|
HC HYDROXYPREGNENOLONE 17
|
Facility
|
IP
|
$90.51
|
|
|
Service Code
|
CPT 84143
|
| Hospital Charge Code |
30100399
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.82 |
| Max. Negotiated Rate |
$81.46 |
| Rate for Payer: Aetna American Axle |
$58.83
|
| Rate for Payer: Aetna Commercial |
$76.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.83
|
| Rate for Payer: Cash Price |
$72.41
|
| Rate for Payer: Cofinity Advantage |
$63.36
|
| Rate for Payer: Cofinity Commercial |
$77.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.41
|
| Rate for Payer: Healthscope Commercial |
$81.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.88
|
| Rate for Payer: PHP Commercial |
$76.93
|
| Rate for Payer: Priority Health SBD |
$57.02
|
| Rate for Payer: UMR Bronson Commercial |
$39.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.88
|
|
|
HC HYDROXYPROGESTERONE 17
|
Facility
|
OP
|
$48.64
|
|
|
Service Code
|
CPT 83498
|
| Hospital Charge Code |
30100249
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.21 |
| Max. Negotiated Rate |
$43.78 |
| Rate for Payer: Aetna American Axle |
$31.62
|
| Rate for Payer: Aetna Commercial |
$41.34
|
| Rate for Payer: Aetna Medicare |
$28.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.96
|
| Rate for Payer: BCBS Complete |
$14.92
|
| Rate for Payer: BCBS MAPPO |
$27.17
|
| Rate for Payer: BCBS Trust/PPO |
$31.41
|
| Rate for Payer: BCN Commercial |
$31.41
|
| Rate for Payer: BCN Medicare Advantage |
$27.17
|
| Rate for Payer: Cash Price |
$38.91
|
| Rate for Payer: Cash Price |
$38.91
|
| Rate for Payer: Cofinity Advantage |
$34.05
|
| Rate for Payer: Cofinity Commercial |
$41.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.17
|
| Rate for Payer: Healthscope Commercial |
$43.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.48
|
| Rate for Payer: Mclaren Medicaid |
$27.17
|
| Rate for Payer: Mclaren Medicare |
$27.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.53
|
| Rate for Payer: Meridian Medicaid |
$28.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.34
|
| Rate for Payer: Nomi Health Commercial |
$40.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.48
|
| Rate for Payer: PACE Medicare |
$25.81
|
| Rate for Payer: PACE SWMI |
$27.17
|
| Rate for Payer: PHP Commercial |
$41.34
|
| Rate for Payer: PHP Medicare Advantage |
$27.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$27.17
|
| Rate for Payer: Priority Health Medicare |
$27.17
|
| Rate for Payer: Priority Health SBD |
$30.64
|
| Rate for Payer: Priority Health Tiered Network |
$21.74
|
| Rate for Payer: Railroad Medicare Medicare |
$27.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.76
|
| Rate for Payer: UHC Core |
$40.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.17
|
| Rate for Payer: UHC Exchange |
$40.76
|
| Rate for Payer: UHC Medicaid |
$14.21
|
| Rate for Payer: UHCCP Medicaid |
$14.21
|
| Rate for Payer: UMR Bronson Commercial |
$18.00
|
| Rate for Payer: VA VA |
$27.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.48
|
|
|
HC HYDROXYPROGESTERONE 17
|
Facility
|
IP
|
$48.64
|
|
|
Service Code
|
CPT 83498
|
| Hospital Charge Code |
30100249
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.40 |
| Max. Negotiated Rate |
$43.78 |
| Rate for Payer: Aetna American Axle |
$31.62
|
| Rate for Payer: Aetna Commercial |
$41.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.62
|
| Rate for Payer: Cash Price |
$38.91
|
| Rate for Payer: Cofinity Advantage |
$34.05
|
| Rate for Payer: Cofinity Commercial |
$41.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.91
|
| Rate for Payer: Healthscope Commercial |
$43.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.48
|
| Rate for Payer: PHP Commercial |
$41.34
|
| Rate for Payer: Priority Health SBD |
$30.64
|
| Rate for Payer: UMR Bronson Commercial |
$21.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.48
|
|
|
HC HYPERSENSITIVITY PNEUMO-CMPTS
|
Facility
|
OP
|
$28.65
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200270
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$25.79 |
| Rate for Payer: Aetna American Axle |
$18.62
|
| Rate for Payer: Aetna Commercial |
$24.35
|
| Rate for Payer: Aetna Medicare |
$12.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.31
|
| Rate for Payer: BCBS Complete |
$6.73
|
| Rate for Payer: BCBS MAPPO |
$12.25
|
| Rate for Payer: BCBS Trust/PPO |
$14.16
|
| Rate for Payer: BCN Commercial |
$14.16
|
| Rate for Payer: BCN Medicare Advantage |
$12.25
|
| Rate for Payer: Cash Price |
$22.92
|
| Rate for Payer: Cash Price |
$22.92
|
| Rate for Payer: Cofinity Advantage |
$20.05
|
| Rate for Payer: Cofinity Commercial |
$24.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.25
|
