|
HC EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Facility
|
OP
|
$4,031.01
|
|
|
Service Code
|
CPT 24071
|
| Hospital Charge Code |
76100324
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,491.47 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$2,620.16
|
| Rate for Payer: Aetna Commercial |
$3,426.36
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,620.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$3,224.81
|
| Rate for Payer: Cash Price |
$3,224.81
|
| Rate for Payer: Cofinity Commercial |
$3,466.67
|
| Rate for Payer: Cofinity Commercial |
$2,821.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,821.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,224.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$3,627.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,821.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,023.26
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,426.36
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$3,426.36
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,620.16
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$2,539.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$5,334.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,491.47
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,023.26
|
|
|
HC EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
IP
|
$7,960.00
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
76100527
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,502.40 |
| Max. Negotiated Rate |
$7,164.00 |
| Rate for Payer: Aetna American Axle |
$5,174.00
|
| Rate for Payer: Aetna Commercial |
$6,766.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,174.00
|
| Rate for Payer: Cash Price |
$6,368.00
|
| Rate for Payer: Cofinity Commercial |
$5,572.00
|
| Rate for Payer: Cofinity Commercial |
$6,845.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,572.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,368.00
|
| Rate for Payer: Healthscope Commercial |
$7,164.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,572.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,970.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,766.00
|
| Rate for Payer: PHP Commercial |
$6,766.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,174.00
|
| Rate for Payer: Priority Health SBD |
$5,014.80
|
| Rate for Payer: UMR Bronson Commercial |
$3,502.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,970.00
|
|
|
HC EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Facility
|
OP
|
$7,960.00
|
|
|
Service Code
|
CPT 24076
|
| Hospital Charge Code |
76100527
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$5,174.00
|
| Rate for Payer: Aetna Commercial |
$6,766.00
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,174.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$6,368.00
|
| Rate for Payer: Cash Price |
$6,368.00
|
| Rate for Payer: Cofinity Commercial |
$6,845.60
|
| Rate for Payer: Cofinity Commercial |
$5,572.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,572.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,368.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$7,164.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,572.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,970.00
|
| 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 |
$6,766.00
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$6,766.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,174.00
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$5,014.80
|
| 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 |
$2,945.20
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,970.00
|
|
|
HC EXC TUMOR UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
OP
|
$2,927.69
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
76100310
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$846.98 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna American Axle |
$1,903.00
|
| Rate for Payer: Aetna Commercial |
$2,488.54
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,903.00
|
| 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 |
$2,342.15
|
| Rate for Payer: Cash Price |
$2,342.15
|
| Rate for Payer: Cofinity Commercial |
$2,517.81
|
| Rate for Payer: Cofinity Commercial |
$2,049.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,049.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,342.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$2,634.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,049.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,195.77
|
| 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 |
$2,488.54
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$2,488.54
|
| 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 |
$1,903.00
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$1,844.44
|
