|
HC ICD CRT/DUAL REPLACEMENT
|
Facility
|
OP
|
$11,673.29
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
36100075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,319.12 |
| Max. Negotiated Rate |
$71,675.05 |
| Rate for Payer: Aetna American Axle |
$7,587.64
|
| Rate for Payer: Aetna Commercial |
$9,922.30
|
| Rate for Payer: Aetna Medicare |
$23,050.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,587.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,704.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,704.49
|
| Rate for Payer: BCBS Complete |
$12,172.24
|
| Rate for Payer: BCBS MAPPO |
$22,163.59
|
| Rate for Payer: BCBS Trust/PPO |
$42,448.98
|
| Rate for Payer: BCN Commercial |
$42,448.98
|
| Rate for Payer: BCN Medicare Advantage |
$22,163.59
|
| Rate for Payer: Cash Price |
$9,338.63
|
| Rate for Payer: Cash Price |
$9,338.63
|
| Rate for Payer: Cash Price |
$9,338.63
|
| Rate for Payer: Cofinity Advantage |
$8,171.30
|
| Rate for Payer: Cofinity Commercial |
$10,039.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,338.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,163.59
|
| Rate for Payer: Healthscope Commercial |
$10,505.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,171.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,754.97
|
| Rate for Payer: Mclaren Medicaid |
$22,163.59
|
| Rate for Payer: Mclaren Medicare |
$22,163.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,271.77
|
| Rate for Payer: Meridian Medicaid |
$23,271.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,488.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$24,379.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,922.30
|
| Rate for Payer: Nomi Health Commercial |
$66,490.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,754.97
|
| Rate for Payer: PACE Medicare |
$21,055.41
|
| Rate for Payer: PACE SWMI |
$22,163.59
|
| Rate for Payer: PHP Commercial |
$9,922.30
|
| Rate for Payer: PHP Medicare Advantage |
$22,163.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,591.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$71,675.05
|
| Rate for Payer: Priority Health Medicare |
$22,163.59
|
| Rate for Payer: Priority Health SBD |
$7,354.17
|
| Rate for Payer: Priority Health Tiered Network |
$57,340.04
|
| Rate for Payer: Railroad Medicare Medicare |
$22,163.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22,163.59
|
| Rate for Payer: UHC Medicaid |
$11,591.56
|
| Rate for Payer: UHCCP Medicaid |
$11,591.56
|
| Rate for Payer: UMR Bronson Commercial |
$4,319.12
|
| Rate for Payer: VA VA |
$22,163.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,754.97
|
|
|
HC ICD LEAD REMOVAL
|
Facility
|
OP
|
$2,772.24
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
36100078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,025.73 |
| Max. Negotiated Rate |
$12,041.54 |
| Rate for Payer: Aetna American Axle |
$1,801.96
|
| Rate for Payer: Aetna Commercial |
$2,356.40
|
| Rate for Payer: Aetna Medicare |
$3,872.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,801.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,654.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,654.40
|
| Rate for Payer: BCBS Complete |
$2,044.96
|
| Rate for Payer: BCBS MAPPO |
$3,723.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,888.09
|
| Rate for Payer: BCN Commercial |
$2,888.09
|
| Rate for Payer: BCN Medicare Advantage |
$3,723.52
|
| Rate for Payer: Cash Price |
$2,217.79
|
| Rate for Payer: Cash Price |
$2,217.79
|
| Rate for Payer: Cash Price |
$2,217.79
|
| Rate for Payer: Cofinity Advantage |
$1,940.57
|
| Rate for Payer: Cofinity Commercial |
$2,384.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,217.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,723.52
|
| Rate for Payer: Healthscope Commercial |
$2,495.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,940.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,079.18
|
| Rate for Payer: Mclaren Medicaid |
$3,723.52
|
| Rate for Payer: Mclaren Medicare |
$3,723.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,909.70
|
| Rate for Payer: Meridian Medicaid |
$3,909.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,282.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,095.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,356.40
|
| Rate for Payer: Nomi Health Commercial |
$11,170.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,079.18
|
| Rate for Payer: PACE Medicare |
$3,537.34
|
| Rate for Payer: PACE SWMI |
$3,723.52
|
| Rate for Payer: PHP Commercial |
$2,356.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,723.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,947.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,041.54
|
| Rate for Payer: Priority Health Medicare |
$3,723.52
|
| Rate for Payer: Priority Health SBD |
$1,746.51
|
| Rate for Payer: Priority Health Tiered Network |
$9,633.23
|
| Rate for Payer: Railroad Medicare Medicare |
$3,723.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,723.52
|
| Rate for Payer: UHC Medicaid |
$1,947.40
|
| Rate for Payer: UHCCP Medicaid |
$1,947.40
|