| Rate for Payer: Healthscope Commercial |
$25.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.49
|
| Rate for Payer: Mclaren Medicaid |
$12.25
|
| Rate for Payer: Mclaren Medicare |
$12.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.86
|
| Rate for Payer: Meridian Medicaid |
$12.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.35
|
| Rate for Payer: Nomi Health Commercial |
$18.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.49
|
| Rate for Payer: PACE Medicare |
$11.64
|
| Rate for Payer: PACE SWMI |
$12.25
|
| Rate for Payer: PHP Commercial |
$24.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.25
|
| Rate for Payer: Priority Health Medicare |
$12.25
|
| Rate for Payer: Priority Health SBD |
$18.05
|
| Rate for Payer: Priority Health Tiered Network |
$9.80
|
| Rate for Payer: Railroad Medicare Medicare |
$12.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.38
|
| Rate for Payer: UHC Core |
$18.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.25
|
| Rate for Payer: UHC Exchange |
$18.38
|
| Rate for Payer: UHC Medicaid |
$6.41
|
| Rate for Payer: UHCCP Medicaid |
$6.41
|
| Rate for Payer: UMR Bronson Commercial |
$10.60
|
| Rate for Payer: VA VA |
$12.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.49
|
|
|
HC HYPERSENSITIVITY PNEUMO-CMPTS
|
Facility
|
IP
|
$28.65
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200270
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.61 |
| Max. Negotiated Rate |
$25.79 |
| Rate for Payer: Aetna American Axle |
$18.62
|
| Rate for Payer: Aetna Commercial |
$24.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.62
|
| Rate for Payer: Cash Price |
$22.92
|
| Rate for Payer: Cofinity Advantage |
$20.05
|
| Rate for Payer: Cofinity Commercial |
$24.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.92
|
| Rate for Payer: Healthscope Commercial |
$25.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.49
|
| Rate for Payer: PHP Commercial |
$24.35
|
| Rate for Payer: Priority Health SBD |
$18.05
|
| Rate for Payer: UMR Bronson Commercial |
$12.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.49
|
|
|
HC HYPERSENSITIVITY PNEUMONITIS P
|
Facility
|
IP
|
$29.71
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200223
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.07 |
| Max. Negotiated Rate |
$26.74 |
| Rate for Payer: Aetna American Axle |
$19.31
|
| Rate for Payer: Aetna Commercial |
$25.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.31
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Advantage |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$25.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Healthscope Commercial |
$26.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: PHP Commercial |
$25.25
|
| Rate for Payer: Priority Health SBD |
$18.72
|
| Rate for Payer: UMR Bronson Commercial |
$13.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.28
|
|
|
HC HYPERSENSITIVITY PNEUMONITIS P
|
Facility
|
OP
|
$29.71
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200223
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$26.74 |
| Rate for Payer: Aetna American Axle |
$19.31
|
| Rate for Payer: Aetna Commercial |
$25.25
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.40
|
| Rate for Payer: BCN Commercial |
$17.40
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Advantage |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$25.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$26.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.28
|
| Rate for Payer: Mclaren Medicaid |
$15.05
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: Meridian Medicaid |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Nomi Health Commercial |
$22.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$25.25
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.05
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health SBD |
$18.72
|
| Rate for Payer: Priority Health Tiered Network |
$12.04
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.58
|
| Rate for Payer: UHC Core |
$22.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.05
|
| Rate for Payer: UHC Exchange |
$22.58
|
| Rate for Payer: UHC Medicaid |
$7.87
|
| Rate for Payer: UHCCP Medicaid |
$7.87
|
| Rate for Payer: UMR Bronson Commercial |
$10.99
|
| Rate for Payer: VA VA |
$15.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.28
|
|
|
HC HYPERSENSITIVITY PNEUMO PANEL
|
Facility
|
IP
|
$23.21
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
30200496
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.21 |
| Max. Negotiated Rate |
$20.89 |
| Rate for Payer: Aetna American Axle |
$15.09
|
| Rate for Payer: Aetna Commercial |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.09
