|
HC GGTP
|
Facility
|
IP
|
$69.36
|
|
|
Service Code
|
CPT 82977
|
| Hospital Charge Code |
30100229
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.52 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna American Axle |
$45.08
|
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.08
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$48.55
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.96
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.08
|
| Rate for Payer: Priority Health SBD |
$43.70
|
| Rate for Payer: UMR Bronson Commercial |
$30.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
HC GIARDIA SCREEN
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 87329
|
| Hospital Charge Code |
30600119
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna American Axle |
$29.76
|
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$11.55
|
| Rate for Payer: BCN Commercial |
$11.55
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Cofinity Commercial |
$32.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Mclaren Medicaid |
$6.42
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$17.97
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.33
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$9.86
|
| Rate for Payer: Priority Health SBD |
$28.84
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$11.98
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.42
|
| Rate for Payer: UMR Bronson Commercial |
$16.94
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC GIARDIA SCREEN
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 87329
|
| Hospital Charge Code |
30600119
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$20.14 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna American Axle |
$29.76
|
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.76
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$32.05
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health SBD |
$28.84
|
| Rate for Payer: UMR Bronson Commercial |
$20.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC GI CONVERT G TO GJ TUBE W
|
Facility
|
IP
|
$1,796.43
|
|
|
Service Code
|
CPT 49446
|
| Hospital Charge Code |
36100228
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$790.43 |
| Max. Negotiated Rate |
$1,616.79 |
| Rate for Payer: Aetna American Axle |
$1,167.68
|
| Rate for Payer: Aetna Commercial |
$1,526.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,167.68
|
| Rate for Payer: Cash Price |
$1,437.14
|
| Rate for Payer: Cofinity Commercial |
$1,257.50
|
| Rate for Payer: Cofinity Commercial |
$1,544.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,257.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,437.14
|
| 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: Multiplan/Beech St/PHCS Commercial |
$1,526.97
|
| Rate for Payer: PHP Commercial |
$1,526.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,167.68
|
| Rate for Payer: Priority Health SBD |
$1,131.75
|
| Rate for Payer: UMR Bronson Commercial |
$790.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,347.32
|
|
|
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 |
$138.82 |
| Max. Negotiated Rate |
$5,841.66 |
| Rate for Payer: Aetna American Axle |
$1,167.68
|
| Rate for Payer: Aetna Commercial |
$1,526.97
|
| Rate for Payer: Aetna Medicare |
$1,932.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,167.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,323.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,323.29
|
| Rate for Payer: BCBS Complete |
$1,046.04
|
| Rate for Payer: BCBS MAPPO |
$1,858.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,261.82
|
| Rate for Payer: BCN Commercial |
$2,261.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,858.63
|
| Rate for Payer: Cash Price |
$1,437.14
|
| 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 |
$1,858.63
|
| 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 |
$996.23
|
| Rate for Payer: Mclaren Medicare |
$1,858.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,951.56
|
| Rate for Payer: Meridian Medicaid |
$1,046.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,137.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,526.97
|
| Rate for Payer: Nomi Health Commercial |
$3,903.12
|
| Rate for Payer: PACE Medicare |
$1,765.70
|
| Rate for Payer: PACE SWMI |
$1,858.63
|
| Rate for Payer: PHP Commercial |
$1,526.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,858.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$996.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,167.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,841.66
|
| Rate for Payer: Priority Health Medicare |
$1,858.63
|
| Rate for Payer: Priority Health Narrow Network |
$4,673.33
|
| Rate for Payer: Priority Health SBD |
$1,131.75
|
| Rate for Payer: Railroad Medicare Medicare |
$1,858.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.70
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,858.63
|
| Rate for Payer: UHC Exchange |
$138.82
|
| Rate for Payer: UHC Medicare Advantage |
$1,858.63
|
| Rate for Payer: UHCCP Medicaid |
$996.23
|
| Rate for Payer: UMR Bronson Commercial |
$664.68
|
| Rate for Payer: VA VA |
$1,858.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,347.32
|
|
|
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 |
$1,177.22
|
| Rate for Payer: Aetna Commercial |
$1,539.44
|
| Rate for Payer: Aetna Medicare |
$905.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,177.22
|
| 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 |
$1,358.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,539.44
|
| Rate for Payer: PHP Commercial |
$1,539.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,177.22
|
| 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 |
$1,358.32
|
|
|
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 |
$1,177.22
|
| Rate for Payer: Aetna Commercial |
$1,539.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,177.22
|
| 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 |
$1,358.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,539.44
