HC SIGMOIDOSCOPY W EUS EXAM
|
Facility
|
IP
|
$2,569.73
|
|
Hospital Charge Code |
36000082
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$1,130.68 |
Max. Negotiated Rate |
$2,312.76 |
Rate for Payer: Aetna American Axle |
$1,670.32
|
Rate for Payer: Aetna Commercial |
$2,184.27
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,670.32
|
Rate for Payer: Cash Price |
$2,055.78
|
Rate for Payer: Cofinity Commercial |
$1,798.81
|
Rate for Payer: Cofinity Commercial |
$2,209.97
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,055.78
|
Rate for Payer: Healthscope Commercial |
$2,312.76
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,798.81
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,927.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,184.27
|
Rate for Payer: PHP Commercial |
$2,184.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,798.81
|
Rate for Payer: Priority Health SBD |
$1,618.93
|
Rate for Payer: UMR Bronson Commercial |
$1,130.68
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,927.30
|
|
HC SIGMOIDOSCOPY W EUS EXAM
|
Facility
|
OP
|
$2,569.73
|
|
Hospital Charge Code |
36000082
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$950.80 |
Max. Negotiated Rate |
$2,312.76 |
Rate for Payer: Aetna American Axle |
$1,670.32
|
Rate for Payer: Aetna Commercial |
$2,184.27
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,670.32
|
Rate for Payer: BCBS Complete |
$1,027.89
|
Rate for Payer: Cash Price |
$2,055.78
|
Rate for Payer: Cofinity Commercial |
$1,798.81
|
Rate for Payer: Cofinity Commercial |
$2,209.97
|
Rate for Payer: Encore Health Key Benefits Commercial |
$2,055.78
|
Rate for Payer: Healthscope Commercial |
$2,312.76
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,798.81
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,927.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,184.27
|
Rate for Payer: PHP Commercial |
$2,184.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,798.81
|
Rate for Payer: Priority Health SBD |
$1,618.93
|
Rate for Payer: UMR Bronson Commercial |
$950.80
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,927.30
|
|
HC SIGMOIDOSCOPY WITH BIOPSY
|
Facility
|
OP
|
$1,240.03
|
|
Service Code
|
CPT 45331
|
Hospital Charge Code |
36000111
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$70.40 |
Max. Negotiated Rate |
$2,557.47 |
Rate for Payer: Aetna American Axle |
$806.02
|
Rate for Payer: Aetna Commercial |
$1,054.03
|
Rate for Payer: Aetna Medicare |
$844.90
|
Rate for Payer: Aetna New Business (MI Preferred) |
$806.02
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,015.50
|
Rate for Payer: Amish Plain Church Group Commercial |
$1,015.50
|
Rate for Payer: BCBS Complete |
$466.64
|
Rate for Payer: BCBS MAPPO |
$812.40
|
Rate for Payer: BCBS Trust/PPO |
$1,109.89
|
Rate for Payer: BCN Medicare Advantage |
$812.40
|
Rate for Payer: Cash Price |
$992.02
|
Rate for Payer: Cash Price |
$992.02
|
Rate for Payer: Cofinity Commercial |
$1,066.43
|
Rate for Payer: Cofinity Commercial |
$868.02
|
Rate for Payer: Encore Health Key Benefits Commercial |
$992.02
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.40
|
Rate for Payer: Healthscope Commercial |
$1,116.03
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$868.02
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$930.02
|
Rate for Payer: Mclaren Medicaid |
$444.38
|
Rate for Payer: Mclaren Medicare |
$812.40
|
Rate for Payer: Meridian Medicaid |
$466.64
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$853.02
|
Rate for Payer: MI Amish Medical Board Commercial |
$934.26
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,054.03
|
Rate for Payer: PACE Medicare |
$771.78
|
Rate for Payer: PACE SWMI |
$812.40
|
Rate for Payer: PHP Commercial |
$1,054.03
|
Rate for Payer: PHP Medicare Advantage |
$812.40
|
Rate for Payer: Priority Health Choice Medicaid |
$444.38
|
Rate for Payer: Priority Health Cigna Priority Health |
$868.02
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,557.47
|
Rate for Payer: Priority Health Medicare |
$812.40
|
Rate for Payer: Priority Health Narrow Network |
$2,045.98
|
Rate for Payer: Priority Health SBD |
