|
HC GI CONVERT G TO GJ TUBE W
|
Facility
|
OP
|
$1,796.43
|
|
|
Service Code
|
CPT 49446
|
| Hospital Charge Code |
36100228
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$664.68 |
| Max. Negotiated Rate |
$5,207.85 |
| Rate for Payer: Aetna American Axle |
$1,167.68
|
| Rate for Payer: Aetna Commercial |
$1,526.97
|
| Rate for Payer: Aetna Medicare |
$1,924.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,167.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,312.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,312.62
|
| Rate for Payer: BCBS Complete |
$1,041.24
|
| Rate for Payer: BCBS MAPPO |
$1,850.10
|
| Rate for Payer: BCN Medicare Advantage |
$1,850.10
|
| Rate for Payer: Cash Price |
$1,437.14
|
| Rate for Payer: Cash Price |
$1,437.14
|
| Rate for Payer: Cofinity Commercial |
$1,544.93
|
| Rate for Payer: Cofinity Commercial |
$1,257.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,257.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,437.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,850.10
|
| Rate for Payer: Healthscope Commercial |
$1,616.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,257.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,347.32
|
| Rate for Payer: Mclaren Medicaid |
$991.65
|
| Rate for Payer: Mclaren Medicare |
$1,850.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,942.61
|
| Rate for Payer: Meridian Medicaid |
$1,041.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,127.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,526.97
|
| Rate for Payer: PACE Medicare |
$1,757.60
|
| Rate for Payer: PACE SWMI |
$1,850.10
|
| Rate for Payer: PHP Commercial |
$1,526.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,850.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$991.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,167.68
|
| Rate for Payer: Priority Health Medicare |
$1,850.10
|
| Rate for Payer: Priority Health SBD |
$1,131.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,850.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,207.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,850.10
|
| Rate for Payer: UHC Exchange |
$3,535.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,850.10
|
| Rate for Payer: UHCCP Medicaid |
$991.65
|
| Rate for Payer: UMR Bronson Commercial |
$664.68
|
| Rate for Payer: VA VA |
$1,850.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,347.32
|
|
|
HC GI FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$1,811.10
|
|
| Hospital Charge Code |
36000049
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$796.88 |
| Max. Negotiated Rate |
$1,629.99 |
| Rate for Payer: Aetna American Axle |
$1,177.21
|
| Rate for Payer: Aetna Commercial |
$1,539.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,177.21
|
| Rate for Payer: Cash Price |
$1,448.88
|
| Rate for Payer: Cofinity Commercial |
$1,267.77
|
| Rate for Payer: Cofinity Commercial |
$1,557.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,267.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,448.88
|
| Rate for Payer: Healthscope Commercial |
$1,629.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,267.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,358.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,539.43
|
| Rate for Payer: PHP Commercial |
$1,539.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,177.21
|
| Rate for Payer: Priority Health SBD |
$1,140.99
|
| Rate for Payer: UMR Bronson Commercial |
$796.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,358.33
|
|
|
HC GI FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$1,811.10
|
|
| Hospital Charge Code |
36000049
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$670.11 |
| Max. Negotiated Rate |
$1,629.99 |
| Rate for Payer: Aetna American Axle |
$1,177.21
|
| Rate for Payer: Aetna Commercial |
$1,539.43
|
| Rate for Payer: Aetna Medicare |
$905.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,177.21
|
| Rate for Payer: BCBS Complete |
$724.44
|
| Rate for Payer: Cash Price |
$1,448.88
|
| Rate for Payer: Cofinity Commercial |
$1,267.77
|
| Rate for Payer: Cofinity Commercial |
$1,557.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,267.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,448.88
|
| Rate for Payer: Healthscope Commercial |
$1,629.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,267.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,358.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,539.43
|
| Rate for Payer: PHP Commercial |
$1,539.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,177.21
|
| Rate for Payer: Priority Health SBD |
$1,140.99
|
| Rate for Payer: UMR Bronson Commercial |
$670.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,358.33
|
|
|
HC GI GASTRIC TUBE REPOSITION
|
Facility
|
OP
|
$1,267.94
|
|
|
Service Code
|
CPT 43761
|
| Hospital Charge Code |
36100192
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.14 |
| Max. Negotiated Rate |
$1,141.15 |
| Rate for Payer: Aetna American Axle |
$824.16
|
| Rate for Payer: Aetna Commercial |
$1,077.75
|
| Rate for Payer: Aetna Medicare |
$246.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.50
|
| Rate for Payer: BCBS Complete |
$133.50
|
| Rate for Payer: BCBS MAPPO |
$237.20
|
| Rate for Payer: BCN Medicare Advantage |
$237.20
|
| Rate for Payer: Cash Price |
$1,014.35
|
| Rate for Payer: Cash Price |
