|
HC REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Facility
|
OP
|
$340.00
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
51000111
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.65 |
| Max. Negotiated Rate |
$369.91 |
| Rate for Payer: Aetna American Axle |
$221.00
|
| Rate for Payer: Aetna Commercial |
$289.00
|
| Rate for Payer: Aetna Medicare |
$122.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.88
|
| Rate for Payer: BCBS Complete |
$67.49
|
| Rate for Payer: BCBS MAPPO |
$117.50
|
| Rate for Payer: BCBS Trust/PPO |
$92.17
|
| Rate for Payer: BCN Medicare Advantage |
$117.50
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cash Price |
$272.00
|
| Rate for Payer: Cofinity Commercial |
$238.00
|
| Rate for Payer: Cofinity Commercial |
$292.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.50
|
| Rate for Payer: Healthscope Commercial |
$306.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.00
|
| Rate for Payer: Mclaren Medicaid |
$64.27
|
| Rate for Payer: Mclaren Medicare |
$117.50
|
| Rate for Payer: Meridian Medicaid |
$67.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$123.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$289.00
|
| Rate for Payer: PACE Medicare |
$111.62
|
| Rate for Payer: PACE SWMI |
$117.50
|
| Rate for Payer: PHP Commercial |
$289.00
|
| Rate for Payer: PHP Medicare Advantage |
$117.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$369.91
|
| Rate for Payer: Priority Health Medicare |
$117.50
|
| Rate for Payer: Priority Health Narrow Network |
$295.93
|
| Rate for Payer: Priority Health SBD |
$214.20
|
| Rate for Payer: Railroad Medicare Medicare |
$117.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.50
|
| Rate for Payer: UHC Exchange |
$19.65
|
| Rate for Payer: UHC Medicare Advantage |
$121.02
|
| Rate for Payer: UMR Bronson Commercial |
$125.80
|
| Rate for Payer: VA VA |
$117.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.00
|
|
|
HC REMOTE THER MON DEVICE SUPPLY MS EA 30 DAY
|
Facility
|
OP
|
$112.50
|
|
|
Service Code
|
CPT 98977
|
| Hospital Charge Code |
42000063
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.34 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$73.12
|
| Rate for Payer: Aetna Commercial |
$95.62
|
| Rate for Payer: Aetna Medicare |
$34.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.90
|
| Rate for Payer: BCBS Complete |
$19.25
|
| Rate for Payer: BCBS MAPPO |
$33.52
|
| Rate for Payer: BCBS Trust/PPO |
$246.31
|
| Rate for Payer: BCN Medicare Advantage |
$33.52
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cofinity Commercial |
$96.75
|
| Rate for Payer: Cofinity Commercial |
$78.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.52
|
| Rate for Payer: Healthscope Commercial |
$101.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.38
|
| Rate for Payer: Mclaren Medicaid |
$18.34
|
| Rate for Payer: Mclaren Medicare |
$33.52
|
| Rate for Payer: Meridian Medicaid |
$19.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$95.62
|
| Rate for Payer: PACE Medicare |
$31.84
|
| Rate for Payer: PACE SWMI |
$33.52
|
| Rate for Payer: PHP Commercial |
$95.62
|
| Rate for Payer: PHP Medicare Advantage |
$33.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.53
|
| Rate for Payer: Priority Health Medicare |
$33.52
|
| Rate for Payer: Priority Health Narrow Network |
$84.42
|
| Rate for Payer: Priority Health SBD |
$70.88
|
| Rate for Payer: Railroad Medicare Medicare |
$33.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.15
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.52
|
| Rate for Payer: UHC Exchange |
$46.50
|
| Rate for Payer: UHC Medicare Advantage |
$34.53
|
| Rate for Payer: UMR Bronson Commercial |
$41.62
|
| Rate for Payer: VA VA |
$33.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.38
|
|
|
HC REMOTE THER MON DEVICE SUPPLY MS EA 30 DAY
|
Facility
|
IP
|
$112.50
|
|
|
Service Code
|
CPT 98977
|
| Hospital Charge Code |
42000063
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$49.50 |
| Max. Negotiated Rate |
$101.25 |
| Rate for Payer: Aetna American Axle |
$73.12
|
| Rate for Payer: Aetna Commercial |
$95.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.12
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cofinity Commercial |
$78.75
|
| Rate for Payer: Cofinity Commercial |
$96.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.00
|
| Rate for Payer: Healthscope Commercial |
$101.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$95.62
|
| Rate for Payer: PHP Commercial |
$95.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.75
|
| Rate for Payer: Priority Health SBD |
$70.88
|
| Rate for Payer: UMR Bronson Commercial |
$49.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.38
|
|
|
HC REMOTE THER MON SETUP & EDU
|
Facility
|
IP
|
$358.96
|
|
|
Service Code
|
CPT 98975
|
| Hospital Charge Code |
42000062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$157.94 |
| Max. Negotiated Rate |
$323.06 |
| Rate for Payer: Aetna American Axle |
$233.32
|
| Rate for Payer: Aetna Commercial |
$305.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.32