$781.22
|
Rate for Payer: Railroad Medicare Medicare |
$812.40
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$77.44
|
Rate for Payer: UHC Dual Complete DSNP |
$812.40
|
Rate for Payer: UHC Exchange |
$70.40
|
Rate for Payer: UHC Medicare Advantage |
$836.77
|
Rate for Payer: UMR Bronson Commercial |
$458.81
|
Rate for Payer: VA VA |
$812.40
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$930.02
|
|
HC SIGMOIDOSCOPY WITH BIOPSY
|
Facility
|
IP
|
$1,240.03
|
|
Service Code
|
CPT 45331
|
Hospital Charge Code |
36000111
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$545.61 |
Max. Negotiated Rate |
$1,116.03 |
Rate for Payer: Aetna American Axle |
$806.02
|
Rate for Payer: Aetna Commercial |
$1,054.03
|
Rate for Payer: Aetna New Business (MI Preferred) |
$806.02
|
Rate for Payer: Cash Price |
$992.02
|
Rate for Payer: Cofinity Commercial |
$1,066.43
|
Rate for Payer: Cofinity Commercial |
$868.02
|
Rate for Payer: Encore Health Key Benefits Commercial |
$992.02
|
Rate for Payer: Healthscope Commercial |
$1,116.03
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$868.02
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$930.02
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,054.03
|
Rate for Payer: PHP Commercial |
$1,054.03
|
Rate for Payer: Priority Health Cigna Priority Health |
$868.02
|
Rate for Payer: Priority Health SBD |
$781.22
|
Rate for Payer: UMR Bronson Commercial |
$545.61
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$930.02
|
|
HC SIGNAL AVERAGE EKG
|
Facility
|
OP
|
$247.91
|
|
Service Code
|
CPT 93278
|
Hospital Charge Code |
73100004
|
Hospital Revenue Code
|
731
|
Min. Negotiated Rate |
$29.74 |
Max. Negotiated Rate |
$816.00 |
Rate for Payer: Aetna American Axle |
$161.14
|
Rate for Payer: Aetna Commercial |
$210.72
|
Rate for Payer: Aetna Medicare |
$56.54
|
Rate for Payer: Aetna New Business (MI Preferred) |
$161.14
|
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 |
$83.80
|
Rate for Payer: BCN Medicare Advantage |
$54.37
|
Rate for Payer: Cash Price |
$198.33
|
Rate for Payer: Cash Price |
$198.33
|
Rate for Payer: Cash Price |
$198.33
|
Rate for Payer: Cofinity Commercial |
$173.54
|
Rate for Payer: Cofinity Commercial |
$213.20
|
Rate for Payer: Encore Health Key Benefits Commercial |
$198.33
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
Rate for Payer: Healthscope Commercial |
$223.12
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.54
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.93
|
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 |
$210.72
|
Rate for Payer: PACE Medicare |
$51.65
|
Rate for Payer: PACE SWMI |
$54.37
|
Rate for Payer: PHP Commercial |
$210.72
|
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 |
$173.54
|
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 |
$156.18
|
Rate for Payer: Railroad Medicare Medicare |
$54.37
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$34.22
|
Rate for Payer: UHC Core |
$816.00
|
Rate for Payer: UHC Dual Complete DSNP |
$54.37
|
Rate for Payer: UHC Exchange |
$31.11
|
Rate for Payer: UHC Medicare Advantage |
$56.00
|
Rate for Payer: UMR Bronson Commercial |
$91.73
|
Rate for Payer: VA VA |
$54.37
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.93
|
|
HC SIGNAL AVERAGE EKG
|
Facility
|
IP
|
$247.91
|
|
Service Code
|
CPT 93278
|
Hospital Charge Code |
73100004
|
Hospital Revenue Code
|
731
|
Min. Negotiated Rate |
$109.08 |
Max. Negotiated Rate |
$223.12 |
Rate for Payer: Aetna American Axle |
$161.14
|
Rate for Payer: Aetna Commercial |
$210.72
|
Rate for Payer: Aetna New Business (MI Preferred) |
$161.14
|
Rate for Payer: Cash Price |
$198.33
|
Rate for Payer: Cofinity Commercial |
$173.54
|
Rate for Payer: Cofinity Commercial |
$213.20
|
Rate for Payer: Encore Health Key Benefits Commercial |
$198.33
|
Rate for Payer: Healthscope Commercial |
$223.12
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.54
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.93
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$210.72
|
Rate for Payer: PHP Commercial |
$210.72
|
Rate for Payer: Priority Health Cigna Priority Health |