$1,014.35
|
| Rate for Payer: Cofinity Commercial |
$887.56
|
| Rate for Payer: Cofinity Commercial |
$1,090.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$887.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,014.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.20
|
| Rate for Payer: Healthscope Commercial |
$1,141.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$887.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$950.96
|
| Rate for Payer: Mclaren Medicaid |
$127.14
|
| Rate for Payer: Mclaren Medicare |
$237.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.06
|
| Rate for Payer: Meridian Medicaid |
$133.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.75
|
| Rate for Payer: PACE Medicare |
$225.34
|
| Rate for Payer: PACE SWMI |
$237.20
|
| Rate for Payer: PHP Commercial |
$1,077.75
|
| Rate for Payer: PHP Medicare Advantage |
$237.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.16
|
| Rate for Payer: Priority Health Medicare |
$237.20
|
| Rate for Payer: Priority Health SBD |
$798.80
|
| Rate for Payer: Railroad Medicare Medicare |
$237.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.20
|
| Rate for Payer: UHC Exchange |
$453.31
|
| Rate for Payer: UHC Medicare Advantage |
$237.20
|
| Rate for Payer: UHCCP Medicaid |
$127.14
|
| Rate for Payer: UMR Bronson Commercial |
$469.14
|
| Rate for Payer: VA VA |
$237.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$950.96
|
|
|
HC GI GASTRIC TUBE REPOSITION
|
Facility
|
IP
|
$1,267.94
|
|
|
Service Code
|
CPT 43761
|
| Hospital Charge Code |
36100192
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$557.89 |
| Max. Negotiated Rate |
$1,141.15 |
| Rate for Payer: Aetna American Axle |
$824.16
|
| Rate for Payer: Aetna Commercial |
$1,077.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.16
|
| Rate for Payer: Cash Price |
$1,014.35
|
| Rate for Payer: Cofinity Commercial |
$1,090.43
|
| Rate for Payer: Cofinity Commercial |
$887.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$887.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,014.35
|
| Rate for Payer: Healthscope Commercial |
$1,141.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$887.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$950.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.75
|
| Rate for Payer: PHP Commercial |
$1,077.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.16
|
| Rate for Payer: Priority Health SBD |
$798.80
|
| Rate for Payer: UMR Bronson Commercial |
$557.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$950.96
|
|
|
HC GI INTRALUMINAL IMAGING ESOPHAGUS
|
Facility
|
OP
|
$1,226.51
|
|
|
Service Code
|
CPT 91111
|
| Hospital Charge Code |
75000009
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$453.81 |
| Max. Negotiated Rate |
$2,573.89 |
| Rate for Payer: Aetna American Axle |
$797.23
|
| Rate for Payer: Aetna Commercial |
$1,042.53
|
| Rate for Payer: Aetna Medicare |
$950.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$797.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Cash Price |
$981.21
|
| Rate for Payer: Cash Price |
$981.21
|
| Rate for Payer: Cofinity Commercial |
$858.56
|
| Rate for Payer: Cofinity Commercial |
$1,054.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$858.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$981.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Healthscope Commercial |
$1,103.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$858.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$919.88
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,042.53
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Commercial |
$1,042.53
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$797.23
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Priority Health SBD |
$772.70
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Exchange |
$1,747.47
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: UMR Bronson Commercial |
$453.81
|
| Rate for Payer: VA VA |
$914.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$919.88
|
|
|
HC GI INTRALUMINAL IMAGING ESOPHAGUS
|
Facility
|
IP
|
$1,226.51
|
|
|
Service Code
|
CPT 91111
|
| Hospital Charge Code |
75000009
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$539.66 |
| Max. Negotiated Rate |
$1,103.86 |
| Rate for Payer: Aetna American Axle |
$797.23
|
| Rate for Payer: Aetna Commercial |
$1,042.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$797.23
|
| Rate for Payer: Cash Price |
$981.21
|
| Rate for Payer: Cofinity Commercial |
$1,054.80
|
| Rate for Payer: Cofinity Commercial |
$858.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$858.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$981.21
|
| Rate for Payer: Healthscope Commercial |
$1,103.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$858.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$919.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,042.53
|
| Rate for Payer: PHP Commercial |
$1,042.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$797.23
|
| Rate for Payer: Priority Health SBD |
$772.70
|
| Rate for Payer: UMR Bronson Commercial |
$539.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$919.88
|
|
|
HC GI INTRALUMINAL IMAGING ESOPH THROUGH ILEUM
|
Facility
|
IP
|
$1,349.16
|
|
|
Service Code
|
CPT 91110
|
| Hospital Charge Code |
75000008
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$593.63 |
