|
HC HYDROCORTIZONE CREAM
|
Facility
|
OP
|
$9.92
|
|
| Hospital Charge Code |
27000116
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.67 |
| Max. Negotiated Rate |
$8.93 |
| Rate for Payer: Aetna American Axle |
$6.45
|
| Rate for Payer: Aetna Commercial |
$8.43
|
| Rate for Payer: Aetna Medicare |
$4.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.45
|
| Rate for Payer: BCBS Complete |
$3.97
|
| Rate for Payer: Cash Price |
$7.94
|
| Rate for Payer: Cofinity Commercial |
$6.94
|
| Rate for Payer: Cofinity Commercial |
$8.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.94
|
| Rate for Payer: Healthscope Commercial |
$8.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.43
|
| Rate for Payer: PHP Commercial |
$8.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.45
|
| Rate for Payer: Priority Health SBD |
$6.25
|
| Rate for Payer: UMR Bronson Commercial |
$3.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.44
|
|
|
HC HYDROCORTIZONE CREAM
|
Facility
|
IP
|
$9.92
|
|
| Hospital Charge Code |
27000116
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.36 |
| Max. Negotiated Rate |
$8.93 |
| Rate for Payer: Aetna American Axle |
$6.45
|
| Rate for Payer: Aetna Commercial |
$8.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.45
|
| Rate for Payer: Cash Price |
$7.94
|
| Rate for Payer: Cofinity Commercial |
$6.94
|
| Rate for Payer: Cofinity Commercial |
$8.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.94
|
| Rate for Payer: Healthscope Commercial |
$8.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.43
|
| Rate for Payer: PHP Commercial |
$8.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.45
|
| Rate for Payer: Priority Health SBD |
$6.25
|
| Rate for Payer: UMR Bronson Commercial |
$4.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.44
|
|
|
HC HYDRODISSECTION TENDON LEG/ANKLE
|
Facility
|
IP
|
$673.20
|
|
|
Service Code
|
CPT 27899
|
| Hospital Charge Code |
76100417
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$296.21 |
| Max. Negotiated Rate |
$605.88 |
| Rate for Payer: Aetna American Axle |
$437.58
|
| Rate for Payer: Aetna Commercial |
$572.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.58
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$471.24
|
| Rate for Payer: Cofinity Commercial |
$578.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$471.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Healthscope Commercial |
$605.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$471.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$504.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: PHP Commercial |
$572.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health SBD |
$424.12
|
| Rate for Payer: UMR Bronson Commercial |
$296.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$504.90
|
|
|
HC HYDRODISSECTION TENDON LEG/ANKLE
|
Facility
|
OP
|
$673.20
|
|
|
Service Code
|
CPT 27899
|
| Hospital Charge Code |
76100417
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.40 |
| Max. Negotiated Rate |
$658.55 |
| Rate for Payer: Aetna American Axle |
$437.58
|
| Rate for Payer: Aetna Commercial |
$572.22
|
| Rate for Payer: Aetna Medicare |
$243.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$578.95
|
| Rate for Payer: Cofinity Commercial |
$471.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$471.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$605.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$471.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$504.90
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$572.22
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health Medicare |
$233.95
|
| Rate for Payer: Priority Health SBD |
$424.12
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$658.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$447.10
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: UMR Bronson Commercial |
$249.08
|
| Rate for Payer: VA VA |
$233.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$504.90
|
|
|
HC HYDROXYPREGNENOLONE 17
|
Facility
|
OP
|
$88.74
|
|
|
Service Code
|
CPT 84143
|
| Hospital Charge Code |
30100399
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.23 |
| Max. Negotiated Rate |
$79.87 |
| Rate for Payer: Aetna American Axle |
$57.68
|
| Rate for Payer: Aetna Commercial |
$75.43
|
| Rate for Payer: Aetna Medicare |
$23.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.51
|