| Rate for Payer: UMR Bronson Commercial |
$1,025.73
|
| Rate for Payer: VA VA |
$3,723.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,079.18
|
|
|
HC ICD LEAD REMOVAL
|
Facility
|
IP
|
$2,772.24
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
36100078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,219.79 |
| Max. Negotiated Rate |
$2,495.02 |
| Rate for Payer: Aetna American Axle |
$1,801.96
|
| Rate for Payer: Aetna Commercial |
$2,356.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,801.96
|
| Rate for Payer: Cash Price |
$2,217.79
|
| Rate for Payer: Cofinity Advantage |
$1,940.57
|
| Rate for Payer: Cofinity Commercial |
$2,384.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,217.79
|
| Rate for Payer: Healthscope Commercial |
$2,495.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,940.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,079.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,356.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,079.18
|
| Rate for Payer: PHP Commercial |
$2,356.40
|
| Rate for Payer: Priority Health SBD |
$1,746.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,219.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,079.18
|
|
|
HC ICD POCKET REVISION
|
Facility
|
OP
|
$3,227.50
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
36100068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,075.21 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna American Axle |
$2,097.88
|
| Rate for Payer: Aetna Commercial |
$2,743.38
|
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,097.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,693.74
|
| Rate for Payer: BCN Commercial |
$1,693.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Cash Price |
$2,582.00
|
| Rate for Payer: Cash Price |
$2,582.00
|
| Rate for Payer: Cash Price |
$2,582.00
|
| Rate for Payer: Cofinity Advantage |
$2,259.25
|
| Rate for Payer: Cofinity Commercial |
$2,775.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,582.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Healthscope Commercial |
$2,904.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,259.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,420.62
|
| Rate for Payer: Mclaren Medicaid |
$2,055.86
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$2,158.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,743.38
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,420.62
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Commercial |
$2,743.38
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,648.46
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health SBD |
$2,033.33
|
| Rate for Payer: Priority Health Tiered Network |
$5,318.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,194.17
|
| Rate for Payer: VA VA |
$2,055.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,420.62
|
|
|
HC ICD POCKET REVISION
|
Facility
|
IP
|
$3,227.50
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
36100068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,420.10 |
| Max. Negotiated Rate |
$2,904.75 |
| Rate for Payer: Aetna American Axle |
$2,097.88
|
| Rate for Payer: Aetna Commercial |
$2,743.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,097.88
|
| Rate for Payer: Cash Price |
$2,582.00
|
| Rate for Payer: Cofinity Advantage |
$2,259.25
|
| Rate for Payer: Cofinity Commercial |
$2,775.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,582.00
|
| Rate for Payer: Healthscope Commercial |
$2,904.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,259.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,420.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,743.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,420.62
|
| Rate for Payer: PHP Commercial |
$2,743.38
|
| Rate for Payer: Priority Health SBD |
$2,033.33
|
| Rate for Payer: UMR Bronson Commercial |
$1,420.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,420.62
|
|
|
HC ICD SINGLE IMPLANT
|
Facility
|
OP
|
$20,027.70
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,410.25 |
| Max. Negotiated Rate |
$101,143.75 |
| Rate for Payer: Aetna American Axle |
$13,018.00
|
| Rate for Payer: Aetna Commercial |
$17,023.54
|
| Rate for Payer: Aetna Medicare |
$32,527.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,018.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,094.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,094.99
|
| Rate for Payer: BCBS Complete |
$17,176.77
|
| Rate for Payer: BCBS MAPPO |
$31,275.99
|
| Rate for Payer: BCBS Trust/PPO |
$45,954.19
|
| Rate for Payer: BCN Commercial |
$45,954.19
|
| Rate for Payer: BCN Medicare Advantage |
$31,275.99
|
| Rate for Payer: Cash Price |
$16,022.16
|
| Rate for Payer: Cash Price |
$16,022.16
|
| Rate for Payer: Cash Price |
$16,022.16
|
| Rate for Payer: Cofinity Advantage |
$14,019.39
|
| Rate for Payer: Cofinity Commercial |
$17,223.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,022.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,275.99
|
| Rate for Payer: Healthscope Commercial |
$18,024.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14,019.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,020.77