|
| Rate for Payer: Cash Price |
$18.57
|
| Rate for Payer: Cofinity Advantage |
$16.25
|
| Rate for Payer: Cofinity Commercial |
$19.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.57
|
| Rate for Payer: Healthscope Commercial |
$20.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.41
|
| Rate for Payer: PHP Commercial |
$19.73
|
| Rate for Payer: Priority Health SBD |
$14.62
|
| Rate for Payer: UMR Bronson Commercial |
$10.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.41
|
|
|
HC HYPERSENSITIVITY PNEUMO PANEL
|
Facility
|
OP
|
$23.21
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
30200496
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.09 |
| Max. Negotiated Rate |
$20.89 |
| Rate for Payer: Aetna American Axle |
$15.09
|
| Rate for Payer: Aetna Commercial |
$19.73
|
| Rate for Payer: Aetna Medicare |
$8.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.78
|
| Rate for Payer: BCBS Complete |
$4.29
|
| Rate for Payer: BCBS MAPPO |
$7.82
|
| Rate for Payer: BCBS Trust/PPO |
$9.05
|
| Rate for Payer: BCN Commercial |
$9.05
|
| Rate for Payer: BCN Medicare Advantage |
$7.82
|
| Rate for Payer: Cash Price |
$18.57
|
| Rate for Payer: Cash Price |
$18.57
|
| Rate for Payer: Cofinity Advantage |
$16.25
|
| Rate for Payer: Cofinity Commercial |
$19.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.82
|
| Rate for Payer: Healthscope Commercial |
$20.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.41
|
| Rate for Payer: Mclaren Medicaid |
$7.82
|
| Rate for Payer: Mclaren Medicare |
$7.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.21
|
| Rate for Payer: Meridian Medicaid |
$8.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.73
|
| Rate for Payer: Nomi Health Commercial |
$11.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.41
|
| Rate for Payer: PACE Medicare |
$7.43
|
| Rate for Payer: PACE SWMI |
$7.82
|
| Rate for Payer: PHP Commercial |
$19.73
|
| Rate for Payer: PHP Medicare Advantage |
$7.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7.82
|
| Rate for Payer: Priority Health Medicare |
$7.82
|
| Rate for Payer: Priority Health SBD |
$14.62
|
| Rate for Payer: Priority Health Tiered Network |
$6.26
|
| Rate for Payer: Railroad Medicare Medicare |
$7.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.73
|
| Rate for Payer: UHC Core |
$11.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.82
|
| Rate for Payer: UHC Exchange |
$11.73
|
| Rate for Payer: UHC Medicaid |
$4.09
|
| Rate for Payer: UHCCP Medicaid |
$4.09
|
| Rate for Payer: UMR Bronson Commercial |
$8.59
|
| Rate for Payer: VA VA |
$7.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.41
|
|
|
HC HYSTEROSCOPY DIAGNOSTIC
|
Facility
|
OP
|
$4,175.67
|
|
|
Service Code
|
CPT 58555
|
| Hospital Charge Code |
76100303
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,545.00 |
| Max. Negotiated Rate |
$10,430.93 |
| Rate for Payer: Aetna American Axle |
$2,714.19
|
| Rate for Payer: Aetna Commercial |
$3,549.32
|
| Rate for Payer: Aetna Medicare |
$3,354.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,714.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,035.75
|
| Rate for Payer: BCN Commercial |
$2,035.75
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$3,340.54
|
| Rate for Payer: Cash Price |
$3,340.54
|
| Rate for Payer: Cash Price |
$3,340.54
|
| Rate for Payer: Cofinity Advantage |
$2,922.97
|
| Rate for Payer: Cofinity Commercial |
$3,591.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,340.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$3,758.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,922.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,131.75
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$3,386.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,549.32
|
| Rate for Payer: Nomi Health Commercial |
$9,676.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,131.75
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$3,549.32
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,430.93
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health SBD |
$2,630.67
|
| Rate for Payer: Priority Health Tiered Network |
$8,344.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,714.19
|
| Rate for Payer: UHC Core |
$2,175.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Exchange |
$1,641.04
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,545.00
|
| Rate for Payer: VA VA |
$3,225.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,131.75
|
|
|
HC HYSTEROSCOPY DIAGNOSTIC
|
Facility
|
IP
|
$4,175.67
|
|
|
Service Code
|
CPT 58555
|
| Hospital Charge Code |
76100303
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,837.29 |
| Max. Negotiated Rate |