| Rate for Payer: BCBS Complete |
$12.84
|
| Rate for Payer: BCBS MAPPO |
$22.81
|
| Rate for Payer: BCN Medicare Advantage |
$22.81
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cofinity Commercial |
$76.32
|
| Rate for Payer: Cofinity Commercial |
$62.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.81
|
| Rate for Payer: Healthscope Commercial |
$79.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.56
|
| Rate for Payer: Mclaren Medicaid |
$12.23
|
| Rate for Payer: Mclaren Medicare |
$22.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.95
|
| Rate for Payer: Meridian Medicaid |
$12.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.43
|
| Rate for Payer: PACE Medicare |
$21.67
|
| Rate for Payer: PACE SWMI |
$22.81
|
| Rate for Payer: PHP Commercial |
$75.43
|
| Rate for Payer: PHP Medicare Advantage |
$22.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.68
|
| Rate for Payer: Priority Health Medicare |
$22.81
|
| Rate for Payer: Priority Health SBD |
$55.91
|
| Rate for Payer: Railroad Medicare Medicare |
$22.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.81
|
| Rate for Payer: UHC Exchange |
$43.59
|
| Rate for Payer: UHC Medicare Advantage |
$22.81
|
| Rate for Payer: UHCCP Medicaid |
$12.23
|
| Rate for Payer: UMR Bronson Commercial |
$32.83
|
| Rate for Payer: VA VA |
$22.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.56
|
|
|
HC HYDROXYPREGNENOLONE 17
|
Facility
|
IP
|
$88.74
|
|
|
Service Code
|
CPT 84143
|
| Hospital Charge Code |
30100399
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.05 |
| Max. Negotiated Rate |
$79.87 |
| Rate for Payer: Aetna American Axle |
$57.68
|
| Rate for Payer: Aetna Commercial |
$75.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.68
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cofinity Commercial |
$62.12
|
| Rate for Payer: Cofinity Commercial |
$76.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.99
|
| Rate for Payer: Healthscope Commercial |
$79.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.43
|
| Rate for Payer: PHP Commercial |
$75.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.68
|
| Rate for Payer: Priority Health SBD |
$55.91
|
| Rate for Payer: UMR Bronson Commercial |
$39.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.56
|
|
|
HC HYDROXYPROGESTERONE 17
|
Facility
|
IP
|
$46.00
|
|
|
Service Code
|
CPT 83498
|
| Hospital Charge Code |
30100249
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$41.40 |
| Rate for Payer: Aetna American Axle |
$29.90
|
| Rate for Payer: Aetna Commercial |
$39.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.90
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$32.20
|
| Rate for Payer: Cofinity Commercial |
$39.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.80
|
| Rate for Payer: Healthscope Commercial |
$41.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.10
|
| Rate for Payer: PHP Commercial |
$39.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
| Rate for Payer: Priority Health SBD |
$28.98
|
| Rate for Payer: UMR Bronson Commercial |
$20.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.50
|
|
|
HC HYDROXYPROGESTERONE 17
|
Facility
|
OP
|
$46.00
|
|
|
Service Code
|
CPT 83498
|
| Hospital Charge Code |
30100249
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.56 |
| Max. Negotiated Rate |
$76.48 |
| Rate for Payer: Aetna American Axle |
$29.90
|
| Rate for Payer: Aetna Commercial |
$39.10
|
| Rate for Payer: Aetna Medicare |
$28.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.96
|
| Rate for Payer: BCBS Complete |
$15.29
|
| Rate for Payer: BCBS MAPPO |
$27.17
|
| Rate for Payer: BCN Medicare Advantage |
$27.17
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$39.56
|
| Rate for Payer: Cofinity Commercial |
$32.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.17
|
| Rate for Payer: Healthscope Commercial |
$41.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.50
|
| Rate for Payer: Mclaren Medicaid |
$14.56
|
| Rate for Payer: Mclaren Medicare |
$27.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.53
|
| Rate for Payer: Meridian Medicaid |
$15.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.10
|
| Rate for Payer: PACE Medicare |
$25.81
|
| Rate for Payer: PACE SWMI |
$27.17
|
| Rate for Payer: PHP Commercial |
$39.10
|
| Rate for Payer: PHP Medicare Advantage |
$27.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
