|
HC REMOVE/BIVALVE SPICA
|
Facility
|
IP
|
$345.19
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$151.88 |
| Max. Negotiated Rate |
$310.67 |
| Rate for Payer: Aetna American Axle |
$224.37
|
| Rate for Payer: Aetna Commercial |
$293.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.37
|
| Rate for Payer: Cash Price |
$276.15
|
| Rate for Payer: Cofinity Commercial |
$241.63
|
| Rate for Payer: Cofinity Commercial |
$296.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.15
|
| Rate for Payer: Healthscope Commercial |
$310.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$293.41
|
| Rate for Payer: PHP Commercial |
$293.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.63
|
| Rate for Payer: Priority Health SBD |
$217.47
|
| Rate for Payer: UMR Bronson Commercial |
$151.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.89
|
|
|
HC REMOVE CERUMEN INSTR BILAT
|
Facility
|
IP
|
$209.17
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$92.03 |
| Max. Negotiated Rate |
$188.25 |
| Rate for Payer: Aetna American Axle |
$135.96
|
| Rate for Payer: Aetna Commercial |
$177.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.96
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cofinity Commercial |
$146.42
|
| Rate for Payer: Cofinity Commercial |
$179.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.34
|
| Rate for Payer: Healthscope Commercial |
$188.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$146.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.79
|
| Rate for Payer: PHP Commercial |
$177.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.42
|
| Rate for Payer: Priority Health SBD |
$131.78
|
| Rate for Payer: UMR Bronson Commercial |
$92.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.88
|
|
|
HC REMOVE CERUMEN INSTR BILAT
|
Facility
|
OP
|
$209.17
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$29.74 |
| Max. Negotiated Rate |
$188.25 |
| Rate for Payer: Aetna American Axle |
$135.96
|
| Rate for Payer: Aetna Commercial |
$177.79
|
| Rate for Payer: Aetna Medicare |
$56.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$102.78
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cofinity Commercial |
$179.89
|
| Rate for Payer: Cofinity Commercial |
$146.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$188.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$146.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.88
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.79
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$177.79
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.15
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$136.92
|
| Rate for Payer: Priority Health SBD |
$131.78
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.37
|
| Rate for Payer: UHC Exchange |
$31.76
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: UMR Bronson Commercial |
$77.39
|
| Rate for Payer: VA VA |
$54.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.88
|
|
|
HC REMOVE CERUMEN INSTR UNILATERAL
|
Facility
|
IP
|
$140.03
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$61.61 |
| Max. Negotiated Rate |
$126.03 |
| Rate for Payer: Aetna American Axle |
$91.02
|
| Rate for Payer: Aetna Commercial |
$119.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.02
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cofinity Commercial |
$120.43
|
| Rate for Payer: Cofinity Commercial |
$98.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.02
|
| Rate for Payer: Healthscope Commercial |
$126.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.03
|
| Rate for Payer: PHP Commercial |
$119.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.02
|
| Rate for Payer: Priority Health SBD |
$88.22
|
| Rate for Payer: UMR Bronson Commercial |
$61.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.02
|
|
|
HC REMOVE CERUMEN INSTR UNILATERAL
|
Facility
|
OP
|
$140.03
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$29.74 |
| Max. Negotiated Rate |
$171.15 |
| Rate for Payer: Aetna American Axle |
$91.02
|
| Rate for Payer: Aetna Commercial |
$119.03
|
| Rate for Payer: Aetna Medicare |
$56.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$102.78
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cofinity Commercial |
$120.43
|
| Rate for Payer: Cofinity Commercial |
$98.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$126.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.02
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.03
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$119.03
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.15
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$136.92
|
| Rate for Payer: Priority Health SBD |
$88.22
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.37
|
| Rate for Payer: UHC Exchange |
$31.76
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: UMR Bronson Commercial |
$51.81
|
| Rate for Payer: VA VA |
$54.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.02
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE BILAT
|
Facility
|
OP
|
$209.17
|
|
|
Service Code
|
CPT 69209
|
| Hospital Charge Code |
45000098
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$15.72 |
| Max. Negotiated Rate |
$188.25 |
| Rate for Payer: Aetna American Axle |
$135.96
|
| Rate for Payer: Aetna Commercial |
$177.79
|
| Rate for Payer: Aetna Medicare |
$56.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$67.33
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cofinity Commercial |
$146.42
|
| Rate for Payer: Cofinity Commercial |
