|
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
|
|
|
HC SIMPLE REP WD SCALPNECKAXILLAEGENITALIIATRUNK EXTREMS 7.6 TO 12.5 CM
|
Facility
|
IP
|
$545.57
|
|
|
Service Code
|
CPT 12004
|
| Hospital Charge Code |
76100437
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$240.05 |
| Max. Negotiated Rate |
$491.01 |
| Rate for Payer: Aetna American Axle |
$354.62
|
| Rate for Payer: Aetna Commercial |
$463.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$354.62
|
| Rate for Payer: Cash Price |
$436.46
|
| Rate for Payer: Cofinity Commercial |
$381.90
|
| Rate for Payer: Cofinity Commercial |
$469.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.46
|
| Rate for Payer: Healthscope Commercial |
$491.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$381.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$409.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$463.73
|
| Rate for Payer: PHP Commercial |
$463.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$381.90
|
| Rate for Payer: Priority Health SBD |
$343.71
|
| Rate for Payer: UMR Bronson Commercial |
$240.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$409.18
|
|
|
HC SIMPLE REP WD SCALPNECKAXILLAEGENITALIIATRUNK EXTREMS 7.6 TO 12.5 CM
|
Facility
|
OP
|
$545.57
|
|
|
Service Code
|
CPT 12004
|
| Hospital Charge Code |
76100437
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.04 |
| Max. Negotiated Rate |
$560.20 |
| Rate for Payer: Aetna American Axle |
$354.62
|
| Rate for Payer: Aetna Commercial |
$463.73
|
| Rate for Payer: Aetna Medicare |
$185.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$354.62
|
| 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 |
$209.45
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$436.46
|
| Rate for Payer: Cash Price |
$436.46
|
| Rate for Payer: Cofinity Commercial |
$469.19
|
| Rate for Payer: Cofinity Commercial |
$381.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$491.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$381.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$409.18
|
| 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 |
$463.73
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$463.73
|
| 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 |
$381.90
|
| 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 |
$343.71
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.95
|
| Rate for Payer: UHC Exchange |
$72.04
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: UMR Bronson Commercial |
$201.86
|
| Rate for Payer: VA VA |
$177.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$409.18
|
|
|
HC SIMULATION - 3D
|
Facility
|
OP
|
$5,145.90
|
|
|
Service Code
|
CPT 77295
|
| Hospital Charge Code |
33300004
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$472.17 |
| Max. Negotiated Rate |
$4,631.31 |
| Rate for Payer: Aetna American Axle |
$3,344.84
|
| Rate for Payer: Aetna American Axle |
$5,760.30
|
| Rate for Payer: Aetna Commercial |
$4,374.02
|
| Rate for Payer: Aetna Commercial |
$7,532.70
|
| Rate for Payer: Aetna Medicare |
$1,280.92
|
| Rate for Payer: Aetna Medicare |
$1,280.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,344.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,760.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,539.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,539.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,539.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,539.56
|
| Rate for Payer: BCBS Complete |
$707.46
|
| Rate for Payer: BCBS Complete |
$707.46
|
| Rate for Payer: BCBS MAPPO |
$1,231.65
|
| Rate for Payer: BCBS MAPPO |
$1,231.65
|
| Rate for Payer: BCBS Trust/PPO |
$497.25
|
| Rate for Payer: BCBS Trust/PPO |
$497.25
|
| Rate for Payer: BCN Medicare Advantage |
$1,231.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,231.65
|
| Rate for Payer: Cash Price |
$7,089.60
|
| Rate for Payer: Cash Price |
$7,089.60
|
| Rate for Payer: Cash Price |
$4,116.72
|
| Rate for Payer: Cash Price |
$7,089.60
|
| Rate for Payer: Cash Price |
$4,116.72
|
| Rate for Payer: Cash Price |
$4,116.72
|
| Rate for Payer: Cofinity Commercial |
$3,602.13
|
| Rate for Payer: Cofinity Commercial |
$7,621.32
|
| Rate for Payer: Cofinity Commercial |
$6,203.40
|
| Rate for Payer: Cofinity Commercial |
$4,425.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,116.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,089.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,231.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,231.65
|
| Rate for Payer: Healthscope Commercial |
$4,631.31
|
| Rate for Payer: Healthscope Commercial |
$7,975.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,203.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,602.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,859.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,646.50
|
| Rate for Payer: Mclaren Medicaid |
$673.71
|
| Rate for Payer: Mclaren Medicaid |
$673.71
|
| Rate for Payer: Mclaren Medicare |
$1,231.65
|
| Rate for Payer: Mclaren Medicare |
$1,231.65
|
| Rate for Payer: Meridian Medicaid |
$707.46
|
| Rate for Payer: Meridian Medicaid |