| Rate for Payer: Priority Health Medicare |
$27.17
|
| Rate for Payer: Priority Health SBD |
$28.98
|
| Rate for Payer: Railroad Medicare Medicare |
$27.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.17
|
| Rate for Payer: UHC Exchange |
$51.92
|
| Rate for Payer: UHC Medicare Advantage |
$27.17
|
| Rate for Payer: UHCCP Medicaid |
$14.56
|
| Rate for Payer: UMR Bronson Commercial |
$17.02
|
| Rate for Payer: VA VA |
$27.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.50
|
|
|
HC HYPERSENSITIVITY PNEUMO-CMPTS
|
Facility
|
IP
|
$28.09
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200270
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.36 |
| Max. Negotiated Rate |
$25.28 |
| Rate for Payer: Aetna American Axle |
$18.26
|
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.26
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$19.66
|
| Rate for Payer: Cofinity Commercial |
$24.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Healthscope Commercial |
$25.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: PHP Commercial |
$23.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health SBD |
$17.70
|
| Rate for Payer: UMR Bronson Commercial |
$12.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.07
|
|
|
HC HYPERSENSITIVITY PNEUMO-CMPTS
|
Facility
|
OP
|
$28.09
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200270
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$34.48 |
| Rate for Payer: Aetna American Axle |
$18.26
|
| Rate for Payer: Aetna Commercial |
$23.88
|
| Rate for Payer: Aetna Medicare |
$12.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.31
|
| Rate for Payer: BCBS Complete |
$6.89
|
| Rate for Payer: BCBS MAPPO |
$12.25
|
| Rate for Payer: BCN Medicare Advantage |
$12.25
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cash Price |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$24.16
|
| Rate for Payer: Cofinity Commercial |
$19.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.25
|
| Rate for Payer: Healthscope Commercial |
$25.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.07
|
| Rate for Payer: Mclaren Medicaid |
$6.57
|
| Rate for Payer: Mclaren Medicare |
$12.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.86
|
| Rate for Payer: Meridian Medicaid |
$6.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.88
|
| Rate for Payer: PACE Medicare |
$11.64
|
| Rate for Payer: PACE SWMI |
$12.25
|
| Rate for Payer: PHP Commercial |
$23.88
|
| Rate for Payer: PHP Medicare Advantage |
$12.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health Medicare |
$12.25
|
| Rate for Payer: Priority Health SBD |
$17.70
|
| Rate for Payer: Railroad Medicare Medicare |
$12.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.25
|
| Rate for Payer: UHC Exchange |
$23.41
|
| Rate for Payer: UHC Medicare Advantage |
$12.25
|
| Rate for Payer: UHCCP Medicaid |
$6.57
|
| Rate for Payer: UMR Bronson Commercial |
$10.39
|
| Rate for Payer: VA VA |
$12.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.07
|
|
|
HC HYPERSENSITIVITY PNEUMONITIS P
|
Facility
|
OP
|
$29.13
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200223
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$42.36 |
| Rate for Payer: Aetna American Axle |
$18.93
|
| Rate for Payer: Aetna Commercial |
$24.76
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: BCBS Complete |
$8.47
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$20.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$26.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.85
|
| Rate for Payer: Mclaren Medicaid |
$8.07
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: Meridian Medicaid |
$8.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.76
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$24.76
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.93
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health SBD |
$18.35
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.05
|
| Rate for Payer: UHC Exchange |
$28.76
|
| Rate for Payer: UHC Medicare Advantage |
$15.05
|
| Rate for Payer: UHCCP Medicaid |
$8.07
|
| Rate for Payer: UMR Bronson Commercial |
$10.78
|
| Rate for Payer: VA VA |
$15.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.85
|
|
|
HC HYPERSENSITIVITY PNEUMONITIS P
|
Facility
|
IP
|
$29.13
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200223
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.82 |