|
| Rate for Payer: Mclaren Medicaid |
$31,275.99
|
| Rate for Payer: Mclaren Medicare |
$31,275.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,839.79
|
| Rate for Payer: Meridian Medicaid |
$32,839.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,967.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$34,403.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,023.54
|
| Rate for Payer: Nomi Health Commercial |
$93,827.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,020.77
|
| Rate for Payer: PACE Medicare |
$29,712.19
|
| Rate for Payer: PACE SWMI |
$31,275.99
|
| Rate for Payer: PHP Commercial |
$17,023.54
|
| Rate for Payer: PHP Medicare Advantage |
$31,275.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,357.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$101,143.75
|
| Rate for Payer: Priority Health Medicare |
$31,275.99
|
| Rate for Payer: Priority Health SBD |
$12,617.45
|
| Rate for Payer: Priority Health Tiered Network |
$80,915.00
|
| Rate for Payer: Railroad Medicare Medicare |
$31,275.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31,275.99
|
| Rate for Payer: UHC Medicaid |
$16,357.34
|
| Rate for Payer: UHCCP Medicaid |
$16,357.34
|
| Rate for Payer: UMR Bronson Commercial |
$7,410.25
|
| Rate for Payer: VA VA |
$31,275.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,020.77
|
|
|
HC ICD SINGLE IMPLANT
|
Facility
|
IP
|
$20,027.70
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,812.19 |
| Max. Negotiated Rate |
$18,024.93 |
| Rate for Payer: Aetna American Axle |
$13,018.00
|
| Rate for Payer: Aetna Commercial |
$17,023.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,018.00
|
| Rate for Payer: Cash Price |
$16,022.16
|
| Rate for Payer: Cofinity Advantage |
$14,019.39
|
| Rate for Payer: Cofinity Commercial |
$17,223.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,022.16
|
| Rate for Payer: Healthscope Commercial |
$18,024.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14,019.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,020.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,023.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,020.77
|
| Rate for Payer: PHP Commercial |
$17,023.54
|
| Rate for Payer: Priority Health SBD |
$12,617.45
|
| Rate for Payer: UMR Bronson Commercial |
$8,812.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,020.77
|
|
|
HC ICP MONITOR
|
Facility
|
OP
|
$2,036.58
|
|
| Hospital Charge Code |
27800143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$753.53 |
| Max. Negotiated Rate |
$1,832.92 |
| Rate for Payer: Aetna American Axle |
$1,323.78
|
| Rate for Payer: Aetna Commercial |
$1,731.09
|
| Rate for Payer: Aetna Medicare |
$1,018.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,323.78
|
| Rate for Payer: BCBS Complete |
$814.63
|
| Rate for Payer: Cash Price |
$1,629.26
|
| Rate for Payer: Cofinity Advantage |
$1,425.61
|
| Rate for Payer: Cofinity Commercial |
$1,751.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,629.26
|
| Rate for Payer: Healthscope Commercial |
$1,832.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,425.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,527.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,629.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,731.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,527.43
|
| Rate for Payer: PHP Commercial |
$1,731.09
|
| Rate for Payer: Priority Health SBD |
$1,283.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,323.78
|
| Rate for Payer: UHC Core |
$1,061.06
|
| Rate for Payer: UHC Exchange |
$800.38
|
| Rate for Payer: UMR Bronson Commercial |
$753.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,527.43
|
|
|
HC ICP MONITOR
|
Facility
|
IP
|
$2,036.58
|
|
| Hospital Charge Code |
27800143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$896.10 |
| Max. Negotiated Rate |
$1,832.92 |
| Rate for Payer: Aetna American Axle |
$1,323.78
|
| Rate for Payer: Aetna Commercial |
$1,731.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,323.78
|
| Rate for Payer: Cash Price |
$1,629.26
|
| Rate for Payer: Cofinity Advantage |
$1,425.61
|
| Rate for Payer: Cofinity Commercial |
$1,751.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,629.26
|
| Rate for Payer: Healthscope Commercial |
$1,832.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,425.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,527.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,731.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,527.43
|
| Rate for Payer: PHP Commercial |
$1,731.09
|
| Rate for Payer: Priority Health SBD |
$1,283.05
|
| Rate for Payer: UMR Bronson Commercial |
$896.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,527.43
|
|
|
HC I&D BARTHOLIN GLAND ABSCESS
|
Facility
|
IP
|
$264.24
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
36100573
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.27 |
| Max. Negotiated Rate |
$237.82 |
| Rate for Payer: Aetna American Axle |
$171.76
|
| Rate for Payer: Aetna Commercial |
