|
HC IBD DIFF
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200488
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna American Axle |
$40.44
|
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$11.61
|
| Rate for Payer: BCN Commercial |
$11.61
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Cofinity Commercial |
$43.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$18.08
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$9.64
|
| Rate for Payer: Priority Health SBD |
$39.20
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$12.05
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: UMR Bronson Commercial |
$23.02
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC IBD DIFF
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200488
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.38 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna American Axle |
$40.44
|
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.44
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$43.55
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health SBD |
$39.20
|
| Rate for Payer: UMR Bronson Commercial |
$27.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC IBD DIFFERENTIATION
|
Facility
|
OP
|
$62.22
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200174
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna American Axle |
$40.44
|
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$11.61
|
| Rate for Payer: BCN Commercial |
$11.61
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Cofinity Commercial |
$43.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: Nomi Health Commercial |
$18.08
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$9.64
|
| Rate for Payer: Priority Health SBD |
$39.20
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$12.05
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: UMR Bronson Commercial |
$23.02
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC IBD DIFFERENTIATION
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200174
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.38 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna American Axle |
$40.44
|
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.44
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$43.55
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health SBD |
$39.20
|
| Rate for Payer: UMR Bronson Commercial |
$27.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC IBD DIFFERENTIATION CMPT
|
Facility
|
OP
|
$58.14
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200386
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna American Axle |
$37.79
|
| Rate for Payer: Aetna Commercial |
$49.42
|
| Rate for Payer: Aetna Medicare |
$12.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.79
|
| 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: BCBS Trust/PPO |
$11.81
|
| Rate for Payer: BCN Commercial |
$11.81
|
| Rate for Payer: BCN Medicare Advantage |
$12.25
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$50.00
|
| Rate for Payer: Cofinity Commercial |
$40.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.25
|
| Rate for Payer: Healthscope Commercial |
$52.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.60
|
| 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 |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$18.38
|
| Rate for Payer: PACE Medicare |
$11.64
|
| Rate for Payer: PACE SWMI |
$12.25
|
| Rate for Payer: PHP Commercial |
$49.42
|
| 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 |
$37.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.61
|
| Rate for Payer: Priority Health Medicare |
$12.25
|
| Rate for Payer: Priority Health Narrow Network |
$10.09
|
| Rate for Payer: Priority Health SBD |
$36.63
|
| Rate for Payer: Railroad Medicare Medicare |
$12.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.25
|
| Rate for Payer: UHC Exchange |
$12.25
|
| Rate for Payer: UHC Medicare Advantage |
$12.25
|
| Rate for Payer: UHCCP Medicaid |
$6.57
|
| Rate for Payer: UMR Bronson Commercial |
$21.51
|
| Rate for Payer: VA VA |
$12.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.60
|
|
|
HC IBD DIFFERENTIATION CMPT
|
Facility
|
IP
|
$58.14
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200386
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.58 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna American Axle |
$37.79
|
| Rate for Payer: Aetna Commercial |
$49.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.79
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$40.70
|
| Rate for Payer: Cofinity Commercial |
$50.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Healthscope Commercial |
$52.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: PHP Commercial |
$49.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: Priority Health SBD |
$36.63
|
| Rate for Payer: UMR Bronson Commercial |
$25.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.60
|
|
|
HC ICD CRT/DUAL IMPLANT/REPLACE
|
Facility
|
IP
|
$26,928.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,848.32 |
