|
HC INTERP REN/VISC PTRA ADD VESS
|
Facility
|
IP
|
$1,926.16
|
|
| Hospital Charge Code |
32000266
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$847.51 |
| Max. Negotiated Rate |
$1,733.54 |
| Rate for Payer: Aetna American Axle |
$1,252.00
|
| Rate for Payer: Aetna Commercial |
$1,637.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,252.00
|
| Rate for Payer: Cash Price |
$1,540.93
|
| Rate for Payer: Cofinity Advantage |
$1,348.31
|
| Rate for Payer: Cofinity Commercial |
$1,656.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.93
|
| Rate for Payer: Healthscope Commercial |
$1,733.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,348.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,444.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,637.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,444.62
|
| Rate for Payer: PHP Commercial |
$1,637.24
|
| Rate for Payer: Priority Health SBD |
$1,213.48
|
| Rate for Payer: UMR Bronson Commercial |
$847.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,444.62
|
|
|
HC INTERP REN/VISC PTRA ADD VESS
|
Facility
|
OP
|
$1,926.16
|
|
| Hospital Charge Code |
32000266
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$712.68 |
| Max. Negotiated Rate |
$1,733.54 |
| Rate for Payer: Aetna American Axle |
$1,252.00
|
| Rate for Payer: Aetna Commercial |
$1,637.24
|
| Rate for Payer: Aetna Medicare |
$963.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,252.00
|
| Rate for Payer: BCBS Complete |
$770.46
|
| Rate for Payer: Cash Price |
$1,540.93
|
| Rate for Payer: Cofinity Advantage |
$1,348.31
|
| Rate for Payer: Cofinity Commercial |
$1,656.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.93
|
| Rate for Payer: Healthscope Commercial |
$1,733.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,348.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,444.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,540.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,637.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,444.62
|
| Rate for Payer: PHP Commercial |
$1,637.24
|
| Rate for Payer: Priority Health SBD |
$1,213.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,252.00
|
| Rate for Payer: UHC Core |
$1,003.53
|
| Rate for Payer: UHC Exchange |
$756.98
|
| Rate for Payer: UMR Bronson Commercial |
$712.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,444.62
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.5 CM OR LESS
|
Facility
|
IP
|
$287.22
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
76100115
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$126.38 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna American Axle |
$186.69
|
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.69
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Advantage |
$201.05
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: Priority Health SBD |
$180.95
|
| Rate for Payer: UMR Bronson Commercial |
$126.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.5 CM OR LESS
|
Facility
|
OP
|
$287.22
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
76100115
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$106.27 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna American Axle |
$186.69
|
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$505.51
|
| Rate for Payer: BCN Commercial |
$505.51
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Advantage |
$201.05
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$180.95
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.69
|
| Rate for Payer: UHC Core |
$149.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$112.88
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: UMR Bronson Commercial |
$106.27
|
| Rate for Payer: VA VA |
$405.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.6 TO 7.5 CM
|
Facility
|
OP
|
$315.95
|
|
|
Service Code
|
CPT 12032
|
| Hospital Charge Code |
76100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.90 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna American Axle |
$205.37
|
| Rate for Payer: Aetna Commercial |
$268.56
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$677.41
|
| Rate for Payer: BCN Commercial |
$677.41
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Advantage |
$221.16
|
| Rate for Payer: Cofinity Commercial |
$271.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$284.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$221.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.96
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.56
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$268.56
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$199.05
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.37
|
| Rate for Payer: UHC Core |
$164.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$124.17
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: UMR Bronson Commercial |
$116.90
|
| Rate for Payer: VA VA |
$405.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.96
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 2.6 TO 7.5 CM
|
Facility
|
IP
|
$315.95
|
|
|
Service Code
|
CPT 12032
|
| Hospital Charge Code |
76100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$139.02 |
| Max. Negotiated Rate |
$284.36 |
| Rate for Payer: Aetna American Axle |
$205.37