$3,758.10 |
| Rate for Payer: Aetna American Axle |
$2,714.19
|
| Rate for Payer: Aetna Commercial |
$3,549.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,714.19
|
| Rate for Payer: Cash Price |
$3,340.54
|
| Rate for Payer: Cofinity Advantage |
$2,922.97
|
| Rate for Payer: Cofinity Commercial |
$3,591.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,340.54
|
| Rate for Payer: Healthscope Commercial |
$3,758.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,922.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,131.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,549.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,131.75
|
| Rate for Payer: PHP Commercial |
$3,549.32
|
| Rate for Payer: Priority Health SBD |
$2,630.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,837.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,131.75
|
|
|
HC HYSTEROSCOPY ENDOMETR ABLATION
|
Facility
|
OP
|
$13,620.60
|
|
|
Service Code
|
CPT 58563
|
| Hospital Charge Code |
76100340
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,606.87 |
| Max. Negotiated Rate |
$16,119.31 |
| Rate for Payer: Aetna American Axle |
$8,853.39
|
| Rate for Payer: Aetna Commercial |
$11,577.51
|
| Rate for Payer: Aetna Medicare |
$5,183.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,853.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,230.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,230.57
|
| Rate for Payer: BCBS Complete |
$2,737.47
|
| Rate for Payer: BCBS MAPPO |
$4,984.46
|
| Rate for Payer: BCBS Trust/PPO |
$4,300.31
|
| Rate for Payer: BCN Commercial |
$4,300.31
|
| Rate for Payer: BCN Medicare Advantage |
$4,984.46
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cofinity Advantage |
$9,534.42
|
| Rate for Payer: Cofinity Commercial |
$11,713.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,896.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,984.46
|
| Rate for Payer: Healthscope Commercial |
$12,258.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,534.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,215.45
|
| Rate for Payer: Mclaren Medicaid |
$4,984.46
|
| Rate for Payer: Mclaren Medicare |
$4,984.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,233.68
|
| Rate for Payer: Meridian Medicaid |
$5,233.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,732.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,482.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,577.51
|
| Rate for Payer: Nomi Health Commercial |
$14,953.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,215.45
|
| Rate for Payer: PACE Medicare |
$4,735.24
|
| Rate for Payer: PACE SWMI |
$4,984.46
|
| Rate for Payer: PHP Commercial |
$11,577.51
|
| Rate for Payer: PHP Medicare Advantage |
$4,984.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,606.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16,119.31
|
| Rate for Payer: Priority Health Medicare |
$4,984.46
|
| Rate for Payer: Priority Health SBD |
$8,580.98
|
| Rate for Payer: Priority Health Tiered Network |
$12,895.45
|
| Rate for Payer: Railroad Medicare Medicare |
$4,984.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,853.39
|
| Rate for Payer: UHC Core |
$7,096.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4,984.46
|
| Rate for Payer: UHC Exchange |
$5,352.90
|
| Rate for Payer: UHC Medicaid |
$2,606.87
|
| Rate for Payer: UHCCP Medicaid |
$2,606.87
|
| Rate for Payer: UMR Bronson Commercial |
$5,039.62
|
| Rate for Payer: VA VA |
$4,984.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,215.45
|
|
|
HC HYSTEROSCOPY ENDOMETR ABLATION
|
Facility
|
IP
|
$13,620.60
|
|
|
Service Code
|
CPT 58563
|
| Hospital Charge Code |
76100340
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,993.06 |
| Max. Negotiated Rate |
$12,258.54 |
| Rate for Payer: Aetna American Axle |
$8,853.39
|
| Rate for Payer: Aetna Commercial |
$11,577.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,853.39
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cofinity Advantage |
$9,534.42
|
| Rate for Payer: Cofinity Commercial |
$11,713.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,896.48
|
| Rate for Payer: Healthscope Commercial |
$12,258.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,534.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,215.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,577.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,215.45
|
| Rate for Payer: PHP Commercial |
$11,577.51
|
| Rate for Payer: Priority Health SBD |
$8,580.98
|
| Rate for Payer: UMR Bronson Commercial |
$5,993.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,215.45
|
|
|
HC HYSTEROSCOPY REMOVE FB
|
Facility
|
OP
|
$8,104.44
|
|
|