$707.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,293.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,293.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,416.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,416.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,532.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,374.02
|
| Rate for Payer: PACE Medicare |
$1,170.07
|
| Rate for Payer: PACE Medicare |
$1,170.07
|
| Rate for Payer: PACE SWMI |
$1,231.65
|
| Rate for Payer: PACE SWMI |
$1,231.65
|
| Rate for Payer: PHP Commercial |
$7,532.70
|
| Rate for Payer: PHP Commercial |
$4,374.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,231.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,231.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,203.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,602.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,877.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,877.29
|
| Rate for Payer: Priority Health Medicare |
$1,231.65
|
| Rate for Payer: Priority Health Medicare |
$1,231.65
|
| Rate for Payer: Priority Health Narrow Network |
$3,101.83
|
| Rate for Payer: Priority Health Narrow Network |
$3,101.83
|
| Rate for Payer: Priority Health SBD |
$5,583.06
|
| Rate for Payer: Priority Health SBD |
$3,241.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,231.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,231.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.39
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,231.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,231.65
|
| Rate for Payer: UHC Exchange |
$472.17
|
| Rate for Payer: UHC Exchange |
$472.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,268.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,268.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,903.98
|
| Rate for Payer: UMR Bronson Commercial |
$3,278.94
|
| Rate for Payer: VA VA |
$1,231.65
|
| Rate for Payer: VA VA |
$1,231.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,859.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,646.50
|
|
|
HC SIMULATION - 3D
|
Facility
|
IP
|
$8,862.00
|
|
|
Service Code
|
CPT 77295
|
| Hospital Charge Code |
33300004
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$3,899.28 |
| Max. Negotiated Rate |
$7,975.80 |
| Rate for Payer: Aetna American Axle |
$5,760.30
|
| Rate for Payer: Aetna American Axle |
$3,344.84
|
| Rate for Payer: Aetna Commercial |
$4,374.02
|
| Rate for Payer: Aetna Commercial |
$7,532.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,344.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,760.30
|
| Rate for Payer: Cash Price |
$4,116.72
|
| Rate for Payer: Cash Price |
$7,089.60
|
| Rate for Payer: Cofinity Commercial |
$4,425.47
|
| Rate for Payer: Cofinity Commercial |
$3,602.13
|
| Rate for Payer: Cofinity Commercial |
$7,621.32
|
| Rate for Payer: Cofinity Commercial |
$6,203.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,116.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,089.60
|
| Rate for Payer: Healthscope Commercial |
$7,975.80
|
| Rate for Payer: Healthscope Commercial |
$4,631.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,602.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,203.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,859.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,646.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,374.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,532.70
|
| Rate for Payer: PHP Commercial |
$7,532.70
|
| Rate for Payer: PHP Commercial |
$4,374.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,203.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,602.13
|
| Rate for Payer: Priority Health SBD |
$3,241.92
|
| Rate for Payer: Priority Health SBD |
$5,583.06
|
| Rate for Payer: UMR Bronson Commercial |
$2,264.20
|
| Rate for Payer: UMR Bronson Commercial |
$3,899.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,646.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,859.42
|
|
|
HC SIMULATION - C
|
Facility
|
OP
|
$3,061.00
|
|
|
Service Code
|
CPT 77290
|
| Hospital Charge Code |
33300003
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$179.65 |
| Max. Negotiated Rate |
$2,754.90 |
| Rate for Payer: Aetna American Axle |
$1,989.65
|
| Rate for Payer: Aetna American Axle |
$1,087.98
|
| Rate for Payer: Aetna Commercial |
$1,422.75
|
| Rate for Payer: Aetna Commercial |
$2,601.85
|
| Rate for Payer: Aetna Medicare |
$341.57
|
| Rate for Payer: Aetna Medicare |
$341.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,989.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,087.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS Trust/PPO |
$702.53
|
| Rate for Payer: BCBS Trust/PPO |
$702.53
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: Cash Price |
$1,339.06
|
| Rate for Payer: Cash Price |
$2,448.80
|
| Rate for Payer: Cash Price |
$1,339.06
|
| Rate for Payer: Cash Price |
$2,448.80
|
| Rate for Payer: Cash Price |
$2,448.80
|
| Rate for Payer: Cash Price |
$1,339.06
|
| Rate for Payer: Cofinity Commercial |
$2,142.70
|
| Rate for Payer: Cofinity Commercial |
$1,439.49
|