|
| Rate for Payer: Cash Price |
$287.17
|
| Rate for Payer: Cofinity Commercial |
$251.27
|
| Rate for Payer: Cofinity Commercial |
$308.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.17
|
| Rate for Payer: Healthscope Commercial |
$323.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$305.12
|
| Rate for Payer: PHP Commercial |
$305.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.27
|
| Rate for Payer: Priority Health SBD |
$226.14
|
| Rate for Payer: UMR Bronson Commercial |
$157.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.22
|
|
|
HC REMOTE THER MON SETUP & EDU
|
Facility
|
OP
|
$358.96
|
|
|
Service Code
|
CPT 98975
|
| Hospital Charge Code |
42000062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.65 |
| Max. Negotiated Rate |
$369.91 |
| Rate for Payer: Aetna American Axle |
$233.32
|
| Rate for Payer: Aetna Commercial |
$305.12
|
| Rate for Payer: Aetna Medicare |
$122.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.88
|
| Rate for Payer: BCBS Complete |
$67.49
|
| Rate for Payer: BCBS MAPPO |
$117.50
|
| Rate for Payer: BCBS Trust/PPO |
$92.17
|
| Rate for Payer: BCN Medicare Advantage |
$117.50
|
| Rate for Payer: Cash Price |
$287.17
|
| Rate for Payer: Cash Price |
$287.17
|
| Rate for Payer: Cash Price |
$287.17
|
| Rate for Payer: Cofinity Commercial |
$251.27
|
| Rate for Payer: Cofinity Commercial |
$308.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.50
|
| Rate for Payer: Healthscope Commercial |
$323.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.22
|
| Rate for Payer: Mclaren Medicaid |
$64.27
|
| Rate for Payer: Mclaren Medicare |
$117.50
|
| Rate for Payer: Meridian Medicaid |
$67.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$123.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$305.12
|
| Rate for Payer: PACE Medicare |
$111.62
|
| Rate for Payer: PACE SWMI |
$117.50
|
| Rate for Payer: PHP Commercial |
$305.12
|
| Rate for Payer: PHP Medicare Advantage |
$117.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$369.91
|
| Rate for Payer: Priority Health Medicare |
$117.50
|
| Rate for Payer: Priority Health Narrow Network |
$295.93
|
| Rate for Payer: Priority Health SBD |
$226.14
|
| Rate for Payer: Railroad Medicare Medicare |
$117.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.62
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.50
|
| Rate for Payer: UHC Exchange |
$19.65
|
| Rate for Payer: UHC Medicare Advantage |
$121.02
|
| Rate for Payer: UMR Bronson Commercial |
$132.82
|
| Rate for Payer: VA VA |
$117.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.22
|
|
|
HC REMOVAL BILIARY STONE
|
Facility
|
IP
|
$649.42
|
|
|
Service Code
|
CPT 47544
|
| Hospital Charge Code |
36100516
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$285.74 |
| Max. Negotiated Rate |
$584.48 |
| Rate for Payer: Aetna American Axle |
$422.12
|
| Rate for Payer: Aetna Commercial |
$552.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.12
|
| Rate for Payer: Cash Price |
$519.54
|
| Rate for Payer: Cofinity Commercial |
$454.59
|
| Rate for Payer: Cofinity Commercial |
$558.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$519.54
|
| Rate for Payer: Healthscope Commercial |
$584.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$454.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.01
|
| Rate for Payer: PHP Commercial |
$552.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$454.59
|
| Rate for Payer: Priority Health SBD |
$409.13
|
| Rate for Payer: UMR Bronson Commercial |
$285.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.06
|
|
|
HC REMOVAL BILIARY STONE
|
Facility
|
OP
|
$649.42
|
|
|
Service Code
|
CPT 47544
|
| Hospital Charge Code |
36100516
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$148.33 |
| Max. Negotiated Rate |
$4,168.49 |
| Rate for Payer: Aetna American Axle |
$422.12
|
| Rate for Payer: Aetna Commercial |
$552.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.12
|
| Rate for Payer: BCBS Complete |
$259.77
|
| Rate for Payer: BCBS Trust/PPO |
$4,168.49
|
| Rate for Payer: Cash Price |
$519.54
|
| Rate for Payer: Cash Price |
$519.54
|
| Rate for Payer: Cofinity Commercial |
$558.50
|
| Rate for Payer: Cofinity Commercial |
$454.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$519.54
|
| Rate for Payer: Healthscope Commercial |
$584.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$454.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.01
|
| Rate for Payer: PHP Commercial |
$552.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$454.59
|
| Rate for Payer: Priority Health SBD |
$409.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.16
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$148.33
|
| Rate for Payer: UMR Bronson Commercial |
$240.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.06
|
|
|
HC REMOVAL CHEST PORT OR PUMP
|
Facility
|
OP
|
$2,135.56
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36100141
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$184.02 |
| Max. Negotiated Rate |
$4,481.48 |
| Rate for Payer: Aetna American Axle |