$173.54
|
Rate for Payer: Priority Health SBD |
$156.18
|
Rate for Payer: UMR Bronson Commercial |
$109.08
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.93
|
|
HC SILICA CLOTTING TIME ASSAY
|
Facility
|
IP
|
$25.50
|
|
Service Code
|
CPT 85730
|
Hospital Charge Code |
30500099
|
Hospital Revenue Code
|
305
|
Min. Negotiated Rate |
$11.22 |
Max. Negotiated Rate |
$22.95 |
Rate for Payer: Aetna American Axle |
$16.58
|
Rate for Payer: Aetna Commercial |
$21.68
|
Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
Rate for Payer: Cash Price |
$20.40
|
Rate for Payer: Cofinity Commercial |
$17.85
|
Rate for Payer: Cofinity Commercial |
$21.93
|
Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
Rate for Payer: Healthscope Commercial |
$22.95
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
Rate for Payer: PHP Commercial |
$21.68
|
Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
Rate for Payer: Priority Health SBD |
$16.06
|
Rate for Payer: UMR Bronson Commercial |
$11.22
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
HC SILICA CLOTTING TIME ASSAY
|
Facility
|
OP
|
$25.50
|
|
Service Code
|
CPT 85730
|
Hospital Charge Code |
30500099
|
Hospital Revenue Code
|
305
|
Min. Negotiated Rate |
$3.29 |
Max. Negotiated Rate |
$22.95 |
Rate for Payer: Aetna American Axle |
$16.58
|
Rate for Payer: Aetna Commercial |
$21.68
|
Rate for Payer: Aetna Medicare |
$6.25
|
Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.51
|
Rate for Payer: Amish Plain Church Group Commercial |
$7.51
|
Rate for Payer: BCBS Complete |
$3.45
|
Rate for Payer: BCBS MAPPO |
$6.01
|
Rate for Payer: BCBS Trust/PPO |
$5.41
|
Rate for Payer: BCN Medicare Advantage |
$6.01
|
Rate for Payer: Cash Price |
$20.40
|
Rate for Payer: Cash Price |
$20.40
|
Rate for Payer: Cofinity Commercial |
$21.93
|
Rate for Payer: Cofinity Commercial |
$17.85
|
Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.01
|
Rate for Payer: Healthscope Commercial |
$22.95
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
Rate for Payer: Mclaren Medicaid |
$3.29
|
Rate for Payer: Mclaren Medicare |
$6.01
|
Rate for Payer: Meridian Medicaid |
$3.45
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.31
|
Rate for Payer: MI Amish Medical Board Commercial |
$6.91
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
Rate for Payer: PACE Medicare |
$5.71
|
Rate for Payer: PACE SWMI |
$6.01
|
Rate for Payer: PHP Commercial |
$21.68
|
Rate for Payer: PHP Medicare Advantage |
$6.01
|
Rate for Payer: Priority Health Choice Medicaid |
$3.29
|
Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.24
|
Rate for Payer: Priority Health Medicare |
$6.01
|
Rate for Payer: Priority Health Narrow Network |
$6.59
|
Rate for Payer: Priority Health SBD |
$16.06
|
Rate for Payer: Railroad Medicare Medicare |
$6.01
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$7.21
|
Rate for Payer: UHC Core |
$9.90
|
Rate for Payer: UHC Dual Complete DSNP |
$6.01
|
Rate for Payer: UHC Exchange |
$6.01
|
Rate for Payer: UHC Medicare Advantage |
$6.19
|
Rate for Payer: UMR Bronson Commercial |
$9.44
|
Rate for Payer: VA VA |
$6.01
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
HC SILVADENE 400 GM
|
Facility
|
OP
|
$248.55
|
|
Hospital Charge Code |
27100016
|
Hospital Revenue Code
|
271
|
Min. Negotiated Rate |
$91.96 |
Max. Negotiated Rate |
$223.70 |
Rate for Payer: Aetna American Axle |
$161.56
|
Rate for Payer: Aetna Commercial |
$211.27
|
Rate for Payer: Aetna New Business (MI Preferred) |
$161.56
|
Rate for Payer: BCBS Complete |
$99.42
|
Rate for Payer: Cash Price |
$198.84
|
Rate for Payer: Cofinity Commercial |
$173.98
|
Rate for Payer: Cofinity Commercial |
$213.75
|
Rate for Payer: Encore Health Key Benefits Commercial |
$198.84
|
Rate for Payer: Healthscope Commercial |
$223.70
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.98
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.41
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$211.27
|
Rate for Payer: PHP Commercial |
$211.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$173.98
|
Rate for Payer: Priority Health SBD |
$156.59
|
Rate for Payer: UMR Bronson Commercial |
