|
HC FFR MEASUREMENT ADD VESS
|
Facility
|
OP
|
$857.37
|
|
|
Service Code
|
CPT 93572
|
| Hospital Charge Code |
48100028
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$262.04 |
| Max. Negotiated Rate |
$771.63 |
| Rate for Payer: Aetna American Axle |
$557.29
|
| Rate for Payer: Aetna Commercial |
$728.76
|
| Rate for Payer: Aetna Medicare |
$428.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.29
|
| Rate for Payer: BCBS Complete |
$342.95
|
| Rate for Payer: BCBS Trust/PPO |
$262.04
|
| Rate for Payer: BCN Commercial |
$262.04
|
| Rate for Payer: Cash Price |
$685.90
|
| Rate for Payer: Cash Price |
$685.90
|
| Rate for Payer: Cofinity Advantage |
$600.16
|
| Rate for Payer: Cofinity Commercial |
$737.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$685.90
|
| Rate for Payer: Healthscope Commercial |
$771.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$600.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$643.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$685.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$728.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$643.03
|
| Rate for Payer: PHP Commercial |
$728.76
|
| Rate for Payer: Priority Health SBD |
$540.14
|
| Rate for Payer: UMR Bronson Commercial |
$317.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$643.03
|
|
|
HC FIBEROPTIC IABP KIT
|
Facility
|
OP
|
$2,729.96
|
|
| Hospital Charge Code |
27200301
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,010.09 |
| Max. Negotiated Rate |
$2,456.96 |
| Rate for Payer: Aetna American Axle |
$1,774.47
|
| Rate for Payer: Aetna Commercial |
$2,320.47
|
| Rate for Payer: Aetna Medicare |
$1,364.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,774.47
|
| Rate for Payer: BCBS Complete |
$1,091.98
|
| Rate for Payer: Cash Price |
$2,183.97
|
| Rate for Payer: Cofinity Advantage |
$1,910.97
|
| Rate for Payer: Cofinity Commercial |
$2,347.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,183.97
|
| Rate for Payer: Healthscope Commercial |
$2,456.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,910.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,047.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,183.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,320.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,047.47
|
| Rate for Payer: PHP Commercial |
$2,320.47
|
| Rate for Payer: Priority Health SBD |
$1,719.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,774.47
|
| Rate for Payer: UHC Core |
$1,422.31
|
| Rate for Payer: UHC Exchange |
$1,072.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,010.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,047.47
|
|
|
HC FIBEROPTIC IABP KIT
|
Facility
|
IP
|
$2,729.96
|
|
| Hospital Charge Code |
27200301
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,201.18 |
| Max. Negotiated Rate |
$2,456.96 |
| Rate for Payer: Aetna American Axle |
$1,774.47
|
| Rate for Payer: Aetna Commercial |
$2,320.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,774.47
|
| Rate for Payer: Cash Price |
$2,183.97
|
| Rate for Payer: Cofinity Advantage |
$1,910.97
|
| Rate for Payer: Cofinity Commercial |
$2,347.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,183.97
|
| Rate for Payer: Healthscope Commercial |
$2,456.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,910.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,047.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,320.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,047.47
|
| Rate for Payer: PHP Commercial |
$2,320.47
|
| Rate for Payer: Priority Health SBD |
$1,719.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,201.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,047.47
|
|
|
HC FIBRINOGEN
|
Facility
|
OP
|
$78.45
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500045
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna American Axle |
$50.99
|
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna Medicare |
$10.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.15
|
| Rate for Payer: BCBS Complete |
$5.34
|
| Rate for Payer: BCBS MAPPO |
$9.72
|
| Rate for Payer: BCBS Trust/PPO |
$11.24
|
| Rate for Payer: BCN Commercial |
$11.24
|
| Rate for Payer: BCN Medicare Advantage |
$9.72
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Advantage |
$54.91
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.72
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.84
|
| Rate for Payer: Mclaren Medicaid |
$9.72
|
| Rate for Payer: Mclaren Medicare |
$9.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.21
|
| Rate for Payer: Meridian Medicaid |
$10.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$14.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PACE Medicare |
$9.23
|
| Rate for Payer: PACE SWMI |
$9.72
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: PHP Medicare Advantage |