| Rate for Payer: Cofinity Commercial |
$1,171.67
|
| Rate for Payer: Cofinity Commercial |
$2,632.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,448.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,339.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Healthscope Commercial |
$1,506.44
|
| Rate for Payer: Healthscope Commercial |
$2,754.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,171.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,142.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,255.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,295.75
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,601.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,422.75
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PHP Commercial |
$1,422.75
|
| Rate for Payer: PHP Commercial |
$2,601.85
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,142.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.94
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Narrow Network |
$827.15
|
| Rate for Payer: Priority Health Narrow Network |
$827.15
|
| Rate for Payer: Priority Health SBD |
$1,928.43
|
| Rate for Payer: Priority Health SBD |
$1,054.51
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$483.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$483.72
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.43
|
| Rate for Payer: UHC Exchange |
$439.75
|
| Rate for Payer: UHC Exchange |
$439.75
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: UMR Bronson Commercial |
$619.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,132.57
|
| Rate for Payer: VA VA |
$328.43
|
| Rate for Payer: VA VA |
$328.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,295.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,255.36
|
|
|
HC SIMULATION - C
|
Facility
|
IP
|
$3,061.00
|
|
|
Service Code
|
CPT 77290
|
| Hospital Charge Code |
33300003
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,346.84 |
| Max. Negotiated Rate |
$2,754.90 |
| Rate for Payer: Aetna American Axle |
$1,989.65
|
| Rate for Payer: Aetna American Axle |
$1,087.98
|
| Rate for Payer: Aetna Commercial |
$2,601.85
|
| Rate for Payer: Aetna Commercial |
$1,422.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,087.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,989.65
|
| Rate for Payer: Cash Price |
$1,339.06
|
| Rate for Payer: Cash Price |
$2,448.80
|
| Rate for Payer: Cofinity Commercial |
$1,171.67
|
| Rate for Payer: Cofinity Commercial |
$1,439.49
|
| Rate for Payer: Cofinity Commercial |
$2,142.70
|
| Rate for Payer: Cofinity Commercial |
$2,632.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,339.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,448.80
|
| Rate for Payer: Healthscope Commercial |
$2,754.90
|
| Rate for Payer: Healthscope Commercial |
$1,506.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,171.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,142.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,255.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,295.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,422.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,601.85
|
| Rate for Payer: PHP Commercial |
$1,422.75
|
| Rate for Payer: PHP Commercial |
$2,601.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,171.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,142.70
|
| Rate for Payer: Priority Health SBD |
$1,054.51
|
| Rate for Payer: Priority Health SBD |
$1,928.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,346.84
|
| Rate for Payer: UMR Bronson Commercial |
$736.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,255.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,295.75
|
|
|
HC SIMULATION - I
|
Facility
|
OP
|
$2,642.00
|
|
|
Service Code
|
CPT 77285
|
| Hospital Charge Code |
33300060
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$179.65 |
| Max. Negotiated Rate |
$2,377.80 |
| Rate for Payer: Aetna American Axle |
$1,717.30
|
| Rate for Payer: Aetna American Axle |
$760.50
|
| Rate for Payer: Aetna Commercial |
$994.50
|
| Rate for Payer: Aetna Commercial |
$2,245.70
|
| Rate for Payer: Aetna Medicare |
$341.57
|
| Rate for Payer: Aetna Medicare |
$341.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,717.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$760.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$410.54
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS Complete |
$188.65
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS MAPPO |
$328.43
|
| Rate for Payer: BCBS Trust/PPO |
$729.77
|
| Rate for Payer: BCBS Trust/PPO |
$729.77
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: BCN Medicare Advantage |
$328.43
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cash Price |
$2,113.60
|
| Rate for Payer: Cash Price |
$2,113.60
|
| Rate for Payer: Cash Price |
$2,113.60
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cofinity Commercial |
$819.00
|
| Rate for Payer: Cofinity Commercial |
$2,272.12
|
| Rate for Payer: Cofinity Commercial |
$1,849.40
|
| Rate for Payer: Cofinity Commercial |