| 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 |
$1,083.25
|
| Rate for Payer: VA VA |
$1,580.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,195.77
|
|
|
HC EXC TUMOR UPPER ARM/ELBOW SUBQ <3CM
|
Facility
|
IP
|
$2,927.69
|
|
|
Service Code
|
CPT 24075
|
| Hospital Charge Code |
76100310
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,288.18 |
| Max. Negotiated Rate |
$2,634.92 |
| Rate for Payer: Aetna American Axle |
$1,903.00
|
| Rate for Payer: Aetna Commercial |
$2,488.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,903.00
|
| Rate for Payer: Cash Price |
$2,342.15
|
| Rate for Payer: Cofinity Commercial |
$2,049.38
|
| Rate for Payer: Cofinity Commercial |
$2,517.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,049.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,342.15
|
| Rate for Payer: Healthscope Commercial |
$2,634.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,049.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,195.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,488.54
|
| Rate for Payer: PHP Commercial |
$2,488.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,903.00
|
| Rate for Payer: Priority Health SBD |
$1,844.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,288.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,195.77
|
|
|
HC EXERCISE CHALLENGE
|
Facility
|
IP
|
$1,020.24
|
|
|
Service Code
|
CPT 93464
|
| Hospital Charge Code |
48100108
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$448.91 |
| Max. Negotiated Rate |
$918.22 |
| Rate for Payer: Aetna American Axle |
$663.16
|
| Rate for Payer: Aetna Commercial |
$867.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.16
|
| Rate for Payer: Cash Price |
$816.19
|
| Rate for Payer: Cofinity Commercial |
$714.17
|
| Rate for Payer: Cofinity Commercial |
$877.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$714.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.19
|
| Rate for Payer: Healthscope Commercial |
$918.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$714.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.20
|
| Rate for Payer: PHP Commercial |
$867.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.16
|
| Rate for Payer: Priority Health SBD |
$642.75
|
| Rate for Payer: UMR Bronson Commercial |
$448.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.18
|
|
|
HC EXERCISE CHALLENGE
|
Facility
|
OP
|
$1,020.24
|
|
|
Service Code
|
CPT 93464
|
| Hospital Charge Code |
48100108
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$377.49 |
| Max. Negotiated Rate |
$918.22 |
| Rate for Payer: Aetna American Axle |
$663.16
|
| Rate for Payer: Aetna Commercial |
$867.20
|
| Rate for Payer: Aetna Medicare |
$510.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.16
|
| Rate for Payer: BCBS Complete |
$408.10
|
| Rate for Payer: Cash Price |
$816.19
|
| Rate for Payer: Cofinity Commercial |
$714.17
|
| Rate for Payer: Cofinity Commercial |
$877.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$714.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.19
|
| Rate for Payer: Healthscope Commercial |
$918.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$714.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.20
|
| Rate for Payer: PHP Commercial |
$867.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.16
|
| Rate for Payer: Priority Health SBD |
$642.75
|
| Rate for Payer: UMR Bronson Commercial |
$377.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.18
|
|
|
HC EXERCISE TEST FOR BRONCHOSPASM W/EKG
|
Facility
|
IP
|
$344.70
|
|
|
Service Code
|
CPT 94617
|
| Hospital Charge Code |
46000033
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$151.67 |
| Max. Negotiated Rate |
$310.23 |
| Rate for Payer: Aetna American Axle |
$224.06
|
| Rate for Payer: Aetna Commercial |
$293.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.06
|
| Rate for Payer: Cash Price |
$275.76
|
| Rate for Payer: Cofinity Commercial |
$241.29
|
| Rate for Payer: Cofinity Commercial |
$296.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$241.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.76
|
| Rate for Payer: Healthscope Commercial |
$310.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.00
|
| Rate for Payer: PHP Commercial |
$293.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.06
|
| Rate for Payer: Priority Health SBD |
$217.16
|
| Rate for Payer: UMR Bronson Commercial |
$151.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.52
|
|
|
HC EXERCISE TEST FOR BRONCHOSPASM W/EKG
|
Facility
|
OP
|
$344.70
|
|
|
Service Code
|
CPT 94617
|
| Hospital Charge Code |
46000033
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$353.86 |
| Rate for Payer: Aetna American Axle |
$224.06
|
| Rate for Payer: Aetna Commercial |
$293.00
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$275.76
|
| Rate for Payer: Cash Price |
