|
HC INCISIONAL BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$499.83
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$175.46 |
| Max. Negotiated Rate |
$2,381.49 |
| Rate for Payer: Aetna American Axle |
$324.89
|
| Rate for Payer: Aetna Commercial |
$424.86
|
| Rate for Payer: Aetna Medicare |
$765.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$920.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$920.51
|
| Rate for Payer: BCBS Complete |
$404.44
|
| Rate for Payer: BCBS MAPPO |
$736.41
|
| Rate for Payer: BCBS Trust/PPO |
$175.46
|
| Rate for Payer: BCN Commercial |
$175.46
|
| Rate for Payer: BCN Medicare Advantage |
$736.41
|
| Rate for Payer: Cash Price |
$399.86
|
| Rate for Payer: Cash Price |
$399.86
|
| Rate for Payer: Cash Price |
$399.86
|
| Rate for Payer: Cofinity Advantage |
$349.88
|
| Rate for Payer: Cofinity Commercial |
$429.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.41
|
| Rate for Payer: Healthscope Commercial |
$449.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$349.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.87
|
| Rate for Payer: Mclaren Medicaid |
$736.41
|
| Rate for Payer: Mclaren Medicare |
$736.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$773.23
|
| Rate for Payer: Meridian Medicaid |
$773.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$846.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$810.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.86
|
| Rate for Payer: Nomi Health Commercial |
$2,209.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.87
|
| Rate for Payer: PACE Medicare |
$699.59
|
| Rate for Payer: PACE SWMI |
$736.41
|
| Rate for Payer: PHP Commercial |
$424.86
|
| Rate for Payer: PHP Medicare Advantage |
$736.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,381.49
|
| Rate for Payer: Priority Health Medicare |
$736.41
|
| Rate for Payer: Priority Health SBD |
$314.89
|
| Rate for Payer: Priority Health Tiered Network |
$1,905.19
|
| Rate for Payer: Railroad Medicare Medicare |
$736.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.89
|
| Rate for Payer: UHC Core |
$260.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$736.41
|
| Rate for Payer: UHC Exchange |
$196.43
|
| Rate for Payer: UHC Medicaid |
$385.14
|
| Rate for Payer: UHCCP Medicaid |
$385.14
|
| Rate for Payer: UMR Bronson Commercial |
$184.94
|
| Rate for Payer: VA VA |
$736.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.87
|
|
|
HC INCISIONAL BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$499.83
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$219.93 |
| Max. Negotiated Rate |
$449.85 |
| Rate for Payer: Aetna American Axle |
$324.89
|
| Rate for Payer: Aetna Commercial |
$424.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.89
|
| Rate for Payer: Cash Price |
$399.86
|
| Rate for Payer: Cofinity Advantage |
$349.88
|
| Rate for Payer: Cofinity Commercial |
$429.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.86
|
| Rate for Payer: Healthscope Commercial |
$449.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$349.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.87
|
| Rate for Payer: PHP Commercial |
$424.86
|
| Rate for Payer: Priority Health SBD |
$314.89
|
| Rate for Payer: UMR Bronson Commercial |
$219.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.87
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
IP
|
$2,044.20
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$899.45 |
| Max. Negotiated Rate |
$1,839.78 |
| Rate for Payer: Aetna American Axle |
$1,328.73
|
| Rate for Payer: Aetna Commercial |
$1,737.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,328.73
|
| Rate for Payer: Cash Price |
$1,635.36
|
| Rate for Payer: Cofinity Advantage |
$1,430.94
|
| Rate for Payer: Cofinity Commercial |
$1,758.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,635.36
|
| Rate for Payer: Healthscope Commercial |
$1,839.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,430.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,533.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,737.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.15
|
| Rate for Payer: PHP Commercial |
$1,737.57
|
| Rate for Payer: Priority Health SBD |
$1,287.85
|
| Rate for Payer: UMR Bronson Commercial |
$899.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,533.15
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
OP
|
$2,044.20
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$756.35 |
| Max. Negotiated Rate |
$1,839.78 |
| Rate for Payer: Aetna American Axle |
$1,328.73
|
| Rate for Payer: Aetna Commercial |
$1,737.57
|
| Rate for Payer: Aetna Medicare |
$1,022.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,328.73
|
| Rate for Payer: BCBS Complete |
$817.68
|
| Rate for Payer: Cash Price |
$1,635.36
|
| Rate for Payer: Cofinity Advantage |
$1,430.94
|
| Rate for Payer: Cofinity Commercial |
$1,758.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,635.36
|