$91.96
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.41
|
|
HC SILVADENE 400 GM
|
Facility
|
IP
|
$248.55
|
|
Hospital Charge Code |
27100016
|
Hospital Revenue Code
|
271
|
Min. Negotiated Rate |
$109.36 |
Max. Negotiated Rate |
$223.70 |
Rate for Payer: Aetna American Axle |
$161.56
|
Rate for Payer: Aetna Commercial |
$211.27
|
Rate for Payer: Aetna New Business (MI Preferred) |
$161.56
|
Rate for Payer: Cash Price |
$198.84
|
Rate for Payer: Cofinity Commercial |
$173.98
|
Rate for Payer: Cofinity Commercial |
$213.75
|
Rate for Payer: Encore Health Key Benefits Commercial |
$198.84
|
Rate for Payer: Healthscope Commercial |
$223.70
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.98
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.41
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$211.27
|
Rate for Payer: PHP Commercial |
$211.27
|
Rate for Payer: Priority Health Cigna Priority Health |
$173.98
|
Rate for Payer: Priority Health SBD |
$156.59
|
Rate for Payer: UMR Bronson Commercial |
$109.36
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.41
|
|
HC SILVADENE 85 GM
|
Facility
|
OP
|
$102.57
|
|
Hospital Charge Code |
27100017
|
Hospital Revenue Code
|
271
|
Min. Negotiated Rate |
$37.95 |
Max. Negotiated Rate |
$92.31 |
Rate for Payer: Aetna American Axle |
$66.67
|
Rate for Payer: Aetna Commercial |
$87.18
|
Rate for Payer: Aetna New Business (MI Preferred) |
$66.67
|
Rate for Payer: BCBS Complete |
$41.03
|
Rate for Payer: Cash Price |
$82.06
|
Rate for Payer: Cofinity Commercial |
$71.80
|
Rate for Payer: Cofinity Commercial |
$88.21
|
Rate for Payer: Encore Health Key Benefits Commercial |
$82.06
|
Rate for Payer: Healthscope Commercial |
$92.31
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.80
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.93
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.18
|
Rate for Payer: PHP Commercial |
$87.18
|
Rate for Payer: Priority Health Cigna Priority Health |
$71.80
|
Rate for Payer: Priority Health SBD |
$64.62
|
Rate for Payer: UMR Bronson Commercial |
$37.95
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.93
|
|
HC SILVADENE 85 GM
|
Facility
|
IP
|
$102.57
|
|
Hospital Charge Code |
27100017
|
Hospital Revenue Code
|
271
|
Min. Negotiated Rate |
$45.13 |
Max. Negotiated Rate |
$92.31 |
Rate for Payer: Aetna American Axle |
$66.67
|
Rate for Payer: Aetna Commercial |
$87.18
|
Rate for Payer: Aetna New Business (MI Preferred) |
$66.67
|
Rate for Payer: Cash Price |
$82.06
|
Rate for Payer: Cofinity Commercial |
$71.80
|
Rate for Payer: Cofinity Commercial |
$88.21
|
Rate for Payer: Encore Health Key Benefits Commercial |
$82.06
|
Rate for Payer: Healthscope Commercial |
$92.31
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.80
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.93
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.18
|
Rate for Payer: PHP Commercial |
$87.18
|
Rate for Payer: Priority Health Cigna Priority Health |
$71.80
|
Rate for Payer: Priority Health SBD |
$64.62
|
Rate for Payer: UMR Bronson Commercial |
$45.13
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.93
|
|
HC SILVER 4X4
|
Facility
|
IP
|
$64.13
|
|
Hospital Charge Code |
27000146
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$28.22 |
Max. Negotiated Rate |
$57.72 |
Rate for Payer: Aetna American Axle |
$41.68
|
Rate for Payer: Aetna Commercial |
$54.51
|
Rate for Payer: Aetna New Business (MI Preferred) |
$41.68
|
Rate for Payer: Cash Price |
$51.30
|
Rate for Payer: Cofinity Commercial |
$44.89
|
Rate for Payer: Cofinity Commercial |
$55.15
|
Rate for Payer: Encore Health Key Benefits Commercial |
$51.30
|
Rate for Payer: Healthscope Commercial |
$57.72
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.89
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.10
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.51
|
Rate for Payer: PHP Commercial |
$54.51
|
Rate for Payer: Priority Health Cigna Priority Health |
$44.89
|
Rate for Payer: Priority Health SBD |
$40.40
|
Rate for Payer: UMR Bronson Commercial |
$28.22
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.10
