|
HC GENERAL ANESTHESIA PER MINUTE
|
Facility
|
OP
|
$16.32
|
|
| Hospital Charge Code |
37000024
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$6.04 |
| Max. Negotiated Rate |
$14.69 |
| Rate for Payer: Aetna American Axle |
$10.61
|
| Rate for Payer: Aetna Commercial |
$13.87
|
| Rate for Payer: Aetna Medicare |
$8.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.61
|
| Rate for Payer: BCBS Complete |
$6.53
|
| Rate for Payer: Cash Price |
$13.06
|
| Rate for Payer: Cofinity Advantage |
$11.42
|
| Rate for Payer: Cofinity Commercial |
$14.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.06
|
| Rate for Payer: Healthscope Commercial |
$14.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.24
|
| Rate for Payer: PHP Commercial |
$13.87
|
| Rate for Payer: Priority Health SBD |
$10.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.61
|
| Rate for Payer: UHC Core |
$8.50
|
| Rate for Payer: UHC Exchange |
$6.41
|
| Rate for Payer: UMR Bronson Commercial |
$6.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.24
|
|
|
HC GENERAL HEALTH PANEL
|
Facility
|
OP
|
$235.33
|
|
|
Service Code
|
CPT 80050
|
| Hospital Charge Code |
30100011
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.61 |
| Max. Negotiated Rate |
$211.80 |
| Rate for Payer: Aetna American Axle |
$152.96
|
| Rate for Payer: Aetna Commercial |
$200.03
|
| Rate for Payer: Aetna Medicare |
$117.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.96
|
| Rate for Payer: BCBS Complete |
$94.13
|
| Rate for Payer: BCBS Trust/PPO |
$55.13
|
| Rate for Payer: BCN Commercial |
$55.13
|
| Rate for Payer: Cash Price |
$188.26
|
| Rate for Payer: Cash Price |
$188.26
|
| Rate for Payer: Cofinity Advantage |
$164.73
|
| Rate for Payer: Cofinity Commercial |
$202.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.26
|
| Rate for Payer: Healthscope Commercial |
$211.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$164.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$176.50
|
| Rate for Payer: PHP Commercial |
$200.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$47.01
|
| Rate for Payer: Priority Health SBD |
$148.26
|
| Rate for Payer: Priority Health Tiered Network |
$37.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.71
|
| Rate for Payer: UHC Core |
$58.71
|
| Rate for Payer: UHC Exchange |
$58.71
|
| Rate for Payer: UMR Bronson Commercial |
$87.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.50
|
|
|
HC GENERAL HEALTH PANEL
|
Facility
|
IP
|
$235.33
|
|
|
Service Code
|
CPT 80050
|
| Hospital Charge Code |
30100011
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$103.55 |
| Max. Negotiated Rate |
$211.80 |
| Rate for Payer: Aetna American Axle |
$152.96
|
| Rate for Payer: Aetna Commercial |
$200.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.96
|
| Rate for Payer: Cash Price |
$188.26
|
| Rate for Payer: Cofinity Advantage |
$164.73
|
| Rate for Payer: Cofinity Commercial |
$202.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.26
|
| Rate for Payer: Healthscope Commercial |
$211.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$164.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$176.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$176.50
|
| Rate for Payer: PHP Commercial |
$200.03
|
| Rate for Payer: Priority Health SBD |
$148.26
|
| Rate for Payer: UMR Bronson Commercial |
$103.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$176.50
|
|
|
HC GENTAMICIN LEVEL
|
Facility
|
OP
|
$125.47
|
|
|
Service Code
|
CPT 80170
|
| Hospital Charge Code |
30100030
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.57 |
| Max. Negotiated Rate |
$112.92 |
| Rate for Payer: Aetna American Axle |
$81.56
|
| Rate for Payer: Aetna Commercial |
$106.65
|
| Rate for Payer: Aetna Medicare |
$17.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.48
|
| Rate for Payer: BCBS Complete |
$9.00
|
| Rate for Payer: BCBS MAPPO |
$16.38
|
| Rate for Payer: BCBS Trust/PPO |
$18.94
|
| Rate for Payer: BCN Commercial |
$18.94
|
| Rate for Payer: BCN Medicare Advantage |
$16.38
|
| Rate for Payer: Cash Price |
$100.38
|
| Rate for Payer: Cash Price |
$100.38
|
| Rate for Payer: Cofinity Advantage |
$87.83
|
| Rate for Payer: Cofinity Commercial |
$107.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.38
|
| Rate for Payer: Healthscope Commercial |