$224.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.76
|
| Rate for Payer: Cash Price |
$211.39
|
| Rate for Payer: Cofinity Advantage |
$184.97
|
| Rate for Payer: Cofinity Commercial |
$227.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.39
|
| Rate for Payer: Healthscope Commercial |
$237.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.18
|
| Rate for Payer: PHP Commercial |
$224.60
|
| Rate for Payer: Priority Health SBD |
$166.47
|
| Rate for Payer: UMR Bronson Commercial |
$116.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.18
|
|
|
HC I&D BARTHOLIN GLAND ABSCESS
|
Facility
|
OP
|
$264.24
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
36100573
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.77 |
| Max. Negotiated Rate |
$651.46 |
| Rate for Payer: Aetna American Axle |
$171.76
|
| Rate for Payer: Aetna Commercial |
$224.60
|
| Rate for Payer: Aetna Medicare |
$209.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$251.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$251.80
|
| Rate for Payer: BCBS Complete |
$110.63
|
| Rate for Payer: BCBS MAPPO |
$201.44
|
| Rate for Payer: BCBS Trust/PPO |
$241.37
|
| Rate for Payer: BCN Commercial |
$241.37
|
| Rate for Payer: BCN Medicare Advantage |
$201.44
|
| Rate for Payer: Cash Price |
$211.39
|
| Rate for Payer: Cash Price |
$211.39
|
| Rate for Payer: Cash Price |
$211.39
|
| Rate for Payer: Cofinity Advantage |
$184.97
|
| Rate for Payer: Cofinity Commercial |
$227.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.44
|
| Rate for Payer: Healthscope Commercial |
$237.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.18
|
| Rate for Payer: Mclaren Medicaid |
$201.44
|
| Rate for Payer: Mclaren Medicare |
$201.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.51
|
| Rate for Payer: Meridian Medicaid |
$211.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.60
|
| Rate for Payer: Nomi Health Commercial |
$604.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.18
|
| Rate for Payer: PACE Medicare |
$191.37
|
| Rate for Payer: PACE SWMI |
$201.44
|
| Rate for Payer: PHP Commercial |
$224.60
|
| Rate for Payer: PHP Medicare Advantage |
$201.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$651.46
|
| Rate for Payer: Priority Health Medicare |
$201.44
|
| Rate for Payer: Priority Health SBD |
$166.47
|
| Rate for Payer: Priority Health Tiered Network |
$521.17
|
| Rate for Payer: Railroad Medicare Medicare |
$201.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.76
|
| Rate for Payer: UHC Core |
$137.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$201.44
|
| Rate for Payer: UHC Exchange |
$103.85
|
| Rate for Payer: UHC Medicaid |
$105.35
|
| Rate for Payer: UHCCP Medicaid |
$105.35
|
| Rate for Payer: UMR Bronson Commercial |
$97.77
|
| Rate for Payer: VA VA |
$201.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.18
|
|
|
HC IDENTIFICATION BY AGGLUTINATION
|
Facility
|
OP
|
$30.46
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
30600091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$27.41 |
| Rate for Payer: Aetna American Axle |
$19.80
|
| Rate for Payer: Aetna Commercial |
$25.89
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: BCBS Complete |
$2.84
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$6.00
|
| Rate for Payer: BCN Commercial |
$6.00
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$24.37
|
| Rate for Payer: Cash Price |
$24.37
|
| Rate for Payer: Cofinity Advantage |
$21.32
|
| Rate for Payer: Cofinity Commercial |
$26.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$27.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.84
|
| Rate for Payer: Mclaren Medicaid |
$5.18
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$5.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.89
|
| Rate for Payer: Nomi Health Commercial |
$7.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.84
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$25.89
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.18
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health SBD |
$19.19
|
| Rate for Payer: Priority Health Tiered Network |
$4.14
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.77
|
| Rate for Payer: UHC Core |
$7.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.18
|
| Rate for Payer: UHC Exchange |
$7.77
|
| Rate for Payer: UHC Medicaid |
$2.71
|
| Rate for Payer: UHCCP Medicaid |
$2.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.27
|
| Rate for Payer: VA VA |
$5.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.84
|
|
|
HC IDENTIFICATION BY AGGLUTINATION
|
Facility
|
IP
|
$30.46
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
30600091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.40 |
| Max. Negotiated Rate |
$27.41 |
| Rate for Payer: Aetna American Axle |
$19.80
|
| Rate for Payer: Aetna Commercial |
$25.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.80
|
| Rate for Payer: Cash Price |
$24.37
|
| Rate for Payer: Cofinity Advantage |
$21.32
|
| Rate for Payer: Cofinity Commercial |
$26.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.37
|
| Rate for Payer: Healthscope Commercial |
