|
HC EXC FACE MM BENIGN +MARG 2.1 - 3 CM
|
Facility
|
IP
|
$4,329.73
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
36000109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,905.08 |
| Max. Negotiated Rate |
$3,896.76 |
| Rate for Payer: Aetna American Axle |
$2,814.32
|
| Rate for Payer: Aetna Commercial |
$3,680.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,814.32
|
| Rate for Payer: Cash Price |
$3,463.78
|
| Rate for Payer: Cofinity Advantage |
$3,030.81
|
| Rate for Payer: Cofinity Commercial |
$3,723.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,463.78
|
| Rate for Payer: Healthscope Commercial |
$3,896.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,030.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,247.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,680.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,247.30
|
| Rate for Payer: PHP Commercial |
$3,680.27
|
| Rate for Payer: Priority Health SBD |
$2,727.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,905.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,247.30
|
|
|
HC EXC FACE MM BENIGN +MARG 2.1 - 3 CM
|
Facility
|
OP
|
$4,329.73
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
36000109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$2,814.32
|
| Rate for Payer: Aetna Commercial |
$3,680.27
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,814.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,031.89
|
| Rate for Payer: BCN Commercial |
$2,031.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,463.78
|
| Rate for Payer: Cash Price |
$3,463.78
|
| Rate for Payer: Cash Price |
$3,463.78
|
| Rate for Payer: Cofinity Advantage |
$3,030.81
|
| Rate for Payer: Cofinity Commercial |
$3,723.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,463.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$3,896.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,030.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,247.30
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,680.27
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,247.30
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$3,680.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$2,727.73
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,814.32
|
| Rate for Payer: UHC Core |
$2,255.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$1,701.58
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,602.00
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,247.30
|
|
|
HC EXC FACE MM BENIGN +MARG 3.1 - 4 CM
|
Facility
|
IP
|
$4,329.73
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
36000108
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,905.08 |
| Max. Negotiated Rate |
$3,896.76 |
| Rate for Payer: Aetna American Axle |
$2,814.32
|
| Rate for Payer: Aetna Commercial |
$3,680.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,814.32
|
| Rate for Payer: Cash Price |
$3,463.78
|
| Rate for Payer: Cofinity Advantage |
$3,030.81
|
| Rate for Payer: Cofinity Commercial |
$3,723.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,463.78
|
| Rate for Payer: Healthscope Commercial |
$3,896.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,030.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,247.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,680.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,247.30
|
| Rate for Payer: PHP Commercial |
$3,680.27
|
| Rate for Payer: Priority Health SBD |
$2,727.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,905.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,247.30
|
|
|
HC EXC FACE MM BENIGN +MARG 3.1 - 4 CM
|
Facility
|
OP
|
$4,329.73
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
36000108
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$860.68 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$2,814.32
|
| Rate for Payer: Aetna Commercial |
$3,680.27
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,814.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,144.50
|
| Rate for Payer: BCN Commercial |
$1,144.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$3,463.78
|
| Rate for Payer: Cash Price |
$3,463.78
|
| Rate for Payer: Cash Price |
$3,463.78
|
| Rate for Payer: Cofinity Advantage |
$3,030.81
|
| Rate for Payer: Cofinity Commercial |
$3,723.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,463.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$3,896.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,030.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,247.30
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,680.27
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,247.30
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$3,680.27
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$2,727.73
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,814.32
|
| Rate for Payer: UHC Core |
$2,255.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$1,701.58
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,602.00
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,247.30
|
|
|
HC EXC FACE MM BENIGN +MARG >4 CM
|
Facility
|
IP
|
$7,293.68
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
36000107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,209.22 |
| Max. Negotiated Rate |
$6,564.31 |
| Rate for Payer: Aetna American Axle |
$4,740.89
|
| Rate for Payer: Aetna Commercial |
$6,199.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,740.89