$112.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.10
|
| Rate for Payer: Mclaren Medicaid |
$16.38
|
| Rate for Payer: Mclaren Medicare |
$16.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.20
|
| Rate for Payer: Meridian Medicaid |
$17.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.65
|
| Rate for Payer: Nomi Health Commercial |
$24.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.10
|
| Rate for Payer: PACE Medicare |
$15.56
|
| Rate for Payer: PACE SWMI |
$16.38
|
| Rate for Payer: PHP Commercial |
$106.65
|
| Rate for Payer: PHP Medicare Advantage |
$16.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.38
|
| Rate for Payer: Priority Health Medicare |
$16.38
|
| Rate for Payer: Priority Health SBD |
$79.05
|
| Rate for Payer: Priority Health Tiered Network |
$13.10
|
| Rate for Payer: Railroad Medicare Medicare |
$16.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.57
|
| Rate for Payer: UHC Core |
$24.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.38
|
| Rate for Payer: UHC Exchange |
$24.57
|
| Rate for Payer: UHC Medicaid |
$8.57
|
| Rate for Payer: UHCCP Medicaid |
$8.57
|
| Rate for Payer: UMR Bronson Commercial |
$46.42
|
| Rate for Payer: VA VA |
$16.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.10
|
|
|
HC GENTAMICIN LEVEL
|
Facility
|
IP
|
$125.47
|
|
|
Service Code
|
CPT 80170
|
| Hospital Charge Code |
30100030
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.21 |
| Max. Negotiated Rate |
$112.92 |
| Rate for Payer: Aetna American Axle |
$81.56
|
| Rate for Payer: Aetna Commercial |
$106.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.56
|
| Rate for Payer: Cash Price |
$100.38
|
| Rate for Payer: Cofinity Advantage |
$87.83
|
| Rate for Payer: Cofinity Commercial |
$107.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.38
|
| Rate for Payer: Healthscope Commercial |
$112.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.10
|
| Rate for Payer: PHP Commercial |
$106.65
|
| Rate for Payer: Priority Health SBD |
$79.05
|
| Rate for Payer: UMR Bronson Commercial |
$55.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.10
|
|
|
HC GGTP
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 82977
|
| Hospital Charge Code |
30100229
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna American Axle |
$45.99
|
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna Medicare |
$7.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.00
|
| Rate for Payer: BCBS Complete |
$3.95
|
| Rate for Payer: BCBS MAPPO |
$7.20
|
| Rate for Payer: BCN Medicare Advantage |
$7.20
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Advantage |
$49.52
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.20
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Mclaren Medicaid |
$7.20
|
| Rate for Payer: Mclaren Medicare |
$7.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.56
|
| Rate for Payer: Meridian Medicaid |
$7.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$10.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PACE Medicare |
$6.84
|
| Rate for Payer: PACE SWMI |
$7.20
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: PHP Medicare Advantage |
$7.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7.20
|
| Rate for Payer: Priority Health Medicare |
$7.20
|
| Rate for Payer: Priority Health SBD |
$44.57
|
| Rate for Payer: Priority Health Tiered Network |
$5.76
|
| Rate for Payer: Railroad Medicare Medicare |
$7.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.80
|
| Rate for Payer: UHC Core |
$10.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.20
|
| Rate for Payer: UHC Exchange |
$10.80
|
| Rate for Payer: UHC Medicaid |
$3.77
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: UMR Bronson Commercial |
$26.18
|
| Rate for Payer: VA VA |
$7.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC GGTP
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
CPT 82977
|
| Hospital Charge Code |
30100229
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna American Axle |
$45.99
|
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.99
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Advantage |
$49.52
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: Priority Health SBD |
$44.57
|
| Rate for Payer: UMR Bronson Commercial |
$31.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC GIARDIA SCREEN