$9.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.72
|
| Rate for Payer: Priority Health Medicare |
$9.72
|
| Rate for Payer: Priority Health SBD |
$49.42
|
| Rate for Payer: Priority Health Tiered Network |
$7.78
|
| Rate for Payer: Railroad Medicare Medicare |
$9.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.58
|
| Rate for Payer: UHC Core |
$14.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.72
|
| Rate for Payer: UHC Exchange |
$14.58
|
| Rate for Payer: UHC Medicaid |
$5.08
|
| Rate for Payer: UHCCP Medicaid |
$5.08
|
| Rate for Payer: UMR Bronson Commercial |
$29.03
|
| Rate for Payer: VA VA |
$9.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.84
|
|
|
HC FIBRINOGEN
|
Facility
|
IP
|
$78.45
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500045
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$34.52 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna American Axle |
$50.99
|
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.99
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Advantage |
$54.91
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: Priority Health SBD |
$49.42
|
| Rate for Payer: UMR Bronson Commercial |
$34.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.84
|
|
|
HC FIBROTEST-ACTITEST, S
|
Facility
|
IP
|
$296.51
|
|
|
Service Code
|
CPT 81596
|
| Hospital Charge Code |
30000155
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$130.46 |
| Max. Negotiated Rate |
$266.86 |
| Rate for Payer: Aetna American Axle |
$192.73
|
| Rate for Payer: Aetna Commercial |
$252.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.73
|
| Rate for Payer: Cash Price |
$237.21
|
| Rate for Payer: Cofinity Advantage |
$207.56
|
| Rate for Payer: Cofinity Commercial |
$255.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.21
|
| Rate for Payer: Healthscope Commercial |
$266.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$207.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$222.38
|
| Rate for Payer: PHP Commercial |
$252.03
|
| Rate for Payer: Priority Health SBD |
$186.80
|
| Rate for Payer: UMR Bronson Commercial |
$130.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.38
|
|
|
HC FIBROTEST-ACTITEST, S
|
Facility
|
OP
|
$296.51
|
|
|
Service Code
|
CPT 81596
|
| Hospital Charge Code |
30000155
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.76 |
| Max. Negotiated Rate |
$266.86 |
| Rate for Payer: Aetna American Axle |
$192.73
|
| Rate for Payer: Aetna Commercial |
$252.03
|
| Rate for Payer: Aetna Medicare |
$75.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$90.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$90.24
|
| Rate for Payer: BCBS Complete |
$39.65
|
| Rate for Payer: BCBS MAPPO |
$72.19
|
| Rate for Payer: BCBS Trust/PPO |
$83.45
|
| Rate for Payer: BCN Commercial |
$83.45
|
| Rate for Payer: BCN Medicare Advantage |
$72.19
|
| Rate for Payer: Cash Price |
$237.21
|
| Rate for Payer: Cash Price |
$237.21
|
| Rate for Payer: Cofinity Advantage |
$207.56
|
| Rate for Payer: Cofinity Commercial |
$255.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.19
|
| Rate for Payer: Healthscope Commercial |
$266.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$207.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.38
|
| Rate for Payer: Mclaren Medicaid |
$72.19
|
| Rate for Payer: Mclaren Medicare |
$72.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.80
|
| Rate for Payer: Meridian Medicaid |
$75.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$79.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.03
|
| Rate for Payer: Nomi Health Commercial |
$216.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$222.38
|
| Rate for Payer: PACE Medicare |
$68.58
|
| Rate for Payer: PACE SWMI |
$72.19
|
| Rate for Payer: PHP Commercial |
$252.03
|
| Rate for Payer: PHP Medicare Advantage |
$72.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$72.19
|
| Rate for Payer: Priority Health Medicare |
$72.19
|
| Rate for Payer: Priority Health SBD |
$186.80
|
| Rate for Payer: Priority Health Tiered Network |
$57.75
|
| Rate for Payer: Railroad Medicare Medicare |
$72.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.29
|
| Rate for Payer: UHC Core |
$108.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$72.19
|
| Rate for Payer: UHC Exchange |
$108.29
|
| Rate for Payer: UHC Medicaid |
$37.76
|
| Rate for Payer: UHCCP Medicaid |
$37.76
|
| Rate for Payer: UMR Bronson Commercial |
$109.71
|
| Rate for Payer: VA VA |
$72.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.38
|
|
|
HC FILSHIE CLIP
|
Facility
|
IP
|
$342.54
|
|
| Hospital Charge Code |
27000076
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$150.72 |
| Max. Negotiated Rate |
$308.29 |
| Rate for Payer: Aetna American Axle |
$222.65
|
| Rate for Payer: Aetna Commercial |
$291.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.65
|
| Rate for Payer: Cash Price |