|
| Rate for Payer: Aetna Commercial |
$268.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.37
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Advantage |
$221.16
|
| Rate for Payer: Cofinity Commercial |
$271.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Healthscope Commercial |
$284.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$221.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: PHP Commercial |
$268.56
|
| Rate for Payer: Priority Health SBD |
$199.05
|
| Rate for Payer: UMR Bronson Commercial |
$139.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.96
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 7.6CM TO 12.5CM
|
Facility
|
IP
|
$508.61
|
|
|
Service Code
|
CPT 12034
|
| Hospital Charge Code |
76100239
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$223.79 |
| Max. Negotiated Rate |
$457.75 |
| Rate for Payer: Aetna American Axle |
$330.60
|
| Rate for Payer: Aetna Commercial |
$432.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.60
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cofinity Advantage |
$356.03
|
| Rate for Payer: Cofinity Commercial |
$437.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.89
|
| Rate for Payer: Healthscope Commercial |
$457.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$356.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.46
|
| Rate for Payer: PHP Commercial |
$432.32
|
| Rate for Payer: Priority Health SBD |
$320.42
|
| Rate for Payer: UMR Bronson Commercial |
$223.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.46
|
|
|
HC INTER REPAIR WOUND SCALP, AXILLAE, TRUNK, EXTREMITIES 7.6CM TO 12.5CM
|
Facility
|
OP
|
$508.61
|
|
|
Service Code
|
CPT 12034
|
| Hospital Charge Code |
76100239
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$188.19 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna American Axle |
$330.60
|
| Rate for Payer: Aetna Commercial |
$432.32
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$677.87
|
| Rate for Payer: BCN Commercial |
$677.87
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cofinity Advantage |
$356.03
|
| Rate for Payer: Cofinity Commercial |
$437.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$457.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$356.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.46
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.32
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.46
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$432.32
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$320.42
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.60
|
| Rate for Payer: UHC Core |
$264.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$199.88
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: UMR Bronson Commercial |
$188.19
|
| Rate for Payer: VA VA |
$405.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.46
|
|
|
HC INTER REP WD FACE, EAR, EYELID, NOSE, LIP, MUC MEMBRS 2.5 CM OR LESS
|
Facility
|
OP
|
$287.22
|
|
|
Service Code
|
CPT 12051
|
| Hospital Charge Code |
76100118
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$106.27 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna American Axle |
$186.69
|
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$298.34
|
| Rate for Payer: BCN Commercial |
$298.34
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Advantage |
$201.05
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$180.95
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.69
|
| Rate for Payer: UHC Core |
$149.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$112.88
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: UMR Bronson Commercial |
$106.27
|
| Rate for Payer: VA VA |
$405.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC INTER REP WD FACE, EAR, EYELID, NOSE, LIP, MUC MEMBRS 2.5 CM OR LESS
|
Facility
|
IP
|
$287.22
|
|
|
Service Code
|
CPT 12051
|
| Hospital Charge Code |
76100118
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$126.38 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna American Axle |
$186.69
|
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.69
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Advantage |
$201.05
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: Priority Health SBD |
$180.95
|
| Rate for Payer: UMR Bronson Commercial |
$126.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC INTER REP WD FACE, EARS, EYELIDS, NOSE, LIP, MUC MEMBRANES 2.6 TO 5.0 CM
|
Facility
|
IP
|
$315.95
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
76100119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$139.02 |
| Max. Negotiated Rate |
$284.36 |
| Rate for Payer: Aetna American Axle |
$205.37
|
| Rate for Payer: Aetna Commercial |
$268.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.37
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Advantage |
$221.16
|
| Rate for Payer: Cofinity Commercial |
$271.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Healthscope Commercial |
$284.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$221.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: PHP Commercial |
$268.56
|
| Rate for Payer: Priority Health SBD |
$199.05
|
| Rate for Payer: UMR Bronson Commercial |
$139.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.96
|
|
|