|
Facility
|
IP
|
$46.70
|
|
|
Service Code
|
CPT 87329
|
| Hospital Charge Code |
30600119
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$20.55 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna American Axle |
$30.36
|
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.36
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Advantage |
$32.69
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: Priority Health SBD |
$29.42
|
| Rate for Payer: UMR Bronson Commercial |
$20.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
|
HC GIARDIA SCREEN
|
Facility
|
OP
|
$46.70
|
|
|
Service Code
|
CPT 87329
|
| Hospital Charge Code |
30600119
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna American Axle |
$30.36
|
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: BCBS Complete |
$6.58
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$13.86
|
| Rate for Payer: BCN Commercial |
$13.86
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Advantage |
$32.69
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.02
|
| Rate for Payer: Mclaren Medicaid |
$11.98
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$17.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.98
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health SBD |
$29.42
|
| Rate for Payer: Priority Health Tiered Network |
$9.58
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.97
|
| Rate for Payer: UHC Core |
$17.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.98
|
| Rate for Payer: UHC Exchange |
$17.97
|
| Rate for Payer: UHC Medicaid |
$6.27
|
| Rate for Payer: UHCCP Medicaid |
$6.27
|
| Rate for Payer: UMR Bronson Commercial |
$17.28
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
|
HC GI CONVERT G TO GJ TUBE W
|
Facility
|
OP
|
$1,886.25
|
|
|
Service Code
|
CPT 49446
|
| Hospital Charge Code |
36100228
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$697.91 |
| Max. Negotiated Rate |
$6,183.25 |
| Rate for Payer: Aetna American Axle |
$1,226.06
|
| Rate for Payer: Aetna Commercial |
$1,603.31
|
| Rate for Payer: Aetna Medicare |
$1,988.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,226.06
|
| 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 |
$2,732.49
|
| Rate for Payer: BCN Commercial |
$2,732.49
|
| Rate for Payer: BCN Medicare Advantage |
$1,912.01
|
| Rate for Payer: Cash Price |
$1,509.00
|
| Rate for Payer: Cash Price |
$1,509.00
|
| Rate for Payer: Cash Price |
$1,509.00
|
| Rate for Payer: Cofinity Advantage |
$1,320.38
|
| Rate for Payer: Cofinity Commercial |
$1,622.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,509.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,912.01
|
| Rate for Payer: Healthscope Commercial |
$1,697.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,320.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,414.69
|
| 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 |
$1,603.31
|
| Rate for Payer: Nomi Health Commercial |
$5,736.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,414.69
|
| Rate for Payer: PACE Medicare |
$1,816.41
|
| Rate for Payer: PACE SWMI |
$1,912.01
|
| Rate for Payer: PHP Commercial |
$1,603.31
|
| 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 |
$1,188.34
|
| 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 |
$697.91
|
| Rate for Payer: VA VA |
$1,912.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,414.69
|
|
|
HC GI CONVERT G TO GJ TUBE W
|
Facility
|
IP
|
$1,886.25
|
|
|
Service Code
|
CPT 49446
|
| Hospital Charge Code |
36100228
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$829.95 |
| Max. Negotiated Rate |
$1,697.62 |
| Rate for Payer: Aetna American Axle |
$1,226.06
|
| Rate for Payer: Aetna Commercial |
$1,603.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,226.06
|
| Rate for Payer: Cash Price |
$1,509.00
|
| Rate for Payer: Cofinity Advantage |
$1,320.38
|
| Rate for Payer: Cofinity Commercial |
$1,622.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,509.00
|
| Rate for Payer: Healthscope Commercial |
$1,697.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,320.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,414.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,603.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,414.69
|
| Rate for Payer: PHP Commercial |
$1,603.31
|