$274.03
|
| Rate for Payer: Cofinity Advantage |
$239.78
|
| Rate for Payer: Cofinity Commercial |
$294.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.03
|
| Rate for Payer: Healthscope Commercial |
$308.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$239.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$256.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$256.90
|
| Rate for Payer: PHP Commercial |
$291.16
|
| Rate for Payer: Priority Health SBD |
$215.80
|
| Rate for Payer: UMR Bronson Commercial |
$150.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$256.90
|
|
|
HC FILSHIE CLIP
|
Facility
|
OP
|
$342.54
|
|
| Hospital Charge Code |
27000076
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$126.74 |
| Max. Negotiated Rate |
$308.29 |
| Rate for Payer: Aetna American Axle |
$222.65
|
| Rate for Payer: Aetna Commercial |
$291.16
|
| Rate for Payer: Aetna Medicare |
$171.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.65
|
| Rate for Payer: BCBS Complete |
$137.02
|
| Rate for Payer: Cash Price |
$274.03
|
| Rate for Payer: Cofinity Advantage |
$239.78
|
| Rate for Payer: Cofinity Commercial |
$294.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.03
|
| Rate for Payer: Healthscope Commercial |
$308.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$239.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$256.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$256.90
|
| Rate for Payer: PHP Commercial |
$291.16
|
| Rate for Payer: Priority Health SBD |
$215.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.65
|
| Rate for Payer: UHC Core |
$178.46
|
| Rate for Payer: UHC Exchange |
$134.62
|
| Rate for Payer: UMR Bronson Commercial |
$126.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$256.90
|
|
|
HC FILTER ATS LIPIGUARD
|
Facility
|
OP
|
$59.30
|
|
| Hospital Charge Code |
27000121
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.94 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna American Axle |
$38.55
|
| Rate for Payer: Aetna Commercial |
$50.41
|
| Rate for Payer: Aetna Medicare |
$29.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.55
|
| Rate for Payer: BCBS Complete |
$23.72
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Advantage |
$41.51
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.48
|
| Rate for Payer: PHP Commercial |
$50.41
|
| Rate for Payer: Priority Health SBD |
$37.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.55
|
| Rate for Payer: UHC Core |
$30.90
|
| Rate for Payer: UHC Exchange |
$23.30
|
| Rate for Payer: UMR Bronson Commercial |
$21.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC FILTER ATS LIPIGUARD
|
Facility
|
IP
|
$59.30
|
|
| Hospital Charge Code |
27000121
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.09 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna American Axle |
$38.55
|
| Rate for Payer: Aetna Commercial |
$50.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.55
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Advantage |
$41.51
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.48
|
| Rate for Payer: PHP Commercial |
$50.41
|
| Rate for Payer: Priority Health SBD |
$37.36
|
| Rate for Payer: UMR Bronson Commercial |
$26.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC FILTERWIRE
|
Facility
|
IP
|
$3,890.74
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,711.93 |
| Max. Negotiated Rate |
$3,501.67 |
| Rate for Payer: Aetna American Axle |
$2,528.98
|
| Rate for Payer: Aetna Commercial |
$3,307.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,528.98
|
| Rate for Payer: Cash Price |
$3,112.59
|
| Rate for Payer: Cofinity Advantage |
$2,723.52
|
| Rate for Payer: Cofinity Commercial |
$3,346.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,112.59
|
| Rate for Payer: Healthscope Commercial |
$3,501.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,723.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,918.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,307.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,918.05
|
| Rate for Payer: PHP Commercial |
$3,307.13
|
| Rate for Payer: Priority Health SBD |
$2,451.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,711.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,918.05
|
|
|
HC FILTERWIRE
|
Facility
|
OP
|
$3,890.74
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,439.57 |
| Max. Negotiated Rate |
$3,501.67 |
| Rate for Payer: Aetna American Axle |
$2,528.98
|
| Rate for Payer: Aetna Commercial |
$3,307.13
|
| Rate for Payer: Aetna Medicare |
$1,945.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,528.98
|
| Rate for Payer: BCBS Complete |
$1,556.30
|
| Rate for Payer: Cash Price |
$3,112.59
|
| Rate for Payer: Cofinity Advantage |
$2,723.52
|
| Rate for Payer: Cofinity Commercial |
$3,346.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,112.59