| Rate for Payer: Healthscope Commercial |
$1,839.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,430.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,533.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,635.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,737.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,533.15
|
| Rate for Payer: PHP Commercial |
$1,737.57
|
| Rate for Payer: Priority Health SBD |
$1,287.85
|
| Rate for Payer: UMR Bronson Commercial |
$756.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,533.15
|
|
|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
IP
|
$640.89
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$281.99 |
| Max. Negotiated Rate |
$576.80 |
| Rate for Payer: Aetna American Axle |
$416.58
|
| Rate for Payer: Aetna Commercial |
$544.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.58
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cofinity Advantage |
$448.62
|
| Rate for Payer: Cofinity Commercial |
$551.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.71
|
| Rate for Payer: Healthscope Commercial |
$576.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$448.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$480.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$544.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$480.67
|
| Rate for Payer: PHP Commercial |
$544.76
|
| Rate for Payer: Priority Health SBD |
$403.76
|
| Rate for Payer: UMR Bronson Commercial |
$281.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$480.67
|
|
|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
OP
|
$640.89
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.43 |
| Max. Negotiated Rate |
$930.04 |
| Rate for Payer: Aetna American Axle |
$416.58
|
| Rate for Payer: Aetna Commercial |
$544.76
|
| Rate for Payer: Aetna Medicare |
$245.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.00
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS Trust/PPO |
$930.04
|
| Rate for Payer: BCN Commercial |
$930.04
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cofinity Advantage |
$448.62
|
| Rate for Payer: Cofinity Commercial |
$551.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$576.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$448.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$480.67
|
| Rate for Payer: Mclaren Medicaid |
$236.00
|
| Rate for Payer: Mclaren Medicare |
$236.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.80
|
| Rate for Payer: Meridian Medicaid |
$247.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$544.76
|
| Rate for Payer: Nomi Health Commercial |
$708.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$480.67
|
| Rate for Payer: PACE Medicare |
$224.20
|
| Rate for Payer: PACE SWMI |
$236.00
|
| Rate for Payer: PHP Commercial |
$544.76
|
| Rate for Payer: PHP Medicare Advantage |
$236.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$763.21
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health SBD |
$403.76
|
| Rate for Payer: Priority Health Tiered Network |
$610.57
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$416.58
|
| Rate for Payer: UHC Core |
$333.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.00
|
| Rate for Payer: UHC Exchange |
$251.87
|
| Rate for Payer: UHC Medicaid |
$123.43
|
| Rate for Payer: UHCCP Medicaid |
$123.43
|
| Rate for Payer: UMR Bronson Commercial |
$237.13
|
| Rate for Payer: VA VA |
$236.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$480.67
|
|
|
HC INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
IP
|
$8,129.40
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
76100528
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,576.94 |
| Max. Negotiated Rate |
$7,316.46 |
| Rate for Payer: Aetna American Axle |
$5,284.11
|
| Rate for Payer: Aetna Commercial |
$6,909.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,284.11
|
| Rate for Payer: Cash Price |
$6,503.52
|
| Rate for Payer: Cofinity Advantage |
$5,690.58
|
| Rate for Payer: Cofinity Commercial |
$6,991.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,503.52
|
| Rate for Payer: Healthscope Commercial |
$7,316.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,690.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,097.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,909.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,097.05
|
| Rate for Payer: PHP Commercial |
$6,909.99
|
| Rate for Payer: Priority Health SBD |
$5,121.52
|
| Rate for Payer: UMR Bronson Commercial |
$3,576.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,097.05
|
|
|
HC INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
OP
|
$8,129.40
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
76100528
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna American Axle |
$5,284.11
|
| Rate for Payer: Aetna Commercial |
$6,909.99
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,284.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,210.08
|