| Max. Negotiated Rate |
$26.22 |
| Rate for Payer: Aetna American Axle |
$18.93
|
| Rate for Payer: Aetna Commercial |
$24.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.93
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$20.39
|
| Rate for Payer: Cofinity Commercial |
$25.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Healthscope Commercial |
$26.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.76
|
| Rate for Payer: PHP Commercial |
$24.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.93
|
| Rate for Payer: Priority Health SBD |
$18.35
|
| Rate for Payer: UMR Bronson Commercial |
$12.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.85
|
|
|
HC HYPERSENSITIVITY PNEUMO PANEL
|
Facility
|
OP
|
$22.75
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
30200496
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$22.01 |
| Rate for Payer: Aetna American Axle |
$14.79
|
| Rate for Payer: Aetna Commercial |
$19.34
|
| Rate for Payer: Aetna Medicare |
$8.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.78
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$7.82
|
| Rate for Payer: BCN Medicare Advantage |
$7.82
|
| Rate for Payer: Cash Price |
$18.20
|
| Rate for Payer: Cash Price |
$18.20
|
| Rate for Payer: Cofinity Commercial |
$19.57
|
| Rate for Payer: Cofinity Commercial |
$15.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.82
|
| Rate for Payer: Healthscope Commercial |
$20.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.06
|
| Rate for Payer: Mclaren Medicaid |
$4.19
|
| Rate for Payer: Mclaren Medicare |
$7.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.21
|
| Rate for Payer: Meridian Medicaid |
$4.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.34
|
| Rate for Payer: PACE Medicare |
$7.43
|
| Rate for Payer: PACE SWMI |
$7.82
|
| Rate for Payer: PHP Commercial |
$19.34
|
| Rate for Payer: PHP Medicare Advantage |
$7.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.79
|
| Rate for Payer: Priority Health Medicare |
$7.82
|
| Rate for Payer: Priority Health SBD |
$14.33
|
| Rate for Payer: Railroad Medicare Medicare |
$7.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.82
|
| Rate for Payer: UHC Exchange |
$14.94
|
| Rate for Payer: UHC Medicare Advantage |
$7.82
|
| Rate for Payer: UHCCP Medicaid |
$4.19
|
| Rate for Payer: UMR Bronson Commercial |
$8.42
|
| Rate for Payer: VA VA |
$7.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.06
|
|
|
HC HYPERSENSITIVITY PNEUMO PANEL
|
Facility
|
IP
|
$22.75
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
30200496
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.01 |
| Max. Negotiated Rate |
$20.48 |
| Rate for Payer: Aetna American Axle |
$14.79
|
| Rate for Payer: Aetna Commercial |
$19.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.79
|
| Rate for Payer: Cash Price |
$18.20
|
| Rate for Payer: Cofinity Commercial |
$15.93
|
| Rate for Payer: Cofinity Commercial |
$19.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.20
|
| Rate for Payer: Healthscope Commercial |
$20.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.34
|
| Rate for Payer: PHP Commercial |
$19.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.79
|
| Rate for Payer: Priority Health SBD |
$14.33
|
| Rate for Payer: UMR Bronson Commercial |
$10.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.06
|
|
|
HC HYSTEROSCOPY DIAGNOSTIC
|
Facility
|
OP
|
$4,093.79
|
|
|
Service Code
|
CPT 58555
|
| Hospital Charge Code |
76100303
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,514.70 |
| Max. Negotiated Rate |
$8,728.81 |
| Rate for Payer: Aetna American Axle |
$2,660.96
|
| Rate for Payer: Aetna Commercial |
$3,479.72
|
| Rate for Payer: Aetna Medicare |
$3,224.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,660.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,876.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,876.16
|
| Rate for Payer: BCBS Complete |
$1,745.20
|
| Rate for Payer: BCBS MAPPO |
$3,100.93
|
| Rate for Payer: BCN Medicare Advantage |
$3,100.93
|
| Rate for Payer: Cash Price |
$3,275.03
|
| Rate for Payer: Cash Price |
$3,275.03
|
| Rate for Payer: Cofinity Commercial |
$3,520.66
|
| Rate for Payer: Cofinity Commercial |
$2,865.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,865.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,275.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,100.93
|