$1,006.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$936.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,113.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$328.43
|
| Rate for Payer: Healthscope Commercial |
$1,053.00
|
| Rate for Payer: Healthscope Commercial |
$2,377.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$819.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,849.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$877.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,981.50
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicaid |
$179.65
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Mclaren Medicare |
$328.43
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Medicaid |
$188.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$344.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$377.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$994.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,245.70
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE Medicare |
$312.01
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PACE SWMI |
$328.43
|
| Rate for Payer: PHP Commercial |
$994.50
|
| Rate for Payer: PHP Commercial |
$2,245.70
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: PHP Medicare Advantage |
$328.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$179.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,849.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,033.94
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Medicare |
$328.43
|
| Rate for Payer: Priority Health Narrow Network |
$827.15
|
| Rate for Payer: Priority Health Narrow Network |
$827.15
|
| Rate for Payer: Priority Health SBD |
$737.10
|
| Rate for Payer: Priority Health SBD |
$1,664.46
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: Railroad Medicare Medicare |
$328.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$476.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$476.53
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$328.43
|
| Rate for Payer: UHC Exchange |
$433.21
|
| Rate for Payer: UHC Exchange |
$433.21
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: UHC Medicare Advantage |
$338.28
|
| Rate for Payer: UMR Bronson Commercial |
$432.90
|
| Rate for Payer: UMR Bronson Commercial |
$977.54
|
| Rate for Payer: VA VA |
$328.43
|
| Rate for Payer: VA VA |
$328.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,981.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$877.50
|
|
|
HC SIMULATION - I
|
Facility
|
IP
|
$1,170.00
|
|
|
Service Code
|
CPT 77285
|
| Hospital Charge Code |
33300060
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$514.80 |
| Max. Negotiated Rate |
$1,053.00 |
| Rate for Payer: Aetna American Axle |
$760.50
|
| Rate for Payer: Aetna American Axle |
$1,717.30
|
| Rate for Payer: Aetna Commercial |
$994.50
|
| Rate for Payer: Aetna Commercial |
$2,245.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$760.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,717.30
|
| Rate for Payer: Cash Price |
$936.00
|
| Rate for Payer: Cash Price |
$2,113.60
|
| Rate for Payer: Cofinity Commercial |
$1,006.20
|
| Rate for Payer: Cofinity Commercial |
$2,272.12
|
| Rate for Payer: Cofinity Commercial |
$1,849.40
|
| Rate for Payer: Cofinity Commercial |
$819.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$936.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,113.60
|
| Rate for Payer: Healthscope Commercial |
$1,053.00
|
| Rate for Payer: Healthscope Commercial |
$2,377.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$819.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,849.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$877.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,981.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,245.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$994.50
|
| Rate for Payer: PHP Commercial |
$2,245.70
|
| Rate for Payer: PHP Commercial |
$994.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,849.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.00
|
| Rate for Payer: Priority Health SBD |
$737.10
|
| Rate for Payer: Priority Health SBD |
$1,664.46
|
| Rate for Payer: UMR Bronson Commercial |
$514.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,162.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$877.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,981.50
|
|
|
HC SIMULATION - S
|
Facility
|
IP
|
$1,591.00
|
|
|
Service Code
|
CPT 77280
|
| Hospital Charge Code |
33300002
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$700.04 |
| Max. Negotiated Rate |
$1,431.90 |
| Rate for Payer: Aetna American Axle |
$1,034.15
|
| Rate for Payer: Aetna American Axle |
$464.10
|
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: Aetna Commercial |
$1,352.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,034.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.10
|
| Rate for Payer: Cash Price |
$1,272.80
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$499.80
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Cofinity Commercial |
$1,113.70
|
| Rate for Payer: Cofinity Commercial |
$1,368.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,272.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Healthscope Commercial |