$179.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$188.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$146.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.88
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.79
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$177.79
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.15
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$136.92
|
| Rate for Payer: Priority Health SBD |
$131.78
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.37
|
| Rate for Payer: UHC Exchange |
$15.72
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: UMR Bronson Commercial |
$77.39
|
| Rate for Payer: VA VA |
$54.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.88
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE BILAT
|
Facility
|
IP
|
$209.17
|
|
|
Service Code
|
CPT 69209
|
| Hospital Charge Code |
45000098
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$92.03 |
| Max. Negotiated Rate |
$188.25 |
| Rate for Payer: Aetna American Axle |
$135.96
|
| Rate for Payer: Aetna Commercial |
$177.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.96
|
| Rate for Payer: Cash Price |
$167.34
|
| Rate for Payer: Cofinity Commercial |
$146.42
|
| Rate for Payer: Cofinity Commercial |
$179.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.34
|
| Rate for Payer: Healthscope Commercial |
$188.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$146.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.79
|
| Rate for Payer: PHP Commercial |
$177.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.42
|
| Rate for Payer: Priority Health SBD |
$131.78
|
| Rate for Payer: UMR Bronson Commercial |
$92.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.88
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE UNILATERAL
|
Facility
|
OP
|
$140.03
|
|
|
Service Code
|
HCPCS 69209
|
| Hospital Charge Code |
45000082
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$15.72 |
| Max. Negotiated Rate |
$171.15 |
| Rate for Payer: Aetna American Axle |
$91.02
|
| Rate for Payer: Aetna Commercial |
$119.03
|
| Rate for Payer: Aetna Medicare |
$56.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$67.33
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cofinity Commercial |
$120.43
|
| Rate for Payer: Cofinity Commercial |
$98.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$126.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.02
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.03
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$119.03
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.15
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$136.92
|
| Rate for Payer: Priority Health SBD |
$88.22
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.37
|
| Rate for Payer: UHC Exchange |
$15.72
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: UMR Bronson Commercial |
$51.81
|
| Rate for Payer: VA VA |
$54.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.02
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE UNILATERAL
|
Facility
|
IP
|
$140.03
|
|
|
Service Code
|
HCPCS 69209
|
| Hospital Charge Code |
45000082
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$61.61 |
| Max. Negotiated Rate |
$126.03 |
| Rate for Payer: Aetna American Axle |
$91.02
|
| Rate for Payer: Aetna Commercial |
$119.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.02
|
| Rate for Payer: Cash Price |
$112.02
|
| Rate for Payer: Cofinity Commercial |
$120.43
|
| Rate for Payer: Cofinity Commercial |
$98.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.02
|
| Rate for Payer: Healthscope Commercial |
$126.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.03
|
| Rate for Payer: PHP Commercial |
$119.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.02
|
| Rate for Payer: Priority Health SBD |
$88.22
|
| Rate for Payer: UMR Bronson Commercial |
$61.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.02
|
|
|
HC REMOVE EAR CANAL LESION(S)
|
Facility
|
OP
|
$6,901.00
|
|
|
Service Code
|
CPT 69145
|
| Hospital Charge Code |
76100481
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$255.73 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$4,485.65
|
| Rate for Payer: Aetna Commercial |
$5,865.85
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,485.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$1,531.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$5,520.80
|
| Rate for Payer: Cash Price |
$5,520.80
|
| Rate for Payer: Cofinity Commercial |
$4,830.70
|
| Rate for Payer: Cofinity Commercial |
$5,934.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,520.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$6,210.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,830.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,175.75
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,865.85
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$5,865.85
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,830.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Priority Health SBD |
$4,347.63
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$281.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$255.73
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$2,553.37
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,175.75
|
|
|
HC REMOVE EAR CANAL LESION(S)
|
Facility
|
IP
|
$6,901.00
|
|
|
Service Code
|
CPT 69145
|
| Hospital Charge Code |
76100481
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,036.44 |
| Max. Negotiated Rate |
$6,210.90 |
| Rate for Payer: Aetna American Axle |
$4,485.65
|
| Rate for Payer: Aetna Commercial |
$5,865.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,485.65
|
| Rate for Payer: Cash Price |