$275.76
|
| Rate for Payer: Cash Price |
$275.76
|
| Rate for Payer: Cofinity Commercial |
$241.29
|
| Rate for Payer: Cofinity Commercial |
$296.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$241.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$310.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.52
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.00
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$293.00
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.06
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$217.16
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$240.24
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: UMR Bronson Commercial |
$127.54
|
| Rate for Payer: VA VA |
$125.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.52
|
|
|
HC EXERCISE TEST FOR BRONCHOSPASM WO ECG
|
Facility
|
OP
|
$136.25
|
|
|
Service Code
|
CPT 94619
|
| Hospital Charge Code |
46000032
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$88.56
|
| Rate for Payer: Aetna Commercial |
$115.81
|
| Rate for Payer: Aetna Medicare |
$60.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$109.00
|
| Rate for Payer: Cash Price |
$109.00
|
| Rate for Payer: Cash Price |
$109.00
|
| Rate for Payer: Cofinity Commercial |
$117.17
|
| Rate for Payer: Cofinity Commercial |
$95.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$95.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$122.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.19
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.81
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$115.81
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.56
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health SBD |
$85.84
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.07
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$110.71
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: UMR Bronson Commercial |
$50.41
|
| Rate for Payer: VA VA |
$57.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.19
|
|
|
HC EXERCISE TEST FOR BRONCHOSPASM WO ECG
|
Facility
|
IP
|
$136.25
|
|
|
Service Code
|
CPT 94619
|
| Hospital Charge Code |
46000032
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$59.95 |
| Max. Negotiated Rate |
$122.62 |
| Rate for Payer: Aetna American Axle |
$88.56
|
| Rate for Payer: Aetna Commercial |
$115.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.56
|
| Rate for Payer: Cash Price |
$109.00
|
| Rate for Payer: Cofinity Commercial |
$117.17
|
| Rate for Payer: Cofinity Commercial |
$95.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$95.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.00
|
| Rate for Payer: Healthscope Commercial |
$122.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.81
|
| Rate for Payer: PHP Commercial |
$115.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.56
|
| Rate for Payer: Priority Health SBD |
$85.84
|
| Rate for Payer: UMR Bronson Commercial |
$59.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.19
|
|
|
HC EXPLORE WOUND EXTREMITY
|
Facility
|
IP
|
$1,942.34
|
|
|
Service Code
|
CPT 20103
|
| Hospital Charge Code |
45000007
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$854.63 |
| Max. Negotiated Rate |
$1,748.11 |
| Rate for Payer: Aetna American Axle |
$1,262.52
|
| Rate for Payer: Aetna Commercial |
$1,650.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,262.52
|
| Rate for Payer: Cash Price |
$1,553.87
|
| Rate for Payer: Cofinity Commercial |
$1,359.64
|
| Rate for Payer: Cofinity Commercial |
$1,670.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,359.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,553.87
|
| Rate for Payer: Healthscope Commercial |
$1,748.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,359.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,456.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,650.99
|
| Rate for Payer: PHP Commercial |
$1,650.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.52
|
| Rate for Payer: Priority Health SBD |
$1,223.67
|
| Rate for Payer: UMR Bronson Commercial |
$854.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,456.76
|
|
|
HC EXPLORE WOUND EXTREMITY
|
Facility
|
OP
|
$1,942.34
|
|
|
Service Code
|
CPT 20103
|
| Hospital Charge Code |
45000007
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$718.67 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna American Axle |
$1,262.52
|
| Rate for Payer: Aetna Commercial |
$1,650.99
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,262.52
|
| 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 |
$1,553.87
|
| Rate for Payer: Cash Price |
$1,553.87
|
| Rate for Payer: Cofinity Commercial |
$1,670.41
|
| Rate for Payer: Cofinity Commercial |