$1,431.90
|
| Rate for Payer: Healthscope Commercial |
$642.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$499.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,113.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,193.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$606.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,352.35
|
| Rate for Payer: PHP Commercial |
$1,352.35
|
| Rate for Payer: PHP Commercial |
$606.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,113.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$499.80
|
| Rate for Payer: Priority Health SBD |
$449.82
|
| Rate for Payer: Priority Health SBD |
$1,002.33
|
| Rate for Payer: UMR Bronson Commercial |
$700.04
|
| Rate for Payer: UMR Bronson Commercial |
$314.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,193.25
|
|
|
HC SIMULATION - S
|
Facility
|
OP
|
$714.00
|
|
|
Service Code
|
CPT 77280
|
| Hospital Charge Code |
33300002
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$65.97 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$464.10
|
| Rate for Payer: Aetna American Axle |
$1,034.15
|
| Rate for Payer: Aetna Commercial |
$1,352.35
|
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: Aetna Medicare |
$125.43
|
| Rate for Payer: Aetna Medicare |
$125.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,034.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.76
|
| Rate for Payer: BCBS Complete |
$69.28
|
| Rate for Payer: BCBS Complete |
$69.28
|
| Rate for Payer: BCBS MAPPO |
$120.61
|
| Rate for Payer: BCBS MAPPO |
$120.61
|
| Rate for Payer: BCBS Trust/PPO |
$439.64
|
| Rate for Payer: BCBS Trust/PPO |
$439.64
|
| Rate for Payer: BCN Medicare Advantage |
$120.61
|
| Rate for Payer: BCN Medicare Advantage |
$120.61
|
| Rate for Payer: Cash Price |
$1,272.80
|
| Rate for Payer: Cash Price |
$1,272.80
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$1,272.80
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$499.80
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Cofinity Commercial |
$1,368.26
|
| Rate for Payer: Cofinity Commercial |
$1,113.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,272.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.61
|
| Rate for Payer: Healthscope Commercial |
$642.60
|
| Rate for Payer: Healthscope Commercial |
$1,431.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$499.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,113.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,193.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.50
|
| Rate for Payer: Mclaren Medicaid |
$65.97
|
| Rate for Payer: Mclaren Medicaid |
$65.97
|
| Rate for Payer: Mclaren Medicare |
$120.61
|
| Rate for Payer: Mclaren Medicare |
$120.61
|
| Rate for Payer: Meridian Medicaid |
$69.28
|
| Rate for Payer: Meridian Medicaid |
$69.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,352.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$606.90
|
| Rate for Payer: PACE Medicare |
$114.58
|
| Rate for Payer: PACE Medicare |
$114.58
|
| Rate for Payer: PACE SWMI |
$120.61
|
| Rate for Payer: PACE SWMI |
$120.61
|
| Rate for Payer: PHP Commercial |
$606.90
|
| Rate for Payer: PHP Commercial |
$1,352.35
|
| Rate for Payer: PHP Medicare Advantage |
$120.61
|
| Rate for Payer: PHP Medicare Advantage |
$120.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$499.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,113.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$379.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$379.68
|
| Rate for Payer: Priority Health Medicare |
$120.61
|
| Rate for Payer: Priority Health Medicare |
$120.61
|
| Rate for Payer: Priority Health Narrow Network |
$303.74
|
| Rate for Payer: Priority Health Narrow Network |
$303.74
|
| Rate for Payer: Priority Health SBD |
$449.82
|
| Rate for Payer: Priority Health SBD |
$1,002.33
|
| Rate for Payer: Railroad Medicare Medicare |
$120.61
|
| Rate for Payer: Railroad Medicare Medicare |
$120.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.03
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.61
|
| Rate for Payer: UHC Exchange |
$264.57
|
| Rate for Payer: UHC Exchange |
$264.57
|
| Rate for Payer: UHC Medicare Advantage |
$124.23
|
| Rate for Payer: UHC Medicare Advantage |
$124.23
|
| Rate for Payer: UMR Bronson Commercial |
$264.18
|
| Rate for Payer: UMR Bronson Commercial |
$588.67
|
| Rate for Payer: VA VA |
$120.61
|
| Rate for Payer: VA VA |
$120.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,193.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.50
|
|
|
HC SINGLE LEAD INSERTION
|
Facility
|
OP
|
$4,255.75
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
36100065
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$359.53 |
| Max. Negotiated Rate |
$23,772.84 |
| Rate for Payer: Aetna American Axle |
$2,766.24
|
| Rate for Payer: Aetna Commercial |
$3,617.39
|
| Rate for Payer: Aetna Medicare |
$7,853.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,766.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,439.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,439.52
|