$1,388.11
|
| Rate for Payer: Aetna Commercial |
$1,815.23
|
| Rate for Payer: Aetna Medicare |
$1,480.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,388.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.43
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,708.45
|
| Rate for Payer: Cash Price |
$1,708.45
|
| Rate for Payer: Cofinity Commercial |
$1,494.89
|
| Rate for Payer: Cofinity Commercial |
$1,836.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,708.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$1,922.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,494.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,601.67
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,815.23
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$1,815.23
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,494.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,481.48
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$3,585.18
|
| Rate for Payer: Priority Health SBD |
$1,345.40
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.42
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,423.57
|
| Rate for Payer: UHC Exchange |
$184.02
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: UMR Bronson Commercial |
$790.16
|
| Rate for Payer: VA VA |
$1,423.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,601.67
|
|
|
HC REMOVAL CHEST PORT OR PUMP
|
Facility
|
IP
|
$2,135.56
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36100141
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$939.65 |
| Max. Negotiated Rate |
$1,922.00 |
| Rate for Payer: Aetna American Axle |
$1,388.11
|
| Rate for Payer: Aetna Commercial |
$1,815.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,388.11
|
| Rate for Payer: Cash Price |
$1,708.45
|
| Rate for Payer: Cofinity Commercial |
$1,836.58
|
| Rate for Payer: Cofinity Commercial |
$1,494.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,708.45
|
| Rate for Payer: Healthscope Commercial |
$1,922.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,494.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,601.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,815.23
|
| Rate for Payer: PHP Commercial |
$1,815.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,494.89
|
| Rate for Payer: Priority Health SBD |
$1,345.40
|
| Rate for Payer: UMR Bronson Commercial |
$939.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,601.67
|
|
|
HC REMOVAL DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$336.60
|
|
|
Service Code
|
CPT 11982
|
| Hospital Charge Code |
76100143
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$148.10 |
| Max. Negotiated Rate |
$302.94 |
| Rate for Payer: Aetna American Axle |
$218.79
|
| Rate for Payer: Aetna Commercial |
$286.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.79
|
| Rate for Payer: Cash Price |
$269.28
|
| Rate for Payer: Cofinity Commercial |
$235.62
|
| Rate for Payer: Cofinity Commercial |
$289.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.28
|
| Rate for Payer: Healthscope Commercial |
$302.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$235.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$252.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$286.11
|
| Rate for Payer: PHP Commercial |
$286.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.62
|
| Rate for Payer: Priority Health SBD |
$212.06
|
| Rate for Payer: UMR Bronson Commercial |
$148.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$252.45
|
|
|
HC REMOVAL DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$336.60
|
|
|
Service Code
|
CPT 11982
|
| Hospital Charge Code |
76100143
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$71.38 |
| Max. Negotiated Rate |
$1,114.93 |
| Rate for Payer: Aetna American Axle |
$218.79
|
| Rate for Payer: Aetna Commercial |
$286.11
|
| Rate for Payer: Aetna Medicare |
$368.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$442.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$442.70
|
| Rate for Payer: BCBS Complete |
$203.43
|
| Rate for Payer: BCBS MAPPO |
$354.16
|
| Rate for Payer: BCBS Trust/PPO |
$497.43
|
| Rate for Payer: BCN Medicare Advantage |
$354.16
|
| Rate for Payer: Cash Price |
$269.28
|
| Rate for Payer: Cash Price |
$269.28
|
| Rate for Payer: Cofinity Commercial |
$235.62
|
| Rate for Payer: Cofinity Commercial |
$289.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.16
|
| Rate for Payer: Healthscope Commercial |
$302.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$235.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$252.45
|
| Rate for Payer: Mclaren Medicaid |
$193.73
|
| Rate for Payer: Mclaren Medicare |
$354.16
|
| Rate for Payer: Meridian Medicaid |
$203.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$371.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$286.11
|
| Rate for Payer: PACE Medicare |
$336.45
|
| Rate for Payer: PACE SWMI |
$354.16
|
| Rate for Payer: PHP Commercial |
$286.11
|
| Rate for Payer: PHP Medicare Advantage |
$354.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,114.93
|