$5,520.80
|
| Rate for Payer: Cofinity Commercial |
$4,830.70
|
| Rate for Payer: Cofinity Commercial |
$5,934.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,520.80
|
| Rate for Payer: Healthscope Commercial |
$6,210.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,830.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,175.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,865.85
|
| Rate for Payer: PHP Commercial |
$5,865.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,830.70
|
| Rate for Payer: Priority Health SBD |
$4,347.63
|
| Rate for Payer: UMR Bronson Commercial |
$3,036.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,175.75
|
|
|
HC REMOVE EXTERNAL URETERAL STENT
|
Facility
|
IP
|
$2,501.42
|
|
|
Service Code
|
CPT 50387
|
| Hospital Charge Code |
36100240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,100.62 |
| Max. Negotiated Rate |
$2,251.28 |
| Rate for Payer: Aetna American Axle |
$1,625.92
|
| Rate for Payer: Aetna Commercial |
$2,126.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,625.92
|
| Rate for Payer: Cash Price |
$2,001.14
|
| Rate for Payer: Cofinity Commercial |
$1,750.99
|
| Rate for Payer: Cofinity Commercial |
$2,151.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,001.14
|
| Rate for Payer: Healthscope Commercial |
$2,251.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,750.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,876.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,126.21
|
| Rate for Payer: PHP Commercial |
$2,126.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,750.99
|
| Rate for Payer: Priority Health SBD |
$1,575.89
|
| Rate for Payer: UMR Bronson Commercial |
$1,100.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,876.06
|
|
|
HC REMOVE EXTERNAL URETERAL STENT
|
Facility
|
OP
|
$2,501.42
|
|
|
Service Code
|
CPT 50387
|
| Hospital Charge Code |
36100240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$79.24 |
| Max. Negotiated Rate |
$5,699.47 |
| Rate for Payer: Aetna American Axle |
$1,625.92
|
| Rate for Payer: Aetna Commercial |
$2,126.21
|
| Rate for Payer: Aetna Medicare |
$1,882.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,625.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,176.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,001.14
|
| Rate for Payer: Cash Price |
$2,001.14
|
| Rate for Payer: Cofinity Commercial |
$2,151.22
|
| Rate for Payer: Cofinity Commercial |
$1,750.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,001.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$2,251.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,750.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,876.06
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,126.21
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$2,126.21
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,750.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,699.47
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$4,559.58
|
| Rate for Payer: Priority Health SBD |
$1,575.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.16
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,810.48
|
| Rate for Payer: UHC Exchange |
$79.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: UMR Bronson Commercial |
$925.53
|
| Rate for Payer: VA VA |
$1,810.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,876.06
|
|
|
HC REMOVE FB EYE
|
Facility
|
OP
|
$370.48
|
|
| Hospital Charge Code |
45000049
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$137.08 |
| Max. Negotiated Rate |
$333.43 |
| Rate for Payer: Aetna American Axle |
$240.81
|
| Rate for Payer: Aetna Commercial |
$314.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.81
|
| Rate for Payer: BCBS Complete |
$148.19
|
| Rate for Payer: Cash Price |
$296.38
|
| Rate for Payer: Cofinity Commercial |
$259.34
|
| Rate for Payer: Cofinity Commercial |
$318.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.38
|
| Rate for Payer: Healthscope Commercial |
$333.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$259.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$314.91
|
| Rate for Payer: PHP Commercial |
$314.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.34
|
| Rate for Payer: Priority Health SBD |
$233.40
|
| Rate for Payer: UMR Bronson Commercial |
$137.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.86
|
|
|
HC REMOVE FB EYE
|
Facility
|
IP
|
$370.48
|
|
| Hospital Charge Code |
45000049
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$163.01 |
| Max. Negotiated Rate |
$333.43 |
| Rate for Payer: Aetna American Axle |
$240.81
|
| Rate for Payer: Aetna Commercial |
$314.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.81
|
| Rate for Payer: Cash Price |
$296.38
|
| Rate for Payer: Cofinity Commercial |
$259.34
|
| Rate for Payer: Cofinity Commercial |
$318.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.38
|
| Rate for Payer: Healthscope Commercial |
$333.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$259.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$314.91
|
| Rate for Payer: PHP Commercial |
$314.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.34
|
| Rate for Payer: Priority Health SBD |
$233.40
|
| Rate for Payer: UMR Bronson Commercial |
$163.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.86
|
|
|
HC REMOVE FB FOOT, SUBQ
|
Facility
|
IP
|
$933.32
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
76100265
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$410.66 |
| Max. Negotiated Rate |
$839.99 |
| Rate for Payer: Aetna American Axle |
$606.66
|
| Rate for Payer: Aetna Commercial |