| Max. Negotiated Rate |
$1,214.24 |
| Rate for Payer: Aetna American Axle |
$876.95
|
| Rate for Payer: Aetna Commercial |
$1,146.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$876.95
|
| Rate for Payer: Cash Price |
$1,079.33
|
| Rate for Payer: Cofinity Commercial |
$1,160.28
|
| Rate for Payer: Cofinity Commercial |
$944.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$944.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,079.33
|
| Rate for Payer: Healthscope Commercial |
$1,214.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$944.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,011.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,146.79
|
| Rate for Payer: PHP Commercial |
$1,146.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.95
|
| Rate for Payer: Priority Health SBD |
$849.97
|
| Rate for Payer: UMR Bronson Commercial |
$593.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,011.87
|
|
|
HC GI INTRALUMINAL IMAGING ESOPH THROUGH ILEUM
|
Facility
|
OP
|
$1,349.16
|
|
|
Service Code
|
CPT 91110
|
| Hospital Charge Code |
75000008
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$490.11 |
| Max. Negotiated Rate |
$2,573.89 |
| Rate for Payer: Aetna American Axle |
$876.95
|
| Rate for Payer: Aetna Commercial |
$1,146.79
|
| Rate for Payer: Aetna Medicare |
$950.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$876.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Cash Price |
$1,079.33
|
| Rate for Payer: Cash Price |
$1,079.33
|
| Rate for Payer: Cofinity Commercial |
$944.41
|
| Rate for Payer: Cofinity Commercial |
$1,160.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$944.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,079.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Healthscope Commercial |
$1,214.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$944.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,011.87
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,146.79
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Commercial |
$1,146.79
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.95
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Priority Health SBD |
$849.97
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Exchange |
$1,747.47
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: UMR Bronson Commercial |
$499.19
|
| Rate for Payer: VA VA |
$914.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,011.87
|
|
|
HC GI LONG TUBE PLACEMENT
|
Facility
|
OP
|
$1,276.51
|
|
|
Service Code
|
CPT 44500
|
| Hospital Charge Code |
36100193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$472.31 |
| Max. Negotiated Rate |
$2,573.89 |
| Rate for Payer: Aetna American Axle |
$829.73
|
| Rate for Payer: Aetna Commercial |
$1,085.03
|
| Rate for Payer: Aetna Medicare |
$950.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$829.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Cash Price |
$1,021.21
|
| Rate for Payer: Cash Price |
$1,021.21
|
| Rate for Payer: Cofinity Commercial |
$893.56
|
| Rate for Payer: Cofinity Commercial |
$1,097.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$893.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,021.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Healthscope Commercial |
$1,148.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$893.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$957.38
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,085.03
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Commercial |
$1,085.03
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$829.73
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Priority Health SBD |
$804.20
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Exchange |
$1,747.47
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: UMR Bronson Commercial |
$472.31
|
| Rate for Payer: VA VA |
$914.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$957.38
|
|
|
HC GI LONG TUBE PLACEMENT
|
Facility
|
IP
|
$1,276.51
|
|
|
Service Code
|
CPT 44500
|
| Hospital Charge Code |
36100193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$561.66 |
| Max. Negotiated Rate |
$1,148.86 |
| Rate for Payer: Aetna American Axle |
$829.73
|
| Rate for Payer: Aetna Commercial |
$1,085.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$829.73
|
| Rate for Payer: Cash Price |
$1,021.21
|
| Rate for Payer: Cofinity Commercial |
$1,097.80
|
| Rate for Payer: Cofinity Commercial |
$893.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$893.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,021.21
|
| Rate for Payer: Healthscope Commercial |
$1,148.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$893.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$957.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,085.03
|
| Rate for Payer: PHP Commercial |
$1,085.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$829.73
|
| Rate for Payer: Priority Health SBD |
$804.20
|
| Rate for Payer: UMR Bronson Commercial |
$561.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$957.38
|
|
|
HC GI OSTOMY OBSTRUCT REMOVL
|
Facility
|
OP
|
$887.36
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
36100232
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$328.32 |
| Max. Negotiated Rate |
$2,573.89 |
| Rate for Payer: Aetna American Axle |
$576.78
|
| Rate for Payer: Aetna Commercial |