| Rate for Payer: Priority Health Medicare |
$354.16
|
| Rate for Payer: Priority Health Narrow Network |
$891.94
|
| Rate for Payer: Priority Health SBD |
$212.06
|
| Rate for Payer: Railroad Medicare Medicare |
$354.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.16
|
| Rate for Payer: UHC Exchange |
$71.38
|
| Rate for Payer: UHC Medicare Advantage |
$364.78
|
| Rate for Payer: UMR Bronson Commercial |
$124.54
|
| Rate for Payer: VA VA |
$354.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$252.45
|
|
|
HC REMOVAL FB EXTERNAL EYE CORNEAL WO SLIT LAMP
|
Facility
|
OP
|
$1,100.00
|
|
|
Service Code
|
CPT 65220
|
| Hospital Charge Code |
76100401
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$40.28 |
| Max. Negotiated Rate |
$1,114.93 |
| Rate for Payer: Aetna American Axle |
$715.00
|
| Rate for Payer: Aetna Commercial |
$935.00
|
| Rate for Payer: Aetna Medicare |
$368.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$715.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$442.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$442.70
|
| Rate for Payer: BCBS Complete |
$203.43
|
| Rate for Payer: BCBS MAPPO |
$354.16
|
| Rate for Payer: BCBS Trust/PPO |
$170.37
|
| Rate for Payer: BCN Medicare Advantage |
$354.16
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cofinity Commercial |
$770.00
|
| Rate for Payer: Cofinity Commercial |
$946.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$880.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.16
|
| Rate for Payer: Healthscope Commercial |
$990.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$770.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$825.00
|
| Rate for Payer: Mclaren Medicaid |
$193.73
|
| Rate for Payer: Mclaren Medicare |
$354.16
|
| Rate for Payer: Meridian Medicaid |
$203.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$371.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$935.00
|
| Rate for Payer: PACE Medicare |
$336.45
|
| Rate for Payer: PACE SWMI |
$354.16
|
| Rate for Payer: PHP Commercial |
$935.00
|
| Rate for Payer: PHP Medicare Advantage |
$354.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,114.93
|
| Rate for Payer: Priority Health Medicare |
$354.16
|
| Rate for Payer: Priority Health Narrow Network |
$891.94
|
| Rate for Payer: Priority Health SBD |
$693.00
|
| Rate for Payer: Railroad Medicare Medicare |
$354.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.16
|
| Rate for Payer: UHC Exchange |
$40.28
|
| Rate for Payer: UHC Medicare Advantage |
$364.78
|
| Rate for Payer: UMR Bronson Commercial |
$407.00
|
| Rate for Payer: VA VA |
$354.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$825.00
|
|
|
HC REMOVAL FB EXTERNAL EYE CORNEAL WO SLIT LAMP
|
Facility
|
IP
|
$1,100.00
|
|
|
Service Code
|
CPT 65220
|
| Hospital Charge Code |
76100401
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$484.00 |
| Max. Negotiated Rate |
$990.00 |
| Rate for Payer: Aetna American Axle |
$715.00
|
| Rate for Payer: Aetna Commercial |
$935.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$715.00
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cofinity Commercial |
$770.00
|
| Rate for Payer: Cofinity Commercial |
$946.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$880.00
|
| Rate for Payer: Healthscope Commercial |
$990.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$770.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$825.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$935.00
|
| Rate for Payer: PHP Commercial |
$935.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.00
|
| Rate for Payer: Priority Health SBD |
$693.00
|
| Rate for Payer: UMR Bronson Commercial |
$484.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$825.00
|
|
|
HC REMOVAL FOREIGN BODY INTRANASAL
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$357.43 |
| Rate for Payer: Aetna American Axle |
$227.50
|
| Rate for Payer: Aetna Commercial |
$297.50
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$71.97
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cofinity Commercial |
$301.00
|
| Rate for Payer: Cofinity Commercial |
$245.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$315.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.50
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.50
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$297.50
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.43
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$285.94
|
| Rate for Payer: Priority Health SBD |
$220.50
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$121.81
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$129.50
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.50
|
|
|
HC REMOVAL FOREIGN BODY INTRANASAL
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$154.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna American Axle |
$227.50
|
| Rate for Payer: Aetna Commercial |
$297.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.50
|
| Rate for Payer: Cash Price |
$280.00
|
| Rate for Payer: Cofinity Commercial |
$245.00
|