| Rate for Payer: BCN Commercial |
$3,210.08
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$6,503.52
|
| Rate for Payer: Cash Price |
$6,503.52
|
| Rate for Payer: Cash Price |
$6,503.52
|
| Rate for Payer: Cofinity Advantage |
$5,690.58
|
| Rate for Payer: Cofinity Commercial |
$6,991.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,503.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$7,316.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,690.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,097.05
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,909.99
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,097.05
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$6,909.99
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$5,121.52
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,284.11
|
| Rate for Payer: UHC Core |
$4,235.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$3,194.85
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: UMR Bronson Commercial |
$3,007.88
|
| Rate for Payer: VA VA |
$2,894.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,097.05
|
|
|
HC INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA
|
Facility
|
IP
|
$8,815.00
|
|
|
Service Code
|
CPT 27603
|
| Hospital Charge Code |
76100546
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,878.60 |
| Max. Negotiated Rate |
$7,933.50 |
| Rate for Payer: Aetna American Axle |
$5,729.75
|
| Rate for Payer: Aetna Commercial |
$7,492.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,729.75
|
| Rate for Payer: Cash Price |
$7,052.00
|
| Rate for Payer: Cofinity Advantage |
$6,170.50
|
| Rate for Payer: Cofinity Commercial |
$7,580.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,052.00
|
| Rate for Payer: Healthscope Commercial |
$7,933.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,170.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,611.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,492.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,611.25
|
| Rate for Payer: PHP Commercial |
$7,492.75
|
| Rate for Payer: Priority Health SBD |
$5,553.45
|
| Rate for Payer: UMR Bronson Commercial |
$3,878.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,611.25
|
|
|
HC INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA
|
Facility
|
OP
|
$8,815.00
|
|
|
Service Code
|
CPT 27603
|
| Hospital Charge Code |
76100546
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,513.70 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna American Axle |
$5,729.75
|
| Rate for Payer: Aetna Commercial |
$7,492.75
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,729.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$1,940.82
|
| Rate for Payer: BCN Commercial |
$1,940.82
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$7,052.00
|
| Rate for Payer: Cash Price |
$7,052.00
|
| Rate for Payer: Cash Price |
$7,052.00
|
| Rate for Payer: Cofinity Advantage |
$6,170.50
|
| Rate for Payer: Cofinity Commercial |
$7,580.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,052.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$7,933.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,170.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,611.25
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,492.75
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,611.25
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$7,492.75
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$5,553.45
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,729.75
|
| Rate for Payer: UHC Core |
$4,592.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Exchange |
$3,464.30
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: UMR Bronson Commercial |
$3,261.55
|
| Rate for Payer: VA VA |
$2,894.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,611.25
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
IP
|
$676.26
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$297.55 |
| Max. Negotiated Rate |
$608.63 |
| Rate for Payer: Aetna American Axle |
$439.57
|
| Rate for Payer: Aetna Commercial |
$574.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.57
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Advantage |
$473.38
|
| Rate for Payer: Cofinity Commercial |
$581.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Healthscope Commercial |
$608.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$473.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$507.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$507.19
|
| Rate for Payer: PHP Commercial |
$574.82
|
| Rate for Payer: Priority Health SBD |
$426.04
|
| Rate for Payer: UMR Bronson Commercial |
$297.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$507.19
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
OP
|
$676.26
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.43 |
| Max. Negotiated Rate |
$930.04 |
| Rate for Payer: Aetna American Axle |
$439.57
|
| Rate for Payer: Aetna Commercial |
$574.82
|