Service Code
|
CPT 58562
|
| Hospital Charge Code |
76100339
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,686.93 |
| Max. Negotiated Rate |
$10,430.93 |
| Rate for Payer: Aetna American Axle |
$5,267.89
|
| Rate for Payer: Aetna Commercial |
$6,888.77
|
| Rate for Payer: Aetna Medicare |
$3,354.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,267.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$3,263.60
|
| Rate for Payer: BCN Commercial |
$3,263.60
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Advantage |
$5,673.11
|
| Rate for Payer: Cofinity Commercial |
$6,969.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$7,294.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,673.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,078.33
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$3,386.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$9,676.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$6,888.77
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,430.93
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health SBD |
$5,105.80
|
| Rate for Payer: Priority Health Tiered Network |
$8,344.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,267.89
|
| Rate for Payer: UHC Core |
$4,222.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Exchange |
$3,185.04
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: UMR Bronson Commercial |
$2,998.64
|
| Rate for Payer: VA VA |
$3,225.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,078.33
|
|
|
HC HYSTEROSCOPY REMOVE FB
|
Facility
|
IP
|
$8,104.44
|
|
|
Service Code
|
CPT 58562
|
| Hospital Charge Code |
76100339
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,565.95 |
| Max. Negotiated Rate |
$7,294.00 |
| Rate for Payer: Aetna American Axle |
$5,267.89
|
| Rate for Payer: Aetna Commercial |
$6,888.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,267.89
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Advantage |
$5,673.11
|
| Rate for Payer: Cofinity Commercial |
$6,969.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Healthscope Commercial |
$7,294.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,673.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,078.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PHP Commercial |
$6,888.77
|
| Rate for Payer: Priority Health SBD |
$5,105.80
|
| Rate for Payer: UMR Bronson Commercial |
$3,565.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,078.33
|
|
|
HC HYSTEROSCOPY REMOVE MYOMA
|
Facility
|
OP
|
$13,620.60
|
|
|
Service Code
|
CPT 58561
|
| Hospital Charge Code |
76100338
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,606.87 |
| Max. Negotiated Rate |
$16,119.31 |
| Rate for Payer: Aetna American Axle |
$8,853.39
|
| Rate for Payer: Aetna Commercial |
$11,577.51
|
| Rate for Payer: Aetna Medicare |
$5,183.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,853.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,230.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,230.57
|
| Rate for Payer: BCBS Complete |
$2,737.47
|
| Rate for Payer: BCBS MAPPO |
$4,984.46
|
| Rate for Payer: BCBS Trust/PPO |
$5,192.60
|
| Rate for Payer: BCN Commercial |
$5,192.60
|
| Rate for Payer: BCN Medicare Advantage |
$4,984.46
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cofinity Advantage |
$9,534.42
|
| Rate for Payer: Cofinity Commercial |
$11,713.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,896.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,984.46
|
| Rate for Payer: Healthscope Commercial |
$12,258.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,534.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,215.45
|
| Rate for Payer: Mclaren Medicaid |
$4,984.46
|
| Rate for Payer: Mclaren Medicare |
$4,984.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,233.68
|
| Rate for Payer: Meridian Medicaid |
$5,233.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,732.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,482.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,577.51
|
| Rate for Payer: Nomi Health Commercial |
$14,953.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,215.45
|
| Rate for Payer: PACE Medicare |
$4,735.24
|
| Rate for Payer: PACE SWMI |
$4,984.46
|
| Rate for Payer: PHP Commercial |
$11,577.51
|
| Rate for Payer: PHP Medicare Advantage |
$4,984.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,606.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16,119.31
|
| Rate for Payer: Priority Health Medicare |
$4,984.46
|
| Rate for Payer: Priority Health SBD |
$8,580.98
|
| Rate for Payer: Priority Health Tiered Network |
$12,895.45
|
| Rate for Payer: Railroad Medicare Medicare |
$4,984.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,853.39