| Rate for Payer: BCBS Complete |
$4,337.65
|
| Rate for Payer: BCBS MAPPO |
$7,551.62
|
| Rate for Payer: BCBS Trust/PPO |
$7,157.55
|
| Rate for Payer: BCN Medicare Advantage |
$7,551.62
|
| Rate for Payer: Cash Price |
$3,404.60
|
| Rate for Payer: Cash Price |
$3,404.60
|
| Rate for Payer: Cofinity Commercial |
$2,979.02
|
| Rate for Payer: Cofinity Commercial |
$3,659.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,404.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,551.62
|
| Rate for Payer: Healthscope Commercial |
$3,830.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,979.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,191.81
|
| Rate for Payer: Mclaren Medicaid |
$4,130.74
|
| Rate for Payer: Mclaren Medicare |
$7,551.62
|
| Rate for Payer: Meridian Medicaid |
$4,337.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,929.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,684.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,617.39
|
| Rate for Payer: PACE Medicare |
$7,174.04
|
| Rate for Payer: PACE SWMI |
$7,551.62
|
| Rate for Payer: PHP Commercial |
$3,617.39
|
| Rate for Payer: PHP Medicare Advantage |
$7,551.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,130.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,979.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,772.84
|
| Rate for Payer: Priority Health Medicare |
$7,551.62
|
| Rate for Payer: Priority Health Narrow Network |
$19,018.27
|
| Rate for Payer: Priority Health SBD |
$2,681.12
|
| Rate for Payer: Railroad Medicare Medicare |
$7,551.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$395.48
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,551.62
|
| Rate for Payer: UHC Exchange |
$359.53
|
| Rate for Payer: UHC Medicare Advantage |
$7,778.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,574.63
|
| Rate for Payer: VA VA |
$7,551.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,191.81
|
|
|
HC SINGLE LEAD INSERTION
|
Facility
|
IP
|
$4,255.75
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
36100065
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,872.53 |
| Max. Negotiated Rate |
$3,830.18 |
| Rate for Payer: Aetna American Axle |
$2,766.24
|
| Rate for Payer: Aetna Commercial |
$3,617.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,766.24
|
| Rate for Payer: Cash Price |
$3,404.60
|
| Rate for Payer: Cofinity Commercial |
$2,979.02
|
| Rate for Payer: Cofinity Commercial |
$3,659.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,404.60
|
| Rate for Payer: Healthscope Commercial |
$3,830.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,979.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,191.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,617.39
|
| Rate for Payer: PHP Commercial |
$3,617.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,979.02
|
| Rate for Payer: Priority Health SBD |
$2,681.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,872.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,191.81
|
|
|
HC SINOGRAM INJECTION
|
Facility
|
OP
|
$443.15
|
|
|
Service Code
|
CPT 20501
|
| Hospital Charge Code |
36100021
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$35.04 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$288.05
|
| Rate for Payer: Aetna Commercial |
$376.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.05
|
| Rate for Payer: BCBS Complete |
$177.26
|
| Rate for Payer: BCBS Trust/PPO |
$403.56
|
| Rate for Payer: Cash Price |
$354.52
|
| Rate for Payer: Cash Price |
$354.52
|
| Rate for Payer: Cofinity Commercial |
$381.11
|
| Rate for Payer: Cofinity Commercial |
$310.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.52
|
| Rate for Payer: Healthscope Commercial |
$398.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$310.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$332.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$376.68
|
| Rate for Payer: PHP Commercial |
$376.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$310.20
|
| Rate for Payer: Priority Health SBD |
$279.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.54
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$35.04
|
| Rate for Payer: UMR Bronson Commercial |
$163.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$332.36
|
|
|
HC SINOGRAM INJECTION
|
Facility
|
IP
|
$443.15
|
|
|
Service Code
|
CPT 20501
|
| Hospital Charge Code |
36100021
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$194.99 |
| Max. Negotiated Rate |
$398.84 |
| Rate for Payer: Aetna American Axle |
$288.05
|
| Rate for Payer: Aetna Commercial |
$376.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.05
|
| Rate for Payer: Cash Price |
$354.52
|
| Rate for Payer: Cofinity Commercial |
$310.20
|
| Rate for Payer: Cofinity Commercial |
$381.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.52
|
| Rate for Payer: Healthscope Commercial |
$398.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$310.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$332.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$376.68
|
| Rate for Payer: PHP Commercial |
$376.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$310.20