| Rate for Payer: Cofinity Commercial |
$301.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.00
|
| Rate for Payer: Healthscope Commercial |
$315.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.50
|
| Rate for Payer: PHP Commercial |
$297.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.00
|
| Rate for Payer: Priority Health SBD |
$220.50
|
| Rate for Payer: UMR Bronson Commercial |
$154.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.50
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
OP
|
$2,100.08
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$143.42 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$1,365.05
|
| Rate for Payer: Aetna Commercial |
$1,785.07
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,365.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,541.64
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,806.07
|
| Rate for Payer: Cofinity Commercial |
$1,470.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,890.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,470.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,575.06
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,785.07
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,785.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,470.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$1,323.05
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$143.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$777.03
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,575.06
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
IP
|
$2,100.08
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$924.04 |
| Max. Negotiated Rate |
$1,890.07 |
| Rate for Payer: Aetna American Axle |
$1,365.05
|
| Rate for Payer: Aetna Commercial |
$1,785.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,365.05
|
| Rate for Payer: Cash Price |
$1,680.06
|
| Rate for Payer: Cofinity Commercial |
$1,806.07
|
| Rate for Payer: Cofinity Commercial |
$1,470.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,680.06
|
| Rate for Payer: Healthscope Commercial |
$1,890.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,470.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,575.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,785.07
|
| Rate for Payer: PHP Commercial |
$1,785.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,470.06
|
| Rate for Payer: Priority Health SBD |
$1,323.05
|
| Rate for Payer: UMR Bronson Commercial |
$924.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,575.06
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
OP
|
$4,984.52
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$171.58 |
| Max. Negotiated Rate |
$7,856.86 |
| Rate for Payer: Aetna American Axle |
$3,239.94
|
| Rate for Payer: Aetna Commercial |
$4,236.84
|
| Rate for Payer: Aetna Medicare |
$2,595.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,239.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,119.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,119.72
|
| Rate for Payer: BCBS Complete |
$1,433.58
|
| Rate for Payer: BCBS MAPPO |
$2,495.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,997.10
|
| Rate for Payer: BCN Medicare Advantage |
$2,495.78
|
| Rate for Payer: Cash Price |
$3,987.62
|
| Rate for Payer: Cash Price |
$3,987.62
|
| Rate for Payer: Cofinity Commercial |
$4,286.69
|
| Rate for Payer: Cofinity Commercial |
$3,489.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,987.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,495.78
|
| Rate for Payer: Healthscope Commercial |
$4,486.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,489.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,738.39
|
| Rate for Payer: Mclaren Medicaid |
$1,365.19
|
| Rate for Payer: Mclaren Medicare |
$2,495.78
|
| Rate for Payer: Meridian Medicaid |
$1,433.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,620.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,870.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,236.84
|
| Rate for Payer: PACE Medicare |
$2,370.99
|
| Rate for Payer: PACE SWMI |
$2,495.78
|
| Rate for Payer: PHP Commercial |
$4,236.84
|
| Rate for Payer: PHP Medicare Advantage |
$2,495.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,365.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,489.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,856.86
|
| Rate for Payer: Priority Health Medicare |
$2,495.78
|
| Rate for Payer: Priority Health Narrow Network |
$6,285.49
|
| Rate for Payer: Priority Health SBD |
$3,140.25
|
| Rate for Payer: Railroad Medicare Medicare |
$2,495.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$188.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,495.78
|
| Rate for Payer: UHC Exchange |
$171.58
|
| Rate for Payer: UHC Medicare Advantage |
$2,570.65
|
| Rate for Payer: UMR Bronson Commercial |
$1,844.27
|
| Rate for Payer: VA VA |
$2,495.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,738.39
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
IP
|
$4,984.52
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,193.19 |