|
| Rate for Payer: Healthscope Commercial |
$3,501.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,723.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,918.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,112.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,307.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,918.05
|
| Rate for Payer: PHP Commercial |
$3,307.13
|
| Rate for Payer: Priority Health SBD |
$2,451.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,528.98
|
| Rate for Payer: UHC Core |
$2,027.08
|
| Rate for Payer: UHC Exchange |
$1,529.06
|
| Rate for Payer: UMR Bronson Commercial |
$1,439.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,918.05
|
|
|
HC FINGER SPLINT, STATIC, SUPPLY
|
Facility
|
OP
|
$21.23
|
|
| Hospital Charge Code |
27000646
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.86 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$10.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.80
|
| Rate for Payer: UHC Core |
$11.06
|
| Rate for Payer: UHC Exchange |
$8.34
|
| Rate for Payer: UMR Bronson Commercial |
$7.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC FINGER SPLINT, STATIC, SUPPLY
|
Facility
|
IP
|
$21.23
|
|
| Hospital Charge Code |
27000646
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: UMR Bronson Commercial |
$9.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC FISH PRENATAL ANEUPLOIDY
|
Facility
|
IP
|
$171.91
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000034
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$75.64 |
| Max. Negotiated Rate |
$154.72 |
| Rate for Payer: Aetna American Axle |
$111.74
|
| Rate for Payer: Aetna Commercial |
$146.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.74
|
| Rate for Payer: Cash Price |
$137.53
|
| Rate for Payer: Cofinity Advantage |
$120.34
|
| Rate for Payer: Cofinity Commercial |
$147.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.53
|
| Rate for Payer: Healthscope Commercial |
$154.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$120.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$128.93
|
| Rate for Payer: PHP Commercial |
$146.12
|
| Rate for Payer: Priority Health SBD |
$108.30
|
| Rate for Payer: UMR Bronson Commercial |
$75.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.93
|
|
|
HC FISH PRENATAL ANEUPLOIDY
|
Facility
|
OP
|
$171.91
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000034
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.77 |
| Max. Negotiated Rate |
$154.72 |
| Rate for Payer: Aetna American Axle |
$111.74
|
| Rate for Payer: Aetna Commercial |
$146.12
|
| Rate for Payer: Aetna Medicare |
$53.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: BCBS Complete |
$28.11
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$59.17
|
| Rate for Payer: BCN Commercial |
$59.17
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$137.53
|
| Rate for Payer: Cash Price |
$137.53
|
| Rate for Payer: Cofinity Advantage |
$120.34
|
| Rate for Payer: Cofinity Commercial |
$147.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$154.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$120.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.93
|
| Rate for Payer: Mclaren Medicaid |
$51.19
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$53.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.12
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$128.93
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$146.12
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.19
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health SBD |
$108.30
|
| Rate for Payer: Priority Health Tiered Network |
$40.95
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.79
|
| Rate for Payer: UHC Core |
$76.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.19
|
| Rate for Payer: UHC Exchange |
$76.79
|
| Rate for Payer: UHC Medicaid |
$26.77
|
| Rate for Payer: UHCCP Medicaid |
$26.77
|
| Rate for Payer: UMR Bronson Commercial |
$63.61
|
| Rate for Payer: VA VA |
$51.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.93
|
|
|
HC FISH PROBES
|
Facility
|
IP
|
$79.43
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000067
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$34.95 |
| Max. Negotiated Rate |
$71.49 |
| Rate for Payer: Aetna American Axle |
$51.63
|
| Rate for Payer: Aetna Commercial |
$67.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.63
|
| Rate for Payer: Cash Price |
$63.54
|
| Rate for Payer: Cofinity Advantage |
$55.60
|
| Rate for Payer: Cofinity Commercial |
$68.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.54
|
| Rate for Payer: Healthscope Commercial |
$71.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.57
|
| Rate for Payer: PHP Commercial |
$67.52
|
| Rate for Payer: Priority Health SBD |
$50.04
|
| Rate for Payer: UMR Bronson Commercial |
$34.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.57