|
| Rate for Payer: UHC Core |
$7,096.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4,984.46
|
| Rate for Payer: UHC Exchange |
$5,352.90
|
| Rate for Payer: UHC Medicaid |
$2,606.87
|
| Rate for Payer: UHCCP Medicaid |
$2,606.87
|
| Rate for Payer: UMR Bronson Commercial |
$5,039.62
|
| Rate for Payer: VA VA |
$4,984.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,215.45
|
|
|
HC HYSTEROSCOPY REMOVE MYOMA
|
Facility
|
IP
|
$13,620.60
|
|
|
Service Code
|
CPT 58561
|
| Hospital Charge Code |
76100338
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,993.06 |
| Max. Negotiated Rate |
$12,258.54 |
| Rate for Payer: Aetna American Axle |
$8,853.39
|
| Rate for Payer: Aetna Commercial |
$11,577.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,853.39
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cofinity Advantage |
$9,534.42
|
| Rate for Payer: Cofinity Commercial |
$11,713.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,896.48
|
| Rate for Payer: Healthscope Commercial |
$12,258.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,534.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,215.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,577.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,215.45
|
| Rate for Payer: PHP Commercial |
$11,577.51
|
| Rate for Payer: Priority Health SBD |
$8,580.98
|
| Rate for Payer: UMR Bronson Commercial |
$5,993.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,215.45
|
|
|
HC HYSTEROSCOPY RESECT SEPTUM
|
Facility
|
OP
|
$13,620.60
|
|
|
Service Code
|
CPT 58560
|
| Hospital Charge Code |
76100337
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,606.87 |
| Max. Negotiated Rate |
$16,119.31 |
| Rate for Payer: Aetna American Axle |
$8,853.39
|
| Rate for Payer: Aetna Commercial |
$11,577.51
|
| Rate for Payer: Aetna Medicare |
$5,183.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,853.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,230.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,230.57
|
| Rate for Payer: BCBS Complete |
$2,737.47
|
| Rate for Payer: BCBS MAPPO |
$4,984.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,943.94
|
| Rate for Payer: BCN Commercial |
$3,943.94
|
| Rate for Payer: BCN Medicare Advantage |
$4,984.46
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cofinity Advantage |
$9,534.42
|
| Rate for Payer: Cofinity Commercial |
$11,713.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,896.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,984.46
|
| Rate for Payer: Healthscope Commercial |
$12,258.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,534.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,215.45
|
| Rate for Payer: Mclaren Medicaid |
$4,984.46
|
| Rate for Payer: Mclaren Medicare |
$4,984.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,233.68
|
| Rate for Payer: Meridian Medicaid |
$5,233.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,732.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$5,482.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,577.51
|
| Rate for Payer: Nomi Health Commercial |
$14,953.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,215.45
|
| Rate for Payer: PACE Medicare |
$4,735.24
|
| Rate for Payer: PACE SWMI |
$4,984.46
|
| Rate for Payer: PHP Commercial |
$11,577.51
|
| Rate for Payer: PHP Medicare Advantage |
$4,984.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,606.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16,119.31
|
| Rate for Payer: Priority Health Medicare |
$4,984.46
|
| Rate for Payer: Priority Health SBD |
$8,580.98
|
| Rate for Payer: Priority Health Tiered Network |
$12,895.45
|
| Rate for Payer: Railroad Medicare Medicare |
$4,984.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,853.39
|
| Rate for Payer: UHC Core |
$7,096.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4,984.46
|
| Rate for Payer: UHC Exchange |
$5,352.90
|
| Rate for Payer: UHC Medicaid |
$2,606.87
|
| Rate for Payer: UHCCP Medicaid |
$2,606.87
|
| Rate for Payer: UMR Bronson Commercial |
$5,039.62
|
| Rate for Payer: VA VA |
$4,984.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,215.45
|
|
|
HC HYSTEROSCOPY RESECT SEPTUM
|
Facility
|
IP
|
$13,620.60
|
|
|
Service Code
|
CPT 58560
|
| Hospital Charge Code |
76100337
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,993.06 |
| Max. Negotiated Rate |
$12,258.54 |
| Rate for Payer: Aetna American Axle |
$8,853.39
|
| Rate for Payer: Aetna Commercial |
$11,577.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,853.39
|
| Rate for Payer: Cash Price |
$10,896.48
|
| Rate for Payer: Cofinity Advantage |
$9,534.42
|
| Rate for Payer: Cofinity Commercial |