| Max. Negotiated Rate |
$24,235.20 |
| Rate for Payer: Aetna American Axle |
$17,503.20
|
| Rate for Payer: Aetna Commercial |
$22,888.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,503.20
|
| Rate for Payer: Cash Price |
$21,542.40
|
| Rate for Payer: Cofinity Commercial |
$18,849.60
|
| Rate for Payer: Cofinity Commercial |
$23,158.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$18,849.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,542.40
|
| Rate for Payer: Healthscope Commercial |
$24,235.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18,849.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,196.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,888.80
|
| Rate for Payer: PHP Commercial |
$22,888.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,503.20
|
| Rate for Payer: Priority Health SBD |
$16,964.64
|
| Rate for Payer: UMR Bronson Commercial |
$11,848.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,196.00
|
|
|
HC ICD CRT/DUAL IMPLANT/REPLACE
|
Facility
|
OP
|
$26,928.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$873.58 |
| Max. Negotiated Rate |
$98,731.50 |
| Rate for Payer: Aetna American Axle |
$17,503.20
|
| Rate for Payer: Aetna Commercial |
$22,888.80
|
| Rate for Payer: Aetna Medicare |
$32,669.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,503.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,266.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,266.61
|
| Rate for Payer: BCBS Complete |
$17,679.40
|
| Rate for Payer: BCBS MAPPO |
$31,413.29
|
| Rate for Payer: BCBS Trust/PPO |
$38,038.54
|
| Rate for Payer: BCN Commercial |
$38,038.54
|
| Rate for Payer: BCN Medicare Advantage |
$31,413.29
|
| Rate for Payer: Cash Price |
$21,542.40
|
| Rate for Payer: Cash Price |
$21,542.40
|
| Rate for Payer: Cash Price |
$21,542.40
|
| Rate for Payer: Cofinity Commercial |
$23,158.08
|
| Rate for Payer: Cofinity Commercial |
$18,849.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$18,849.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,542.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,413.29
|
| Rate for Payer: Healthscope Commercial |
$24,235.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18,849.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,196.00
|
| Rate for Payer: Mclaren Medicaid |
$16,837.52
|
| Rate for Payer: Mclaren Medicare |
$31,413.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,983.95
|
| Rate for Payer: Meridian Medicaid |
$17,679.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36,125.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,888.80
|
| Rate for Payer: Nomi Health Commercial |
$65,967.91
|
| Rate for Payer: PACE Medicare |
$29,842.63
|
| Rate for Payer: PACE SWMI |
$31,413.29
|
| Rate for Payer: PHP Commercial |
$22,888.80
|
| Rate for Payer: PHP Medicare Advantage |
$31,413.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,837.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,503.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98,731.50
|
| Rate for Payer: Priority Health Medicare |
$31,413.29
|
| Rate for Payer: Priority Health Narrow Network |
$78,985.20
|
| Rate for Payer: Priority Health SBD |
$16,964.64
|
| Rate for Payer: Railroad Medicare Medicare |
$31,413.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$960.94
|
| Rate for Payer: UHC Core |
$52,490.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$31,413.29
|
| Rate for Payer: UHC Exchange |
$873.58
|
| Rate for Payer: UHC Medicare Advantage |
$31,413.29
|
| Rate for Payer: UHCCP Medicaid |
$16,837.52
|
| Rate for Payer: UMR Bronson Commercial |
$9,963.36
|
| Rate for Payer: VA VA |
$31,413.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,196.00
|
|
|
HC ICD CRT/DUAL REPLACEMENT
|
Facility
|
IP
|
$11,444.40
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
36100075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,035.54 |
| Max. Negotiated Rate |
$10,299.96 |
| Rate for Payer: Cofinity Commercial |
$8,011.08
|
| Rate for Payer: Aetna American Axle |
$7,438.86
|
| Rate for Payer: Aetna Commercial |
$9,727.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,438.86
|
| Rate for Payer: Cash Price |
$9,155.52
|
| Rate for Payer: Cofinity Commercial |
$9,842.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,011.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,155.52
|
| Rate for Payer: Healthscope Commercial |
$10,299.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,011.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,583.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,727.74
|
| Rate for Payer: PHP Commercial |
$9,727.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,438.86
|
| Rate for Payer: Priority Health SBD |
$7,209.97
|
| Rate for Payer: UMR Bronson Commercial |
$5,035.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,583.30
|
|
|
HC ICD CRT/DUAL REPLACEMENT
|
Facility
|
OP
|
$11,444.40
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
36100075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$352.86 |