|
| Rate for Payer: Priority Health SBD |
$279.18
|
| Rate for Payer: UMR Bronson Commercial |
$194.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$332.36
|
|
|
HC SIROLIMUS
|
Facility
|
IP
|
$74.46
|
|
|
Service Code
|
CPT 80195
|
| Hospital Charge Code |
30100045
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.76 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna American Axle |
$48.40
|
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.40
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$52.12
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.29
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.12
|
| Rate for Payer: Priority Health SBD |
$46.91
|
| Rate for Payer: UMR Bronson Commercial |
$32.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
HC SIROLIMUS
|
Facility
|
OP
|
$74.46
|
|
|
Service Code
|
CPT 80195
|
| Hospital Charge Code |
30100045
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.51 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna American Axle |
$48.40
|
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: Aetna Medicare |
$14.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.16
|
| Rate for Payer: BCBS Complete |
$7.89
|
| Rate for Payer: BCBS MAPPO |
$13.73
|
| Rate for Payer: BCBS Trust/PPO |
$12.35
|
| Rate for Payer: BCN Medicare Advantage |
$13.73
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Cofinity Commercial |
$52.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.73
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Mclaren Medicaid |
$7.51
|
| Rate for Payer: Mclaren Medicare |
$13.73
|
| Rate for Payer: Meridian Medicaid |
$7.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.29
|
| Rate for Payer: PACE Medicare |
$13.04
|
| Rate for Payer: PACE SWMI |
$13.73
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: PHP Medicare Advantage |
$13.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.84
|
| Rate for Payer: Priority Health Medicare |
$13.73
|
| Rate for Payer: Priority Health Narrow Network |
$15.07
|
| Rate for Payer: Priority Health SBD |
$46.91
|
| Rate for Payer: Railroad Medicare Medicare |
$13.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.48
|
| Rate for Payer: UHC Core |
$22.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.73
|
| Rate for Payer: UHC Exchange |
$13.73
|
| Rate for Payer: UHC Medicare Advantage |
$14.14
|
| Rate for Payer: UMR Bronson Commercial |
$27.55
|
| Rate for Payer: VA VA |
$13.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
HC SKIN FULL GRFT FACE/GENIT/HF 20 SQ CM OR <
|
Facility
|
IP
|
$5,000.00
|
|
|
Service Code
|
CPT 15240
|
| Hospital Charge Code |
76100445
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,200.00 |
| Max. Negotiated Rate |
$4,500.00 |
| Rate for Payer: Aetna American Axle |
$3,250.00
|
| Rate for Payer: Aetna Commercial |
$4,250.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,250.00
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Cofinity Commercial |
$3,500.00
|
| Rate for Payer: Cofinity Commercial |
$4,300.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,000.00
|
| Rate for Payer: Healthscope Commercial |
$4,500.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,500.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,750.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,250.00
|
| Rate for Payer: PHP Commercial |
$4,250.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,500.00
|
| Rate for Payer: Priority Health SBD |
$3,150.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,200.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,750.00
|
|
|
HC SKIN FULL GRFT FACE/GENIT/HF 20 SQ CM OR <
|
Facility
|
OP
|
$5,000.00
|
|
|
Service Code
|
CPT 15240
|
| Hospital Charge Code |
76100445
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$783.24 |
| Max. Negotiated Rate |
$5,102.91 |
| Rate for Payer: Aetna American Axle |
$3,250.00
|
| Rate for Payer: Aetna Commercial |
$4,250.00
|
| Rate for Payer: Aetna Medicare |
$1,685.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,250.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$2,843.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Cash Price |
$4,000.00
|
| Rate for Payer: Cofinity Commercial |
$4,300.00
|
| Rate for Payer: Cofinity Commercial |
$3,500.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,000.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Healthscope Commercial |
$4,500.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,500.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,750.00
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,250.00
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Commercial |
$4,250.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,500.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,102.91
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$4,082.33
|
| Rate for Payer: Priority Health SBD |
$3,150.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$861.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,620.98
|
| Rate for Payer: UHC Exchange |
$783.24
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,850.00
|
| Rate for Payer: VA VA |