| Rate for Payer: Priority Health SBD |
$1,188.34
|
| Rate for Payer: UMR Bronson Commercial |
$829.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,414.69
|
|
|
HC GI FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$1,847.32
|
|
| Hospital Charge Code |
36000049
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$812.82 |
| Max. Negotiated Rate |
$1,662.59 |
| Rate for Payer: Aetna American Axle |
$1,200.76
|
| Rate for Payer: Aetna Commercial |
$1,570.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,200.76
|
| Rate for Payer: Cash Price |
$1,477.86
|
| Rate for Payer: Cofinity Advantage |
$1,293.12
|
| Rate for Payer: Cofinity Commercial |
$1,588.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,477.86
|
| Rate for Payer: Healthscope Commercial |
$1,662.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,293.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,385.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,570.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,385.49
|
| Rate for Payer: PHP Commercial |
$1,570.22
|
| Rate for Payer: Priority Health SBD |
$1,163.81
|
| Rate for Payer: UMR Bronson Commercial |
$812.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,385.49
|
|
|
HC GI FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$1,847.32
|
|
| Hospital Charge Code |
36000049
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.51 |
| Max. Negotiated Rate |
$1,662.59 |
| Rate for Payer: Aetna American Axle |
$1,200.76
|
| Rate for Payer: Aetna Commercial |
$1,570.22
|
| Rate for Payer: Aetna Medicare |
$923.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,200.76
|
| Rate for Payer: BCBS Complete |
$738.93
|
| Rate for Payer: Cash Price |
$1,477.86
|
| Rate for Payer: Cofinity Advantage |
$1,293.12
|
| Rate for Payer: Cofinity Commercial |
$1,588.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,477.86
|
| Rate for Payer: Healthscope Commercial |
$1,662.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,293.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,385.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,477.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,570.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,385.49
|
| Rate for Payer: PHP Commercial |
$1,570.22
|
| Rate for Payer: Priority Health SBD |
$1,163.81
|
| Rate for Payer: UMR Bronson Commercial |
$683.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,385.49
|
|
|
HC GI GASTRIC TUBE REPOSITION
|
Facility
|
OP
|
$1,293.30
|
|
|
Service Code
|
CPT 43761
|
| Hospital Charge Code |
36100192
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$130.20 |
| Max. Negotiated Rate |
$1,163.97 |
| Rate for Payer: Aetna American Axle |
$840.64
|
| Rate for Payer: Aetna Commercial |
$1,099.31
|
| Rate for Payer: Aetna Medicare |
$258.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$840.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.19
|
| Rate for Payer: BCBS Complete |
$136.72
|
| Rate for Payer: BCBS MAPPO |
$248.95
|
| Rate for Payer: BCBS Trust/PPO |
$646.66
|
| Rate for Payer: BCN Commercial |
$646.66
|
| Rate for Payer: BCN Medicare Advantage |
$248.95
|
| Rate for Payer: Cash Price |
$1,034.64
|
| Rate for Payer: Cash Price |
$1,034.64
|
| Rate for Payer: Cash Price |
$1,034.64
|
| Rate for Payer: Cofinity Advantage |
$905.31
|
| Rate for Payer: Cofinity Commercial |
$1,112.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.95
|
| Rate for Payer: Healthscope Commercial |
$1,163.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$905.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$969.98
|
| Rate for Payer: Mclaren Medicaid |
$248.95
|
| Rate for Payer: Mclaren Medicare |
$248.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.40
|
| Rate for Payer: Meridian Medicaid |
$261.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,099.31
|
| Rate for Payer: Nomi Health Commercial |
$746.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.98
|
| Rate for Payer: PACE Medicare |
$236.50
|
| Rate for Payer: PACE SWMI |
$248.95
|
| Rate for Payer: PHP Commercial |
$1,099.31
|
| Rate for Payer: PHP Medicare Advantage |
$248.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$805.08
|
| Rate for Payer: Priority Health Medicare |
$248.95
|
| Rate for Payer: Priority Health SBD |
$814.78
|
| Rate for Payer: Priority Health Tiered Network |