| Max. Negotiated Rate |
$69,121.55 |
| Rate for Payer: Aetna American Axle |
$7,438.86
|
| Rate for Payer: Aetna Commercial |
$9,727.74
|
| Rate for Payer: Aetna Medicare |
$22,872.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,438.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,490.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,490.41
|
| Rate for Payer: BCBS Complete |
$12,377.28
|
| Rate for Payer: BCBS MAPPO |
$21,992.33
|
| Rate for Payer: BCBS Trust/PPO |
$35,137.10
|
| Rate for Payer: BCN Commercial |
$35,137.10
|
| Rate for Payer: BCN Medicare Advantage |
$21,992.33
|
| Rate for Payer: Cash Price |
$9,155.52
|
| Rate for Payer: Cash Price |
$9,155.52
|
| Rate for Payer: Cash Price |
$9,155.52
|
| Rate for Payer: Cofinity Commercial |
$9,842.18
|
| Rate for Payer: Cofinity Commercial |
$8,011.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,011.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,155.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,992.33
|
| Rate for Payer: Healthscope Commercial |
$10,299.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,011.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,583.30
|
| Rate for Payer: Mclaren Medicaid |
$11,787.89
|
| Rate for Payer: Mclaren Medicare |
$21,992.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,091.95
|
| Rate for Payer: Meridian Medicaid |
$12,377.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,291.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,727.74
|
| Rate for Payer: Nomi Health Commercial |
$46,183.89
|
| Rate for Payer: PACE Medicare |
$20,892.71
|
| Rate for Payer: PACE SWMI |
$21,992.33
|
| Rate for Payer: PHP Commercial |
$9,727.74
|
| Rate for Payer: PHP Medicare Advantage |
$21,992.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,787.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,438.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69,121.55
|
| Rate for Payer: Priority Health Medicare |
$21,992.33
|
| Rate for Payer: Priority Health Narrow Network |
$55,297.24
|
| Rate for Payer: Priority Health SBD |
$7,209.97
|
| Rate for Payer: Railroad Medicare Medicare |
$21,992.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$388.15
|
| Rate for Payer: UHC Core |
$52,490.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,992.33
|
| Rate for Payer: UHC Exchange |
$352.86
|
| Rate for Payer: UHC Medicare Advantage |
$21,992.33
|
| Rate for Payer: UHCCP Medicaid |
$11,787.89
|
| Rate for Payer: UMR Bronson Commercial |
$4,234.43
|
| Rate for Payer: VA VA |
$21,992.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,583.30
|
|
|
HC ICD LEAD REMOVAL
|
Facility
|
IP
|
$2,717.88
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
36100078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,195.87 |
| Max. Negotiated Rate |
$2,446.09 |
| Rate for Payer: Aetna American Axle |
$1,766.62
|
| Rate for Payer: Aetna Commercial |
$2,310.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,766.62
|
| Rate for Payer: Cash Price |
$2,174.30
|
| Rate for Payer: Cofinity Commercial |
$1,902.52
|
| Rate for Payer: Cofinity Commercial |
$2,337.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,902.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,174.30
|
| Rate for Payer: Healthscope Commercial |
$2,446.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,902.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,038.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,310.20
|
| Rate for Payer: PHP Commercial |
$2,310.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,766.62
|
| Rate for Payer: Priority Health SBD |
$1,712.26
|
| Rate for Payer: UMR Bronson Commercial |
$1,195.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,038.41
|
|
|
HC ICD LEAD REMOVAL
|
Facility
|
OP
|
$2,717.88
|
|
|
Service Code
|
CPT 33244
|
| Hospital Charge Code |
36100078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$826.03 |
| Max. Negotiated Rate |
$11,206.98 |
| Rate for Payer: Aetna American Axle |
$1,766.62
|
| Rate for Payer: Aetna Commercial |
$2,310.20
|
| Rate for Payer: Aetna Medicare |
$3,708.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,766.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,457.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,457.14
|
| Rate for Payer: BCBS Complete |
$2,006.78
|
| Rate for Payer: BCBS MAPPO |
$3,565.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,390.61
|
| Rate for Payer: BCN Commercial |
$2,390.61
|
| Rate for Payer: BCN Medicare Advantage |
$3,565.71
|
| Rate for Payer: Cash Price |
$2,174.30
|
| Rate for Payer: Cash Price |
$2,174.30
|
| Rate for Payer: Cash Price |
$2,174.30
|
| Rate for Payer: Cofinity Commercial |
$1,902.52
|
| Rate for Payer: Cofinity Commercial |
$2,337.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,902.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,174.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,565.71
|
| Rate for Payer: Healthscope Commercial |
$2,446.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,902.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,038.41