HC INTER REP WD FACE, EARS, EYELIDS, NOSE, LIP, MUC MEMBRANES 2.6 TO 5.0 CM
|
Facility
|
OP
|
$315.95
|
|
|
Service Code
|
CPT 12052
|
| Hospital Charge Code |
76100119
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.90 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna American Axle |
$205.37
|
| Rate for Payer: Aetna Commercial |
$268.56
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$538.73
|
| Rate for Payer: BCN Commercial |
$538.73
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cash Price |
$252.76
|
| Rate for Payer: Cofinity Advantage |
$221.16
|
| Rate for Payer: Cofinity Commercial |
$271.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$284.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$221.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.96
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.56
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.96
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$268.56
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$199.05
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.37
|
| Rate for Payer: UHC Core |
$164.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$124.17
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: UMR Bronson Commercial |
$116.90
|
| Rate for Payer: VA VA |
$405.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.96
|
|
|
HC INTMD RPR WND FACE/MM 5.1-7.5 CM
|
Facility
|
OP
|
$917.52
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
76100315
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$211.84 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna American Axle |
$596.39
|
| Rate for Payer: Aetna Commercial |
$779.89
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$596.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$252.90
|
| Rate for Payer: BCN Commercial |
$252.90
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$734.02
|
| Rate for Payer: Cash Price |
$734.02
|
| Rate for Payer: Cash Price |
$734.02
|
| Rate for Payer: Cofinity Advantage |
$642.26
|
| Rate for Payer: Cofinity Commercial |
$789.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$825.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$642.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$688.14
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$779.89
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$688.14
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$779.89
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$578.04
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$596.39
|
| Rate for Payer: UHC Core |
$478.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$360.59
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: UMR Bronson Commercial |
$339.48
|
| Rate for Payer: VA VA |
$405.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$688.14
|
|
|
HC INTMD RPR WND FACE/MM 5.1-7.5 CM
|
Facility
|
IP
|
$917.52
|
|
|
Service Code
|
CPT 12053
|
| Hospital Charge Code |
76100315
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$403.71 |
| Max. Negotiated Rate |
$825.77 |
| Rate for Payer: Aetna American Axle |
$596.39
|
| Rate for Payer: Aetna Commercial |
$779.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$596.39
|
| Rate for Payer: Cash Price |
$734.02
|
| Rate for Payer: Cofinity Advantage |
$642.26
|
| Rate for Payer: Cofinity Commercial |
$789.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$734.02
|
| Rate for Payer: Healthscope Commercial |
$825.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$642.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$688.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$779.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$688.14
|
| Rate for Payer: PHP Commercial |
$779.89
|
| Rate for Payer: Priority Health SBD |
$578.04
|
| Rate for Payer: UMR Bronson Commercial |
$403.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$688.14
|
|
|
HC INTRA AORTIC BALLOON INSERTION
|
Facility
|
OP
|
$2,249.92
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
36100083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$832.47 |
| Max. Negotiated Rate |
$2,024.93 |
| Rate for Payer: Aetna American Axle |
$1,462.45
|
| Rate for Payer: Aetna Commercial |
$1,912.43
|
| Rate for Payer: Aetna Medicare |
$1,124.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,462.45
|
| Rate for Payer: BCBS Complete |
$899.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,153.95
|
| Rate for Payer: BCN Commercial |
$1,153.95
|
| Rate for Payer: Cash Price |
$1,799.94
|
| Rate for Payer: Cash Price |
$1,799.94
|
| Rate for Payer: Cash Price |
$1,799.94
|
| Rate for Payer: Cofinity Advantage |
$1,574.94
|
| Rate for Payer: Cofinity Commercial |
$1,934.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,799.94
|
| Rate for Payer: Healthscope Commercial |
$2,024.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,574.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,687.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,799.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,687.44
|
| Rate for Payer: PHP Commercial |
$1,912.43
|
| Rate for Payer: Priority Health SBD |
$1,417.45
|
| Rate for Payer: UMR Bronson Commercial |
$832.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,687.44
|
|
|
HC INTRA AORTIC BALLOON INSERTION