| Max. Negotiated Rate |
$4,486.07 |
| Rate for Payer: Aetna American Axle |
$3,239.94
|
| Rate for Payer: Aetna Commercial |
$4,236.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,239.94
|
| Rate for Payer: Cash Price |
$3,987.62
|
| Rate for Payer: Cofinity Commercial |
$3,489.16
|
| Rate for Payer: Cofinity Commercial |
$4,286.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,987.62
|
| Rate for Payer: Healthscope Commercial |
$4,486.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,489.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,738.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,236.84
|
| Rate for Payer: PHP Commercial |
$4,236.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,489.16
|
| Rate for Payer: Priority Health SBD |
$3,140.25
|
| Rate for Payer: UMR Bronson Commercial |
$2,193.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,738.39
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
OP
|
$3,001.99
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$208.58 |
| Max. Negotiated Rate |
$10,988.67 |
| Rate for Payer: Aetna American Axle |
$1,951.29
|
| Rate for Payer: Aetna Commercial |
$2,551.69
|
| Rate for Payer: Aetna Medicare |
$3,630.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,951.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,363.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,363.29
|
| Rate for Payer: BCBS Complete |
$2,005.02
|
| Rate for Payer: BCBS MAPPO |
$3,490.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,396.39
|
| Rate for Payer: BCN Medicare Advantage |
$3,490.63
|
| Rate for Payer: Cash Price |
$2,401.59
|
| Rate for Payer: Cash Price |
$2,401.59
|
| Rate for Payer: Cofinity Commercial |
$2,101.39
|
| Rate for Payer: Cofinity Commercial |
$2,581.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,401.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,490.63
|
| Rate for Payer: Healthscope Commercial |
$2,701.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,101.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,251.49
|
| Rate for Payer: Mclaren Medicaid |
$1,909.37
|
| Rate for Payer: Mclaren Medicare |
$3,490.63
|
| Rate for Payer: Meridian Medicaid |
$2,005.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,665.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,014.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,551.69
|
| Rate for Payer: PACE Medicare |
$3,316.10
|
| Rate for Payer: PACE SWMI |
$3,490.63
|
| Rate for Payer: PHP Commercial |
$2,551.69
|
| Rate for Payer: PHP Medicare Advantage |
$3,490.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,909.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,101.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,988.67
|
| Rate for Payer: Priority Health Medicare |
$3,490.63
|
| Rate for Payer: Priority Health Narrow Network |
$8,790.94
|
| Rate for Payer: Priority Health SBD |
$1,891.25
|
| Rate for Payer: Railroad Medicare Medicare |
$3,490.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$229.44
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,490.63
|
| Rate for Payer: UHC Exchange |
$208.58
|
| Rate for Payer: UHC Medicare Advantage |
$3,595.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,110.74
|
| Rate for Payer: VA VA |
$3,490.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,251.49
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
IP
|
$3,001.99
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,320.88 |
| Max. Negotiated Rate |
$2,701.79 |
| Rate for Payer: Aetna American Axle |
$1,951.29
|
| Rate for Payer: Aetna Commercial |
$2,551.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,951.29
|
| Rate for Payer: Cash Price |
$2,401.59
|
| Rate for Payer: Cofinity Commercial |
$2,101.39
|
| Rate for Payer: Cofinity Commercial |
$2,581.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,401.59
|
| Rate for Payer: Healthscope Commercial |
$2,701.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,101.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,251.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,551.69
|
| Rate for Payer: PHP Commercial |
$2,551.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,101.39
|
| Rate for Payer: Priority Health SBD |
$1,891.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,320.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,251.49
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
OP
|
$3,302.19
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$226.59 |
| Max. Negotiated Rate |
$23,772.84 |
| Rate for Payer: Aetna American Axle |
$2,146.42
|
| Rate for Payer: Aetna Commercial |
$2,806.86
|
| Rate for Payer: Aetna Medicare |
$7,853.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,146.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,439.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,439.52
|
| Rate for Payer: BCBS Complete |
$4,337.65
|
| Rate for Payer: BCBS MAPPO |
$7,551.62
|
| Rate for Payer: BCBS Trust/PPO |
$7,041.45
|
| Rate for Payer: BCN Medicare Advantage |
$7,551.62
|
| Rate for Payer: Cash Price |
$2,641.75
|