| Rate for Payer: Healthscope Commercial |
$3,684.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,865.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,070.34
|
| Rate for Payer: Mclaren Medicaid |
$1,662.10
|
| Rate for Payer: Mclaren Medicare |
$3,100.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,255.98
|
| Rate for Payer: Meridian Medicaid |
$1,745.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,566.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,479.72
|
| Rate for Payer: PACE Medicare |
$2,945.88
|
| Rate for Payer: PACE SWMI |
$3,100.93
|
| Rate for Payer: PHP Commercial |
$3,479.72
|
| Rate for Payer: PHP Medicare Advantage |
$3,100.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,662.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,660.96
|
| Rate for Payer: Priority Health Medicare |
$3,100.93
|
| Rate for Payer: Priority Health SBD |
$2,579.09
|
| Rate for Payer: Railroad Medicare Medicare |
$3,100.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,728.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,100.93
|
| Rate for Payer: UHC Exchange |
$5,926.19
|
| Rate for Payer: UHC Medicare Advantage |
$3,100.93
|
| Rate for Payer: UHCCP Medicaid |
$1,662.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,514.70
|
| Rate for Payer: VA VA |
$3,100.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,070.34
|
|
|
HC HYSTEROSCOPY DIAGNOSTIC
|
Facility
|
IP
|
$4,093.79
|
|
|
Service Code
|
CPT 58555
|
| Hospital Charge Code |
76100303
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,801.27 |
| Max. Negotiated Rate |
$3,684.41 |
| Rate for Payer: Aetna American Axle |
$2,660.96
|
| Rate for Payer: Aetna Commercial |
$3,479.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,660.96
|
| Rate for Payer: Cash Price |
$3,275.03
|
| Rate for Payer: Cofinity Commercial |
$2,865.65
|
| Rate for Payer: Cofinity Commercial |
$3,520.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,865.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,275.03
|
| Rate for Payer: Healthscope Commercial |
$3,684.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,865.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,070.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,479.72
|
| Rate for Payer: PHP Commercial |
$3,479.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,660.96
|
| Rate for Payer: Priority Health SBD |
$2,579.09
|
| Rate for Payer: UMR Bronson Commercial |
$1,801.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,070.34
|
|
|
HC HYSTEROSCOPY ENDOMETR ABLATION
|
Facility
|
OP
|
$13,353.53
|
|
|
Service Code
|
CPT 58563
|
| Hospital Charge Code |
76100340
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,580.53 |
| Max. Negotiated Rate |
$13,552.11 |
| Rate for Payer: Aetna American Axle |
$8,679.79
|
| Rate for Payer: Aetna Commercial |
$11,350.50
|
| Rate for Payer: Aetna Medicare |
$5,007.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,679.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,018.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,018.02
|
| Rate for Payer: BCBS Complete |
$2,709.56
|
| Rate for Payer: BCBS MAPPO |
$4,814.42
|
| Rate for Payer: BCN Medicare Advantage |
$4,814.42
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$9,347.47
|
| Rate for Payer: Cofinity Commercial |
$11,484.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,347.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,814.42
|
| Rate for Payer: Healthscope Commercial |
$12,018.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,347.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,015.15
|
| Rate for Payer: Mclaren Medicaid |
$2,580.53
|
| Rate for Payer: Mclaren Medicare |
$4,814.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,055.14
|
| Rate for Payer: Meridian Medicaid |
$2,709.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,536.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: PACE Medicare |
$4,573.70
|
| Rate for Payer: PACE SWMI |
$4,814.42
|
| Rate for Payer: PHP Commercial |
$11,350.50
|
| Rate for Payer: PHP Medicare Advantage |
$4,814.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,580.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: Priority Health Medicare |
$4,814.42
|
| Rate for Payer: Priority Health SBD |
$8,412.72
|
| Rate for Payer: Railroad Medicare Medicare |
$4,814.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,552.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,814.42