| Rate for Payer: Aetna Medicare |
$245.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.00
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS Trust/PPO |
$930.04
|
| Rate for Payer: BCN Commercial |
$930.04
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cash Price |
$541.01
|
| Rate for Payer: Cofinity Advantage |
$473.38
|
| Rate for Payer: Cofinity Commercial |
$581.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$541.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$608.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$473.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$507.19
|
| Rate for Payer: Mclaren Medicaid |
$236.00
|
| Rate for Payer: Mclaren Medicare |
$236.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.80
|
| Rate for Payer: Meridian Medicaid |
$247.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$574.82
|
| Rate for Payer: Nomi Health Commercial |
$708.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$507.19
|
| Rate for Payer: PACE Medicare |
$224.20
|
| Rate for Payer: PACE SWMI |
$236.00
|
| Rate for Payer: PHP Commercial |
$574.82
|
| Rate for Payer: PHP Medicare Advantage |
$236.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$763.21
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health SBD |
$426.04
|
| Rate for Payer: Priority Health Tiered Network |
$610.57
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.57
|
| Rate for Payer: UHC Core |
$352.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.00
|
| Rate for Payer: UHC Exchange |
$265.77
|
| Rate for Payer: UHC Medicaid |
$123.43
|
| Rate for Payer: UHCCP Medicaid |
$123.43
|
| Rate for Payer: UMR Bronson Commercial |
$250.22
|
| Rate for Payer: VA VA |
$236.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$507.19
|
|
|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
OP
|
$1,898.27
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$702.36 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$1,233.88
|
| Rate for Payer: Aetna Commercial |
$1,613.53
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,233.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,031.89
|
| Rate for Payer: BCN Commercial |
$2,031.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,518.62
|
| Rate for Payer: Cash Price |
$1,518.62
|
| Rate for Payer: Cash Price |
$1,518.62
|
| Rate for Payer: Cofinity Advantage |
$1,328.79
|
| Rate for Payer: Cofinity Commercial |
$1,632.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,518.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,708.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,328.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,423.70
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,613.53
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,423.70
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,613.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,195.91
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,233.88
|
| Rate for Payer: UHC Core |
$989.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Exchange |
$746.02
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$702.36
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,423.70
|
|
|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
IP
|
$1,898.27
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$835.24 |
| Max. Negotiated Rate |
$1,708.44 |
| Rate for Payer: Aetna American Axle |
$1,233.88
|
| Rate for Payer: Aetna Commercial |
$1,613.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,233.88
|
| Rate for Payer: Cash Price |
$1,518.62
|
| Rate for Payer: Cofinity Advantage |
$1,328.79
|
| Rate for Payer: Cofinity Commercial |
$1,632.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,518.62
|
| Rate for Payer: Healthscope Commercial |
$1,708.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,328.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,423.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,613.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,423.70
|
| Rate for Payer: PHP Commercial |
$1,613.53
|
| Rate for Payer: Priority Health SBD |
$1,195.91
|
| Rate for Payer: UMR Bronson Commercial |
$835.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,423.70
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
IP
|
$990.10
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$435.64 |
| Max. Negotiated Rate |
$891.09 |
| Rate for Payer: Aetna American Axle |
$643.57
|
| Rate for Payer: Aetna Commercial |
$841.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$643.57
|
| Rate for Payer: Cash Price |
$792.08
|
| Rate for Payer: Cofinity Advantage |
$693.07
|
| Rate for Payer: Cofinity Commercial |
$851.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.08
|
| Rate for Payer: Healthscope Commercial |
$891.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$693.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$742.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$841.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$742.58