$644.06
|
| Rate for Payer: Railroad Medicare Medicare |
$248.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$248.95
|
| Rate for Payer: UHC Medicaid |
$130.20
|
| Rate for Payer: UHCCP Medicaid |
$130.20
|
| Rate for Payer: UMR Bronson Commercial |
$478.52
|
| Rate for Payer: VA VA |
$248.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$969.98
|
|
|
HC GI GASTRIC TUBE REPOSITION
|
Facility
|
IP
|
$1,293.30
|
|
|
Service Code
|
CPT 43761
|
| Hospital Charge Code |
36100192
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$569.05 |
| Max. Negotiated Rate |
$1,163.97 |
| Rate for Payer: Aetna American Axle |
$840.64
|
| Rate for Payer: Aetna Commercial |
$1,099.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$840.64
|
| Rate for Payer: Cash Price |
$1,034.64
|
| Rate for Payer: Cofinity Advantage |
$905.31
|
| Rate for Payer: Cofinity Commercial |
$1,112.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,034.64
|
| Rate for Payer: Healthscope Commercial |
$1,163.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$905.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$969.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,099.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$969.98
|
| Rate for Payer: PHP Commercial |
$1,099.31
|
| Rate for Payer: Priority Health SBD |
$814.78
|
| Rate for Payer: UMR Bronson Commercial |
$569.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$969.98
|
|
|
HC GI INTRALUMINAL IMAGING ESOPHAGUS
|
Facility
|
OP
|
$1,251.04
|
|
|
Service Code
|
CPT 91111
|
| Hospital Charge Code |
75000009
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$462.88 |
| Max. Negotiated Rate |
$2,922.56 |
| Rate for Payer: Aetna American Axle |
$813.18
|
| Rate for Payer: Aetna Commercial |
$1,063.38
|
| Rate for Payer: Aetna Medicare |
$939.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$813.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,129.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,129.65
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$1,000.83
|
| Rate for Payer: Cash Price |
$1,000.83
|
| Rate for Payer: Cofinity Advantage |
$875.73
|
| Rate for Payer: Cofinity Commercial |
$1,075.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,000.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$1,125.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$875.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$938.28
|
| Rate for Payer: Mclaren Medicaid |
$903.72
|
| Rate for Payer: Mclaren Medicare |
$903.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.91
|
| Rate for Payer: Meridian Medicaid |
$948.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,039.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,063.38
|
| Rate for Payer: Nomi Health Commercial |
$2,711.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$938.28
|
| Rate for Payer: PACE Medicare |
$858.53
|
| Rate for Payer: PACE SWMI |
$903.72
|
| Rate for Payer: PHP Commercial |
$1,063.38
|
| Rate for Payer: PHP Medicare Advantage |
$903.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,922.56
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health SBD |
$788.16
|
| Rate for Payer: Priority Health Tiered Network |
$2,338.05
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$903.72
|
| Rate for Payer: UHC Medicaid |
$472.65
|
| Rate for Payer: UHCCP Medicaid |
$472.65
|
| Rate for Payer: UMR Bronson Commercial |
$462.88
|
| Rate for Payer: VA VA |
$903.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$938.28
|
|
|
HC GI INTRALUMINAL IMAGING ESOPHAGUS
|
Facility
|
IP
|
$1,251.04
|
|
|
Service Code
|
CPT 91111
|
| Hospital Charge Code |
75000009
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$550.46 |
| Max. Negotiated Rate |
$1,125.94 |
| Rate for Payer: Aetna American Axle |
$813.18
|
| Rate for Payer: Aetna Commercial |
$1,063.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$813.18
|
| Rate for Payer: Cash Price |
$1,000.83
|
| Rate for Payer: Cofinity Advantage |
$875.73
|
| Rate for Payer: Cofinity Commercial |
$1,075.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,000.83
|
| Rate for Payer: Healthscope Commercial |
$1,125.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$875.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$938.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,063.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$938.28
