|
HC EXAM AND SELECT ARCHIVE RETRIEVED
|
Facility
|
IP
|
$60.11
|
|
|
Service Code
|
CPT 88363
|
| Hospital Charge Code |
31000059
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.45 |
| Max. Negotiated Rate |
$54.10 |
| Rate for Payer: Aetna American Axle |
$39.07
|
| Rate for Payer: Aetna Commercial |
$51.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.07
|
| Rate for Payer: Cash Price |
$48.09
|
| Rate for Payer: Cofinity Commercial |
$42.08
|
| Rate for Payer: Cofinity Commercial |
$51.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.09
|
| Rate for Payer: Healthscope Commercial |
$54.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.09
|
| Rate for Payer: PHP Commercial |
$51.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.07
|
| Rate for Payer: Priority Health SBD |
$37.87
|
| Rate for Payer: UMR Bronson Commercial |
$26.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.08
|
|
|
HC EXAM AND SELECT ARCHIVE RETRIEVED
|
Facility
|
OP
|
$60.11
|
|
|
Service Code
|
CPT 88363
|
| Hospital Charge Code |
31000059
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$67.22 |
| Rate for Payer: Aetna American Axle |
$39.07
|
| Rate for Payer: Aetna Commercial |
$51.09
|
| Rate for Payer: Aetna Medicare |
$24.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.85
|
| Rate for Payer: BCBS Complete |
$13.44
|
| Rate for Payer: BCBS MAPPO |
$23.88
|
| Rate for Payer: BCN Medicare Advantage |
$23.88
|
| Rate for Payer: Cash Price |
$48.09
|
| Rate for Payer: Cash Price |
$48.09
|
| Rate for Payer: Cofinity Commercial |
$51.69
|
| Rate for Payer: Cofinity Commercial |
$42.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.88
|
| Rate for Payer: Healthscope Commercial |
$54.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.08
|
| Rate for Payer: Mclaren Medicaid |
$12.80
|
| Rate for Payer: Mclaren Medicare |
$23.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.07
|
| Rate for Payer: Meridian Medicaid |
$13.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.09
|
| Rate for Payer: PACE Medicare |
$22.69
|
| Rate for Payer: PACE SWMI |
$23.88
|
| Rate for Payer: PHP Commercial |
$51.09
|
| Rate for Payer: PHP Medicare Advantage |
$23.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.07
|
| Rate for Payer: Priority Health Medicare |
$23.88
|
| Rate for Payer: Priority Health SBD |
$37.87
|
| Rate for Payer: Railroad Medicare Medicare |
$23.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.88
|
| Rate for Payer: UHC Exchange |
$45.64
|
| Rate for Payer: UHC Medicare Advantage |
$23.88
|
| Rate for Payer: UHCCP Medicaid |
$12.80
|
| Rate for Payer: UMR Bronson Commercial |
$22.24
|
| Rate for Payer: VA VA |
$23.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.08
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.5 OF LESS
|
Facility
|
IP
|
$600.08
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
76100101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$264.04 |
| Max. Negotiated Rate |
$540.07 |
| Rate for Payer: Aetna American Axle |
$390.05
|
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.05
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$420.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$420.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health SBD |
$378.05
|
| Rate for Payer: UMR Bronson Commercial |
$264.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.06
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.5 OF LESS
|
Facility
|
OP
|
$600.08
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
76100101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$222.03 |
| Max. Negotiated Rate |
$1,931.58 |
| Rate for Payer: Aetna American Axle |
$390.05
|
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna Medicare |
$713.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Cofinity Commercial |
$420.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$420.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.06
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health SBD |
$378.05
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,931.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,311.40
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: UMR Bronson Commercial |
$222.03
|
| Rate for Payer: VA VA |
$686.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.06
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.6 TO 1.0 CM
|
Facility
|
IP
|
$600.08
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
76100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$264.04 |
| Max. Negotiated Rate |
$540.07 |
| Rate for Payer: Aetna American Axle |
$390.05
|
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.05
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$420.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$420.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health SBD |
$378.05
|
| Rate for Payer: UMR Bronson Commercial |
$264.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.06
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 0.6 TO 1.0 CM
|
Facility
|
OP
|
$600.08
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
76100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$222.03 |
| Max. Negotiated Rate |
$1,931.58 |
| Rate for Payer: Aetna American Axle |
$390.05
|
| Rate for Payer: Aetna Commercial |
$510.07
|
| Rate for Payer: Aetna Medicare |
$713.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cash Price |
$480.06
|
| Rate for Payer: Cofinity Commercial |
$516.07
|
| Rate for Payer: Cofinity Commercial |
$420.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$420.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$540.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.06
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.07
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$510.07
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.05
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health SBD |
$378.05