|
| Rate for Payer: PHP Commercial |
$841.59
|
| Rate for Payer: Priority Health SBD |
$623.76
|
| Rate for Payer: UMR Bronson Commercial |
$435.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$742.58
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
OP
|
$990.10
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$366.34 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna American Axle |
$643.57
|
| Rate for Payer: Aetna Commercial |
$841.59
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$643.57
|
| 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 |
$879.35
|
| Rate for Payer: BCN Commercial |
$879.35
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$792.08
|
| Rate for Payer: Cash Price |
$792.08
|
| Rate for Payer: Cash Price |
$792.08
|
| Rate for Payer: Cofinity Advantage |
$693.07
|
| Rate for Payer: Cofinity Commercial |
$851.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$891.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$693.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$742.58
|
| 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 |
$841.59
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$742.58
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$841.59
|
| 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 |
$623.76
|
| 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) |
$643.57
|
| Rate for Payer: UHC Core |
$515.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Exchange |
$389.11
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: UMR Bronson Commercial |
$366.34
|
| Rate for Payer: VA VA |
$705.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$742.58
|
|
|
HC INCISION EXT THROMBOSED HEMORRHOID
|
Facility
|
IP
|
$303.89
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
45000066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$133.71 |
| Max. Negotiated Rate |
$273.50 |
| Rate for Payer: Aetna American Axle |
$197.53
|
| Rate for Payer: Aetna Commercial |
$258.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.53
|
| Rate for Payer: Cash Price |
$243.11
|
| Rate for Payer: Cofinity Advantage |
$212.72
|
| Rate for Payer: Cofinity Commercial |
$261.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.11
|
| Rate for Payer: Healthscope Commercial |
$273.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$212.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$227.92
|
| Rate for Payer: PHP Commercial |
$258.31
|
| Rate for Payer: Priority Health SBD |
$191.45
|
| Rate for Payer: UMR Bronson Commercial |
$133.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.92
|
|
|
HC INCISION EXT THROMBOSED HEMORRHOID
|
Facility
|
OP
|
$303.89
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
45000066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$112.44 |
| Max. Negotiated Rate |
$805.08 |
| Rate for Payer: Aetna American Axle |
$197.53
|
| Rate for Payer: Aetna Commercial |
$258.31
|
| Rate for Payer: Aetna Medicare |
$258.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.19
|
| Rate for Payer: BCBS Complete |
$136.72
|
| Rate for Payer: BCBS MAPPO |
$248.95
|
| Rate for Payer: BCBS Trust/PPO |
$251.05
|
| Rate for Payer: BCN Commercial |
$251.05
|
| Rate for Payer: BCN Medicare Advantage |
$248.95
|
| Rate for Payer: Cash Price |
$243.11
|
| Rate for Payer: Cash Price |
$243.11
|
| Rate for Payer: Cash Price |
$243.11
|
| Rate for Payer: Cofinity Advantage |
$212.72
|
| Rate for Payer: Cofinity Commercial |
$261.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.95
|
| Rate for Payer: Healthscope Commercial |
$273.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$212.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.92
|
| Rate for Payer: Mclaren Medicaid |
$248.95
|
| Rate for Payer: Mclaren Medicare |
$248.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.40
|
| Rate for Payer: Meridian Medicaid |
$261.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.31
|
| Rate for Payer: Nomi Health Commercial |
$746.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$227.92
|
| Rate for Payer: PACE Medicare |
$236.50
|
| Rate for Payer: PACE SWMI |
$248.95
|
| Rate for Payer: PHP Commercial |
$258.31
|
| Rate for Payer: PHP Medicare Advantage |
$248.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$805.08
|
| Rate for Payer: Priority Health Medicare |
$248.95
|
| Rate for Payer: Priority Health SBD |
$191.45
|
| Rate for Payer: Priority Health Tiered Network |
$644.06
|
| Rate for Payer: Railroad Medicare Medicare |
$248.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.53
|
| Rate for Payer: UHC Core |
$158.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$248.95
|
| Rate for Payer: UHC Exchange |
$119.43
|
| Rate for Payer: UHC Medicaid |
$130.20
|
| Rate for Payer: UHCCP Medicaid |
$130.20
|
| Rate for Payer: UMR Bronson Commercial |
$112.44
|
| Rate for Payer: VA VA |
$248.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.92
|
|
|
HC INCISION OF LABIAL FRENUM FRENOTOMY