|
| Rate for Payer: PHP Commercial |
$1,539.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,177.22
|
| 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 |
$1,358.32
|
|
|
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 |
$101.12 |
| 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 |
$247.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.86
|
| Rate for Payer: BCBS Complete |
$134.11
|
| Rate for Payer: BCBS MAPPO |
$238.29
|
| Rate for Payer: BCBS Trust/PPO |
$535.27
|
| Rate for Payer: BCN Commercial |
$535.27
|
| Rate for Payer: BCN Medicare Advantage |
$238.29
|
| Rate for Payer: Cash Price |
$1,014.35
|
| 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 |
$238.29
|
| 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 |
$127.72
|
| Rate for Payer: Mclaren Medicare |
$238.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.20
|
| Rate for Payer: Meridian Medicaid |
$134.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,077.75
|
| Rate for Payer: Nomi Health Commercial |
$500.41
|
| Rate for Payer: PACE Medicare |
$226.38
|
| Rate for Payer: PACE SWMI |
$238.29
|
| Rate for Payer: PHP Commercial |
$1,077.75
|
| Rate for Payer: PHP Medicare Advantage |
$238.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$824.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$748.94
|
| Rate for Payer: Priority Health Medicare |
$238.29
|
| Rate for Payer: Priority Health Narrow Network |
$599.15
|
| Rate for Payer: Priority Health SBD |
$798.80
|
| Rate for Payer: Railroad Medicare Medicare |
$238.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.23
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.29
|
| Rate for Payer: UHC Exchange |
$101.12
|
| Rate for Payer: UHC Medicare Advantage |
$238.29
|
| Rate for Payer: UHCCP Medicaid |
$127.72
|
| Rate for Payer: UMR Bronson Commercial |
$469.14
|
| Rate for Payer: VA VA |
$238.29
|
| 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
|
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 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 |
$2,887.15 |
| Rate for Payer: Aetna American Axle |
$797.23
|
| Rate for Payer: Aetna Commercial |
$1,042.53
|
| Rate for Payer: Aetna Medicare |
$955.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$797.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$981.21
|
| 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 |
$918.60
|
| 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 |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,042.53
|
| Rate for Payer: Nomi Health Commercial |
$1,929.06
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$1,042.53
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$797.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,887.15
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,309.72
|
| Rate for Payer: Priority Health SBD |
$772.70
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$864.27
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Exchange |
$785.70
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$492.37
|
| Rate for Payer: UMR Bronson Commercial |
$453.81
|
| Rate for Payer: VA VA |
$918.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$919.88
|
|
|
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 |
$492.37 |
| Max. Negotiated Rate |
$2,887.15 |
| Rate for Payer: Aetna American Axle |
$876.95
|
| Rate for Payer: Aetna Commercial |
$1,146.79
|
| Rate for Payer: Aetna Medicare |
$955.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$876.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,621.63
|
| Rate for Payer: BCN Commercial |
$2,621.63
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$1,079.33
|
| 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 |
$918.60
|
| 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 |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,146.79
|
| Rate for Payer: Nomi Health Commercial |
$1,929.06
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$1,146.79
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,887.15
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,309.72
|
| Rate for Payer: Priority Health SBD |
$849.97
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$726.54
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Exchange |
$660.49
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$492.37
|
| Rate for Payer: UMR Bronson Commercial |
$499.19
|
| Rate for Payer: VA VA |
$918.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,011.87
|
|
|
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 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 LONG TUBE PLACEMENT
|
Facility
|
OP
|
$1,276.51
|
|
|
Service Code
|
CPT 44500
|
| Hospital Charge Code |
36100193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18.18 |
| Max. Negotiated Rate |
$2,887.15 |
| Rate for Payer: Aetna American Axle |
$829.73
|
| Rate for Payer: Aetna Commercial |
$1,085.03
|
| Rate for Payer: Aetna Medicare |
$955.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$829.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,292.67
|
| Rate for Payer: BCN Commercial |
$1,292.67
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$1,021.21
|
| 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 |
$918.60
|
| 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 |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,085.03
|
| Rate for Payer: Nomi Health Commercial |
$1,929.06
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$1,085.03
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$829.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,887.15
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,309.72
|
| Rate for Payer: Priority Health SBD |
$804.20
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.00
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Exchange |
$18.18
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$492.37
|
| Rate for Payer: UMR Bronson Commercial |
$472.31
|
| Rate for Payer: VA VA |
$918.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$957.38
|
|
|