|
|
HC SILVER 4X4
|
Facility
|
OP
|
$64.13
|
|
Hospital Charge Code |
27000146
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$23.73 |
Max. Negotiated Rate |
$57.72 |
Rate for Payer: Aetna American Axle |
$41.68
|
Rate for Payer: Aetna Commercial |
$54.51
|
Rate for Payer: Aetna New Business (MI Preferred) |
$41.68
|
Rate for Payer: BCBS Complete |
$25.65
|
Rate for Payer: Cash Price |
$51.30
|
Rate for Payer: Cofinity Commercial |
$44.89
|
Rate for Payer: Cofinity Commercial |
$55.15
|
Rate for Payer: Encore Health Key Benefits Commercial |
$51.30
|
Rate for Payer: Healthscope Commercial |
$57.72
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.89
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.10
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.51
|
Rate for Payer: PHP Commercial |
$54.51
|
Rate for Payer: Priority Health Cigna Priority Health |
$44.89
|
Rate for Payer: Priority Health SBD |
$40.40
|
Rate for Payer: UMR Bronson Commercial |
$23.73
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.10
|
|
HC SILVER HAWK CATHETER
|
Facility
|
IP
|
$8,575.06
|
|
Service Code
|
HCPCS C1888
|
Hospital Charge Code |
27200070
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$3,773.03 |
Max. Negotiated Rate |
$7,717.55 |
Rate for Payer: Aetna American Axle |
$5,573.79
|
Rate for Payer: Aetna Commercial |
$7,288.80
|
Rate for Payer: Aetna New Business (MI Preferred) |
$5,573.79
|
Rate for Payer: Cash Price |
$6,860.05
|
Rate for Payer: Cofinity Commercial |
$6,002.54
|
Rate for Payer: Cofinity Commercial |
$7,374.55
|
Rate for Payer: Encore Health Key Benefits Commercial |
$6,860.05
|
Rate for Payer: Healthscope Commercial |
$7,717.55
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,002.54
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,431.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,288.80
|
Rate for Payer: PHP Commercial |
$7,288.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$6,002.54
|
Rate for Payer: Priority Health SBD |
$5,402.29
|
Rate for Payer: UMR Bronson Commercial |
$3,773.03
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,431.30
|
|
HC SILVER HAWK CATHETER
|
Facility
|
OP
|
$8,575.06
|
|
Service Code
|
HCPCS C1888
|
Hospital Charge Code |
27200070
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$3,172.77 |
Max. Negotiated Rate |
$7,717.55 |
Rate for Payer: Aetna American Axle |
$5,573.79
|
Rate for Payer: Aetna Commercial |
$7,288.80
|
Rate for Payer: Aetna New Business (MI Preferred) |
$5,573.79
|
Rate for Payer: BCBS Complete |
$3,430.02
|
Rate for Payer: Cash Price |
$6,860.05
|
Rate for Payer: Cofinity Commercial |
$6,002.54
|
Rate for Payer: Cofinity Commercial |
$7,374.55
|
Rate for Payer: Encore Health Key Benefits Commercial |
$6,860.05
|
Rate for Payer: Healthscope Commercial |
$7,717.55
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,002.54
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,431.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,288.80
|
Rate for Payer: PHP Commercial |
$7,288.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$6,002.54
|
Rate for Payer: Priority Health SBD |
$5,402.29
|
Rate for Payer: UMR Bronson Commercial |
$3,172.77
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,431.30
|
|
HC SILVER ROPE
|
Facility
|
OP
|
$53.51
|
|
Hospital Charge Code |
27000147
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$19.80 |
Max. Negotiated Rate |
$48.16 |
Rate for Payer: Aetna American Axle |
$34.78
|
Rate for Payer: Aetna Commercial |
$45.48
|
Rate for Payer: Aetna New Business (MI Preferred) |
$34.78
|
Rate for Payer: BCBS Complete |
$21.40
|
Rate for Payer: Cash Price |
$42.81
|
Rate for Payer: Cofinity Commercial |
$37.46
|
Rate for Payer: Cofinity Commercial |
$46.02
|
Rate for Payer: Encore Health Key Benefits Commercial |
$42.81
|
Rate for Payer: Healthscope Commercial |
$48.16
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.46
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.13
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.48
|
Rate for Payer: PHP Commercial |
$45.48
|
Rate for Payer: Priority Health Cigna Priority Health |
$37.46