|
Facility
|
IP
|
$1,404.54
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
76100459
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$618.00 |
| Max. Negotiated Rate |
$1,264.09 |
| Rate for Payer: Aetna American Axle |
$912.95
|
| Rate for Payer: Aetna Commercial |
$1,193.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.95
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cofinity Advantage |
$983.18
|
| Rate for Payer: Cofinity Commercial |
$1,207.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.63
|
| Rate for Payer: Healthscope Commercial |
$1,264.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$983.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,053.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,193.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.40
|
| Rate for Payer: PHP Commercial |
$1,193.86
|
| Rate for Payer: Priority Health SBD |
$884.86
|
| Rate for Payer: UMR Bronson Commercial |
$618.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,053.40
|
|
|
HC INCISION OF LABIAL FRENUM FRENOTOMY
|
Facility
|
OP
|
$1,404.54
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
76100459
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$152.02 |
| Max. Negotiated Rate |
$1,737.88 |
| Rate for Payer: Aetna American Axle |
$912.95
|
| Rate for Payer: Aetna Commercial |
$1,193.86
|
| Rate for Payer: Aetna Medicare |
$558.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$671.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$671.74
|
| Rate for Payer: BCBS Complete |
$295.13
|
| Rate for Payer: BCBS MAPPO |
$537.39
|
| Rate for Payer: BCBS Trust/PPO |
$152.02
|
| Rate for Payer: BCN Commercial |
$152.02
|
| Rate for Payer: BCN Medicare Advantage |
$537.39
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cofinity Advantage |
$983.18
|
| Rate for Payer: Cofinity Commercial |
$1,207.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.39
|
| Rate for Payer: Healthscope Commercial |
$1,264.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$983.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,053.40
|
| Rate for Payer: Mclaren Medicaid |
$537.39
|
| Rate for Payer: Mclaren Medicare |
$537.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.26
|
| Rate for Payer: Meridian Medicaid |
$564.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$618.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,193.86
|
| Rate for Payer: Nomi Health Commercial |
$1,612.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.40
|
| Rate for Payer: PACE Medicare |
$510.52
|
| Rate for Payer: PACE SWMI |
$537.39
|
| Rate for Payer: PHP Commercial |
$1,193.86
|
| Rate for Payer: PHP Medicare Advantage |
$537.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,737.88
|
| Rate for Payer: Priority Health Medicare |
$537.39
|
| Rate for Payer: Priority Health SBD |
$884.86
|
| Rate for Payer: Priority Health Tiered Network |
$1,390.30
|
| Rate for Payer: Railroad Medicare Medicare |
$537.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$912.95
|
| Rate for Payer: UHC Core |
$731.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$537.39
|
| Rate for Payer: UHC Exchange |
$551.98
|
| Rate for Payer: UHC Medicaid |
$281.05
|
| Rate for Payer: UHCCP Medicaid |
$281.05
|
| Rate for Payer: UMR Bronson Commercial |
$519.68
|
| Rate for Payer: VA VA |
$537.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,053.40
|
|
|
HC INCISION OF URETHRA
|
Facility
|
IP
|
$2,853.59
|
|
|
Service Code
|
CPT 53020
|
| Hospital Charge Code |
76100296
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,255.58 |
| Max. Negotiated Rate |
$2,568.23 |
| Rate for Payer: Aetna American Axle |
$1,854.83
|
| Rate for Payer: Aetna Commercial |
$2,425.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,854.83
|
| Rate for Payer: Cash Price |
$2,282.87
|
| Rate for Payer: Cofinity Advantage |
$1,997.51
|
| Rate for Payer: Cofinity Commercial |
$2,454.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,282.87
|
| Rate for Payer: Healthscope Commercial |
$2,568.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,997.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,140.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,425.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,140.19
|
| Rate for Payer: PHP Commercial |
$2,425.55
|
| Rate for Payer: Priority Health SBD |
$1,797.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,255.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,140.19
|
|
|
HC INCISION OF URETHRA
|
Facility
|
OP
|
$2,853.59
|
|
|
Service Code
|
CPT 53020
|
| Hospital Charge Code |
76100296
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,055.83 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna American Axle |
$1,854.83
|
| Rate for Payer: Aetna Commercial |
$2,425.55
|
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,854.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,739.40
|
| Rate for Payer: BCN Commercial |
$1,739.40