|
| Rate for Payer: UHC Exchange |
$9,200.84
|
| Rate for Payer: UHC Medicare Advantage |
$4,814.42
|
| Rate for Payer: UHCCP Medicaid |
$2,580.53
|
| Rate for Payer: UMR Bronson Commercial |
$4,940.81
|
| Rate for Payer: VA VA |
$4,814.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,015.15
|
|
|
HC HYSTEROSCOPY ENDOMETR ABLATION
|
Facility
|
IP
|
$13,353.53
|
|
|
Service Code
|
CPT 58563
|
| Hospital Charge Code |
76100340
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,875.55 |
| Max. Negotiated Rate |
$12,018.18 |
| Rate for Payer: Aetna American Axle |
$8,679.79
|
| Rate for Payer: Aetna Commercial |
$11,350.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,679.79
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$11,484.04
|
| Rate for Payer: Cofinity Commercial |
$9,347.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,347.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Healthscope Commercial |
$12,018.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,347.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,015.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: PHP Commercial |
$11,350.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: Priority Health SBD |
$8,412.72
|
| Rate for Payer: UMR Bronson Commercial |
$5,875.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,015.15
|
|
|
HC HYSTEROSCOPY REMOVE FB
|
Facility
|
OP
|
$7,945.53
|
|
|
Service Code
|
CPT 58562
|
| Hospital Charge Code |
76100339
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,662.10 |
| Max. Negotiated Rate |
$8,728.81 |
| Rate for Payer: Aetna American Axle |
$5,164.59
|
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: Aetna Medicare |
$3,224.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,164.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,876.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,876.16
|
| Rate for Payer: BCBS Complete |
$1,745.20
|
| Rate for Payer: BCBS MAPPO |
$3,100.93
|
| Rate for Payer: BCN Medicare Advantage |
$3,100.93
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Cofinity Commercial |
$5,561.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,561.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,100.93
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,561.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Mclaren Medicaid |
$1,662.10
|
| Rate for Payer: Mclaren Medicare |
$3,100.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,255.98
|
| Rate for Payer: Meridian Medicaid |
$1,745.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,566.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: PACE Medicare |
$2,945.88
|
| Rate for Payer: PACE SWMI |
$3,100.93
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,100.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,662.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health Medicare |
$3,100.93
|
| Rate for Payer: Priority Health SBD |
$5,005.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,100.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,728.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,100.93
|
| Rate for Payer: UHC Exchange |
$5,926.19
|
| Rate for Payer: UHC Medicare Advantage |
$3,100.93
|
| Rate for Payer: UHCCP Medicaid |
$1,662.10
|
| Rate for Payer: UMR Bronson Commercial |
$2,939.85
|
| Rate for Payer: VA VA |
$3,100.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC HYSTEROSCOPY REMOVE FB
|
Facility
|
IP
|
$7,945.53
|
|
|
Service Code
|
CPT 58562
|
| Hospital Charge Code |
76100339
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,496.03 |
| Max. Negotiated Rate |
$7,150.98 |
| Rate for Payer: Aetna American Axle |
$5,164.59
|
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,164.59
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$5,561.87
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,561.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,561.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health SBD |
$5,005.68
|
| Rate for Payer: UMR Bronson Commercial |
$3,496.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC HYSTEROSCOPY REMOVE MYOMA
|
Facility
|
OP
|
$13,353.53
|
|
|
Service Code
|
CPT 58561
|
| Hospital Charge Code |
76100338
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,580.53 |
| Max. Negotiated Rate |
$13,552.11 |
| Rate for Payer: Aetna American Axle |
$8,679.79
|