$1,359.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,359.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,553.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$1,748.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,359.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,456.76
|
| 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 |
$1,650.99
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,650.99
|
| 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 |
$1,262.52
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$1,223.67
|
| 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 |
$718.67
|
| Rate for Payer: VA VA |
$1,580.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,456.76
|
|
|
HC EXTENDED RECOVERY 0-6 HRS
|
Facility
|
IP
|
$1,760.92
|
|
| Hospital Charge Code |
71000005
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$774.80 |
| Max. Negotiated Rate |
$1,584.83 |
| Rate for Payer: Aetna American Axle |
$1,144.60
|
| Rate for Payer: Aetna Commercial |
$1,496.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,144.60
|
| Rate for Payer: Cash Price |
$1,408.74
|
| Rate for Payer: Cofinity Commercial |
$1,232.64
|
| Rate for Payer: Cofinity Commercial |
$1,514.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,232.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,408.74
|
| Rate for Payer: Healthscope Commercial |
$1,584.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,232.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,320.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,496.78
|
| Rate for Payer: PHP Commercial |
$1,496.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,144.60
|
| Rate for Payer: Priority Health SBD |
$1,109.38
|
| Rate for Payer: UMR Bronson Commercial |
$774.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,320.69
|
|
|
HC EXTENDED RECOVERY 0-6 HRS
|
Facility
|
OP
|
$1,760.92
|
|
| Hospital Charge Code |
71000005
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$651.54 |
| Max. Negotiated Rate |
$1,584.83 |
| Rate for Payer: Aetna American Axle |
$1,144.60
|
| Rate for Payer: Aetna Commercial |
$1,496.78
|
| Rate for Payer: Aetna Medicare |
$880.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,144.60
|
| Rate for Payer: BCBS Complete |
$704.37
|
| Rate for Payer: Cash Price |
$1,408.74
|
| Rate for Payer: Cofinity Commercial |
$1,232.64
|
| Rate for Payer: Cofinity Commercial |
$1,514.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,232.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,408.74
|
| Rate for Payer: Healthscope Commercial |
$1,584.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,232.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,320.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,496.78
|
| Rate for Payer: PHP Commercial |
$1,496.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,144.60
|
| Rate for Payer: Priority Health SBD |
$1,109.38
|
| Rate for Payer: UMR Bronson Commercial |
$651.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,320.69
|
|
|
HC EXTENDED RECOVERY 12-18 HRS
|
Facility
|
IP
|
$2,058.81
|
|
| Hospital Charge Code |
71000006
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$905.88 |
| Max. Negotiated Rate |
$1,852.93 |
| Rate for Payer: Aetna American Axle |
$1,338.23
|
| Rate for Payer: Aetna Commercial |
$1,749.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,338.23
|
| Rate for Payer: Cash Price |
$1,647.05
|
| Rate for Payer: Cofinity Commercial |
$1,441.17
|
| Rate for Payer: Cofinity Commercial |
$1,770.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,441.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,647.05
|
| Rate for Payer: Healthscope Commercial |
$1,852.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,441.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,544.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,749.99
|
| Rate for Payer: PHP Commercial |
$1,749.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,338.23
|
| Rate for Payer: Priority Health SBD |
$1,297.05
|
| Rate for Payer: UMR Bronson Commercial |
$905.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,544.11
|
|
|
HC EXTENDED RECOVERY 12-18 HRS
|
Facility
|
OP
|
$2,058.81
|
|
| Hospital Charge Code |
71000006
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$761.76 |
| Max. Negotiated Rate |
$1,852.93 |
| Rate for Payer: Aetna American Axle |
$1,338.23
|
| Rate for Payer: Aetna Commercial |
$1,749.99
|
| Rate for Payer: Aetna Medicare |
$1,029.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,338.23
|
| Rate for Payer: BCBS Complete |
$823.52
|
| Rate for Payer: Cash Price |
$1,647.05
|
| Rate for Payer: Cofinity Commercial |
$1,441.17
|
| Rate for Payer: Cofinity Commercial |
$1,770.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,441.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,647.05
|
| Rate for Payer: Healthscope Commercial |