$793.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.66
|
| Rate for Payer: Cash Price |
$746.66
|
| Rate for Payer: Cofinity Commercial |
$653.32
|
| Rate for Payer: Cofinity Commercial |
$802.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$746.66
|
| Rate for Payer: Healthscope Commercial |
$839.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$653.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$699.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$793.32
|
| Rate for Payer: PHP Commercial |
$793.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.32
|
| Rate for Payer: Priority Health SBD |
$587.99
|
| Rate for Payer: UMR Bronson Commercial |
$410.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$699.99
|
|
|
HC REMOVE FB FOOT, SUBQ
|
Facility
|
OP
|
$933.32
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
76100265
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$130.98 |
| Max. Negotiated Rate |
$1,968.76 |
| Rate for Payer: Aetna American Axle |
$606.66
|
| Rate for Payer: Aetna Commercial |
$793.32
|
| Rate for Payer: Aetna Medicare |
$650.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$694.01
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$746.66
|
| Rate for Payer: Cash Price |
$746.66
|
| Rate for Payer: Cofinity Commercial |
$802.66
|
| Rate for Payer: Cofinity Commercial |
$653.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$746.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$839.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$653.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$699.99
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$793.32
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$793.32
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.76
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.01
|
| Rate for Payer: Priority Health SBD |
$587.99
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.39
|
| Rate for Payer: UHC Exchange |
$130.98
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: UMR Bronson Commercial |
$345.33
|
| Rate for Payer: VA VA |
$625.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$699.99
|
|
|
HC REMOVE F/B SKIN,SIMPLE,INCISIO
|
Facility
|
OP
|
$242.60
|
|
| Hospital Charge Code |
45000048
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$89.76 |
| Max. Negotiated Rate |
$218.34 |
| Rate for Payer: Aetna American Axle |
$157.69
|
| Rate for Payer: Aetna Commercial |
$206.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.69
|
| Rate for Payer: BCBS Complete |
$97.04
|
| Rate for Payer: Cash Price |
$194.08
|
| Rate for Payer: Cofinity Commercial |
$169.82
|
| Rate for Payer: Cofinity Commercial |
$208.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.08
|
| Rate for Payer: Healthscope Commercial |
$218.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$169.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$206.21
|
| Rate for Payer: PHP Commercial |
$206.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.82
|
| Rate for Payer: Priority Health SBD |
$152.84
|
| Rate for Payer: UMR Bronson Commercial |
$89.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.95
|
|
|
HC REMOVE F/B SKIN,SIMPLE,INCISIO
|
Facility
|
IP
|
$242.60
|
|
| Hospital Charge Code |
45000048
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$106.74 |
| Max. Negotiated Rate |
$218.34 |
| Rate for Payer: Aetna American Axle |
$157.69
|
| Rate for Payer: Aetna Commercial |
$206.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.69
|
| Rate for Payer: Cash Price |
$194.08
|
| Rate for Payer: Cofinity Commercial |
$169.82
|
| Rate for Payer: Cofinity Commercial |
$208.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.08
|
| Rate for Payer: Healthscope Commercial |
$218.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$169.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$206.21
|
| Rate for Payer: PHP Commercial |
$206.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.82
|
| Rate for Payer: Priority Health SBD |
$152.84
|
| Rate for Payer: UMR Bronson Commercial |
$106.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.95
|
|
|
HC REMOVE FB UPPER ARM/ELBOW SUBQ
|
Facility
|
OP
|
$1,683.00
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
76100159
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$140.80 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$1,093.95
|
| Rate for Payer: Aetna Commercial |
$1,430.55
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,093.95
|
| 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 |
$171.60
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,346.40
|
| Rate for Payer: Cash Price |
$1,346.40
|
| Rate for Payer: Cofinity Commercial |
$1,447.38
|
| Rate for Payer: Cofinity Commercial |
$1,178.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,346.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,514.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,178.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,262.25
|
| 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 |
$1,430.55
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,430.55
|
| 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 |
$1,178.10
|
| 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 |
$1,060.29
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$140.80
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$622.71
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,262.25
|
|
|
HC REMOVE FB UPPER ARM/ELBOW SUBQ
|
Facility
|
IP
|
$1,683.00
|
|
|
Service Code
|
CPT 24200
|
| Hospital Charge Code |
76100159
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$740.52 |
| Max. Negotiated Rate |