|
Rate for Payer: Priority Health SBD |
$33.71
|
Rate for Payer: UMR Bronson Commercial |
$19.80
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.13
|
|
HC SILVER ROPE
|
Facility
|
IP
|
$53.51
|
|
Hospital Charge Code |
27000147
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$23.54 |
Max. Negotiated Rate |
$48.16 |
Rate for Payer: Aetna American Axle |
$34.78
|
Rate for Payer: Aetna Commercial |
$45.48
|
Rate for Payer: Aetna New Business (MI Preferred) |
$34.78
|
Rate for Payer: Cash Price |
$42.81
|
Rate for Payer: Cofinity Commercial |
$37.46
|
Rate for Payer: Cofinity Commercial |
$46.02
|
Rate for Payer: Encore Health Key Benefits Commercial |
$42.81
|
Rate for Payer: Healthscope Commercial |
$48.16
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.46
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.13
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.48
|
Rate for Payer: PHP Commercial |
$45.48
|
Rate for Payer: Priority Health Cigna Priority Health |
$37.46
|
Rate for Payer: Priority Health SBD |
$33.71
|
Rate for Payer: UMR Bronson Commercial |
$23.54
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.13
|
|
HC SIMIAN B AB
|
Facility
|
IP
|
$89.30
|
|
Service Code
|
CPT 86790
|
Hospital Charge Code |
30200333
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$39.29 |
Max. Negotiated Rate |
$80.37 |
Rate for Payer: Aetna American Axle |
$58.04
|
Rate for Payer: Aetna Commercial |
$75.90
|
Rate for Payer: Aetna New Business (MI Preferred) |
$58.04
|
Rate for Payer: Cash Price |
$71.44
|
Rate for Payer: Cofinity Commercial |
$62.51
|
Rate for Payer: Cofinity Commercial |
$76.80
|
Rate for Payer: Encore Health Key Benefits Commercial |
$71.44
|
Rate for Payer: Healthscope Commercial |
$80.37
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.51
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.98
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.90
|
Rate for Payer: PHP Commercial |
$75.90
|
Rate for Payer: Priority Health Cigna Priority Health |
$62.51
|
Rate for Payer: Priority Health SBD |
$56.26
|
Rate for Payer: UMR Bronson Commercial |
$39.29
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.98
|
|
HC SIMIAN B AB
|
Facility
|
OP
|
$89.30
|
|
Service Code
|
CPT 86790
|
Hospital Charge Code |
30200333
|
Hospital Revenue Code
|
302
|
Min. Negotiated Rate |
$7.05 |
Max. Negotiated Rate |
$80.37 |
Rate for Payer: Aetna American Axle |
$58.04
|
Rate for Payer: Aetna Commercial |
$75.90
|
Rate for Payer: Aetna Medicare |
$13.40
|
Rate for Payer: Aetna New Business (MI Preferred) |
$58.04
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.10
|
Rate for Payer: Amish Plain Church Group Commercial |
$16.10
|
Rate for Payer: BCBS Complete |
$7.40
|
Rate for Payer: BCBS MAPPO |
$12.88
|
Rate for Payer: BCBS Trust/PPO |
$11.58
|
Rate for Payer: BCN Medicare Advantage |
$12.88
|
Rate for Payer: Cash Price |
$71.44
|
Rate for Payer: Cash Price |
$71.44
|
Rate for Payer: Cofinity Commercial |
$76.80
|
Rate for Payer: Cofinity Commercial |
$62.51
|
Rate for Payer: Encore Health Key Benefits Commercial |
$71.44
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.88
|
Rate for Payer: Healthscope Commercial |
$80.37
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.51
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.98
|
Rate for Payer: Mclaren Medicaid |
$7.05
|
Rate for Payer: Mclaren Medicare |
$12.88
|
Rate for Payer: Meridian Medicaid |
$7.40
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.52
|
Rate for Payer: MI Amish Medical Board Commercial |
$14.81
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.90
|
Rate for Payer: PACE Medicare |
$12.24
|
Rate for Payer: PACE SWMI |
$12.88
|
Rate for Payer: PHP Commercial |
$75.90
|
Rate for Payer: PHP Medicare Advantage |
$12.88
|
Rate for Payer: Priority Health Choice Medicaid |
$7.05
|
Rate for Payer: Priority Health Cigna Priority Health |
$62.51
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.67
|
Rate for Payer: Priority Health Medicare |
$12.88
|
Rate for Payer: Priority Health Narrow Network |
$14.14
|
Rate for Payer: Priority Health SBD |
$56.26
|
Rate for Payer: Railroad Medicare Medicare |