|
| Rate for Payer: Mclaren Medicaid |
$1,911.22
|
| Rate for Payer: Mclaren Medicare |
$3,565.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,744.00
|
| Rate for Payer: Meridian Medicaid |
$2,006.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,100.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,310.20
|
| Rate for Payer: Nomi Health Commercial |
$10,697.13
|
| Rate for Payer: PACE Medicare |
$3,387.42
|
| Rate for Payer: PACE SWMI |
$3,565.71
|
| Rate for Payer: PHP Commercial |
$2,310.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,565.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,911.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,766.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,206.98
|
| Rate for Payer: Priority Health Medicare |
$3,565.71
|
| Rate for Payer: Priority Health Narrow Network |
$8,965.58
|
| Rate for Payer: Priority Health SBD |
$1,712.26
|
| Rate for Payer: Railroad Medicare Medicare |
$3,565.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$908.63
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,565.71
|
| Rate for Payer: UHC Exchange |
$826.03
|
| Rate for Payer: UHC Medicare Advantage |
$3,565.71
|
| Rate for Payer: UHCCP Medicaid |
$1,911.22
|
| Rate for Payer: UMR Bronson Commercial |
$1,005.62
|
| Rate for Payer: VA VA |
$3,565.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,038.41
|
|
|
HC ICD POCKET REVISION
|
Facility
|
IP
|
$3,164.22
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
36100068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,392.26 |
| Max. Negotiated Rate |
$2,847.80 |
| Rate for Payer: Aetna American Axle |
$2,056.74
|
| Rate for Payer: Aetna Commercial |
$2,689.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,056.74
|
| Rate for Payer: Cash Price |
$2,531.38
|
| Rate for Payer: Cofinity Commercial |
$2,214.95
|
| Rate for Payer: Cofinity Commercial |
$2,721.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,214.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,531.38
|
| Rate for Payer: Healthscope Commercial |
$2,847.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,214.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,373.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,689.59
|
| Rate for Payer: PHP Commercial |
$2,689.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,056.74
|
| Rate for Payer: Priority Health SBD |
$1,993.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,392.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,373.16
|
|
|
HC ICD POCKET REVISION
|
Facility
|
OP
|
$3,164.22
|
|
|
Service Code
|
CPT 33223
|
| Hospital Charge Code |
36100068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$391.44 |
| Max. Negotiated Rate |
$5,632.99 |
| Rate for Payer: Aetna American Axle |
$2,056.74
|
| Rate for Payer: Aetna Commercial |
$2,689.59
|
| Rate for Payer: Aetna Medicare |
$1,863.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,056.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,240.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,240.30
|
| Rate for Payer: BCBS Complete |
$1,008.67
|
| Rate for Payer: BCBS MAPPO |
$1,792.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,401.99
|
| Rate for Payer: BCN Commercial |
$1,401.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,792.24
|
| Rate for Payer: Cash Price |
$2,531.38
|
| Rate for Payer: Cash Price |
$2,531.38
|
| Rate for Payer: Cash Price |
$2,531.38
|
| Rate for Payer: Cofinity Commercial |
$2,721.23
|
| Rate for Payer: Cofinity Commercial |
$2,214.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,214.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,531.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,792.24
|
| Rate for Payer: Healthscope Commercial |
$2,847.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,214.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,373.16
|
| Rate for Payer: Mclaren Medicaid |
$960.64
|
| Rate for Payer: Mclaren Medicare |
$1,792.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,881.85
|
| Rate for Payer: Meridian Medicaid |
$1,008.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,061.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,689.59
|
| Rate for Payer: Nomi Health Commercial |
$3,763.70
|
| Rate for Payer: PACE Medicare |
$1,702.63
|
| Rate for Payer: PACE SWMI |
$1,792.24
|
| Rate for Payer: PHP Commercial |
$2,689.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,792.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$960.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,056.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,632.99
|
| Rate for Payer: Priority Health Medicare |
$1,792.24
|
| Rate for Payer: Priority Health Narrow Network |
$4,506.39
|
| Rate for Payer: Priority Health SBD |
$1,993.46
|
| Rate for Payer: Railroad Medicare Medicare |
$1,792.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$430.58
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,792.24
|
| Rate for Payer: UHC Exchange |
$391.44
|
| Rate for Payer: UHC Medicare Advantage |