|
| Rate for Payer: PHP Commercial |
$1,063.38
|
| Rate for Payer: Priority Health SBD |
$788.16
|
| Rate for Payer: UMR Bronson Commercial |
$550.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$938.28
|
|
|
HC GI INTRALUMINAL IMAGING ESOPH THROUGH ILEUM
|
Facility
|
OP
|
$1,376.14
|
|
|
Service Code
|
CPT 91110
|
| Hospital Charge Code |
75000008
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$472.65 |
| Max. Negotiated Rate |
$2,922.56 |
| Rate for Payer: Aetna American Axle |
$894.49
|
| Rate for Payer: Aetna Commercial |
$1,169.72
|
| Rate for Payer: Aetna Medicare |
$939.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$894.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,129.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,129.65
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,269.42
|
| Rate for Payer: BCN Commercial |
$1,269.42
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$1,100.91
|
| Rate for Payer: Cash Price |
$1,100.91
|
| Rate for Payer: Cash Price |
$1,100.91
|
| Rate for Payer: Cofinity Advantage |
$963.30
|
| Rate for Payer: Cofinity Commercial |
$1,183.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,100.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$1,238.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$963.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.11
|
| Rate for Payer: Mclaren Medicaid |
$903.72
|
| Rate for Payer: Mclaren Medicare |
$903.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.91
|
| Rate for Payer: Meridian Medicaid |
$948.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,039.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,169.72
|
| Rate for Payer: Nomi Health Commercial |
$2,711.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,032.11
|
| Rate for Payer: PACE Medicare |
$858.53
|
| Rate for Payer: PACE SWMI |
$903.72
|
| Rate for Payer: PHP Commercial |
$1,169.72
|
| Rate for Payer: PHP Medicare Advantage |
$903.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,922.56
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health SBD |
$866.97
|
| Rate for Payer: Priority Health Tiered Network |
$2,338.05
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$903.72
|
| Rate for Payer: UHC Medicaid |
$472.65
|
| Rate for Payer: UHCCP Medicaid |
$472.65
|
| Rate for Payer: UMR Bronson Commercial |
$509.17
|
| Rate for Payer: VA VA |
$903.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.11
|
|
|
HC GI INTRALUMINAL IMAGING ESOPH THROUGH ILEUM
|
Facility
|
IP
|
$1,376.14
|
|
|
Service Code
|
CPT 91110
|
| Hospital Charge Code |
75000008
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$605.50 |
| Max. Negotiated Rate |
$1,238.53 |
| Rate for Payer: Aetna American Axle |
$894.49
|
| Rate for Payer: Aetna Commercial |
$1,169.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$894.49
|
| Rate for Payer: Cash Price |
$1,100.91
|
| Rate for Payer: Cofinity Advantage |
$963.30
|
| Rate for Payer: Cofinity Commercial |
$1,183.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,100.91
|
| Rate for Payer: Healthscope Commercial |
$1,238.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$963.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,169.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,032.11
|
| Rate for Payer: PHP Commercial |
$1,169.72
|
| Rate for Payer: Priority Health SBD |
$866.97
|
| Rate for Payer: UMR Bronson Commercial |
$605.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.11
|
|
|
HC GI LONG TUBE PLACEMENT
|
Facility
|
IP
|
$1,302.04
|
|
|
Service Code
|
CPT 44500
|
| Hospital Charge Code |
36100193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$572.90 |
| Max. Negotiated Rate |
$1,171.84 |
| Rate for Payer: Aetna American Axle |
$846.33
|
| Rate for Payer: Aetna Commercial |
$1,106.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.33
|
| Rate for Payer: Cash Price |
$1,041.63
|
| Rate for Payer: Cofinity Advantage |
$911.43
|
| Rate for Payer: Cofinity Commercial |
$1,119.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,041.63
|
| Rate for Payer: Healthscope Commercial |
$1,171.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$911.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$976.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,106.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$976.53