| Rate for Payer: Cash Price |
$2,641.75
|
| Rate for Payer: Cofinity Commercial |
$2,311.53
|
| Rate for Payer: Cofinity Commercial |
$2,839.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,641.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,551.62
|
| Rate for Payer: Healthscope Commercial |
$2,971.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,311.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,476.64
|
| Rate for Payer: Mclaren Medicaid |
$4,130.74
|
| Rate for Payer: Mclaren Medicare |
$7,551.62
|
| Rate for Payer: Meridian Medicaid |
$4,337.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,929.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,684.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,806.86
|
| Rate for Payer: PACE Medicare |
$7,174.04
|
| Rate for Payer: PACE SWMI |
$7,551.62
|
| Rate for Payer: PHP Commercial |
$2,806.86
|
| Rate for Payer: PHP Medicare Advantage |
$7,551.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,130.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,311.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,772.84
|
| Rate for Payer: Priority Health Medicare |
$7,551.62
|
| Rate for Payer: Priority Health Narrow Network |
$19,018.27
|
| Rate for Payer: Priority Health SBD |
$2,080.38
|
| Rate for Payer: Railroad Medicare Medicare |
$7,551.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$249.25
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,551.62
|
| Rate for Payer: UHC Exchange |
$226.59
|
| Rate for Payer: UHC Medicare Advantage |
$7,778.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,221.81
|
| Rate for Payer: VA VA |
$7,551.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,476.64
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
IP
|
$3,302.19
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,452.96 |
| Max. Negotiated Rate |
$2,971.97 |
| Rate for Payer: Aetna American Axle |
$2,146.42
|
| Rate for Payer: Aetna Commercial |
$2,806.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,146.42
|
| Rate for Payer: Cash Price |
$2,641.75
|
| Rate for Payer: Cofinity Commercial |
$2,311.53
|
| Rate for Payer: Cofinity Commercial |
$2,839.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,641.75
|
| Rate for Payer: Healthscope Commercial |
$2,971.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,311.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,476.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,806.86
|
| Rate for Payer: PHP Commercial |
$2,806.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,311.53
|
| Rate for Payer: Priority Health SBD |
$2,080.38
|
| Rate for Payer: UMR Bronson Commercial |
$1,452.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,476.64
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
IP
|
$7,900.00
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,476.00 |
| Max. Negotiated Rate |
$7,110.00 |
| Rate for Payer: Aetna American Axle |
$5,135.00
|
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,135.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$5,530.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,530.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,925.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health SBD |
$4,977.00
|
| Rate for Payer: UMR Bronson Commercial |
$3,476.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,925.00
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
OP
|
$7,900.00
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$164.05 |
| Max. Negotiated Rate |
$9,009.23 |
| Rate for Payer: Aetna American Axle |
$5,135.00
|
| Rate for Payer: Aetna Commercial |
$6,715.00
|
| Rate for Payer: Aetna Medicare |
$2,976.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,135.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$185.17
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cash Price |
$6,320.00
|
| Rate for Payer: Cofinity Commercial |
$5,530.00
|
| Rate for Payer: Cofinity Commercial |
$6,794.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,320.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Healthscope Commercial |
$7,110.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,530.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,925.00
|
| Rate for Payer: Mclaren Medicaid |
$1,565.43
|
| Rate for Payer: Mclaren Medicare |
$2,861.84
|
| Rate for Payer: Meridian Medicaid |
$1,643.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,715.00
|
| Rate for Payer: PACE Medicare |
$2,718.75
|
| Rate for Payer: PACE SWMI |
$2,861.84
|
| Rate for Payer: PHP Commercial |
$6,715.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,530.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,009.23
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$7,207.38
|
| Rate for Payer: Priority Health SBD |
$4,977.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,861.84
|
| Rate for Payer: UHC Exchange |
$164.05
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: UMR Bronson Commercial |
$2,923.00
|
| Rate for Payer: VA VA |
$2,861.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,925.00
|
|