|
Facility
|
IP
|
$2,249.92
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
36100083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$989.96 |
| Max. Negotiated Rate |
$2,024.93 |
| Rate for Payer: Aetna American Axle |
$1,462.45
|
| Rate for Payer: Aetna Commercial |
$1,912.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,462.45
|
| Rate for Payer: Cash Price |
$1,799.94
|
| Rate for Payer: Cofinity Advantage |
$1,574.94
|
| Rate for Payer: Cofinity Commercial |
$1,934.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,799.94
|
| Rate for Payer: Healthscope Commercial |
$2,024.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,574.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,687.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,912.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,687.44
|
| Rate for Payer: PHP Commercial |
$1,912.43
|
| Rate for Payer: Priority Health SBD |
$1,417.45
|
| Rate for Payer: UMR Bronson Commercial |
$989.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,687.44
|
|
|
HC INTRA AORTIC BALLOON REMOVAL PERCUTANEOUS
|
Facility
|
OP
|
$1,367.04
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
48100104
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$149.59 |
| Max. Negotiated Rate |
$1,230.34 |
| Rate for Payer: Aetna American Axle |
$888.58
|
| Rate for Payer: Aetna Commercial |
$1,161.98
|
| Rate for Payer: Aetna Medicare |
$683.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$888.58
|
| Rate for Payer: BCBS Complete |
$546.82
|
| Rate for Payer: BCBS Trust/PPO |
$149.59
|
| Rate for Payer: BCN Commercial |
$149.59
|
| Rate for Payer: Cash Price |
$1,093.63
|
| Rate for Payer: Cash Price |
$1,093.63
|
| Rate for Payer: Cash Price |
$1,093.63
|
| Rate for Payer: Cofinity Advantage |
$956.93
|
| Rate for Payer: Cofinity Commercial |
$1,175.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,093.63
|
| Rate for Payer: Healthscope Commercial |
$1,230.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$956.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,025.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,093.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,161.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,025.28
|
| Rate for Payer: PHP Commercial |
$1,161.98
|
| Rate for Payer: Priority Health SBD |
$861.24
|
| Rate for Payer: UMR Bronson Commercial |
$505.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,025.28
|
|
|
HC INTRA AORTIC BALLOON REMOVAL PERCUTANEOUS
|
Facility
|
IP
|
$1,367.04
|
|
|
Service Code
|
CPT 33968
|
| Hospital Charge Code |
48100104
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$601.50 |
| Max. Negotiated Rate |
$1,230.34 |
| Rate for Payer: Aetna American Axle |
$888.58
|
| Rate for Payer: Aetna Commercial |
$1,161.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$888.58
|
| Rate for Payer: Cash Price |
$1,093.63
|
| Rate for Payer: Cofinity Advantage |
$956.93
|
| Rate for Payer: Cofinity Commercial |
$1,175.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,093.63
|
| Rate for Payer: Healthscope Commercial |
$1,230.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$956.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,025.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,161.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,025.28
|
| Rate for Payer: PHP Commercial |
$1,161.98
|
| Rate for Payer: Priority Health SBD |
$861.24
|
| Rate for Payer: UMR Bronson Commercial |
$601.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,025.28
|
|
|
HC INTRA ART ADMIN RP PARTICULATE
|
Facility
|
OP
|
$1,094.58
|
|
|
Service Code
|
CPT 79445
|
| Hospital Charge Code |
34200001
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$121.60 |
| Max. Negotiated Rate |
$985.12 |
| Rate for Payer: Aetna American Axle |
$711.48
|
| Rate for Payer: Aetna Commercial |
$930.39
|
| Rate for Payer: Aetna Medicare |
$241.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$711.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$290.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$290.62
|
| Rate for Payer: BCBS Complete |
$127.69
|
| Rate for Payer: BCBS MAPPO |
$232.50
|
| Rate for Payer: BCBS Trust/PPO |
$345.45
|
| Rate for Payer: BCN Commercial |
$345.45
|
| Rate for Payer: BCN Medicare Advantage |
$232.50
|
| Rate for Payer: Cash Price |
$875.66
|
| Rate for Payer: Cash Price |
$875.66
|
| Rate for Payer: Cofinity Advantage |
$766.21
|
| Rate for Payer: Cofinity Commercial |
$941.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$875.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.50
|
| Rate for Payer: Healthscope Commercial |
$985.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$766.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$820.93
|
| Rate for Payer: Mclaren Medicaid |
$232.50
|
| Rate for Payer: Mclaren Medicare |
$232.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$244.12
|
| Rate for Payer: Meridian Medicaid |
$244.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$267.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$255.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$930.39
|
| Rate for Payer: Nomi Health Commercial |
$697.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$820.93
|
| Rate for Payer: PACE Medicare |
$220.88