$1,792.24
|
| Rate for Payer: UHCCP Medicaid |
$960.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,170.76
|
| Rate for Payer: VA VA |
$1,792.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,373.16
|
|
|
HC ICD SINGLE IMPLANT
|
Facility
|
OP
|
$19,074.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$873.58 |
| Max. Negotiated Rate |
$98,731.50 |
| Rate for Payer: Aetna American Axle |
$12,398.10
|
| Rate for Payer: Aetna Commercial |
$16,212.90
|
| Rate for Payer: Aetna Medicare |
$32,669.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,398.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,266.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,266.61
|
| Rate for Payer: BCBS Complete |
$17,679.40
|
| Rate for Payer: BCBS MAPPO |
$31,413.29
|
| Rate for Payer: BCBS Trust/PPO |
$38,038.54
|
| Rate for Payer: BCN Commercial |
$38,038.54
|
| Rate for Payer: BCN Medicare Advantage |
$31,413.29
|
| Rate for Payer: Cash Price |
$15,259.20
|
| Rate for Payer: Cash Price |
$15,259.20
|
| Rate for Payer: Cash Price |
$15,259.20
|
| Rate for Payer: Cofinity Commercial |
$16,403.64
|
| Rate for Payer: Cofinity Commercial |
$13,351.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$13,351.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,259.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,413.29
|
| Rate for Payer: Healthscope Commercial |
$17,166.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,351.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,305.50
|
| Rate for Payer: Mclaren Medicaid |
$16,837.52
|
| Rate for Payer: Mclaren Medicare |
$31,413.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,983.95
|
| Rate for Payer: Meridian Medicaid |
$17,679.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36,125.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,212.90
|
| Rate for Payer: Nomi Health Commercial |
$65,967.91
|
| Rate for Payer: PACE Medicare |
$29,842.63
|
| Rate for Payer: PACE SWMI |
$31,413.29
|
| Rate for Payer: PHP Commercial |
$16,212.90
|
| Rate for Payer: PHP Medicare Advantage |
$31,413.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,837.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,398.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98,731.50
|
| Rate for Payer: Priority Health Medicare |
$31,413.29
|
| Rate for Payer: Priority Health Narrow Network |
$78,985.20
|
| Rate for Payer: Priority Health SBD |
$12,016.62
|
| Rate for Payer: Railroad Medicare Medicare |
$31,413.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$960.94
|
| Rate for Payer: UHC Core |
$52,490.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$31,413.29
|
| Rate for Payer: UHC Exchange |
$873.58
|
| Rate for Payer: UHC Medicare Advantage |
$31,413.29
|
| Rate for Payer: UHCCP Medicaid |
$16,837.52
|
| Rate for Payer: UMR Bronson Commercial |
$7,057.38
|
| Rate for Payer: VA VA |
$31,413.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,305.50
|
|
|
HC ICD SINGLE IMPLANT
|
Facility
|
IP
|
$19,074.00
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,392.56 |
| Max. Negotiated Rate |
$17,166.60 |
| Rate for Payer: Aetna American Axle |
$12,398.10
|
| Rate for Payer: Aetna Commercial |
$16,212.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,398.10
|
| Rate for Payer: Cash Price |
$15,259.20
|
| Rate for Payer: Cofinity Commercial |
$13,351.80
|
| Rate for Payer: Cofinity Commercial |
$16,403.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$13,351.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,259.20
|
| Rate for Payer: Healthscope Commercial |
$17,166.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,351.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,305.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,212.90
|
| Rate for Payer: PHP Commercial |
$16,212.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,398.10
|
| Rate for Payer: Priority Health SBD |
$12,016.62
|
| Rate for Payer: UMR Bronson Commercial |
$8,392.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,305.50
|
|
|
HC ICP MONITOR
|
Facility
|
IP
|
$1,996.65
|
|
| Hospital Charge Code |
27800143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$878.53 |
| Max. Negotiated Rate |
$1,796.98 |
| Rate for Payer: Aetna American Axle |
$1,297.82
|
| Rate for Payer: Aetna Commercial |
$1,697.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,297.82
|
| Rate for Payer: Cash Price |
$1,597.32
|
| Rate for Payer: Cofinity Commercial |
$1,397.66
|
| Rate for Payer: Cofinity Commercial |
$1,717.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,397.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,597.32
|
| Rate for Payer: Healthscope Commercial |
$1,796.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,397.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,497.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,697.15
|
| Rate for Payer: PHP Commercial |
$1,697.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.82
|
| Rate for Payer: Priority Health SBD |
$1,257.89
|
| Rate for Payer: UMR Bronson Commercial |
