
|
|
|
HC DEBRIDE SKIN AT FX SITE
|
Facility
|
OP
|
$1,887.00
|
|
|
Service Code
|
CPT 11010
|
| Hospital Charge Code |
76100390
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.80 |
| Max. Negotiated Rate |
$1,931.58 |
| Rate for Payer: Aetna American Axle |
$1,226.55
|
| Rate for Payer: Aetna Commercial |
$1,603.95
|
| Rate for Payer: Aetna Medicare |
$713.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,226.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Cofinity Commercial |
$1,622.82
|
| Rate for Payer: Cofinity Commercial |
$1,320.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,320.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,509.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$1,698.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,320.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,415.25
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,603.95
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$1,603.95
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,226.55
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health SBD |
$1,188.81
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,931.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,311.40
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: UMR Bronson Commercial |
$698.19
|
| Rate for Payer: VA VA |
$686.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,415.25
|
|
|
HC DEBRIDE SKIN AT FX SITE
|
Facility
|
IP
|
$1,887.00
|
|
|
Service Code
|
CPT 11010
|
| Hospital Charge Code |
76100390
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$830.28 |
| Max. Negotiated Rate |
$1,698.30 |
| Rate for Payer: Aetna American Axle |
$1,226.55
|
| Rate for Payer: Aetna Commercial |
$1,603.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,226.55
|
| Rate for Payer: Cash Price |
$1,509.60
|
| Rate for Payer: Cofinity Commercial |
$1,320.90
|
| Rate for Payer: Cofinity Commercial |
$1,622.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,320.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,509.60
|
| Rate for Payer: Healthscope Commercial |
$1,698.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,320.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,415.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,603.95
|
| Rate for Payer: PHP Commercial |
$1,603.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,226.55
|
| Rate for Payer: Priority Health SBD |
$1,188.81
|
| Rate for Payer: UMR Bronson Commercial |
$830.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,415.25
|
|
|
HC DEBRIDE SKIN BONE AT FX SITE
|
Facility
|
OP
|
$4,080.00
|
|
|
Service Code
|
CPT 11012
|
| Hospital Charge Code |
76100391
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$2,652.00
|
| Rate for Payer: Aetna Commercial |
$3,468.00
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,652.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cofinity Commercial |
$3,508.80
|
| Rate for Payer: Cofinity Commercial |
$2,856.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,856.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,264.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$3,672.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,856.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,060.00
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,468.00
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,468.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,652.00
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$2,570.40
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$5,334.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,509.60
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,060.00
|
|
|
HC DEBRIDE SKIN BONE AT FX SITE
|
Facility
|
IP
|
$4,080.00
|
|
|
Service Code
|
CPT 11012
|
| Hospital Charge Code |
76100391
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,795.20 |
| Max. Negotiated Rate |
$3,672.00 |
| Rate for Payer: Aetna American Axle |
$2,652.00
|
| Rate for Payer: Aetna Commercial |
$3,468.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,652.00
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cofinity Commercial |
$2,856.00
|
| Rate for Payer: Cofinity Commercial |
$3,508.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,856.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,264.00
|
| Rate for Payer: Healthscope Commercial |
$3,672.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,856.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,060.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,468.00
|
| Rate for Payer: PHP Commercial |
$3,468.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,652.00
|
| Rate for Payer: Priority Health SBD |
$2,570.40
|
| Rate for Payer: UMR Bronson Commercial |
$1,795.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,060.00
|
|
|
HC DEBRIDE SQ TISSUE EACH ADDL 20SQ CM
|
Facility
|
OP
|
$509.07
|
|
|
Service Code
|
CPT 11045
|
| Hospital Charge Code |
36100405
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$188.36 |
| Max. Negotiated Rate |
$458.16 |
| Rate for Payer: Aetna American Axle |
$330.90
|
| Rate for Payer: Aetna Commercial |
$432.71
|
| Rate for Payer: Aetna Medicare |
$254.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.90
|
| Rate for Payer: BCBS Complete |
$203.63
|
| Rate for Payer: Cash Price |
$407.26
|
| Rate for Payer: Cofinity Commercial |
$356.35
|
| Rate for Payer: Cofinity Commercial |
$437.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$356.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$407.26
|
| Rate for Payer: Healthscope Commercial |