| Rate for Payer: Aetna Commercial |
$11,350.50
|
| Rate for Payer: Aetna Medicare |
$5,007.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,679.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,018.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,018.02
|
| Rate for Payer: BCBS Complete |
$2,709.56
|
| Rate for Payer: BCBS MAPPO |
$4,814.42
|
| Rate for Payer: BCN Medicare Advantage |
$4,814.42
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$9,347.47
|
| Rate for Payer: Cofinity Commercial |
$11,484.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,347.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,814.42
|
| Rate for Payer: Healthscope Commercial |
$12,018.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,347.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,015.15
|
| Rate for Payer: Mclaren Medicaid |
$2,580.53
|
| Rate for Payer: Mclaren Medicare |
$4,814.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,055.14
|
| Rate for Payer: Meridian Medicaid |
$2,709.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,536.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: PACE Medicare |
$4,573.70
|
| Rate for Payer: PACE SWMI |
$4,814.42
|
| Rate for Payer: PHP Commercial |
$11,350.50
|
| Rate for Payer: PHP Medicare Advantage |
$4,814.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,580.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: Priority Health Medicare |
$4,814.42
|
| Rate for Payer: Priority Health SBD |
$8,412.72
|
| Rate for Payer: Railroad Medicare Medicare |
$4,814.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,552.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,814.42
|
| Rate for Payer: UHC Exchange |
$9,200.84
|
| Rate for Payer: UHC Medicare Advantage |
$4,814.42
|
| Rate for Payer: UHCCP Medicaid |
$2,580.53
|
| Rate for Payer: UMR Bronson Commercial |
$4,940.81
|
| Rate for Payer: VA VA |
$4,814.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,015.15
|
|
|
HC HYSTEROSCOPY REMOVE MYOMA
|
Facility
|
IP
|
$13,353.53
|
|
|
Service Code
|
CPT 58561
|
| Hospital Charge Code |
76100338
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,875.55 |
| Max. Negotiated Rate |
$12,018.18 |
| Rate for Payer: Aetna American Axle |
$8,679.79
|
| Rate for Payer: Aetna Commercial |
$11,350.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,679.79
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$11,484.04
|
| Rate for Payer: Cofinity Commercial |
$9,347.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,347.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Healthscope Commercial |
$12,018.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,347.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,015.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: PHP Commercial |
$11,350.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: Priority Health SBD |
$8,412.72
|
| Rate for Payer: UMR Bronson Commercial |
$5,875.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,015.15
|
|
|
HC HYSTEROSCOPY RESECT SEPTUM
|
Facility
|
OP
|
$13,353.53
|
|
|
Service Code
|
CPT 58560
|
| Hospital Charge Code |
76100337
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,580.53 |
| Max. Negotiated Rate |
$13,552.11 |
| Rate for Payer: Aetna American Axle |
$8,679.79
|
| Rate for Payer: Aetna Commercial |
$11,350.50
|
| Rate for Payer: Aetna Medicare |
$5,007.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,679.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,018.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,018.02
|
| Rate for Payer: BCBS Complete |
$2,709.56
|
| Rate for Payer: BCBS MAPPO |
$4,814.42
|
| Rate for Payer: BCN Medicare Advantage |
$4,814.42
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$9,347.47
|
| Rate for Payer: Cofinity Commercial |
$11,484.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,347.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,814.42
|
| Rate for Payer: Healthscope Commercial |
$12,018.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,347.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,015.15
|
| Rate for Payer: Mclaren Medicaid |
$2,580.53
|
| Rate for Payer: Mclaren Medicare |
$4,814.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,055.14
|
| Rate for Payer: Meridian Medicaid |
$2,709.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,536.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: PACE Medicare |
$4,573.70