$1,620.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,750.00
|
|
|
HC SKIN TAG REMOVAL UP TO 15
|
Facility
|
OP
|
$267.34
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
45000078
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$75.64 |
| 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 |
$139.16
|
| 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 |
$187.14
|
| Rate for Payer: Cofinity Commercial |
$229.91
|
| 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) |
$83.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.95
|
| Rate for Payer: UHC Exchange |
$75.64
|
| 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 SKIN TAG REMOVAL UP TO 15
|
Facility
|
IP
|
$267.34
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
45000078
|
|
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 SKIN TAGS REMOVAL EA ADDL 10 LESIONS
|
Facility
|
OP
|
$18.36
|
|
|
Service Code
|
CPT 11201
|
| Hospital Charge Code |
76100079
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6.79 |
| Max. Negotiated Rate |
$65.05 |
| Rate for Payer: Aetna American Axle |
$11.93
|
| Rate for Payer: Aetna Commercial |
$15.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.93
|
| Rate for Payer: BCBS Complete |
$7.34
|
| Rate for Payer: BCBS Trust/PPO |
$65.05
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$15.79
|
| Rate for Payer: Cofinity Commercial |
$12.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Healthscope Commercial |
$16.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.61
|
| Rate for Payer: PHP Commercial |
$15.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: Priority Health SBD |
$11.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.29
|
| Rate for Payer: UHC Exchange |
$15.72
|
| Rate for Payer: UMR Bronson Commercial |
$6.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.77
|
|
|
HC SKIN TAGS REMOVAL EA ADDL 10 LESIONS
|
Facility
|
IP
|
$18.36
|
|
|
Service Code
|
CPT 11201
|
| Hospital Charge Code |
76100079
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$16.52 |
| Rate for Payer: Aetna American Axle |
$11.93
|
| Rate for Payer: Aetna Commercial |
$15.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.93
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$12.85
|
| Rate for Payer: Cofinity Commercial |
$15.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Healthscope Commercial |
$16.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.61
|
| Rate for Payer: PHP Commercial |
$15.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: Priority Health SBD |
$11.57
|
| Rate for Payer: UMR Bronson Commercial |
$8.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.77
|
|
|
HC SLITTING OF PREPUCE, DORSAL/LAT, EXCEPT NEWBORN
|
Facility
|
IP
|
$2,710.48
|
|
|
Service Code
|
CPT 54001
|
| Hospital Charge Code |
76100250
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,192.61 |
| Max. Negotiated Rate |
$2,439.43 |
| Rate for Payer: Aetna American Axle |
$1,761.81
|
| Rate for Payer: Aetna Commercial |
$2,303.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,761.81
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cofinity Commercial |
$1,897.34
|
| Rate for Payer: Cofinity Commercial |
$2,331.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,168.38
|
| Rate for Payer: Healthscope Commercial |
$2,439.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,897.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,032.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,303.91
|
| Rate for Payer: PHP Commercial |
$2,303.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.34
|
| Rate for Payer: Priority Health SBD |
$1,707.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,192.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,032.86
|
|
|
HC SLITTING OF PREPUCE, DORSAL/LAT, EXCEPT NEWBORN
|
Facility
|
OP
|
$2,710.48
|
|
|
Service Code
|
CPT 54001
|
| Hospital Charge Code |
76100250
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$138.51 |
| Max. Negotiated Rate |
$5,699.47 |
| Rate for Payer: Aetna American Axle |
$1,761.81
|
| Rate for Payer: Aetna Commercial |
$2,303.91
|
| Rate for Payer: Aetna Medicare |
$1,882.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,761.81
|
| 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 |
$1,421.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cofinity Commercial |
$1,897.34
|
| Rate for Payer: Cofinity Commercial |
$2,331.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,168.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$2,439.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,897.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,032.86
|
| 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 |
$2,303.91
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$2,303.91
|
| 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 |
$1,897.34
|
| 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 |
$1,707.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,810.48
|
| Rate for Payer: UHC Exchange |
$138.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,002.88
|
| Rate for Payer: VA VA |
$1,810.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,032.86
|
|