$12.88
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$15.46
|
Rate for Payer: UHC Core |
$21.25
|
Rate for Payer: UHC Dual Complete DSNP |
$12.88
|
Rate for Payer: UHC Exchange |
$12.88
|
Rate for Payer: UHC Medicare Advantage |
$13.27
|
Rate for Payer: UMR Bronson Commercial |
$33.04
|
Rate for Payer: VA VA |
$12.88
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.98
|
|
HC SIMPLE CYSTOMETROGRAM
|
Facility
|
IP
|
$354.07
|
|
Service Code
|
CPT 51725
|
Hospital Charge Code |
76100189
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$155.79 |
Max. Negotiated Rate |
$318.66 |
Rate for Payer: Aetna American Axle |
$230.15
|
Rate for Payer: Aetna Commercial |
$300.96
|
Rate for Payer: Aetna New Business (MI Preferred) |
$230.15
|
Rate for Payer: Cash Price |
$283.26
|
Rate for Payer: Cofinity Commercial |
$247.85
|
Rate for Payer: Cofinity Commercial |
$304.50
|
Rate for Payer: Encore Health Key Benefits Commercial |
$283.26
|
Rate for Payer: Healthscope Commercial |
$318.66
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$247.85
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.55
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$300.96
|
Rate for Payer: PHP Commercial |
$300.96
|
Rate for Payer: Priority Health Cigna Priority Health |
$247.85
|
Rate for Payer: Priority Health SBD |
$223.06
|
Rate for Payer: UMR Bronson Commercial |
$155.79
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.55
|
|
HC SIMPLE CYSTOMETROGRAM
|
Facility
|
OP
|
$354.07
|
|
Service Code
|
CPT 51725
|
Hospital Charge Code |
76100189
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$119.67 |
Max. Negotiated Rate |
$691.57 |
Rate for Payer: Aetna American Axle |
$230.15
|
Rate for Payer: Aetna Commercial |
$300.96
|
Rate for Payer: Aetna Medicare |
$228.47
|
Rate for Payer: Aetna New Business (MI Preferred) |
$230.15
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.60
|
Rate for Payer: Amish Plain Church Group Commercial |
$274.60
|
Rate for Payer: BCBS Complete |
$126.18
|
Rate for Payer: BCBS MAPPO |
$219.68
|
Rate for Payer: BCBS Trust/PPO |
$119.67
|
Rate for Payer: BCN Medicare Advantage |
$219.68
|
Rate for Payer: Cash Price |
$283.26
|
Rate for Payer: Cash Price |
$283.26
|
Rate for Payer: Cofinity Commercial |
$304.50
|
Rate for Payer: Cofinity Commercial |
$247.85
|
Rate for Payer: Encore Health Key Benefits Commercial |
$283.26
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.68
|
Rate for Payer: Healthscope Commercial |
$318.66
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$247.85
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.55
|
Rate for Payer: Mclaren Medicaid |
$120.16
|
Rate for Payer: Mclaren Medicare |
$219.68
|
Rate for Payer: Meridian Medicaid |
$126.18
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.66
|
Rate for Payer: MI Amish Medical Board Commercial |
$252.63
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$300.96
|
Rate for Payer: PACE Medicare |
$208.70
|
Rate for Payer: PACE SWMI |
$219.68
|
Rate for Payer: PHP Commercial |
$300.96
|
Rate for Payer: PHP Medicare Advantage |
$219.68
|
Rate for Payer: Priority Health Choice Medicaid |
$120.16
|
Rate for Payer: Priority Health Cigna Priority Health |
$247.85
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$691.57
|
Rate for Payer: Priority Health Medicare |
$219.68
|
Rate for Payer: Priority Health Narrow Network |
$553.26
|
Rate for Payer: Priority Health SBD |
$223.06
|
Rate for Payer: Railroad Medicare Medicare |
$219.68
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$246.00
|
Rate for Payer: UHC Dual Complete DSNP |
$219.68
|
Rate for Payer: UHC Exchange |
$223.64
|
Rate for Payer: UHC Medicare Advantage |
$226.27
|
Rate for Payer: UMR Bronson Commercial |
$131.01
|
Rate for Payer: VA VA |
$219.68
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.55
|
|
HC SIMPLE REP WD FACE,EAR,EYELID,NOSE,LIP,MUC MEMB 2.5CM OR LESS
|
Facility
|
IP
|
$267.34
|
|
Service Code
|
CPT 12011
|
Hospital Charge Code |
76100274
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$117.63 |
Max. Negotiated Rate |
$240.61 |
Rate for Payer: Aetna American Axle |