|
|
|
HC FISH PROBES
|
Facility
|
OP
|
$79.43
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000067
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.77 |
| Max. Negotiated Rate |
$76.79 |
| Rate for Payer: Aetna American Axle |
$51.63
|
| Rate for Payer: Aetna Commercial |
$67.52
|
| Rate for Payer: Aetna Medicare |
$53.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: BCBS Complete |
$28.11
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$59.17
|
| Rate for Payer: BCN Commercial |
$59.17
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$63.54
|
| Rate for Payer: Cash Price |
$63.54
|
| Rate for Payer: Cofinity Advantage |
$55.60
|
| Rate for Payer: Cofinity Commercial |
$68.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$71.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.57
|
| Rate for Payer: Mclaren Medicaid |
$51.19
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$53.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.52
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.57
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$67.52
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.19
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health SBD |
$50.04
|
| Rate for Payer: Priority Health Tiered Network |
$40.95
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.79
|
| Rate for Payer: UHC Core |
$76.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.19
|
| Rate for Payer: UHC Exchange |
$76.79
|
| Rate for Payer: UHC Medicaid |
$26.77
|
| Rate for Payer: UHCCP Medicaid |
$26.77
|
| Rate for Payer: UMR Bronson Commercial |
$29.39
|
| Rate for Payer: VA VA |
$51.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.57
|
|
|
HC FISTULA SHUNTOGRAM
|
Facility
|
OP
|
$2,299.22
|
|
| Hospital Charge Code |
32000264
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$850.71 |
| Max. Negotiated Rate |
$2,069.30 |
| Rate for Payer: Aetna American Axle |
$1,494.49
|
| Rate for Payer: Aetna Commercial |
$1,954.34
|
| Rate for Payer: Aetna Medicare |
$1,149.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,494.49
|
| Rate for Payer: BCBS Complete |
$919.69
|
| Rate for Payer: Cash Price |
$1,839.38
|
| Rate for Payer: Cofinity Advantage |
$1,609.45
|
| Rate for Payer: Cofinity Commercial |
$1,977.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,839.38
|
| Rate for Payer: Healthscope Commercial |
$2,069.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,609.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,724.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,839.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,954.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,724.41
|
| Rate for Payer: PHP Commercial |
$1,954.34
|
| Rate for Payer: Priority Health SBD |
$1,448.51
|
| Rate for Payer: UMR Bronson Commercial |
$850.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,724.41
|
|
|
HC FISTULA SHUNTOGRAM
|
Facility
|
IP
|
$2,299.22
|
|
| Hospital Charge Code |
32000264
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,011.66 |
| Max. Negotiated Rate |
$2,069.30 |
| Rate for Payer: Aetna American Axle |
$1,494.49
|
| Rate for Payer: Aetna Commercial |
$1,954.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,494.49
|
| Rate for Payer: Cash Price |
$1,839.38
|
| Rate for Payer: Cofinity Advantage |
$1,609.45
|
| Rate for Payer: Cofinity Commercial |
$1,977.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,839.38
|
| Rate for Payer: Healthscope Commercial |
$2,069.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,609.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,724.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,954.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,724.41
|
| Rate for Payer: PHP Commercial |
$1,954.34
|
| Rate for Payer: Priority Health SBD |
$1,448.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,011.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,724.41
|
|
|
HC FIT INSERT INTRAVAG SUPPORT DEVICE
|
Facility
|
OP
|
$264.14
|
|
|
Service Code
|
CPT 57150
|
| Hospital Charge Code |
76100203
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$237.73 |
| Rate for Payer: Aetna American Axle |
$171.69
|
| Rate for Payer: Aetna Commercial |
$224.52
|
| Rate for Payer: Aetna Medicare |
$61.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$112.86
|
| Rate for Payer: BCN Commercial |
$112.86
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$211.31
|
| Rate for Payer: Cash Price |
$211.31
|
| Rate for Payer: Cash Price |
$211.31
|
| Rate for Payer: Cofinity Advantage |
$184.90
|
| Rate for Payer: Cofinity Commercial |
$227.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$237.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.10
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$61.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.52
|