$11,713.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,896.48
|
| Rate for Payer: Healthscope Commercial |
$12,258.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,534.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,215.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,577.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,215.45
|
| Rate for Payer: PHP Commercial |
$11,577.51
|
| Rate for Payer: Priority Health SBD |
$8,580.98
|
| Rate for Payer: UMR Bronson Commercial |
$5,993.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,215.45
|
|
|
HC HYSTEROSCOPY W BX AND/OR POLYPECTOMY W OR WO D&C
|
Facility
|
OP
|
$4,175.67
|
|
|
Service Code
|
CPT 58558
|
| Hospital Charge Code |
76100304
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,545.00 |
| Max. Negotiated Rate |
$10,430.93 |
| Rate for Payer: Aetna American Axle |
$2,714.19
|
| Rate for Payer: Aetna Commercial |
$3,549.32
|
| Rate for Payer: Aetna Medicare |
$3,354.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,714.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$3,900.10
|
| Rate for Payer: BCN Commercial |
$3,900.10
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$3,340.54
|
| Rate for Payer: Cash Price |
$3,340.54
|
| Rate for Payer: Cash Price |
$3,340.54
|
| Rate for Payer: Cofinity Advantage |
$2,922.97
|
| Rate for Payer: Cofinity Commercial |
$3,591.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,340.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$3,758.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,922.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,131.75
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$3,386.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,549.32
|
| Rate for Payer: Nomi Health Commercial |
$9,676.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,131.75
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$3,549.32
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,430.93
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health SBD |
$2,630.67
|
| Rate for Payer: Priority Health Tiered Network |
$8,344.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,714.19
|
| Rate for Payer: UHC Core |
$2,175.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Exchange |
$1,641.04
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,545.00
|
| Rate for Payer: VA VA |
$3,225.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,131.75
|
|
|
HC HYSTEROSCOPY W BX AND/OR POLYPECTOMY W OR WO D&C
|
Facility
|
IP
|
$4,175.67
|
|
|
Service Code
|
CPT 58558
|
| Hospital Charge Code |
76100304
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,837.29 |
| Max. Negotiated Rate |
$3,758.10 |
| Rate for Payer: Aetna American Axle |
$2,714.19
|
| Rate for Payer: Aetna Commercial |
$3,549.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,714.19
|
| Rate for Payer: Cash Price |
$3,340.54
|
| Rate for Payer: Cofinity Advantage |
$2,922.97
|
| Rate for Payer: Cofinity Commercial |
$3,591.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,340.54
|
| Rate for Payer: Healthscope Commercial |
$3,758.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,922.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,131.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,549.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,131.75
|
| Rate for Payer: PHP Commercial |
$3,549.32
|
| Rate for Payer: Priority Health SBD |
$2,630.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,837.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,131.75
|
|
|
HC I-123 CAPSULE PER 100 UCI
|
Facility
|
IP
|
$107.78
|
|
|
Service Code
|
HCPCS A9516
|
| Hospital Charge Code |
34300009
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$47.42 |
| Max. Negotiated Rate |
$97.00 |
| Rate for Payer: Aetna American Axle |
$70.06
|
| Rate for Payer: Aetna Commercial |
$91.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.06
|
| Rate for Payer: Cash Price |
$86.22
|
| Rate for Payer: Cofinity Advantage |
$75.45
|
| Rate for Payer: Cofinity Commercial |
$92.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.22
|
| Rate for Payer: Healthscope Commercial |
$97.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.83
|
| Rate for Payer: PHP Commercial |
$91.61
|
| Rate for Payer: Priority Health SBD |
$67.90
|
| Rate for Payer: UMR Bronson Commercial |
$47.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.83
|
|
|
HC I-123 CAPSULE PER 100 UCI
|
Facility
|
OP
|
$107.78
|
|
|
Service Code
|
HCPCS A9516
|
| Hospital Charge Code |
34300009
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$39.88 |
| Max. Negotiated Rate |
$199.50 |
| Rate for Payer: Aetna American Axle |
$70.06
|
| Rate for Payer: Aetna Commercial |
$91.61