|
| Rate for Payer: Cash Price |
$5,834.94
|
| Rate for Payer: Cofinity Advantage |
$5,105.58
|
| Rate for Payer: Cofinity Commercial |
$6,272.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,834.94
|
| Rate for Payer: Healthscope Commercial |
$6,564.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,105.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,470.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,199.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,470.26
|
| Rate for Payer: PHP Commercial |
$6,199.63
|
| Rate for Payer: Priority Health SBD |
$4,595.02
|
| Rate for Payer: UMR Bronson Commercial |
$3,209.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,470.26
|
|
|
HC EXC FACE MM BENIGN +MARG >4 CM
|
Facility
|
OP
|
$7,293.68
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
36000107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna American Axle |
$4,740.89
|
| Rate for Payer: Aetna Commercial |
$6,199.63
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,740.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,940.82
|
| Rate for Payer: BCN Commercial |
$1,940.82
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$5,834.94
|
| Rate for Payer: Cash Price |
$5,834.94
|
| Rate for Payer: Cash Price |
$5,834.94
|
| Rate for Payer: Cofinity Advantage |
$5,105.58
|
| Rate for Payer: Cofinity Commercial |
$6,272.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,834.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$6,564.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,105.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,470.26
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,199.63
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,470.26
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$6,199.63
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$4,595.02
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,740.89
|
| Rate for Payer: UHC Core |
$3,800.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$2,866.42
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: UMR Bronson Commercial |
$2,698.66
|
| Rate for Payer: VA VA |
$2,894.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,470.26
|
|
|
HC EXCHANGE ABSCESS CYST DRAIN CATHETER
|
Facility
|
IP
|
$2,614.20
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
36100222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,150.25 |
| Max. Negotiated Rate |
$2,352.78 |
| Rate for Payer: Aetna American Axle |
$1,699.23
|
| Rate for Payer: Aetna Commercial |
$2,222.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,699.23
|
| Rate for Payer: Cash Price |
$2,091.36
|
| Rate for Payer: Cofinity Advantage |
$1,829.94
|
| Rate for Payer: Cofinity Commercial |
$2,248.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,091.36
|
| Rate for Payer: Healthscope Commercial |
$2,352.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,829.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,960.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,222.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,960.65
|
| Rate for Payer: PHP Commercial |
$2,222.07
|
| Rate for Payer: Priority Health SBD |
$1,646.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,150.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,960.65
|
|
|
HC EXCHANGE ABSCESS CYST DRAIN CATHETER
|
Facility
|
OP
|
$2,614.20
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
36100222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$967.25 |
| Max. Negotiated Rate |
$6,183.25 |
| Rate for Payer: Aetna American Axle |
$1,699.23
|
| Rate for Payer: Aetna Commercial |
$2,222.07
|
| Rate for Payer: Aetna Medicare |
$1,988.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,699.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,390.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,390.01
|
| Rate for Payer: BCBS Complete |
$1,050.08
|
| Rate for Payer: BCBS MAPPO |
$1,912.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,342.13
|
| Rate for Payer: BCN Commercial |
$1,342.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,912.01
|
| Rate for Payer: Cash Price |
$2,091.36
|
| Rate for Payer: Cash Price |
$2,091.36
|
| Rate for Payer: Cash Price |
$2,091.36
|
| Rate for Payer: Cofinity Advantage |
$1,829.94
|
| Rate for Payer: Cofinity Commercial |
$2,248.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,091.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,912.01
|
| Rate for Payer: Healthscope Commercial |
$2,352.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,829.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,960.65
|
| Rate for Payer: Mclaren Medicaid |
$1,912.01
|
| Rate for Payer: Mclaren Medicare |
$1,912.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,007.61
|
| Rate for Payer: Meridian Medicaid |
$2,007.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,198.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,103.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,222.07
|
| Rate for Payer: Nomi Health Commercial |
$5,736.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,960.65
|
| Rate for Payer: PACE Medicare |
$1,816.41
|
| Rate for Payer: PACE SWMI |
$1,912.01
|
| Rate for Payer: PHP Commercial |
$2,222.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,912.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$999.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,183.25
|