|
| Rate for Payer: PHP Commercial |
$1,106.73
|
| Rate for Payer: Priority Health SBD |
$820.29
|
| Rate for Payer: UMR Bronson Commercial |
$572.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$976.53
|
|
|
HC GI LONG TUBE PLACEMENT
|
Facility
|
OP
|
$1,302.04
|
|
|
Service Code
|
CPT 44500
|
| Hospital Charge Code |
36100193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$472.65 |
| Max. Negotiated Rate |
$2,922.56 |
| Rate for Payer: Aetna American Axle |
$846.33
|
| Rate for Payer: Aetna Commercial |
$1,106.73
|
| Rate for Payer: Aetna Medicare |
$939.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,129.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,129.65
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,561.66
|
| Rate for Payer: BCN Commercial |
$1,561.66
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$1,041.63
|
| Rate for Payer: Cash Price |
$1,041.63
|
| Rate for Payer: Cash Price |
$1,041.63
|
| Rate for Payer: Cofinity Advantage |
$911.43
|
| Rate for Payer: Cofinity Commercial |
$1,119.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,041.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$1,171.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$911.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$976.53
|
| Rate for Payer: Mclaren Medicaid |
$903.72
|
| Rate for Payer: Mclaren Medicare |
$903.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.91
|
| Rate for Payer: Meridian Medicaid |
$948.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,039.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,106.73
|
| Rate for Payer: Nomi Health Commercial |
$2,711.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$976.53
|
| Rate for Payer: PACE Medicare |
$858.53
|
| Rate for Payer: PACE SWMI |
$903.72
|
| Rate for Payer: PHP Commercial |
$1,106.73
|
| Rate for Payer: PHP Medicare Advantage |
$903.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,922.56
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health SBD |
$820.29
|
| Rate for Payer: Priority Health Tiered Network |
$2,338.05
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$903.72
|
| Rate for Payer: UHC Medicaid |
$472.65
|
| Rate for Payer: UHCCP Medicaid |
$472.65
|
| Rate for Payer: UMR Bronson Commercial |
$481.75
|
| Rate for Payer: VA VA |
$903.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$976.53
|
|
|
HC GI OSTOMY OBSTRUCT REMOVL
|
Facility
|
OP
|
$905.11
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
36100232
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$334.89 |
| Max. Negotiated Rate |
$2,922.56 |
| Rate for Payer: Aetna American Axle |
$588.32
|
| Rate for Payer: Aetna Commercial |
$769.34
|
| Rate for Payer: Aetna Medicare |
$939.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$588.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,129.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,129.65
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$711.54
|
| Rate for Payer: BCN Commercial |
$711.54
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$724.09
|
| Rate for Payer: Cash Price |
$724.09
|
| Rate for Payer: Cash Price |
$724.09
|
| Rate for Payer: Cofinity Advantage |
$633.58
|
| Rate for Payer: Cofinity Commercial |
$778.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$814.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$633.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$678.83
|
| Rate for Payer: Mclaren Medicaid |
$903.72
|
| Rate for Payer: Mclaren Medicare |
$903.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.91
|
| Rate for Payer: Meridian Medicaid |
$948.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,039.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$769.34
|
| Rate for Payer: Nomi Health Commercial |
$2,711.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$678.83
|
| Rate for Payer: PACE Medicare |
$858.53
|
| Rate for Payer: PACE SWMI |
$903.72
|
| Rate for Payer: PHP Commercial |
$769.34
|
| Rate for Payer: PHP Medicare Advantage |
$903.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,922.56
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health SBD |
$570.22
|
| Rate for Payer: Priority Health Tiered Network |
$2,338.05
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$903.72