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 OSTOMY OBSTRUCT REMOVL
|
Facility
|
OP
|
$887.36
|
|
|
Service Code
|
CPT 49460
|
| Hospital Charge Code |
36100232
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$48.36 |
| Max. Negotiated Rate |
$2,887.15 |
| Rate for Payer: Aetna American Axle |
$576.78
|
| Rate for Payer: Aetna Commercial |
$754.26
|
| Rate for Payer: Aetna Medicare |
$955.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$588.97
|
| Rate for Payer: BCN Commercial |
$588.97
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$709.89
|
| 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 |
$918.60
|
| 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 |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.26
|
| Rate for Payer: Nomi Health Commercial |
$1,929.06
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$754.26
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$576.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,887.15
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,309.72
|
| Rate for Payer: Priority Health SBD |
$559.04
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.20
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Exchange |
$48.36
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$492.37
|
| Rate for Payer: UMR Bronson Commercial |
$328.32
|
| Rate for Payer: VA VA |
$918.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.52
|
|
|
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 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 |
$646.84 |
| 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: BCBS Trust/PPO |
$401.55
|
| Rate for Payer: BCN Commercial |
$401.55
|
| 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: Nomi Health Commercial |
$625.17
|
| 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 HMO/PPO/Tiered Network |
$428.79
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health Narrow Network |
$343.03
|
| Rate for Payer: Priority Health SBD |
$452.79
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$500.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.78
|
| Rate for Payer: UHC Exchange |
$416.78
|
| 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 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 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 |
$84.04 |
| Max. Negotiated Rate |
$2,887.15 |
| Rate for Payer: Aetna American Axle |
$576.78
|
| Rate for Payer: Aetna Commercial |
$754.26
|
| Rate for Payer: Aetna Medicare |
$955.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,205.89
|
| Rate for Payer: BCN Commercial |
$1,205.89
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$709.89
|
| 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 |
$918.60
|
| 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 |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.26
|
| Rate for Payer: Nomi Health Commercial |
$1,929.06
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$754.26
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$576.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,887.15
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,309.72
|
| Rate for Payer: Priority Health SBD |
$559.04
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.44
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Exchange |
$84.04
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$492.37
|
| Rate for Payer: UMR Bronson Commercial |
$328.32
|
| Rate for Payer: VA VA |
$918.60
|
| 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 |
$129.33 |
| Max. Negotiated Rate |
$2,887.15 |
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: Aetna American Axle |
$576.78
|
| Rate for Payer: Aetna Commercial |
$754.26
|
| Rate for Payer: Aetna Medicare |
$955.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$925.89
|
| Rate for Payer: BCN Commercial |
$925.89
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$709.89
|
| 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 |
$918.60
|
| 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 |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$754.26
|
| Rate for Payer: Nomi Health Commercial |
$1,929.06
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$754.26
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$576.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,887.15
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,309.72
|
| Rate for Payer: Priority Health SBD |
$559.04
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Exchange |
$129.33
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$492.37
|
| Rate for Payer: UMR Bronson Commercial |
$328.32
|
| Rate for Payer: VA VA |
$918.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.52
|
|
|
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 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 |
$62.23 |
| Max. Negotiated Rate |
$2,887.15 |
| Rate for Payer: Aetna American Axle |
$593.75
|
| Rate for Payer: Aetna Commercial |
$776.44
|
| Rate for Payer: Aetna Medicare |
$955.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$593.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,013.53
|
| Rate for Payer: BCN Commercial |
$1,013.53
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$730.77
|
| 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 |
$918.60
|
| 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 |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$776.44
|
| Rate for Payer: Nomi Health Commercial |
$1,929.06
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$776.44
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$593.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,887.15
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,309.72
|
| Rate for Payer: Priority Health SBD |
$575.48
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.45
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Exchange |
$62.23
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$492.37
|
| Rate for Payer: UMR Bronson Commercial |
$337.98
|
| Rate for Payer: VA VA |
$918.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$685.10
|
|