| Rate for Payer: Priority Health Medicare |
$1,912.01
|
| Rate for Payer: Priority Health SBD |
$1,646.95
|
| Rate for Payer: Priority Health Tiered Network |
$4,946.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,912.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,912.01
|
| Rate for Payer: UHC Medicaid |
$999.98
|
| Rate for Payer: UHCCP Medicaid |
$999.98
|
| Rate for Payer: UMR Bronson Commercial |
$967.25
|
| Rate for Payer: VA VA |
$1,912.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,960.65
|
|
|
HC EXCHANGE BILIARY DRAIN CATH
|
Facility
|
OP
|
$4,550.49
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
36100493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,683.68 |
| Max. Negotiated Rate |
$11,537.07 |
| Rate for Payer: Aetna American Axle |
$2,957.82
|
| Rate for Payer: Aetna Commercial |
$3,867.92
|
| Rate for Payer: Aetna Medicare |
$3,710.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,957.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$2,692.48
|
| Rate for Payer: BCN Commercial |
$2,692.48
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$3,640.39
|
| Rate for Payer: Cash Price |
$3,640.39
|
| Rate for Payer: Cash Price |
$3,640.39
|
| Rate for Payer: Cofinity Advantage |
$3,185.34
|
| Rate for Payer: Cofinity Commercial |
$3,913.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,640.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$4,095.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,185.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,412.87
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$3,745.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,867.92
|
| Rate for Payer: Nomi Health Commercial |
$10,702.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,412.87
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$3,867.92
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,537.07
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health SBD |
$2,866.81
|
| Rate for Payer: Priority Health Tiered Network |
$9,229.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,683.68
|
| Rate for Payer: VA VA |
$3,567.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,412.87
|
|
|
HC EXCHANGE BILIARY DRAIN CATH
|
Facility
|
IP
|
$4,550.49
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
36100493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,002.22 |
| Max. Negotiated Rate |
$4,095.44 |
| Rate for Payer: Aetna American Axle |
$2,957.82
|
| Rate for Payer: Aetna Commercial |
$3,867.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,957.82
|
| Rate for Payer: Cash Price |
$3,640.39
|
| Rate for Payer: Cofinity Advantage |
$3,185.34
|
| Rate for Payer: Cofinity Commercial |
$3,913.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,640.39
|
| Rate for Payer: Healthscope Commercial |
$4,095.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,185.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,412.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,867.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,412.87
|
| Rate for Payer: PHP Commercial |
$3,867.92
|
| Rate for Payer: Priority Health SBD |
$2,866.81
|
| Rate for Payer: UMR Bronson Commercial |
$2,002.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,412.87
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER
|
Facility
|
OP
|
$3,719.45
|
|
|
Service Code
|
CPT 50435
|
| Hospital Charge Code |
36100507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna American Axle |
$2,417.64
|
| Rate for Payer: Aetna Commercial |
$3,161.53
|
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,417.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,513.36
|
| Rate for Payer: BCN Commercial |
$2,513.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$2,975.56
|
| Rate for Payer: Cash Price |
$2,975.56
|
| Rate for Payer: Cash Price |
$2,975.56
|
| Rate for Payer: Cofinity Advantage |
$2,603.61
|
| Rate for Payer: Cofinity Commercial |
$3,198.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,975.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$3,347.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,603.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,789.59
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$2,187.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,161.53
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,789.59
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$3,161.53
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,735.82
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health SBD |
$2,343.25
|
| Rate for Payer: Priority Health Tiered Network |
$5,388.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,376.20
|
| Rate for Payer: VA VA |
$2,082.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,789.59
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER
|
Facility
|
IP
|
$3,719.45
|
|
|
Service Code
|
CPT 50435
|
| Hospital Charge Code |
36100507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,636.56 |
| Max. Negotiated Rate |
$3,347.51 |
| Rate for Payer: Aetna American Axle |
$2,417.64
|
| Rate for Payer: Aetna Commercial |
$3,161.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,417.64
|
| Rate for Payer: Cash Price |
$2,975.56
|
| Rate for Payer: Cofinity Advantage |
$2,603.61
|
| Rate for Payer: Cofinity Commercial |
$3,198.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,975.56
|
| Rate for Payer: Healthscope Commercial |