|
| Rate for Payer: UHC Medicaid |
$472.65
|
| Rate for Payer: UHCCP Medicaid |
$472.65
|
| Rate for Payer: UMR Bronson Commercial |
$334.89
|
| Rate for Payer: VA VA |
$903.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$678.83
|
|
|
HC GI OSTOMY OBSTRUCT REMOVL
|
Facility
|
IP
|
$905.11
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
36100232
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$398.25 |
| Max. Negotiated Rate |
$814.60 |
| Rate for Payer: Aetna American Axle |
$588.32
|
| Rate for Payer: Aetna Commercial |
$769.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$588.32
|
| Rate for Payer: Cash Price |
$724.09
|
| Rate for Payer: Cofinity Advantage |
$633.58
|
| Rate for Payer: Cofinity Commercial |
$778.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.09
|
| Rate for Payer: Healthscope Commercial |
$814.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$633.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$678.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$769.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$678.83
|
| Rate for Payer: PHP Commercial |
$769.34
|
| Rate for Payer: Priority Health SBD |
$570.22
|
| Rate for Payer: UMR Bronson Commercial |
$398.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$678.83
|
|
|
HC GI PATHOGEN PANEL, PCR, F
|
Facility
|
OP
|
$733.08
|
|
|
Service Code
|
HCPCS 87507
|
| Hospital Charge Code |
30600322
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$217.98 |
| Max. Negotiated Rate |
$659.77 |
| Rate for Payer: Aetna American Axle |
$476.50
|
| Rate for Payer: Aetna Commercial |
$623.12
|
| Rate for Payer: Aetna Medicare |
$433.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$476.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: BCBS Complete |
$228.90
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$586.46
|
| Rate for Payer: Cash Price |
$586.46
|
| Rate for Payer: Cofinity Advantage |
$513.16
|
| Rate for Payer: Cofinity Commercial |
$630.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$586.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$659.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$513.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$549.81
|
| Rate for Payer: Mclaren Medicaid |
$416.78
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: Meridian Medicaid |
$437.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$458.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$623.12
|
| Rate for Payer: Nomi Health Commercial |
$625.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$549.81
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$623.12
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$416.78
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health SBD |
$461.84
|
| Rate for Payer: Priority Health Tiered Network |
$333.42
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.17
|
| Rate for Payer: UHC Core |
$625.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$416.78
|
| Rate for Payer: UHC Exchange |
$625.17
|
| Rate for Payer: UHC Medicaid |
$217.98
|
| Rate for Payer: UHCCP Medicaid |
$217.98
|
| Rate for Payer: UMR Bronson Commercial |
$271.24
|
| Rate for Payer: VA VA |
$416.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$549.81
|
|
|
HC GI PATHOGEN PANEL, PCR, F
|
Facility
|
IP
|
$733.08
|
|
|
Service Code
|
HCPCS 87507
|
| Hospital Charge Code |
30600322
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$322.56 |
| Max. Negotiated Rate |
$659.77 |
| Rate for Payer: Aetna American Axle |
$476.50
|
| Rate for Payer: Aetna Commercial |
$623.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$476.50
|
| Rate for Payer: Cash Price |
$586.46
|
| Rate for Payer: Cofinity Advantage |
$513.16
|
| Rate for Payer: Cofinity Commercial |
$630.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$586.46
|
| Rate for Payer: Healthscope Commercial |
$659.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$513.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$549.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$623.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$549.81
|
| Rate for Payer: PHP Commercial |
$623.12
|
| Rate for Payer: Priority Health SBD |
$461.84
|
| Rate for Payer: UMR Bronson Commercial |
$322.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$549.81
|
|