$1,514.70 |
| Rate for Payer: Aetna American Axle |
$1,093.95
|
| Rate for Payer: Aetna Commercial |
$1,430.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,093.95
|
| Rate for Payer: Cash Price |
$1,346.40
|
| Rate for Payer: Cofinity Commercial |
$1,178.10
|
| Rate for Payer: Cofinity Commercial |
$1,447.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,346.40
|
| Rate for Payer: Healthscope Commercial |
$1,514.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,178.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,262.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,430.55
|
| Rate for Payer: PHP Commercial |
$1,430.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,178.10
|
| Rate for Payer: Priority Health SBD |
$1,060.29
|
| Rate for Payer: UMR Bronson Commercial |
$740.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,262.25
|
|
|
HC REMOVE FB XTRNL AUDITORY CANAL ANES
|
Facility
|
IP
|
$4,095.00
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
76100482
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,801.80 |
| Max. Negotiated Rate |
$3,685.50 |
| Rate for Payer: Aetna American Axle |
$2,661.75
|
| Rate for Payer: Aetna Commercial |
$3,480.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,661.75
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cofinity Commercial |
$2,866.50
|
| Rate for Payer: Cofinity Commercial |
$3,521.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.00
|
| Rate for Payer: Healthscope Commercial |
$3,685.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,866.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,071.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,480.75
|
| Rate for Payer: PHP Commercial |
$3,480.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,866.50
|
| Rate for Payer: Priority Health SBD |
$2,579.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,801.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,071.25
|
|
|
HC REMOVE FB XTRNL AUDITORY CANAL ANES
|
Facility
|
OP
|
$4,095.00
|
|
|
Service Code
|
CPT 69205
|
| Hospital Charge Code |
76100482
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$94.30 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$2,661.75
|
| Rate for Payer: Aetna Commercial |
$3,480.75
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,661.75
|
| 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 |
$1,859.16
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cash Price |
$3,276.00
|
| Rate for Payer: Cofinity Commercial |
$3,521.70
|
| Rate for Payer: Cofinity Commercial |
$2,866.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,276.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$3,685.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,866.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,071.25
|
| 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 |
$3,480.75
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$3,480.75
|
| 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 |
$2,866.50
|
| 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 |
$2,579.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$94.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,515.15
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,071.25
|
|
|
HC REMOVE FOREIGN BODY COMPLIC
|
Facility
|
OP
|
$2,099.85
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
76100225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$180.75 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$1,364.90
|
| Rate for Payer: Aetna Commercial |
$1,784.87
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,364.90
|
| 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 |
$1,490.67
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,679.88
|
| Rate for Payer: Cash Price |
$1,679.88
|
| Rate for Payer: Cofinity Commercial |
$1,469.90
|
| Rate for Payer: Cofinity Commercial |
$1,805.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,679.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,889.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,469.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,574.89
|
| 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 |
$1,784.87
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,784.87
|
| 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 |
$1,469.90
|
| 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 |
$1,322.91
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$180.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$776.94
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,574.89
|
|
|
HC REMOVE FOREIGN BODY COMPLIC
|
Facility
|
IP
|
$2,099.85
|
|
|
Service Code
|
CPT 10121
|
| Hospital Charge Code |
76100225
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$923.93 |
| Max. Negotiated Rate |
$1,889.86 |
| Rate for Payer: Aetna American Axle |
$1,364.90
|
| Rate for Payer: Aetna Commercial |
$1,784.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,364.90
|
| Rate for Payer: Cash Price |
$1,679.88
|
| Rate for Payer: Cofinity Commercial |
$1,805.87
|
| Rate for Payer: Cofinity Commercial |
$1,469.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,679.88
|
| Rate for Payer: Healthscope Commercial |
$1,889.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,469.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,574.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,784.87
|
| Rate for Payer: PHP Commercial |
$1,784.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,469.90
|
| Rate for Payer: Priority Health SBD |
$1,322.91
|
| Rate for Payer: UMR Bronson Commercial |
$923.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,574.89
|
|