|
| Rate for Payer: PACE SWMI |
$232.50
|
| Rate for Payer: PHP Commercial |
$930.39
|
| Rate for Payer: PHP Medicare Advantage |
$232.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$751.88
|
| Rate for Payer: Priority Health Medicare |
$232.50
|
| Rate for Payer: Priority Health SBD |
$689.59
|
| Rate for Payer: Priority Health Tiered Network |
$601.50
|
| Rate for Payer: Railroad Medicare Medicare |
$232.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$711.48
|
| Rate for Payer: UHC Core |
$570.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$232.50
|
| Rate for Payer: UHC Exchange |
$430.17
|
| Rate for Payer: UHC Medicaid |
$121.60
|
| Rate for Payer: UHCCP Medicaid |
$121.60
|
| Rate for Payer: UMR Bronson Commercial |
$404.99
|
| Rate for Payer: VA VA |
$232.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$820.93
|
|
|
HC INTRA ART ADMIN RP PARTICULATE
|
Facility
|
IP
|
$1,094.58
|
|
|
Service Code
|
CPT 79445
|
| Hospital Charge Code |
34200001
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$481.62 |
| Max. Negotiated Rate |
$985.12 |
| Rate for Payer: Aetna American Axle |
$711.48
|
| Rate for Payer: Aetna Commercial |
$930.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$711.48
|
| Rate for Payer: Cash Price |
$875.66
|
| Rate for Payer: Cofinity Advantage |
$766.21
|
| Rate for Payer: Cofinity Commercial |
$941.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$875.66
|
| Rate for Payer: Healthscope Commercial |
$985.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$766.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$820.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$930.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$820.93
|
| Rate for Payer: PHP Commercial |
$930.39
|
| Rate for Payer: Priority Health SBD |
$689.59
|
| Rate for Payer: UMR Bronson Commercial |
$481.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$820.93
|
|
|
HC INTRA ATRIAL PACING
|
Facility
|
IP
|
$3,211.46
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
48100033
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,413.04 |
| Max. Negotiated Rate |
$2,890.31 |
| Rate for Payer: Aetna American Axle |
$2,087.45
|
| Rate for Payer: Aetna Commercial |
$2,729.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,087.45
|
| Rate for Payer: Cash Price |
$2,569.17
|
| Rate for Payer: Cofinity Advantage |
$2,248.02
|
| Rate for Payer: Cofinity Commercial |
$2,761.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,569.17
|
| Rate for Payer: Healthscope Commercial |
$2,890.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,248.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,408.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,729.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,408.59
|
| Rate for Payer: PHP Commercial |
$2,729.74
|
| Rate for Payer: Priority Health SBD |
$2,023.22
|
| Rate for Payer: UMR Bronson Commercial |
$1,413.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,408.59
|
|
|
HC INTRA ATRIAL PACING
|
Facility
|
OP
|
$3,211.46
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
48100033
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,188.24 |
| Max. Negotiated Rate |
$25,132.71 |
| Rate for Payer: Aetna American Axle |
$2,087.45
|
| Rate for Payer: Aetna Commercial |
$2,729.74
|
| Rate for Payer: Aetna Medicare |
$8,082.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,087.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,714.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,714.52
|
| Rate for Payer: BCBS Complete |
$4,268.17
|
| Rate for Payer: BCBS MAPPO |
$7,771.62
|
| Rate for Payer: BCBS Trust/PPO |
$20,072.80
|
| Rate for Payer: BCN Commercial |
$20,072.80
|
| Rate for Payer: BCN Medicare Advantage |
$7,771.62
|
| Rate for Payer: Cash Price |
$2,569.17
|
| Rate for Payer: Cash Price |
$2,569.17
|
| Rate for Payer: Cofinity Advantage |
$2,248.02
|
| Rate for Payer: Cofinity Commercial |
$2,761.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,569.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,771.62
|
| Rate for Payer: Healthscope Commercial |
$2,890.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,248.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,408.59
|
| Rate for Payer: Mclaren Medicaid |
$7,771.62
|
| Rate for Payer: Mclaren Medicare |
$7,771.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,160.20
|
| Rate for Payer: Meridian Medicaid |
$8,160.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,937.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,548.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,729.74
|
| Rate for Payer: Nomi Health Commercial |
$23,314.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,408.59
|
| Rate for Payer: PACE Medicare |
$7,383.04
|
| Rate for Payer: PACE SWMI |
$7,771.62
|
| Rate for Payer: PHP Commercial |
$2,729.74
|
| Rate for Payer: PHP Medicare Advantage |
$7,771.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,064.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,132.71
|
| Rate for Payer: Priority Health Medicare |
$7,771.62
|
| Rate for Payer: Priority Health SBD |
$2,023.22
|
| Rate for Payer: Priority Health Tiered Network |
$20,106.17
|
| Rate for Payer: Railroad Medicare Medicare |
$7,771.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,771.62