$878.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,497.49
|
|
|
HC ICP MONITOR
|
Facility
|
OP
|
$1,996.65
|
|
| Hospital Charge Code |
27800143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$738.76 |
| Max. Negotiated Rate |
$1,796.98 |
| Rate for Payer: Aetna American Axle |
$1,297.82
|
| Rate for Payer: Aetna Commercial |
$1,697.15
|
| Rate for Payer: Aetna Medicare |
$998.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,297.82
|
| Rate for Payer: BCBS Complete |
$798.66
|
| Rate for Payer: Cash Price |
$1,597.32
|
| Rate for Payer: Cofinity Commercial |
$1,397.66
|
| Rate for Payer: Cofinity Commercial |
$1,717.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,397.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,597.32
|
| Rate for Payer: Healthscope Commercial |
$1,796.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,397.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,497.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,697.15
|
| Rate for Payer: PHP Commercial |
$1,697.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,297.82
|
| Rate for Payer: Priority Health SBD |
$1,257.89
|
| Rate for Payer: UMR Bronson Commercial |
$738.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,497.49
|
|
|
HC I&D BARTHOLIN GLAND ABSCESS
|
Facility
|
IP
|
$259.06
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
36100573
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$113.99 |
| Max. Negotiated Rate |
$233.15 |
| Rate for Payer: Aetna American Axle |
$168.39
|
| Rate for Payer: Aetna Commercial |
$220.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.39
|
| Rate for Payer: Cash Price |
$207.25
|
| Rate for Payer: Cofinity Commercial |
$181.34
|
| Rate for Payer: Cofinity Commercial |
$222.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$181.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.25
|
| Rate for Payer: Healthscope Commercial |
$233.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.20
|
| Rate for Payer: PHP Commercial |
$220.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.39
|
| Rate for Payer: Priority Health SBD |
$163.21
|
| Rate for Payer: UMR Bronson Commercial |
$113.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.30
|
|
|
HC I&D BARTHOLIN GLAND ABSCESS
|
Facility
|
OP
|
$259.06
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
36100573
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$95.85 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$168.39
|
| Rate for Payer: Aetna Commercial |
$220.20
|
| Rate for Payer: Aetna Medicare |
$204.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$246.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$246.38
|
| Rate for Payer: BCBS Complete |
$110.93
|
| Rate for Payer: BCBS MAPPO |
$197.10
|
| Rate for Payer: BCBS Trust/PPO |
$199.79
|
| Rate for Payer: BCN Commercial |
$199.79
|
| Rate for Payer: BCN Medicare Advantage |
$197.10
|
| Rate for Payer: Cash Price |
$207.25
|
| Rate for Payer: Cash Price |
$207.25
|
| Rate for Payer: Cash Price |
$207.25
|
| Rate for Payer: Cofinity Commercial |
$222.79
|
| Rate for Payer: Cofinity Commercial |
$181.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$181.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.10
|
| Rate for Payer: Healthscope Commercial |
$233.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.30
|
| Rate for Payer: Mclaren Medicaid |
$105.65
|
| Rate for Payer: Mclaren Medicare |
$197.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.96
|
| Rate for Payer: Meridian Medicaid |
$110.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.20
|
| Rate for Payer: Nomi Health Commercial |
$413.91
|
| Rate for Payer: PACE Medicare |
$187.24
|
| Rate for Payer: PACE SWMI |
$197.10
|
| Rate for Payer: PHP Commercial |
$220.20
|
| Rate for Payer: PHP Medicare Advantage |
$197.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$619.50
|
| Rate for Payer: Priority Health Medicare |
$197.10
|
| Rate for Payer: Priority Health Narrow Network |
$495.60
|
| Rate for Payer: Priority Health SBD |
$163.21
|
| Rate for Payer: Railroad Medicare Medicare |
$197.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.81
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.10
|
| Rate for Payer: UHC Exchange |
$106.19
|
| Rate for Payer: UHC Medicare Advantage |
$197.10
|
| Rate for Payer: UHCCP Medicaid |
$105.65
|
| Rate for Payer: UMR Bronson Commercial |
$95.85
|
| Rate for Payer: VA VA |
$197.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.30
|
|
|
HC IDENTIFICATION BY AGGLUTINATION
|
Facility
|
IP
|
$29.86
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
30600091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.14 |
| Max. Negotiated Rate |
$26.87 |
| Rate for Payer: Aetna American Axle |
$19.41
|
| Rate for Payer: Aetna Commercial |
$25.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.41
|
| Rate for Payer: Cash Price |
$23.89
|
| Rate for Payer: Cofinity Commercial |
$20.90
|
| Rate for Payer: Cofinity Commercial |
$25.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.89