| Rate for Payer: Nomi Health Commercial |
$176.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.10
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$224.52
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.09
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health SBD |
$166.41
|
| Rate for Payer: Priority Health Tiered Network |
$152.07
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.69
|
| Rate for Payer: UHC Core |
$137.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$103.81
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: UMR Bronson Commercial |
$97.73
|
| Rate for Payer: VA VA |
$58.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.10
|
|
|
HC FIT INSERT INTRAVAG SUPPORT DEVICE
|
Facility
|
IP
|
$264.14
|
|
|
Service Code
|
CPT 57150
|
| Hospital Charge Code |
76100203
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.22 |
| Max. Negotiated Rate |
$237.73 |
| Rate for Payer: Aetna American Axle |
$171.69
|
| Rate for Payer: Aetna Commercial |
$224.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.69
|
| Rate for Payer: Cash Price |
$211.31
|
| Rate for Payer: Cofinity Advantage |
$184.90
|
| Rate for Payer: Cofinity Commercial |
$227.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.31
|
| Rate for Payer: Healthscope Commercial |
$237.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.10
|
| Rate for Payer: PHP Commercial |
$224.52
|
| Rate for Payer: Priority Health SBD |
$166.41
|
| Rate for Payer: UMR Bronson Commercial |
$116.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.10
|
|
|
HC FIT & INSERT PESSARY/OTHER DEVICE
|
Facility
|
IP
|
$535.45
|
|
|
Service Code
|
CPT 57160
|
| Hospital Charge Code |
76100357
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$235.60 |
| Max. Negotiated Rate |
$481.90 |
| Rate for Payer: Aetna American Axle |
$348.04
|
| Rate for Payer: Aetna Commercial |
$455.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.04
|
| Rate for Payer: Cash Price |
$428.36
|
| Rate for Payer: Cofinity Advantage |
$374.81
|
| Rate for Payer: Cofinity Commercial |
$460.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.36
|
| Rate for Payer: Healthscope Commercial |
$481.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$374.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$401.59
|
| Rate for Payer: PHP Commercial |
$455.13
|
| Rate for Payer: Priority Health SBD |
$337.33
|
| Rate for Payer: UMR Bronson Commercial |
$235.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.59
|
|
|
HC FIT & INSERT PESSARY/OTHER DEVICE
|
Facility
|
OP
|
$535.45
|
|
|
Service Code
|
CPT 57160
|
| Hospital Charge Code |
76100357
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.35 |
| Max. Negotiated Rate |
$651.46 |
| Rate for Payer: Aetna American Axle |
$348.04
|
| Rate for Payer: Aetna Commercial |
$455.13
|
| Rate for Payer: Aetna Medicare |
$209.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$251.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$251.80
|
| Rate for Payer: BCBS Complete |
$110.63
|
| Rate for Payer: BCBS MAPPO |
$201.44
|
| Rate for Payer: BCBS Trust/PPO |
$241.37
|
| Rate for Payer: BCN Commercial |
$241.37
|
| Rate for Payer: BCN Medicare Advantage |
$201.44
|
| Rate for Payer: Cash Price |
$428.36
|
| Rate for Payer: Cash Price |
$428.36
|
| Rate for Payer: Cash Price |
$428.36
|
| Rate for Payer: Cofinity Advantage |
$374.81
|
| Rate for Payer: Cofinity Commercial |
$460.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.44
|
| Rate for Payer: Healthscope Commercial |
$481.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$374.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.59
|
| Rate for Payer: Mclaren Medicaid |
$201.44
|
| Rate for Payer: Mclaren Medicare |
$201.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.51
|
| Rate for Payer: Meridian Medicaid |
$211.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.13
|
| Rate for Payer: Nomi Health Commercial |
$604.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$401.59
|
| Rate for Payer: PACE Medicare |
$191.37
|
| Rate for Payer: PACE SWMI |
$201.44
|
| Rate for Payer: PHP Commercial |
$455.13
|
| Rate for Payer: PHP Medicare Advantage |
$201.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$651.46
|
| Rate for Payer: Priority Health Medicare |
$201.44
|
| Rate for Payer: Priority Health SBD |
$337.33
|
| Rate for Payer: Priority Health Tiered Network |
$521.17
|
| Rate for Payer: Railroad Medicare Medicare |
$201.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.04
|
| Rate for Payer: UHC Core |
$278.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$201.44
|
| Rate for Payer: UHC Exchange |
$210.43
|
| Rate for Payer: UHC Medicaid |
$105.35
|
| Rate for Payer: UHCCP Medicaid |
$105.35
|
| Rate for Payer: UMR Bronson Commercial |
$198.12
|
| Rate for Payer: VA VA |
$201.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.59
|
|