|
| Rate for Payer: UHC Medicaid |
$4,064.56
|
| Rate for Payer: UHCCP Medicaid |
$4,064.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,188.24
|
| Rate for Payer: VA VA |
$7,771.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,408.59
|
|
|
HC INTRA ATRIAL RECORDING
|
Facility
|
IP
|
$3,098.73
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
48100030
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,363.44 |
| Max. Negotiated Rate |
$2,788.86 |
| Rate for Payer: Aetna American Axle |
$2,014.17
|
| Rate for Payer: Aetna Commercial |
$2,633.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,014.17
|
| Rate for Payer: Cash Price |
$2,478.98
|
| Rate for Payer: Cofinity Advantage |
$2,169.11
|
| Rate for Payer: Cofinity Commercial |
$2,664.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,478.98
|
| Rate for Payer: Healthscope Commercial |
$2,788.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,169.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,324.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,633.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,324.05
|
| Rate for Payer: PHP Commercial |
$2,633.92
|
| Rate for Payer: Priority Health SBD |
$1,952.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,363.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,324.05
|
|
|
HC INTRA ATRIAL RECORDING
|
Facility
|
OP
|
$3,098.73
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
48100030
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,146.53 |
| Max. Negotiated Rate |
$25,132.71 |
| Rate for Payer: Aetna American Axle |
$2,014.17
|
| Rate for Payer: Aetna Commercial |
$2,633.92
|
| Rate for Payer: Aetna Medicare |
$8,082.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,014.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,714.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,714.52
|
| Rate for Payer: BCBS Complete |
$4,268.17
|
| Rate for Payer: BCBS MAPPO |
$7,771.62
|
| Rate for Payer: BCBS Trust/PPO |
$20,072.80
|
| Rate for Payer: BCN Commercial |
$20,072.80
|
| Rate for Payer: BCN Medicare Advantage |
$7,771.62
|
| Rate for Payer: Cash Price |
$2,478.98
|
| Rate for Payer: Cash Price |
$2,478.98
|
| Rate for Payer: Cofinity Advantage |
$2,169.11
|
| Rate for Payer: Cofinity Commercial |
$2,664.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,478.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,771.62
|
| Rate for Payer: Healthscope Commercial |
$2,788.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,169.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,324.05
|
| Rate for Payer: Mclaren Medicaid |
$7,771.62
|
| Rate for Payer: Mclaren Medicare |
$7,771.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,160.20
|
| Rate for Payer: Meridian Medicaid |
$8,160.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,937.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,548.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,633.92
|
| Rate for Payer: Nomi Health Commercial |
$23,314.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,324.05
|
| Rate for Payer: PACE Medicare |
$7,383.04
|
| Rate for Payer: PACE SWMI |
$7,771.62
|
| Rate for Payer: PHP Commercial |
$2,633.92
|
| Rate for Payer: PHP Medicare Advantage |
$7,771.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,064.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,132.71
|
| Rate for Payer: Priority Health Medicare |
$7,771.62
|
| Rate for Payer: Priority Health SBD |
$1,952.20
|
| Rate for Payer: Priority Health Tiered Network |
$20,106.17
|
| Rate for Payer: Railroad Medicare Medicare |
$7,771.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,771.62
|
| Rate for Payer: UHC Medicaid |
$4,064.56
|
| Rate for Payer: UHCCP Medicaid |
$4,064.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,146.53
|
| Rate for Payer: VA VA |
$7,771.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,324.05
|
|
|
HC INTRACARDIAC ECHOCARDIOGRAPHY
|
Facility
|
OP
|
$5,621.61
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
48100047
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$288.81 |
| Max. Negotiated Rate |
$5,059.45 |
| Rate for Payer: Aetna American Axle |
$3,654.05
|
| Rate for Payer: Aetna Commercial |
$4,778.37
|
| Rate for Payer: Aetna Medicare |
$2,810.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,654.05
|
| Rate for Payer: BCBS Complete |
$2,248.64
|
| Rate for Payer: BCBS Trust/PPO |
$288.81
|
| Rate for Payer: BCN Commercial |
$288.81
|
| Rate for Payer: Cash Price |
$4,497.29
|
| Rate for Payer: Cash Price |
$4,497.29
|
| Rate for Payer: Cofinity Advantage |
$3,935.13
|
| Rate for Payer: Cofinity Commercial |
$4,834.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,497.29
|
| Rate for Payer: Healthscope Commercial |
$5,059.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,935.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,216.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,497.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,778.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,216.21
|
| Rate for Payer: PHP Commercial |
$4,778.37
|
| Rate for Payer: Priority Health SBD |
$3,541.61
|
| Rate for Payer: UMR Bronson Commercial |
$2,080.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,216.21
|
|