$754.26
|
| Rate for Payer: Aetna Medicare |
$950.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Cash Price |
$709.89
|
| Rate for Payer: Cash Price |
$709.89
|
| Rate for Payer: Cofinity Commercial |
$763.13
|
| Rate for Payer: Cofinity Commercial |
$621.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$621.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Healthscope Commercial |
$798.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$621.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$665.52
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.26
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Commercial |
$754.26
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$576.78
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Priority Health SBD |
$559.04
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Exchange |
$1,747.47
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: UMR Bronson Commercial |
$328.32
|
| Rate for Payer: VA VA |
$914.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.52
|
|
|
HC GI OSTOMY OBSTRUCT REMOVL
|
Facility
|
IP
|
$887.36
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
36100232
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$390.44 |
| Max. Negotiated Rate |
$798.62 |
| Rate for Payer: Aetna American Axle |
$576.78
|
| Rate for Payer: Aetna Commercial |
$754.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.78
|
| Rate for Payer: Cash Price |
$709.89
|
| Rate for Payer: Cofinity Commercial |
$621.15
|
| Rate for Payer: Cofinity Commercial |
$763.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$621.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.89
|
| Rate for Payer: Healthscope Commercial |
$798.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$621.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$665.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.26
|
| Rate for Payer: PHP Commercial |
$754.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$576.78
|
| Rate for Payer: Priority Health SBD |
$559.04
|
| Rate for Payer: UMR Bronson Commercial |
$390.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.52
|
|
|
HC GI PATHOGEN PANEL, PCR, F
|
Facility
|
OP
|
$718.71
|
|
|
Service Code
|
HCPCS 87507
|
| Hospital Charge Code |
30600322
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$223.39 |
| Max. Negotiated Rate |
$1,173.19 |
| Rate for Payer: Aetna American Axle |
$467.16
|
| Rate for Payer: Aetna Commercial |
$610.90
|
| Rate for Payer: Aetna Medicare |
$433.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: BCBS Complete |
$234.56
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$574.97
|
| Rate for Payer: Cash Price |
$574.97
|
| Rate for Payer: Cofinity Commercial |
$618.09
|
| Rate for Payer: Cofinity Commercial |
$503.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$503.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$574.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$646.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$503.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.03
|
| Rate for Payer: Mclaren Medicaid |
$223.39
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: Meridian Medicaid |
$234.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$610.90
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$610.90
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$467.16
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health SBD |
$452.79
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,173.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.78
|
| Rate for Payer: UHC Exchange |
$796.51
|
| Rate for Payer: UHC Medicare Advantage |
$416.78
|
| Rate for Payer: UHCCP Medicaid |
$223.39
|
| Rate for Payer: UMR Bronson Commercial |
$265.92
|
| Rate for Payer: VA VA |
$416.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.03
|
|
|
HC GI PATHOGEN PANEL, PCR, F
|
Facility
|
IP
|
$718.71
|
|
|
Service Code
|
HCPCS 87507
|
| Hospital Charge Code |
30600322
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$316.23 |
| Max. Negotiated Rate |
$646.84 |
| Rate for Payer: Aetna American Axle |
$467.16
|
| Rate for Payer: Aetna Commercial |
$610.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.16
|
| Rate for Payer: Cash Price |
$574.97
|
| Rate for Payer: Cofinity Commercial |
$503.10
|
| Rate for Payer: Cofinity Commercial |
$618.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$503.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$574.97
|
| Rate for Payer: Healthscope Commercial |
$646.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$503.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$610.90
|
| Rate for Payer: PHP Commercial |
$610.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$467.16
|
| Rate for Payer: Priority Health SBD |
$452.79
|
| Rate for Payer: UMR Bronson Commercial |
$316.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.03
|
|
|
HC GI REPLAC D OR J TUBE W F
|
Facility
|
OP
|
$887.36
|
|
|
Service Code
|
CPT 49451
|
| Hospital Charge Code |
36100230
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$328.32 |
| Max. Negotiated Rate |
$2,573.89 |
| Rate for Payer: Aetna American Axle |
$576.78
|
| Rate for Payer: Aetna Commercial |
$754.26
|
| Rate for Payer: Aetna Medicare |
$950.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Cash Price |
$709.89
|
| Rate for Payer: Cash Price |