$27.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.84
|
| Rate for Payer: PHP Commercial |
$25.89
|
| Rate for Payer: Priority Health SBD |
$19.19
|
| Rate for Payer: UMR Bronson Commercial |
$13.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.84
|
|
|
HC I&D (OB SURGERY)
|
Facility
|
IP
|
$546.22
|
|
| Hospital Charge Code |
36000054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$240.34 |
| Max. Negotiated Rate |
$491.60 |
| Rate for Payer: Aetna American Axle |
$355.04
|
| Rate for Payer: Aetna Commercial |
$464.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.04
|
| Rate for Payer: Cash Price |
$436.98
|
| Rate for Payer: Cofinity Advantage |
$382.35
|
| Rate for Payer: Cofinity Commercial |
$469.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.98
|
| Rate for Payer: Healthscope Commercial |
$491.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$382.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$409.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$464.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.67
|
| Rate for Payer: PHP Commercial |
$464.29
|
| Rate for Payer: Priority Health SBD |
$344.12
|
| Rate for Payer: UMR Bronson Commercial |
$240.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$409.67
|
|
|
HC I&D (OB SURGERY)
|
Facility
|
OP
|
$546.22
|
|
| Hospital Charge Code |
36000054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$202.10 |
| Max. Negotiated Rate |
$491.60 |
| Rate for Payer: Aetna American Axle |
$355.04
|
| Rate for Payer: Aetna Commercial |
$464.29
|
| Rate for Payer: Aetna Medicare |
$273.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$355.04
|
| Rate for Payer: BCBS Complete |
$218.49
|
| Rate for Payer: Cash Price |
$436.98
|
| Rate for Payer: Cofinity Advantage |
$382.35
|
| Rate for Payer: Cofinity Commercial |
$469.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.98
|
| Rate for Payer: Healthscope Commercial |
$491.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$382.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$409.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$436.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$464.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.67
|
| Rate for Payer: PHP Commercial |
$464.29
|
| Rate for Payer: Priority Health SBD |
$344.12
|
| Rate for Payer: UMR Bronson Commercial |
$202.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$409.67
|
|
|
HC I&D PILONIDAL CYST
|
Facility
|
OP
|
$950.54
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
45000097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$351.70 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna American Axle |
$617.85
|
| Rate for Payer: Aetna Commercial |
$807.96
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$617.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$511.44
|
| Rate for Payer: BCN Commercial |
$511.44
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$760.43
|
| Rate for Payer: Cash Price |
$760.43
|
| Rate for Payer: Cash Price |
$760.43
|
| Rate for Payer: Cofinity Advantage |
$665.38
|
| Rate for Payer: Cofinity Commercial |
$817.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$760.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$855.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$665.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$712.90
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$807.96
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$712.90
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$807.96
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$598.84
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$617.85
|
| Rate for Payer: UHC Core |
$495.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$373.56
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: UMR Bronson Commercial |
$351.70
|
| Rate for Payer: VA VA |
$705.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$712.90
|
|
|
HC I&D PILONIDAL CYST
|
Facility
|
IP
|
$950.54
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
45000097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$418.24 |
| Max. Negotiated Rate |
$855.49 |
| Rate for Payer: Aetna American Axle |
$617.85
|
| Rate for Payer: Aetna Commercial |
$807.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$617.85
|
| Rate for Payer: Cash Price |
$760.43
|
| Rate for Payer: Cofinity Advantage |
$665.38
|
| Rate for Payer: Cofinity Commercial |
$817.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$760.43
|
| Rate for Payer: Healthscope Commercial |
$855.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$665.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$712.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$807.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$712.90
|
| Rate for Payer: PHP Commercial |
$807.96
|
| Rate for Payer: Priority Health SBD |
$598.84
|
| Rate for Payer: UMR Bronson Commercial |
$418.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$712.90
|
|
|
HC I&D PROCEDURE
|
Facility
|
IP
|
$499.95
|
|
| Hospital Charge Code |