$1,852.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,441.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,544.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,749.99
|
| Rate for Payer: PHP Commercial |
$1,749.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,338.23
|
| Rate for Payer: Priority Health SBD |
$1,297.05
|
| Rate for Payer: UMR Bronson Commercial |
$761.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,544.11
|
|
|
HC EXTENDED RECOVERY 18-24 HRS
|
Facility
|
OP
|
$2,250.28
|
|
| Hospital Charge Code |
71000007
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$832.60 |
| Max. Negotiated Rate |
$2,025.25 |
| Rate for Payer: Aetna American Axle |
$1,462.68
|
| Rate for Payer: Aetna Commercial |
$1,912.74
|
| Rate for Payer: Aetna Medicare |
$1,125.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,462.68
|
| Rate for Payer: BCBS Complete |
$900.11
|
| Rate for Payer: Cash Price |
$1,800.22
|
| Rate for Payer: Cofinity Commercial |
$1,575.20
|
| Rate for Payer: Cofinity Commercial |
$1,935.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,575.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,800.22
|
| Rate for Payer: Healthscope Commercial |
$2,025.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,575.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,687.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.74
|
| Rate for Payer: PHP Commercial |
$1,912.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,462.68
|
| Rate for Payer: Priority Health SBD |
$1,417.68
|
| Rate for Payer: UMR Bronson Commercial |
$832.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,687.71
|
|
|
HC EXTENDED RECOVERY 18-24 HRS
|
Facility
|
IP
|
$2,250.28
|
|
| Hospital Charge Code |
71000007
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$990.12 |
| Max. Negotiated Rate |
$2,025.25 |
| Rate for Payer: Aetna American Axle |
$1,462.68
|
| Rate for Payer: Aetna Commercial |
$1,912.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,462.68
|
| Rate for Payer: Cash Price |
$1,800.22
|
| Rate for Payer: Cofinity Commercial |
$1,575.20
|
| Rate for Payer: Cofinity Commercial |
$1,935.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,575.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,800.22
|
| Rate for Payer: Healthscope Commercial |
$2,025.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,575.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,687.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.74
|
| Rate for Payer: PHP Commercial |
$1,912.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,462.68
|
| Rate for Payer: Priority Health SBD |
$1,417.68
|
| Rate for Payer: UMR Bronson Commercial |
$990.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,687.71
|
|
|
HC EXTENDED RECOVERY 6-12 HRS
|
Facility
|
OP
|
$1,925.80
|
|
| Hospital Charge Code |
71000008
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$712.55 |
| Max. Negotiated Rate |
$1,733.22 |
| Rate for Payer: Aetna American Axle |
$1,251.77
|
| Rate for Payer: Aetna Commercial |
$1,636.93
|
| Rate for Payer: Aetna Medicare |
$962.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.77
|
| Rate for Payer: BCBS Complete |
$770.32
|
| Rate for Payer: Cash Price |
$1,540.64
|
| Rate for Payer: Cofinity Commercial |
$1,348.06
|
| Rate for Payer: Cofinity Commercial |
$1,656.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,348.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.64
|
| Rate for Payer: Healthscope Commercial |
$1,733.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,348.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,444.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,636.93
|
| Rate for Payer: PHP Commercial |
$1,636.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,251.77
|
| Rate for Payer: Priority Health SBD |
$1,213.25
|
| Rate for Payer: UMR Bronson Commercial |
$712.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,444.35
|
|
|
HC EXTENDED RECOVERY 6-12 HRS
|
Facility
|
IP
|
$1,925.80
|
|
| Hospital Charge Code |
71000008
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$847.35 |
| Max. Negotiated Rate |
$1,733.22 |
| Rate for Payer: Aetna American Axle |
$1,251.77
|
| Rate for Payer: Aetna Commercial |
$1,636.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.77
|
| Rate for Payer: Cash Price |
$1,540.64
|
| Rate for Payer: Cofinity Commercial |
$1,348.06
|
| Rate for Payer: Cofinity Commercial |
$1,656.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,348.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.64
|
| Rate for Payer: Healthscope Commercial |
$1,733.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,348.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,444.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,636.93
|
| Rate for Payer: PHP Commercial |
$1,636.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,251.77
|