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,931.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,311.40
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: UMR Bronson Commercial |
$222.03
|
| Rate for Payer: VA VA |
$686.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.06
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
76100103
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$517.46 |
| Max. Negotiated Rate |
$1,058.44 |
| Rate for Payer: Aetna American Axle |
$764.43
|
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$764.43
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Cofinity Commercial |
$823.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$823.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$823.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health SBD |
$740.91
|
| Rate for Payer: UMR Bronson Commercial |
$517.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXC BENIGN LESION FACE, EAR, EYELID, NOSE, LIP, MUC MEMB 1.1 TO 2.0 CM
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
76100103
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.80 |
| Max. Negotiated Rate |
$1,931.58 |
| Rate for Payer: Aetna American Axle |
$764.43
|
| Rate for Payer: Aetna Commercial |
$999.64
|
| Rate for Payer: Aetna Medicare |
$713.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$764.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$823.24
|
| Rate for Payer: Cofinity Commercial |
$1,011.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$823.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$1,058.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$823.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$882.04
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$999.64
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health SBD |
$740.91
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,931.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,311.40
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: UMR Bronson Commercial |
$435.14
|
| Rate for Payer: VA VA |
$686.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$882.04
|
|
|
HC EXC FACE MM BENIGN +MARG 2.1 - 3 CM
|
Facility
|
IP
|
$4,244.83
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
36000109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,867.73 |
| Max. Negotiated Rate |
$3,820.35 |
| Rate for Payer: Aetna American Axle |
$2,759.14
|
| Rate for Payer: Aetna Commercial |
$3,608.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,759.14
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cofinity Commercial |
$2,971.38
|
| Rate for Payer: Cofinity Commercial |
$3,650.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,971.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,395.86
|
| Rate for Payer: Healthscope Commercial |
$3,820.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,971.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,183.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,608.11
|
| Rate for Payer: PHP Commercial |
$3,608.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,759.14
|
| Rate for Payer: Priority Health SBD |
$2,674.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,867.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,183.62
|
|
|
HC EXC FACE MM BENIGN +MARG 2.1 - 3 CM
|
Facility
|
OP
|
$4,244.83
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
36000109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna American Axle |
$2,759.14
|
| Rate for Payer: Aetna Commercial |
$3,608.11
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,759.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cofinity Commercial |
$3,650.55
|
| Rate for Payer: Cofinity Commercial |
$2,971.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,971.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,395.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$3,820.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,971.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,183.62
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,608.11
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$3,608.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,759.14
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$2,674.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$3,019.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,570.59
|
| Rate for Payer: VA VA |
$1,580.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,183.62
|
|
|
HC EXC FACE MM BENIGN +MARG 3.1 - 4 CM
|
Facility
|
IP
|
$4,244.83
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
36000108
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,867.73 |
| Max. Negotiated Rate |
$3,820.35 |
| Rate for Payer: Aetna American Axle |
$2,759.14
|
| Rate for Payer: Aetna Commercial |
$3,608.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,759.14
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cofinity Commercial |
$2,971.38
|
| Rate for Payer: Cofinity Commercial |
$3,650.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,971.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,395.86
|
| Rate for Payer: Healthscope Commercial |
$3,820.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,971.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,183.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,608.11
|
| Rate for Payer: PHP Commercial |
$3,608.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,759.14
|
| Rate for Payer: Priority Health SBD |
$2,674.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,867.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,183.62
|
|
|
HC EXC FACE MM BENIGN +MARG 3.1 - 4 CM
|
Facility
|
OP
|
$4,244.83
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
36000108
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna American Axle |
$2,759.14
|
| Rate for Payer: Aetna Commercial |
$3,608.11
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,759.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cash Price |