45000045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$219.98 |
| Max. Negotiated Rate |
$449.95 |
| Rate for Payer: Aetna American Axle |
$324.97
|
| Rate for Payer: Aetna Commercial |
$424.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.97
|
| Rate for Payer: Cash Price |
$399.96
|
| Rate for Payer: Cofinity Advantage |
$349.96
|
| Rate for Payer: Cofinity Commercial |
$429.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.96
|
| Rate for Payer: Healthscope Commercial |
$449.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$349.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.96
|
| Rate for Payer: PHP Commercial |
$424.96
|
| Rate for Payer: Priority Health SBD |
$314.97
|
| Rate for Payer: UMR Bronson Commercial |
$219.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.96
|
|
|
HC I&D PROCEDURE
|
Facility
|
OP
|
$499.95
|
|
| Hospital Charge Code |
45000045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$449.95 |
| Rate for Payer: Aetna American Axle |
$324.97
|
| Rate for Payer: Aetna Commercial |
$424.96
|
| Rate for Payer: Aetna Medicare |
$249.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.97
|
| Rate for Payer: BCBS Complete |
$199.98
|
| Rate for Payer: Cash Price |
$399.96
|
| Rate for Payer: Cash Price |
$399.96
|
| Rate for Payer: Cofinity Advantage |
$349.96
|
| Rate for Payer: Cofinity Commercial |
$429.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.96
|
| Rate for Payer: Healthscope Commercial |
$449.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$349.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$399.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.96
|
| Rate for Payer: PHP Commercial |
$424.96
|
| Rate for Payer: Priority Health SBD |
$314.97
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: UMR Bronson Commercial |
$184.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.96
|
|
|
HC I&D VULVA/PERINEAL ABSCESS
|
Facility
|
OP
|
$866.26
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
76100319
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$158.80 |
| Max. Negotiated Rate |
$981.93 |
| Rate for Payer: Aetna American Axle |
$563.07
|
| Rate for Payer: Aetna Commercial |
$736.32
|
| Rate for Payer: Aetna Medicare |
$315.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$395.61
|
| Rate for Payer: BCN Commercial |
$395.61
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$693.01
|
| Rate for Payer: Cash Price |
$693.01
|
| Rate for Payer: Cash Price |
$693.01
|
| Rate for Payer: Cofinity Advantage |
$606.38
|
| Rate for Payer: Cofinity Commercial |
$744.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$693.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$779.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$606.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$649.70
|
| Rate for Payer: Mclaren Medicaid |
$303.63
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$318.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$736.32
|
| Rate for Payer: Nomi Health Commercial |
$910.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$649.70
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$736.32
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$981.93
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health SBD |
$545.74
|
| Rate for Payer: Priority Health Tiered Network |
$785.54
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$563.07
|
| Rate for Payer: UHC Core |
$451.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Exchange |
$340.44
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: UMR Bronson Commercial |
$320.52
|
| Rate for Payer: VA VA |
$303.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$649.70
|
|
|
HC I&D VULVA/PERINEAL ABSCESS
|
Facility
|
IP
|
$866.26
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
76100319
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$381.15 |
| Max. Negotiated Rate |
$779.63 |
| Rate for Payer: Aetna American Axle |
$563.07
|
| Rate for Payer: Aetna Commercial |
$736.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.07
|
| Rate for Payer: Cash Price |
$693.01
|
| Rate for Payer: Cofinity Advantage |
$606.38
|
| Rate for Payer: Cofinity Commercial |
$744.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$693.01
|
| Rate for Payer: Healthscope Commercial |
$779.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$606.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$649.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$736.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$649.70
|
| Rate for Payer: PHP Commercial |
$736.32
|
| Rate for Payer: Priority Health SBD |
$545.74
|
| Rate for Payer: UMR Bronson Commercial |
$381.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$649.70
|
|
|
HC IFR MEASUREMENT
|
Facility
|
OP
|
$3,956.14
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100132
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$3,560.53 |
| Rate for Payer: Aetna American Axle |
$2,571.49
|
| Rate for Payer: Aetna Commercial |
$3,362.72
|
| Rate for Payer: Aetna Medicare |
$133.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,571.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$413.88