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$2,282.87
|
| Rate for Payer: Cash Price |
$2,282.87
|
| Rate for Payer: Cash Price |
$2,282.87
|
| Rate for Payer: Cofinity Advantage |
$1,997.51
|
| Rate for Payer: Cofinity Commercial |
$2,454.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,282.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$2,568.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,997.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,140.19
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$2,187.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,425.55
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,140.19
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$2,425.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,735.82
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health SBD |
$1,797.76
|
| Rate for Payer: Priority Health Tiered Network |
$5,388.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,854.83
|
| Rate for Payer: UHC Core |
$1,486.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Exchange |
$1,121.46
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,055.83
|
| Rate for Payer: VA VA |
$2,082.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,140.19
|
|
|
HC INDIRECT CALORIMETRY
|
Facility
|
OP
|
$1,189.62
|
|
|
Service Code
|
CPT 94690
|
| Hospital Charge Code |
46000008
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$1,070.66 |
| Rate for Payer: Aetna American Axle |
$773.25
|
| Rate for Payer: Aetna Commercial |
$1,011.18
|
| Rate for Payer: Aetna Medicare |
$61.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$773.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$188.80
|
| Rate for Payer: BCN Commercial |
$188.80
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$951.70
|
| Rate for Payer: Cash Price |
$951.70
|
| Rate for Payer: Cofinity Advantage |
$832.73
|
| Rate for Payer: Cofinity Commercial |
$1,023.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$951.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$1,070.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$832.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$892.22
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$61.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,011.18
|
| Rate for Payer: Nomi Health Commercial |
$176.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.22
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$1,011.18
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.09
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health SBD |
$749.46
|
| Rate for Payer: Priority Health Tiered Network |
$152.07
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$773.25
|
| Rate for Payer: UHC Core |
$619.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$467.52
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: UMR Bronson Commercial |
$440.16
|
| Rate for Payer: VA VA |
$58.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$892.22
|
|
|
HC INDIRECT CALORIMETRY
|
Facility
|
IP
|
$1,189.62
|
|
|
Service Code
|
CPT 94690
|
| Hospital Charge Code |
46000008
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$523.43 |
| Max. Negotiated Rate |
$1,070.66 |
| Rate for Payer: Aetna American Axle |
$773.25
|
| Rate for Payer: Aetna Commercial |
$1,011.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$773.25
|
| Rate for Payer: Cash Price |
$951.70
|
| Rate for Payer: Cofinity Advantage |
$832.73
|
| Rate for Payer: Cofinity Commercial |
$1,023.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$951.70
|
| Rate for Payer: Healthscope Commercial |
$1,070.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$832.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$892.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,011.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$892.22
|
| Rate for Payer: PHP Commercial |
$1,011.18
|
| Rate for Payer: Priority Health SBD |
$749.46
|
| Rate for Payer: UMR Bronson Commercial |
$523.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$892.22
|
|
|
HC INDIUM 111 DTPA PER MCI
|
Facility
|
IP
|
$594.95
|
|
|
Service Code
|
HCPCS A9548
|
| Hospital Charge Code |
34300015
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$261.78 |
| Max. Negotiated Rate |
$535.46 |
| Rate for Payer: Aetna American Axle |
$386.72
|
| Rate for Payer: Aetna Commercial |
$505.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.72
|
| Rate for Payer: Cash Price |
$475.96
|
| Rate for Payer: Cofinity Advantage |
$416.46
|
| Rate for Payer: Cofinity Commercial |
$511.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.96
|
| Rate for Payer: Healthscope Commercial |
$535.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$416.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.21
|
| Rate for Payer: PHP Commercial |
$505.71
|
| Rate for Payer: Priority Health SBD |
$374.82
|
| Rate for Payer: UMR Bronson Commercial |
$261.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.21
|
|