$173.77
|
Rate for Payer: Aetna Commercial |
$227.24
|
Rate for Payer: Aetna New Business (MI Preferred) |
$173.77
|
Rate for Payer: Cash Price |
$213.87
|
Rate for Payer: Cofinity Commercial |
$187.14
|
Rate for Payer: Cofinity Commercial |
$229.91
|
Rate for Payer: Encore Health Key Benefits Commercial |
$213.87
|
Rate for Payer: Healthscope Commercial |
$240.61
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.14
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.50
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$227.24
|
Rate for Payer: PHP Commercial |
$227.24
|
Rate for Payer: Priority Health Cigna Priority Health |
$187.14
|
Rate for Payer: Priority Health SBD |
$168.42
|
Rate for Payer: UMR Bronson Commercial |
$117.63
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.50
|
|
HC SIMPLE REP WD FACE,EAR,EYELID,NOSE,LIP,MUC MEMB 2.5CM OR LESS
|
Facility
|
OP
|
$267.34
|
|
Service Code
|
CPT 12011
|
Hospital Charge Code |
76100274
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$54.36 |
Max. Negotiated Rate |
$560.20 |
Rate for Payer: Aetna American Axle |
$173.77
|
Rate for Payer: Aetna Commercial |
$227.24
|
Rate for Payer: Aetna Medicare |
$185.07
|
Rate for Payer: Aetna New Business (MI Preferred) |
$173.77
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
Rate for Payer: BCBS Complete |
$102.21
|
Rate for Payer: BCBS MAPPO |
$177.95
|
Rate for Payer: BCBS Trust/PPO |
$136.72
|
Rate for Payer: BCN Medicare Advantage |
$177.95
|
Rate for Payer: Cash Price |
$213.87
|
Rate for Payer: Cash Price |
$213.87
|
Rate for Payer: Cofinity Commercial |
$229.91
|
Rate for Payer: Cofinity Commercial |
$187.14
|
Rate for Payer: Encore Health Key Benefits Commercial |
$213.87
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
Rate for Payer: Healthscope Commercial |
$240.61
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.14
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$200.50
|
Rate for Payer: Mclaren Medicaid |
$97.34
|
Rate for Payer: Mclaren Medicare |
$177.95
|
Rate for Payer: Meridian Medicaid |
$102.21
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$227.24
|
Rate for Payer: PACE Medicare |
$169.05
|
Rate for Payer: PACE SWMI |
$177.95
|
Rate for Payer: PHP Commercial |
$227.24
|
Rate for Payer: PHP Medicare Advantage |
$177.95
|
Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
Rate for Payer: Priority Health Cigna Priority Health |
$187.14
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.20
|
Rate for Payer: Priority Health Medicare |
$177.95
|
Rate for Payer: Priority Health Narrow Network |
$448.16
|
Rate for Payer: Priority Health SBD |
$168.42
|
Rate for Payer: Railroad Medicare Medicare |
$177.95
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$59.80
|
Rate for Payer: UHC Dual Complete DSNP |
$177.95
|
Rate for Payer: UHC Exchange |
$54.36
|
Rate for Payer: UHC Medicare Advantage |
$183.29
|
Rate for Payer: UMR Bronson Commercial |
$98.92
|
Rate for Payer: VA VA |
$177.95
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$200.50
|
|
HC SIMPLE REP WD SCALP,NECK,AXILLAE,GENITALIA,TRUNK, EXTREMS 2.6 TO 7.5 CM
|
Facility
|
IP
|
$144.23
|
|
Service Code
|
CPT 12002
|
Hospital Charge Code |
76100114
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$63.46 |
Max. Negotiated Rate |
$129.81 |
Rate for Payer: Aetna American Axle |
$93.75
|
Rate for Payer: Aetna Commercial |
$122.60
|
Rate for Payer: Aetna New Business (MI Preferred) |
$93.75
|
Rate for Payer: Cash Price |
$115.38
|
Rate for Payer: Cofinity Commercial |
$100.96
|
Rate for Payer: Cofinity Commercial |
$124.04
|
Rate for Payer: Encore Health Key Benefits Commercial |
$115.38
|
Rate for Payer: Healthscope Commercial |
$129.81
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$100.96
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.17
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$122.60
|
Rate for Payer: PHP Commercial |
$122.60
|
Rate for Payer: Priority Health Cigna Priority Health |
$100.96
|
Rate for Payer: Priority Health SBD |
$90.86
|
Rate for Payer: UMR Bronson Commercial |
$63.46
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.17
|
|