$3,395.86
|
| Rate for Payer: Cofinity Commercial |
$3,650.55
|
| Rate for Payer: Cofinity Commercial |
$2,971.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,971.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,395.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$3,820.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,971.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,183.62
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,608.11
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$3,608.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,759.14
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$2,674.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$3,019.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,570.59
|
| Rate for Payer: VA VA |
$1,580.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,183.62
|
|
|
HC EXC FACE MM BENIGN +MARG >4 CM
|
Facility
|
IP
|
$7,150.67
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
36000107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,146.29 |
| Max. Negotiated Rate |
$6,435.60 |
| Rate for Payer: Aetna American Axle |
$4,647.94
|
| Rate for Payer: Aetna Commercial |
$6,078.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,647.94
|
| Rate for Payer: Cash Price |
$5,720.54
|
| Rate for Payer: Cofinity Commercial |
$5,005.47
|
| Rate for Payer: Cofinity Commercial |
$6,149.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,005.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,720.54
|
| Rate for Payer: Healthscope Commercial |
$6,435.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,005.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,363.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,078.07
|
| Rate for Payer: PHP Commercial |
$6,078.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,647.94
|
| Rate for Payer: Priority Health SBD |
$4,504.92
|
| Rate for Payer: UMR Bronson Commercial |
$3,146.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,363.00
|
|
|
HC EXC FACE MM BENIGN +MARG >4 CM
|
Facility
|
OP
|
$7,150.67
|
|
|
Service Code
|
CPT 11446
|
| Hospital Charge Code |
36000107
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$4,647.94
|
| Rate for Payer: Aetna Commercial |
$6,078.07
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,647.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$5,720.54
|
| Rate for Payer: Cash Price |
$5,720.54
|
| Rate for Payer: Cofinity Commercial |
$6,149.58
|
| Rate for Payer: Cofinity Commercial |
$5,005.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,005.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,720.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$6,435.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,005.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,363.00
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,078.07
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$6,078.07
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,647.94
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$4,504.92
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$5,334.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: UMR Bronson Commercial |
$2,645.75
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,363.00
|
|
|
HC EXCHANGE ABSCESS CYST DRAIN CATHETER
|
Facility
|
IP
|
$2,562.94
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
36100222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,127.69 |
| Max. Negotiated Rate |
$2,306.65 |
| Rate for Payer: Aetna American Axle |
$1,665.91
|
| Rate for Payer: Aetna Commercial |
$2,178.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,665.91
|
| Rate for Payer: Cash Price |
$2,050.35
|
| Rate for Payer: Cofinity Commercial |
$1,794.06
|
| Rate for Payer: Cofinity Commercial |
$2,204.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,794.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,050.35
|
| Rate for Payer: Healthscope Commercial |
$2,306.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,794.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,922.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,178.50
|
| Rate for Payer: PHP Commercial |
$2,178.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,665.91
|
| Rate for Payer: Priority Health SBD |
$1,614.65
|
| Rate for Payer: UMR Bronson Commercial |
$1,127.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,922.20
|
|
|
HC EXCHANGE ABSCESS CYST DRAIN CATHETER
|
Facility
|
OP
|
$2,562.94
|
|
|
Service Code
|
CPT 49423
|
| Hospital Charge Code |
36100222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$948.29 |
| Max. Negotiated Rate |
$5,207.85 |
| Rate for Payer: Aetna American Axle |
$1,665.91
|
| Rate for Payer: Aetna Commercial |
$2,178.50
|
| Rate for Payer: Aetna Medicare |
$1,924.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,665.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Cash Price |
$2,050.35
|
| Rate for Payer: Cash Price |
$2,050.35
|
| Rate for Payer: Cofinity Commercial |
$2,204.13
|
| Rate for Payer: Cofinity Commercial |
$1,794.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,794.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,050.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Healthscope Commercial |
$2,306.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,794.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,922.20
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,178.50
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Commercial |
$2,178.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,665.91
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Priority Health SBD |
$1,614.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,207.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Exchange |
$3,535.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$991.65
|
| Rate for Payer: UMR Bronson Commercial |
$948.29
|
| Rate for Payer: VA VA |