|
| Rate for Payer: PACE SWMI |
$4,814.42
|
| Rate for Payer: PHP Commercial |
$11,350.50
|
| Rate for Payer: PHP Medicare Advantage |
$4,814.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,580.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: Priority Health Medicare |
$4,814.42
|
| Rate for Payer: Priority Health SBD |
$8,412.72
|
| Rate for Payer: Railroad Medicare Medicare |
$4,814.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,552.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,814.42
|
| Rate for Payer: UHC Exchange |
$9,200.84
|
| Rate for Payer: UHC Medicare Advantage |
$4,814.42
|
| Rate for Payer: UHCCP Medicaid |
$2,580.53
|
| Rate for Payer: UMR Bronson Commercial |
$4,940.81
|
| Rate for Payer: VA VA |
$4,814.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,015.15
|
|
|
HC HYSTEROSCOPY RESECT SEPTUM
|
Facility
|
IP
|
$13,353.53
|
|
|
Service Code
|
CPT 58560
|
| Hospital Charge Code |
76100337
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,875.55 |
| Max. Negotiated Rate |
$12,018.18 |
| Rate for Payer: Aetna American Axle |
$8,679.79
|
| Rate for Payer: Aetna Commercial |
$11,350.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,679.79
|
| Rate for Payer: Cash Price |
$10,682.82
|
| Rate for Payer: Cofinity Commercial |
$11,484.04
|
| Rate for Payer: Cofinity Commercial |
$9,347.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,347.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,682.82
|
| Rate for Payer: Healthscope Commercial |
$12,018.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,347.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,015.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,350.50
|
| Rate for Payer: PHP Commercial |
$11,350.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,679.79
|
| Rate for Payer: Priority Health SBD |
$8,412.72
|
| Rate for Payer: UMR Bronson Commercial |
$5,875.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,015.15
|
|
|
HC HYSTEROSCOPY W BX AND/OR POLYPECTOMY W OR WO D&C
|
Facility
|
OP
|
$4,093.79
|
|
|
Service Code
|
CPT 58558
|
| Hospital Charge Code |
76100304
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,514.70 |
| Max. Negotiated Rate |
$8,728.81 |
| Rate for Payer: Aetna American Axle |
$2,660.96
|
| Rate for Payer: Aetna Commercial |
$3,479.72
|
| Rate for Payer: Aetna Medicare |
$3,224.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,660.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,876.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,876.16
|
| Rate for Payer: BCBS Complete |
$1,745.20
|
| Rate for Payer: BCBS MAPPO |
$3,100.93
|
| Rate for Payer: BCN Medicare Advantage |
$3,100.93
|
| Rate for Payer: Cash Price |
$3,275.03
|
| Rate for Payer: Cash Price |
$3,275.03
|
| Rate for Payer: Cofinity Commercial |
$3,520.66
|
| Rate for Payer: Cofinity Commercial |
$2,865.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,865.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,275.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,100.93
|
| Rate for Payer: Healthscope Commercial |
$3,684.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,865.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,070.34
|
| Rate for Payer: Mclaren Medicaid |
$1,662.10
|
| Rate for Payer: Mclaren Medicare |
$3,100.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,255.98
|
| Rate for Payer: Meridian Medicaid |
$1,745.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,566.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,479.72
|
| Rate for Payer: PACE Medicare |
$2,945.88
|
| Rate for Payer: PACE SWMI |
$3,100.93
|
| Rate for Payer: PHP Commercial |
$3,479.72
|
| Rate for Payer: PHP Medicare Advantage |
$3,100.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,662.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,660.96
|
| Rate for Payer: Priority Health Medicare |
$3,100.93
|
| Rate for Payer: Priority Health SBD |
$2,579.09
|
| Rate for Payer: Railroad Medicare Medicare |
$3,100.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,728.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,100.93
|
| Rate for Payer: UHC Exchange |
$5,926.19
|
| Rate for Payer: UHC Medicare Advantage |
$3,100.93
|
| Rate for Payer: UHCCP Medicaid |
$1,662.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,514.70
|
| Rate for Payer: VA VA |
$3,100.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,070.34
|
|