| Rate for Payer: Priority Health SBD |
$1,213.25
|
| Rate for Payer: UMR Bronson Commercial |
$847.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,444.35
|
|
|
HC EXTENSION KIT
|
Facility
|
IP
|
$2,031.98
|
|
|
Service Code
|
HCPCS C1883
|
| Hospital Charge Code |
27800052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$894.07 |
| Max. Negotiated Rate |
$1,828.78 |
| Rate for Payer: Aetna American Axle |
$1,320.79
|
| Rate for Payer: Aetna Commercial |
$1,727.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,320.79
|
| Rate for Payer: Cash Price |
$1,625.58
|
| Rate for Payer: Cofinity Commercial |
$1,422.39
|
| Rate for Payer: Cofinity Commercial |
$1,747.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,422.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,625.58
|
| Rate for Payer: Healthscope Commercial |
$1,828.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,422.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,523.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,727.18
|
| Rate for Payer: PHP Commercial |
$1,727.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.79
|
| Rate for Payer: Priority Health SBD |
$1,280.15
|
| Rate for Payer: UMR Bronson Commercial |
$894.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,523.98
|
|
|
HC EXTENSION KIT
|
Facility
|
OP
|
$2,031.98
|
|
|
Service Code
|
HCPCS C1883
|
| Hospital Charge Code |
27800052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$751.83 |
| Max. Negotiated Rate |
$1,828.78 |
| Rate for Payer: Aetna American Axle |
$1,320.79
|
| Rate for Payer: Aetna Commercial |
$1,727.18
|
| Rate for Payer: Aetna Medicare |
$1,015.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,320.79
|
| Rate for Payer: BCBS Complete |
$812.79
|
| Rate for Payer: Cash Price |
$1,625.58
|
| Rate for Payer: Cofinity Commercial |
$1,422.39
|
| Rate for Payer: Cofinity Commercial |
$1,747.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,422.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,625.58
|
| Rate for Payer: Healthscope Commercial |
$1,828.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,422.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,523.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,727.18
|
| Rate for Payer: PHP Commercial |
$1,727.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.79
|
| Rate for Payer: Priority Health SBD |
$1,280.15
|
| Rate for Payer: UMR Bronson Commercial |
$751.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,523.98
|
|
|
HC EXTENSION ST JUDE
|
Facility
|
OP
|
$2,370.66
|
|
|
Service Code
|
HCPCS C1883
|
| Hospital Charge Code |
27800053
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$877.14 |
| Max. Negotiated Rate |
$2,133.59 |
| Rate for Payer: Aetna American Axle |
$1,540.93
|
| Rate for Payer: Aetna Commercial |
$2,015.06
|
| Rate for Payer: Aetna Medicare |
$1,185.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,540.93
|
| Rate for Payer: BCBS Complete |
$948.26
|
| Rate for Payer: Cash Price |
$1,896.53
|
| Rate for Payer: Cofinity Commercial |
$1,659.46
|
| Rate for Payer: Cofinity Commercial |
$2,038.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,659.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,896.53
|
| Rate for Payer: Healthscope Commercial |
$2,133.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,659.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,777.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,015.06
|
| Rate for Payer: PHP Commercial |
$2,015.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,540.93
|
| Rate for Payer: Priority Health SBD |
$1,493.52
|
| Rate for Payer: UMR Bronson Commercial |
$877.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,777.99
|
|
|
HC EXTENSION ST JUDE
|
Facility
|
IP
|
$2,370.66
|
|
|
Service Code
|
HCPCS C1883
|
| Hospital Charge Code |
27800053
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,043.09 |
| Max. Negotiated Rate |
$2,133.59 |
| Rate for Payer: Aetna American Axle |
$1,540.93
|
| Rate for Payer: Aetna Commercial |
$2,015.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,540.93
|
| Rate for Payer: Cash Price |
$1,896.53
|
| Rate for Payer: Cofinity Commercial |
$1,659.46
|
| Rate for Payer: Cofinity Commercial |
$2,038.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,659.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,896.53
|
| Rate for Payer: Healthscope Commercial |
$2,133.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,659.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,777.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,015.06
|
| Rate for Payer: PHP Commercial |
$2,015.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,540.93
|
| Rate for Payer: Priority Health SBD |
$1,493.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,043.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,777.99
|
|