$3,347.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,603.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,789.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,161.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,789.59
|
| Rate for Payer: PHP Commercial |
$3,161.53
|
| Rate for Payer: Priority Health SBD |
$2,343.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,636.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,789.59
|
|
|
HC EXCHANGE TRANSFUSION NONINFANT
|
Facility
|
IP
|
$1,554.53
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
39100001
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$683.99 |
| Max. Negotiated Rate |
$1,399.08 |
| Rate for Payer: Aetna American Axle |
$1,010.44
|
| Rate for Payer: Aetna Commercial |
$1,321.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,010.44
|
| Rate for Payer: Cash Price |
$1,243.62
|
| Rate for Payer: Cofinity Advantage |
$1,088.17
|
| Rate for Payer: Cofinity Commercial |
$1,336.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,243.62
|
| Rate for Payer: Healthscope Commercial |
$1,399.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,088.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,165.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,321.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,165.90
|
| Rate for Payer: PHP Commercial |
$1,321.35
|
| Rate for Payer: Priority Health SBD |
$979.35
|
| Rate for Payer: UMR Bronson Commercial |
$683.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,165.90
|
|
|
HC EXCHANGE TRANSFUSION NONINFANT
|
Facility
|
OP
|
$1,554.53
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
39100001
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$95.81 |
| Max. Negotiated Rate |
$1,421.59 |
| Rate for Payer: Aetna American Axle |
$1,010.44
|
| Rate for Payer: Aetna Commercial |
$1,321.35
|
| Rate for Payer: Aetna Medicare |
$457.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,010.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$549.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$549.49
|
| Rate for Payer: BCBS Complete |
$241.42
|
| Rate for Payer: BCBS MAPPO |
$439.59
|
| Rate for Payer: BCBS Trust/PPO |
$95.81
|
| Rate for Payer: BCN Commercial |
$95.81
|
| Rate for Payer: BCN Medicare Advantage |
$439.59
|
| Rate for Payer: Cash Price |
$1,243.62
|
| Rate for Payer: Cash Price |
$1,243.62
|
| Rate for Payer: Cofinity Advantage |
$1,088.17
|
| Rate for Payer: Cofinity Commercial |
$1,336.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,243.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.59
|
| Rate for Payer: Healthscope Commercial |
$1,399.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,088.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,165.90
|
| Rate for Payer: Mclaren Medicaid |
$439.59
|
| Rate for Payer: Mclaren Medicare |
$439.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.57
|
| Rate for Payer: Meridian Medicaid |
$461.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$505.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$483.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,321.35
|
| Rate for Payer: Nomi Health Commercial |
$1,318.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,165.90
|
| Rate for Payer: PACE Medicare |
$417.61
|
| Rate for Payer: PACE SWMI |
$439.59
|
| Rate for Payer: PHP Commercial |
$1,321.35
|
| Rate for Payer: PHP Medicare Advantage |
$439.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,421.59
|
| Rate for Payer: Priority Health Medicare |
$439.59
|
| Rate for Payer: Priority Health SBD |
$979.35
|
| Rate for Payer: Priority Health Tiered Network |
$1,137.27
|
| Rate for Payer: Railroad Medicare Medicare |
$439.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,010.44
|
| Rate for Payer: UHC Core |
$809.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$439.59
|
| Rate for Payer: UHC Exchange |
$610.93
|
| Rate for Payer: UHC Medicaid |
$229.91
|
| Rate for Payer: UHCCP Medicaid |
$229.91
|
| Rate for Payer: UMR Bronson Commercial |
$575.18
|
| Rate for Payer: VA VA |
$439.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,165.90
|
|
|
HC EXCHANGE WIRE PTCA
|
Facility
|
IP
|
$561.27
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$246.96 |
| Max. Negotiated Rate |
$505.14 |
| Rate for Payer: Aetna American Axle |
$364.83
|
| Rate for Payer: Aetna Commercial |
$477.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.83
|
| Rate for Payer: Cash Price |
$449.02
|
| Rate for Payer: Cofinity Advantage |
$392.89
|
| Rate for Payer: Cofinity Commercial |
$482.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.02
|
| Rate for Payer: Healthscope Commercial |
$505.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$392.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$420.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$420.95
|
| Rate for Payer: PHP Commercial |
$477.08
|
| Rate for Payer: Priority Health SBD |
$353.60
|
| Rate for Payer: UMR Bronson Commercial |
$246.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$420.95
|
|
|
HC EXCHANGE WIRE PTCA
|
Facility
|
OP
|
$561.27
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$207.67 |
| Max. Negotiated Rate |
$505.14 |
| Rate for Payer: Aetna American Axle |
$364.83
|
| Rate for Payer: Aetna Commercial |
$477.08
|
| Rate for Payer: Aetna Medicare |
$280.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$364.83
|
| Rate for Payer: BCBS Complete |