|
| Rate for Payer: Healthscope Commercial |
$26.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.38
|
| Rate for Payer: PHP Commercial |
$25.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.41
|
| Rate for Payer: Priority Health SBD |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$13.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.40
|
|
|
HC IDENTIFICATION BY AGGLUTINATION
|
Facility
|
OP
|
$29.86
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
30600091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.78 |
| Max. Negotiated Rate |
$26.87 |
| Rate for Payer: Aetna American Axle |
$19.41
|
| Rate for Payer: Aetna Commercial |
$25.38
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.48
|
| Rate for Payer: BCBS Complete |
$2.92
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$5.00
|
| Rate for Payer: BCN Commercial |
$5.00
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$23.89
|
| Rate for Payer: Cash Price |
$23.89
|
| Rate for Payer: Cofinity Commercial |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$20.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$26.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.40
|
| Rate for Payer: Mclaren Medicaid |
$2.78
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$2.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.38
|
| Rate for Payer: Nomi Health Commercial |
$7.77
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$25.38
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.33
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$4.26
|
| Rate for Payer: Priority Health SBD |
$18.81
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Exchange |
$5.18
|
| Rate for Payer: UHC Medicare Advantage |
$5.18
|
| Rate for Payer: UHCCP Medicaid |
$2.78
|
| Rate for Payer: UMR Bronson Commercial |
$11.05
|
| Rate for Payer: VA VA |
$5.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.40
|
|
|
HC I&D (OB SURGERY)
|
Facility
|
OP
|
$535.51
|
|
| Hospital Charge Code |
36000054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$198.14 |
| Max. Negotiated Rate |
$481.96 |
| Rate for Payer: Aetna American Axle |
$348.08
|
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna Medicare |
$267.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.08
|
| Rate for Payer: BCBS Complete |
$214.20
|
| Rate for Payer: Cash Price |
$428.41
|
| Rate for Payer: Cofinity Commercial |
$374.86
|
| Rate for Payer: Cofinity Commercial |
$460.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$374.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.41
|
| Rate for Payer: Healthscope Commercial |
$481.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$374.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.18
|
| Rate for Payer: PHP Commercial |
$455.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.08
|
| Rate for Payer: Priority Health SBD |
$337.37
|
| Rate for Payer: UMR Bronson Commercial |
$198.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.63
|
|
|
HC I&D (OB SURGERY)
|
Facility
|
IP
|
$535.51
|
|
| Hospital Charge Code |
36000054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$235.62 |
| Max. Negotiated Rate |
$481.96 |
| Rate for Payer: Aetna American Axle |
$348.08
|
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.08
|
| Rate for Payer: Cash Price |
$428.41
|
| Rate for Payer: Cofinity Commercial |
$374.86
|
| Rate for Payer: Cofinity Commercial |
$460.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$374.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.41
|
| Rate for Payer: Healthscope Commercial |
$481.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$374.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.18
|
| Rate for Payer: PHP Commercial |
$455.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.08
|
| Rate for Payer: Priority Health SBD |
$337.37
|
| Rate for Payer: UMR Bronson Commercial |
$235.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.63
|
|
|
HC I&D PILONIDAL CYST
|
Facility
|
IP
|
$931.90
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
45000097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$410.04 |
| Max. Negotiated Rate |
$838.71 |
| Rate for Payer: Aetna American Axle |
$605.74
|
| Rate for Payer: Aetna Commercial |
$792.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$605.74
|
| Rate for Payer: Cash Price |
$745.52
|
| Rate for Payer: Cofinity Commercial |
$652.33
|
| Rate for Payer: Cofinity Commercial |
$801.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$652.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$745.52
|
| Rate for Payer: Healthscope Commercial |
$838.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$652.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$698.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$792.12
|
| Rate for Payer: PHP Commercial |
$792.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$605.74
|
| Rate for Payer: Priority Health SBD |
$587.10
|
| Rate for Payer: UMR Bronson Commercial |
$410.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$698.92
|
|