|
| Rate for Payer: BCN Commercial |
$413.88
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$3,164.91
|
| Rate for Payer: Cash Price |
$3,164.91
|
| Rate for Payer: Cofinity Advantage |
$2,769.30
|
| Rate for Payer: Cofinity Commercial |
$3,402.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,164.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$3,560.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,769.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,967.11
|
| Rate for Payer: Mclaren Medicaid |
$128.21
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$134.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,362.72
|
| Rate for Payer: Nomi Health Commercial |
$384.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,967.11
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$3,362.72
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$414.63
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health SBD |
$2,492.37
|
| Rate for Payer: Priority Health Tiered Network |
$331.70
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,463.77
|
| Rate for Payer: VA VA |
$128.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,967.11
|
|
|
HC IFR MEASUREMENT
|
Facility
|
IP
|
$3,956.14
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100132
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,740.70 |
| Max. Negotiated Rate |
$3,560.53 |
| Rate for Payer: Aetna American Axle |
$2,571.49
|
| Rate for Payer: Aetna Commercial |
$3,362.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,571.49
|
| Rate for Payer: Cash Price |
$3,164.91
|
| Rate for Payer: Cofinity Advantage |
$2,769.30
|
| Rate for Payer: Cofinity Commercial |
$3,402.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,164.91
|
| Rate for Payer: Healthscope Commercial |
$3,560.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,769.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,967.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,362.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,967.11
|
| Rate for Payer: PHP Commercial |
$3,362.72
|
| Rate for Payer: Priority Health SBD |
$2,492.37
|
| Rate for Payer: UMR Bronson Commercial |
$1,740.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,967.11
|
|
|
HC IGG SUBCLASS 1-4
|
Facility
|
OP
|
$14.37
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100214
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$12.93 |
| Rate for Payer: Aetna American Axle |
$9.34
|
| Rate for Payer: Aetna Commercial |
$12.21
|
| Rate for Payer: Aetna Medicare |
$8.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.03
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$8.02
|
| Rate for Payer: BCBS Trust/PPO |
$9.28
|
| Rate for Payer: BCN Commercial |
$9.28
|
| Rate for Payer: BCN Medicare Advantage |
$8.02
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cofinity Advantage |
$10.06
|
| Rate for Payer: Cofinity Commercial |
$12.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.02
|
| Rate for Payer: Healthscope Commercial |
$12.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.78
|
| Rate for Payer: Mclaren Medicaid |
$8.02
|
| Rate for Payer: Mclaren Medicare |
$8.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.42
|
| Rate for Payer: Meridian Medicaid |
$8.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.21
|
| Rate for Payer: Nomi Health Commercial |
$12.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.78
|
| Rate for Payer: PACE Medicare |
$7.62
|
| Rate for Payer: PACE SWMI |
$8.02
|
| Rate for Payer: PHP Commercial |
$12.21
|
| Rate for Payer: PHP Medicare Advantage |
$8.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.02
|
| Rate for Payer: Priority Health Medicare |
$8.02
|
| Rate for Payer: Priority Health SBD |
$9.05
|
| Rate for Payer: Priority Health Tiered Network |
$6.42
|
| Rate for Payer: Railroad Medicare Medicare |
$8.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.03
|
| Rate for Payer: UHC Core |
$12.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.02
|
| Rate for Payer: UHC Exchange |
$12.03
|
| Rate for Payer: UHC Medicaid |
$4.19
|
| Rate for Payer: UHCCP Medicaid |
$4.19
|
| Rate for Payer: UMR Bronson Commercial |
$5.32
|
| Rate for Payer: VA VA |
$8.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.78
|
|
|
HC IGG SUBCLASS 1-4
|
Facility
|
IP
|
$14.37
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100214
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$12.93 |
| Rate for Payer: Aetna American Axle |
$9.34
|
| Rate for Payer: Aetna Commercial |
$12.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.34
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cofinity Advantage |
$10.06
|
| Rate for Payer: Cofinity Commercial |
$12.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.50
|
| Rate for Payer: Healthscope Commercial |
$12.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.78
|
| Rate for Payer: PHP Commercial |
$12.21
|
| Rate for Payer: Priority Health SBD |
$9.05
|
| Rate for Payer: UMR Bronson Commercial |
$6.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.78
|
|