$224.51
|
| Rate for Payer: Cash Price |
$449.02
|
| Rate for Payer: Cofinity Advantage |
$392.89
|
| Rate for Payer: Cofinity Commercial |
$482.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.02
|
| Rate for Payer: Healthscope Commercial |
$505.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$392.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$420.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$449.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$420.95
|
| Rate for Payer: PHP Commercial |
$477.08
|
| Rate for Payer: Priority Health SBD |
$353.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.83
|
| Rate for Payer: UHC Core |
$292.42
|
| Rate for Payer: UHC Exchange |
$220.58
|
| Rate for Payer: UMR Bronson Commercial |
$207.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$420.95
|
|
|
HC EXCIS/DESTRUCT INTRANASAL LESION INT APPR
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
76100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,616.43 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna American Axle |
$5,342.45
|
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,342.45
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Advantage |
$5,753.41
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,753.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: Priority Health SBD |
$5,178.07
|
| Rate for Payer: UMR Bronson Commercial |
$3,616.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
|
HC EXCIS/DESTRUCT INTRANASAL LESION INT APPR
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
76100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$10,683.35 |
| Rate for Payer: Aetna American Axle |
$5,342.45
|
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,342.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,064.42
|
| Rate for Payer: BCN Commercial |
$2,064.42
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Advantage |
$5,753.41
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,753.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$3,468.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,683.35
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health SBD |
$5,178.07
|
| Rate for Payer: Priority Health Tiered Network |
$8,546.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,342.45
|
| Rate for Payer: UHC Core |
$4,282.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$3,230.13
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: UMR Bronson Commercial |
$3,041.09
|
| Rate for Payer: VA VA |
$3,303.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
76100095
|
|
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 EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.5 CM OR LESS
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
76100095
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$443.84 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$779.72
|
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,031.89
|
| Rate for Payer: BCN Commercial |
$2,031.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| 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 |
$1,645.66
|
| 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: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$755.73
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| 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 |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$471.43
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$443.84
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.68
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
76100096
|
|
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 EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 0.6 TO 1.0 CM
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
76100096
|
|
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
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
OP
|
$1,199.57
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
76100097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$443.84 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$779.72
|
| Rate for Payer: Aetna Commercial |
$1,019.63
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$779.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,031.89
|
| Rate for Payer: BCN Commercial |
$2,031.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| 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 |
$1,645.66
|
| 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: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,019.63
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$899.68
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,019.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$755.73
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| 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 |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$471.43
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$443.84
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.68
|
|
|
HC EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 1.1 TO 2.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
76100097
|
|
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 EXCISE BENIGN LESION SCALP, NECK, HANDS, FEET, GENITALIA 2.1 TO 3.0 CM
|
Facility
|
IP
|
$1,199.57
|
|
|
Service Code
|
CPT 11423
|
| Hospital Charge Code |
76100098
|
|
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
|
|