|
| Rate for Payer: Aetna Medicare |
$53.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.06
|
| Rate for Payer: BCBS Complete |
$43.11
|
| Rate for Payer: BCBS Trust/PPO |
$88.83
|
| Rate for Payer: BCN Commercial |
$88.83
|
| Rate for Payer: Cash Price |
$86.22
|
| Rate for Payer: Cash Price |
$86.22
|
| Rate for Payer: Cofinity Advantage |
$75.45
|
| Rate for Payer: Cofinity Commercial |
$92.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.22
|
| Rate for Payer: Healthscope Commercial |
$97.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.83
|
| Rate for Payer: PHP Commercial |
$91.61
|
| Rate for Payer: Priority Health SBD |
$67.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.50
|
| Rate for Payer: UHC Core |
$199.50
|
| Rate for Payer: UHC Exchange |
$199.50
|
| Rate for Payer: UMR Bronson Commercial |
$39.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.83
|
|
|
HC I-123 MIBG PER STUDY
|
Facility
|
OP
|
$12,420.34
|
|
|
Service Code
|
HCPCS A9582
|
| Hospital Charge Code |
34300010
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,212.05 |
| Max. Negotiated Rate |
$11,178.31 |
| Rate for Payer: Aetna American Axle |
$8,073.22
|
| Rate for Payer: Aetna Commercial |
$10,557.29
|
| Rate for Payer: Aetna Medicare |
$2,410.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,073.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,896.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,896.88
|
| Rate for Payer: BCBS Complete |
$1,272.77
|
| Rate for Payer: BCBS MAPPO |
$2,317.50
|
| Rate for Payer: BCBS Trust/PPO |
$7,873.59
|
| Rate for Payer: BCN Commercial |
$7,873.59
|
| Rate for Payer: BCN Medicare Advantage |
$2,317.50
|
| Rate for Payer: Cash Price |
$9,936.27
|
| Rate for Payer: Cash Price |
$9,936.27
|
| Rate for Payer: Cofinity Advantage |
$8,694.24
|
| Rate for Payer: Cofinity Commercial |
$10,681.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,936.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,317.50
|
| Rate for Payer: Healthscope Commercial |
$11,178.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,694.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,315.25
|
| Rate for Payer: Mclaren Medicaid |
$2,317.50
|
| Rate for Payer: Mclaren Medicare |
$2,317.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,433.38
|
| Rate for Payer: Meridian Medicaid |
$2,433.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,665.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,549.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,557.29
|
| Rate for Payer: Nomi Health Commercial |
$6,952.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,315.25
|
| Rate for Payer: PACE Medicare |
$2,201.62
|
| Rate for Payer: PACE SWMI |
$2,317.50
|
| Rate for Payer: PHP Commercial |
$10,557.29
|
| Rate for Payer: PHP Medicare Advantage |
$2,317.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,212.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7,309.32
|
| Rate for Payer: Priority Health Medicare |
$2,317.50
|
| Rate for Payer: Priority Health SBD |
$7,824.81
|
| Rate for Payer: Priority Health Tiered Network |
$5,847.46
|
| Rate for Payer: Railroad Medicare Medicare |
$2,317.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,823.88
|
| Rate for Payer: UHC Core |
$3,823.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,317.50
|
| Rate for Payer: UHC Exchange |
$3,823.88
|
| Rate for Payer: UHC Medicaid |
$1,212.05
|
| Rate for Payer: UHCCP Medicaid |
$1,212.05
|
| Rate for Payer: UMR Bronson Commercial |
$4,595.53
|
| Rate for Payer: VA VA |
$2,317.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,315.25
|
|
|
HC I-123 MIBG PER STUDY
|
Facility
|
IP
|
$12,420.34
|
|
|
Service Code
|
HCPCS A9582
|
| Hospital Charge Code |
34300010
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$5,464.95 |
| Max. Negotiated Rate |
$11,178.31 |
| Rate for Payer: Aetna American Axle |
$8,073.22
|
| Rate for Payer: Aetna Commercial |
$10,557.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,073.22
|
| Rate for Payer: Cash Price |
$9,936.27
|
| Rate for Payer: Cofinity Advantage |
$8,694.24
|
| Rate for Payer: Cofinity Commercial |
$10,681.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,936.27
|
| Rate for Payer: Healthscope Commercial |
$11,178.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,694.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,315.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,557.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,315.25
|
| Rate for Payer: PHP Commercial |
$10,557.29
|
| Rate for Payer: Priority Health SBD |
$7,824.81
|
| Rate for Payer: UMR Bronson Commercial |
$5,464.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,315.25
|
|