$1,850.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,922.20
|
|
|
HC EXCHANGE BILIARY DRAIN CATH
|
Facility
|
OP
|
$4,333.80
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
36100493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,603.51 |
| Max. Negotiated Rate |
$9,688.38 |
| Rate for Payer: Aetna American Axle |
$2,816.97
|
| Rate for Payer: Aetna Commercial |
$3,683.73
|
| Rate for Payer: Aetna Medicare |
$3,579.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,816.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$3,467.04
|
| Rate for Payer: Cash Price |
$3,467.04
|
| Rate for Payer: Cofinity Commercial |
$3,727.07
|
| Rate for Payer: Cofinity Commercial |
$3,033.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,033.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,467.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| Rate for Payer: Healthscope Commercial |
$3,900.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,033.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,250.35
|
| Rate for Payer: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,683.73
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$3,683.73
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,816.97
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health SBD |
$2,730.29
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,688.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Exchange |
$6,577.66
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,844.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,603.51
|
| Rate for Payer: VA VA |
$3,441.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,250.35
|
|
|
HC EXCHANGE BILIARY DRAIN CATH
|
Facility
|
IP
|
$4,333.80
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
36100493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,906.87 |
| Max. Negotiated Rate |
$3,900.42 |
| Rate for Payer: Aetna American Axle |
$2,816.97
|
| Rate for Payer: Aetna Commercial |
$3,683.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,816.97
|
| Rate for Payer: Cash Price |
$3,467.04
|
| Rate for Payer: Cofinity Commercial |
$3,033.66
|
| Rate for Payer: Cofinity Commercial |
$3,727.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,033.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,467.04
|
| Rate for Payer: Healthscope Commercial |
$3,900.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,033.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,250.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,683.73
|
| Rate for Payer: PHP Commercial |
$3,683.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,816.97
|
| Rate for Payer: Priority Health SBD |
$2,730.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,906.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,250.35
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER
|
Facility
|
OP
|
$3,542.33
|
|
|
Service Code
|
CPT 50435
|
| Hospital Charge Code |
36100507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,070.86 |
| Max. Negotiated Rate |
$5,623.80 |
| Rate for Payer: Aetna American Axle |
$2,302.51
|
| Rate for Payer: Aetna Commercial |
$3,010.98
|
| Rate for Payer: Aetna Medicare |
$2,077.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,302.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$2,833.86
|
| Rate for Payer: Cash Price |
$2,833.86
|
| Rate for Payer: Cofinity Commercial |
$3,046.40
|
| Rate for Payer: Cofinity Commercial |
$2,479.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,479.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,833.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$3,188.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,479.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,656.75
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,010.98
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$3,010.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,302.51
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health SBD |
$2,231.67
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,623.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Exchange |
$3,818.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,070.86
|
| Rate for Payer: UMR Bronson Commercial |
$1,310.66
|
| Rate for Payer: VA VA |
$1,997.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,656.75
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER
|
Facility
|
IP
|
$3,542.33
|
|
|
Service Code
|
CPT 50435
|
| Hospital Charge Code |
36100507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,558.63 |
| Max. Negotiated Rate |
$3,188.10 |
| Rate for Payer: Aetna American Axle |
$2,302.51
|
| Rate for Payer: Aetna Commercial |
$3,010.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,302.51
|
| Rate for Payer: Cash Price |
$2,833.86
|
| Rate for Payer: Cofinity Commercial |
$2,479.63
|
| Rate for Payer: Cofinity Commercial |
$3,046.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,479.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,833.86
|
| Rate for Payer: Healthscope Commercial |
$3,188.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,479.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,656.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,010.98
|
| Rate for Payer: PHP Commercial |
$3,010.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,302.51
|
| Rate for Payer: Priority Health SBD |
$2,231.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,558.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,656.75
|
|
|
HC EXCHANGE TRANSFUSION NONINFANT
|
Facility
|
IP
|
$1,524.05
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
39100001
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$670.58 |
| Max. Negotiated Rate |
$1,371.64 |
| Rate for Payer: Aetna American Axle |
$990.63
|
| Rate for Payer: Aetna Commercial |
$1,295.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$990.63
|
| Rate for Payer: Cash Price |
$1,219.24
|
| Rate for Payer: Cofinity Commercial |
$1,066.84
|