$458.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$356.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.71
|
| Rate for Payer: PHP Commercial |
$432.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.90
|
| Rate for Payer: Priority Health SBD |
$320.71
|
| Rate for Payer: UMR Bronson Commercial |
$188.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.80
|
|
|
HC DEBRIDE SQ TISSUE EACH ADDL 20SQ CM
|
Facility
|
IP
|
$509.07
|
|
|
Service Code
|
CPT 11045
|
| Hospital Charge Code |
36100405
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$223.99 |
| Max. Negotiated Rate |
$458.16 |
| Rate for Payer: Aetna American Axle |
$330.90
|
| Rate for Payer: Aetna Commercial |
$432.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.90
|
| Rate for Payer: Cash Price |
$407.26
|
| Rate for Payer: Cofinity Commercial |
$356.35
|
| Rate for Payer: Cofinity Commercial |
$437.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$356.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$407.26
|
| Rate for Payer: Healthscope Commercial |
$458.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$356.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.71
|
| Rate for Payer: PHP Commercial |
$432.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.90
|
| Rate for Payer: Priority Health SBD |
$320.71
|
| Rate for Payer: UMR Bronson Commercial |
$223.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.80
|
|
|
HC DEBRIDE SQ TISSUE FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$645.08
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
76100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna American Axle |
$419.30
|
| Rate for Payer: Aetna Commercial |
$548.32
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$516.06
|
| Rate for Payer: Cash Price |
$516.06
|
| Rate for Payer: Cofinity Commercial |
$554.77
|
| Rate for Payer: Cofinity Commercial |
$451.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$451.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$516.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$580.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$451.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$483.81
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$548.32
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$548.32
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.30
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$406.40
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$744.66
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: UMR Bronson Commercial |
$238.68
|
| Rate for Payer: VA VA |
$389.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$483.81
|
|
|
HC DEBRIDE SQ TISSUE FIRST 20 SQ CM OR LESS
|
Facility
|
IP
|
$645.08
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
76100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$283.84 |
| Max. Negotiated Rate |
$580.57 |
| Rate for Payer: Aetna American Axle |
$419.30
|
| Rate for Payer: Aetna Commercial |
$548.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$419.30
|
| Rate for Payer: Cash Price |
$516.06
|
| Rate for Payer: Cofinity Commercial |
$451.56
|
| Rate for Payer: Cofinity Commercial |
$554.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$451.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$516.06
|
| Rate for Payer: Healthscope Commercial |
$580.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$451.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$483.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$548.32
|
| Rate for Payer: PHP Commercial |
$548.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$419.30
|
| Rate for Payer: Priority Health SBD |
$406.40
|
| Rate for Payer: UMR Bronson Commercial |
$283.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$483.81
|
|
|
HC DECALCIFICATION
|
Facility
|
IP
|
$37.56
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
31000051
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$16.53 |
| Max. Negotiated Rate |
$33.80 |
| Rate for Payer: Aetna American Axle |
$24.41
|
| Rate for Payer: Aetna Commercial |
$31.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.41
|
| Rate for Payer: Cash Price |
$30.05
|
| Rate for Payer: Cofinity Commercial |
$26.29
|
| Rate for Payer: Cofinity Commercial |
$32.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.05
|
| Rate for Payer: Healthscope Commercial |
$33.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.93
|
| Rate for Payer: PHP Commercial |
$31.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.41
|
| Rate for Payer: Priority Health SBD |
$23.66
|
| Rate for Payer: UMR Bronson Commercial |
$16.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.17
|
|
|
HC DECALCIFICATION
|
Facility
|
OP
|
$37.56
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
31000051
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$13.90 |
| Max. Negotiated Rate |
$33.80 |
| Rate for Payer: Aetna American Axle |
$24.41
|
| Rate for Payer: Aetna Commercial |
$31.93
|
| Rate for Payer: Aetna Medicare |
$18.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.41
|
| Rate for Payer: BCBS Complete |
$15.02
|
| Rate for Payer: Cash Price |
$30.05
|
| Rate for Payer: Cofinity Commercial |
$26.29
|
| Rate for Payer: Cofinity Commercial |
$32.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.05
|
| Rate for Payer: Healthscope Commercial |
$33.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.93
|
| Rate for Payer: PHP Commercial |
$31.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.41
|
| Rate for Payer: Priority Health SBD |
$23.66
|
| Rate for Payer: UMR Bronson Commercial |
$13.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.17
|
|