$709.89
|
| Rate for Payer: Cofinity Commercial |
$763.13
|
| Rate for Payer: Cofinity Commercial |
$621.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$621.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Healthscope Commercial |
$798.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$621.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$665.52
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.26
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Commercial |
$754.26
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$576.78
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Priority Health SBD |
$559.04
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Exchange |
$1,747.47
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: UMR Bronson Commercial |
$328.32
|
| Rate for Payer: VA VA |
$914.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.52
|
|
|
HC GI REPLAC D OR J TUBE W F
|
Facility
|
IP
|
$887.36
|
|
|
Service Code
|
CPT 49451
|
| Hospital Charge Code |
36100230
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$390.44 |
| Max. Negotiated Rate |
$798.62 |
| Rate for Payer: Aetna American Axle |
$576.78
|
| Rate for Payer: Aetna Commercial |
$754.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.78
|
| Rate for Payer: Cash Price |
$709.89
|
| Rate for Payer: Cofinity Commercial |
$621.15
|
| Rate for Payer: Cofinity Commercial |
$763.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$621.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.89
|
| Rate for Payer: Healthscope Commercial |
$798.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$621.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$665.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.26
|
| Rate for Payer: PHP Commercial |
$754.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$576.78
|
| Rate for Payer: Priority Health SBD |
$559.04
|
| Rate for Payer: UMR Bronson Commercial |
$390.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.52
|
|
|
HC GI REPLAC GJ TUBE W FLUOR
|
Facility
|
IP
|
$887.36
|
|
|
Service Code
|
CPT 49452
|
| Hospital Charge Code |
36100231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$390.44 |
| Max. Negotiated Rate |
$798.62 |
| Rate for Payer: Aetna American Axle |
$576.78
|
| Rate for Payer: Aetna Commercial |
$754.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.78
|
| Rate for Payer: Cash Price |
$709.89
|
| Rate for Payer: Cofinity Commercial |
$621.15
|
| Rate for Payer: Cofinity Commercial |
$763.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$621.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.89
|
| Rate for Payer: Healthscope Commercial |
$798.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$621.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$665.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.26
|
| Rate for Payer: PHP Commercial |
$754.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$576.78
|
| Rate for Payer: Priority Health SBD |
$559.04
|
| Rate for Payer: UMR Bronson Commercial |
$390.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.52
|
|
|
HC GI REPLAC GJ TUBE W FLUOR
|
Facility
|
OP
|
$887.36
|
|
|
Service Code
|
CPT 49452
|
| Hospital Charge Code |
36100231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$328.32 |
| Max. Negotiated Rate |
$2,573.89 |
| Rate for Payer: Aetna American Axle |
$576.78
|
| Rate for Payer: Aetna Commercial |
$754.26
|
| Rate for Payer: Aetna Medicare |
$950.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Cash Price |
$709.89
|
| Rate for Payer: Cash Price |
$709.89
|
| Rate for Payer: Cofinity Commercial |
$763.13
|
| Rate for Payer: Cofinity Commercial |
$621.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$621.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Healthscope Commercial |
$798.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$621.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$665.52
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.26
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Commercial |
$754.26
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$576.78
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Priority Health SBD |
$559.04
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Exchange |
$1,747.47
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: UMR Bronson Commercial |
$328.32
|
| Rate for Payer: VA VA |
$914.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.52
|
|
|
HC GI REPLAC G OR EC TUBE W
|
Facility
|
OP
|
$913.46
|
|
|
Service Code
|
CPT 49450
|
| Hospital Charge Code |
36100229
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$337.98 |
| Max. Negotiated Rate |
$2,573.89 |
| Rate for Payer: Aetna American Axle |
$593.75
|
| Rate for Payer: Aetna Commercial |
$776.44
|
| Rate for Payer: Aetna Medicare |
$950.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$593.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Cash Price |
$730.77
|
| Rate for Payer: Cash Price |
$730.77
|
| Rate for Payer: Cofinity Commercial |
$785.58
|
| Rate for Payer: Cofinity Commercial |
$639.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$639.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$730.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Healthscope Commercial |
$822.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$639.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$685.10