| Rate for Payer: Cofinity Commercial |
$1,310.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,066.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,219.24
|
| Rate for Payer: Healthscope Commercial |
$1,371.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,066.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,143.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,295.44
|
| Rate for Payer: PHP Commercial |
$1,295.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$990.63
|
| Rate for Payer: Priority Health SBD |
$960.15
|
| Rate for Payer: UMR Bronson Commercial |
$670.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,143.04
|
|
|
HC EXCHANGE TRANSFUSION NONINFANT
|
Facility
|
OP
|
$1,524.05
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
39100001
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$228.53 |
| Max. Negotiated Rate |
$1,371.64 |
| Rate for Payer: Aetna American Axle |
$990.63
|
| Rate for Payer: Aetna Commercial |
$1,295.44
|
| Rate for Payer: Aetna Medicare |
$443.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$990.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$532.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$532.96
|
| Rate for Payer: BCBS Complete |
$239.96
|
| Rate for Payer: BCBS MAPPO |
$426.37
|
| Rate for Payer: BCN Medicare Advantage |
$426.37
|
| Rate for Payer: Cash Price |
$1,219.24
|
| Rate for Payer: Cash Price |
$1,219.24
|
| Rate for Payer: Cash Price |
$1,219.24
|
| Rate for Payer: Cofinity Commercial |
$1,066.84
|
| Rate for Payer: Cofinity Commercial |
$1,310.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,066.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,219.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$426.37
|
| Rate for Payer: Healthscope Commercial |
$1,371.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,066.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,143.04
|
| Rate for Payer: Mclaren Medicaid |
$228.53
|
| Rate for Payer: Mclaren Medicare |
$426.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$447.69
|
| Rate for Payer: Meridian Medicaid |
$239.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$490.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,295.44
|
| Rate for Payer: PACE Medicare |
$405.05
|
| Rate for Payer: PACE SWMI |
$426.37
|
| Rate for Payer: PHP Commercial |
$1,295.44
|
| Rate for Payer: PHP Medicare Advantage |
$426.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$990.63
|
| Rate for Payer: Priority Health Medicare |
$426.37
|
| Rate for Payer: Priority Health SBD |
$960.15
|
| Rate for Payer: Railroad Medicare Medicare |
$426.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,200.19
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$426.37
|
| Rate for Payer: UHC Exchange |
$814.84
|
| Rate for Payer: UHC Medicare Advantage |
$426.37
|
| Rate for Payer: UHCCP Medicaid |
$228.53
|
| Rate for Payer: UMR Bronson Commercial |
$563.90
|
| Rate for Payer: VA VA |
$426.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,143.04
|
|
|
HC EXCHANGE WIRE PTCA
|
Facility
|
IP
|
$550.26
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$242.11 |
| Max. Negotiated Rate |
$495.23 |
| Rate for Payer: Aetna American Axle |
$357.67
|
| Rate for Payer: Aetna Commercial |
$467.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$357.67
|
| Rate for Payer: Cash Price |
$440.21
|
| Rate for Payer: Cofinity Commercial |
$385.18
|
| Rate for Payer: Cofinity Commercial |
$473.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$385.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.21
|
| Rate for Payer: Healthscope Commercial |
$495.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$385.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$412.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$467.72
|
| Rate for Payer: PHP Commercial |
$467.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.67
|
| Rate for Payer: Priority Health SBD |
$346.66
|
| Rate for Payer: UMR Bronson Commercial |
$242.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$412.69
|
|
|
HC EXCHANGE WIRE PTCA
|
Facility
|
OP
|
$550.26
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$203.60 |
| Max. Negotiated Rate |
$495.23 |
| Rate for Payer: Aetna American Axle |
$357.67
|
| Rate for Payer: Aetna Commercial |
$467.72
|
| Rate for Payer: Aetna Medicare |
$275.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$357.67
|
| Rate for Payer: BCBS Complete |
$220.10
|
| Rate for Payer: Cash Price |
$440.21
|
| Rate for Payer: Cofinity Commercial |
$385.18
|
| Rate for Payer: Cofinity Commercial |
$473.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$385.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$440.21
|
| Rate for Payer: Healthscope Commercial |
$495.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$385.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$412.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$467.72
|
| Rate for Payer: PHP Commercial |
$467.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$357.67
|
| Rate for Payer: Priority Health SBD |
$346.66
|
| Rate for Payer: UMR Bronson Commercial |
$203.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$412.69
|
|
|
HC EXCIS/DESTRUCT INTRANASAL LESION INT APPR
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 30117
|
| Hospital Charge Code |
76100449
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,545.52 |
| Max. Negotiated Rate |
$7,252.20 |
| Rate for Payer: Aetna American Axle |
$5,237.70
|
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,237.70
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$5,640.60
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,640.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,640.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,043.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health SBD |
$5,076.54
|
| Rate for Payer: UMR Bronson Commercial |
$3,545.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