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$776.44
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Commercial |
$776.44
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$593.75
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Priority Health SBD |
$575.48
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Exchange |
$1,747.47
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: UMR Bronson Commercial |
$337.98
|
| Rate for Payer: VA VA |
$914.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$685.10
|
|
|
HC GI REPLAC G OR EC TUBE W
|
Facility
|
IP
|
$913.46
|
|
|
Service Code
|
CPT 49450
|
| Hospital Charge Code |
36100229
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$401.92 |
| Max. Negotiated Rate |
$822.11 |
| Rate for Payer: Aetna American Axle |
$593.75
|
| Rate for Payer: Aetna Commercial |
$776.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$593.75
|
| Rate for Payer: Cash Price |
$730.77
|
| Rate for Payer: Cofinity Commercial |
$639.42
|
| Rate for Payer: Cofinity Commercial |
$785.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$639.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$730.77
|
| Rate for Payer: Healthscope Commercial |
$822.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$639.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$685.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$776.44
|
| Rate for Payer: PHP Commercial |
$776.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$593.75
|
| Rate for Payer: Priority Health SBD |
$575.48
|
| Rate for Payer: UMR Bronson Commercial |
$401.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$685.10
|
|
|
HC GI TRANSIT WIRELESS CAPSULE STOMACH TO COLON
|
Facility
|
OP
|
$1,226.51
|
|
|
Service Code
|
CPT 91112
|
| Hospital Charge Code |
75000010
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$453.81 |
| Max. Negotiated Rate |
$2,573.89 |
| Rate for Payer: Aetna American Axle |
$797.23
|
| Rate for Payer: Aetna Commercial |
$1,042.53
|
| Rate for Payer: Aetna Medicare |
$950.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$797.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Cash Price |
$981.21
|
| Rate for Payer: Cash Price |
$981.21
|
| Rate for Payer: Cofinity Commercial |
$858.56
|
| Rate for Payer: Cofinity Commercial |
$1,054.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$858.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$981.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Healthscope Commercial |
$1,103.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$858.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$919.88
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,042.53
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Commercial |
$1,042.53
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$797.23
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Priority Health SBD |
$772.70
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Exchange |
$1,747.47
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: UMR Bronson Commercial |
$453.81
|
| Rate for Payer: VA VA |
$914.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$919.88
|
|
|
HC GI TRANSIT WIRELESS CAPSULE STOMACH TO COLON
|
Facility
|
IP
|
$1,226.51
|
|
|
Service Code
|
CPT 91112
|
| Hospital Charge Code |
75000010
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$539.66 |
| Max. Negotiated Rate |
$1,103.86 |
| Rate for Payer: Aetna American Axle |
$797.23
|
| Rate for Payer: Aetna Commercial |
$1,042.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$797.23
|
| Rate for Payer: Cash Price |
$981.21
|
| Rate for Payer: Cofinity Commercial |
$1,054.80
|
| Rate for Payer: Cofinity Commercial |
$858.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$858.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$981.21
|
| Rate for Payer: Healthscope Commercial |
$1,103.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$858.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$919.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,042.53
|
| Rate for Payer: PHP Commercial |
$1,042.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$797.23
|
| Rate for Payer: Priority Health SBD |
$772.70
|
| Rate for Payer: UMR Bronson Commercial |
$539.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$919.88
|
|
|
HC GLIADIN AB DEAMINATED IGA
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200007
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna American Axle |
$23.67
|
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Cofinity Commercial |
$25.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health SBD |
$22.94
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$22.03
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: UMR Bronson Commercial |
$13.47
|
| Rate for Payer: VA VA |
$11.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC GLIADIN AB DEAMINATED IGA
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200007
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.02 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna American Axle |
$23.67
|
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.67
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$25.49
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health SBD |
$22.94
|
| Rate for Payer: UMR Bronson Commercial |
$16.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
