|
HC SPLENOPORTOGRAPHY
|
Facility
|
OP
|
$4,118.56
|
|
|
Service Code
|
CPT 75810
|
| Hospital Charge Code |
32000318
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$2,677.06
|
| Rate for Payer: Aetna Commercial |
$3,500.78
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,677.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,572.08
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,294.85
|
| Rate for Payer: Cash Price |
$3,294.85
|
| Rate for Payer: Cofinity Commercial |
$2,882.99
|
| Rate for Payer: Cofinity Commercial |
$3,541.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,294.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$3,706.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,882.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,088.92
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,500.78
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,500.78
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,882.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$2,594.69
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,523.87
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,088.92
|
|
|
HC SPLENOPORTOGRAPHY
|
Facility
|
IP
|
$4,118.56
|
|
|
Service Code
|
CPT 75810
|
| Hospital Charge Code |
32000318
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,812.17 |
| Max. Negotiated Rate |
$3,706.70 |
| Rate for Payer: Aetna American Axle |
$2,677.06
|
| Rate for Payer: Aetna Commercial |
$3,500.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,677.06
|
| Rate for Payer: Cash Price |
$3,294.85
|
| Rate for Payer: Cofinity Commercial |
$2,882.99
|
| Rate for Payer: Cofinity Commercial |
$3,541.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,294.85
|
| Rate for Payer: Healthscope Commercial |
$3,706.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,882.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,088.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,500.78
|
| Rate for Payer: PHP Commercial |
$3,500.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,882.99
|
| Rate for Payer: Priority Health SBD |
$2,594.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,812.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,088.92
|
|
|
HC SPLINT FINGER DYNAMIC
|
Facility
|
OP
|
$137.49
|
|
|
Service Code
|
CPT 29131
|
| Hospital Charge Code |
43000005
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$29.74 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$89.37
|
| Rate for Payer: Aetna Commercial |
$116.87
|
| Rate for Payer: Aetna Medicare |
$56.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$48.57
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$109.99
|
| Rate for Payer: Cash Price |
$109.99
|
| Rate for Payer: Cash Price |
$109.99
|
| Rate for Payer: Cofinity Commercial |
$118.24
|
| Rate for Payer: Cofinity Commercial |
$96.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$123.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.12
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$116.87
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$116.87
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.15
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$136.92
|
| Rate for Payer: Priority Health SBD |
$86.62
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.46
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.37
|
| Rate for Payer: UHC Exchange |
$34.05
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: UMR Bronson Commercial |
$50.87
|
| Rate for Payer: VA VA |
$54.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.12
|
|
|
HC SPLINT FINGER DYNAMIC
|
Facility
|
IP
|
$137.49
|
|
|
Service Code
|
CPT 29131
|
| Hospital Charge Code |
43000005
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$60.50 |
| Max. Negotiated Rate |
$123.74 |
| Rate for Payer: Aetna American Axle |
$89.37
|
| Rate for Payer: Aetna Commercial |
$116.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.37
|
| Rate for Payer: Cash Price |
$109.99
|
| Rate for Payer: Cofinity Commercial |
$118.24
|
| Rate for Payer: Cofinity Commercial |
$96.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.99
|
| Rate for Payer: Healthscope Commercial |
$123.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$116.87
|
| Rate for Payer: PHP Commercial |
$116.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.24
|
| Rate for Payer: Priority Health SBD |
$86.62
|
| Rate for Payer: UMR Bronson Commercial |
$60.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.12
|
|
|
HC SPLINT FINGER STATIC
|
Facility
|
IP
|
$137.49
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
43000004
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$60.50 |
| Max. Negotiated Rate |
$123.74 |
| Rate for Payer: Aetna American Axle |
$89.37
|
| Rate for Payer: Aetna Commercial |
$116.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.37
|
| Rate for Payer: Cash Price |
$109.99
|
| Rate for Payer: Cofinity Commercial |
$118.24
|
| Rate for Payer: Cofinity Commercial |
$96.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.99
|
| Rate for Payer: Healthscope Commercial |
$123.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$116.87
|
| Rate for Payer: PHP Commercial |
$116.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.24
|
| Rate for Payer: Priority Health SBD |
$86.62
|
| Rate for Payer: UMR Bronson Commercial |
$60.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.12
|
|
|
HC SPLINT FINGER STATIC
|
Facility
|
OP
|
$137.49
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
43000004
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$28.49 |
| Max. Negotiated Rate |
$357.43 |
| Rate for Payer: Aetna American Axle |
$89.37
|
| Rate for Payer: Aetna Commercial |
$116.87
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$71.82
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$109.99
|
| Rate for Payer: Cash Price |
$109.99
|
| Rate for Payer: Cash Price |
$109.99
|
| Rate for Payer: Cofinity Commercial |
$96.24
|
| Rate for Payer: Cofinity Commercial |
$118.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$123.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.12
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$116.87
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$116.87
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.43
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$285.94
|
| Rate for Payer: Priority Health SBD |
$86.62
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.34
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$28.49
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$50.87
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.12
|
|
|
HC SPLINT LONG ARM
|
Facility
|
OP
|
$389.19
|
|
|
Service Code
|
CPT 29105
|
| Hospital Charge Code |
70000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$40.93 |
| Max. Negotiated Rate |
$440.92 |
| Rate for Payer: Aetna American Axle |
$252.97
|
| Rate for Payer: Aetna Commercial |
$330.81
|
| Rate for Payer: Aetna Medicare |
$145.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.08
|
| Rate for Payer: BCBS Complete |
$80.45
|
| Rate for Payer: BCBS MAPPO |
$140.06
|
| Rate for Payer: BCBS Trust/PPO |
$118.12
|
| Rate for Payer: BCN Medicare Advantage |
$140.06
|
| Rate for Payer: Cash Price |
$311.35
|
| Rate for Payer: Cash Price |
$311.35
|
| Rate for Payer: Cofinity Commercial |
$272.43
|
| Rate for Payer: Cofinity Commercial |
$334.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$350.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.89
|
| Rate for Payer: Mclaren Medicaid |
$76.61
|
| Rate for Payer: Mclaren Medicare |
$140.06
|
| Rate for Payer: Meridian Medicaid |
$80.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$330.81
|
| Rate for Payer: PACE Medicare |
$133.06
|
| Rate for Payer: PACE SWMI |
$140.06
|
| Rate for Payer: PHP Commercial |
$330.81
|
| Rate for Payer: PHP Medicare Advantage |
$140.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$440.92
|
| Rate for Payer: Priority Health Medicare |
$140.06
|
| Rate for Payer: Priority Health Narrow Network |
$352.74
|
| Rate for Payer: Priority Health SBD |
$245.19
|
| Rate for Payer: Railroad Medicare Medicare |
$140.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.06
|
| Rate for Payer: UHC Exchange |
$40.93
|
| Rate for Payer: UHC Medicare Advantage |
$144.26
|
| Rate for Payer: UMR Bronson Commercial |
$144.00
|
| Rate for Payer: VA VA |
$140.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.89
|
|
|
HC SPLINT LONG ARM
|
Facility
|
IP
|
$389.19
|
|
|
Service Code
|
CPT 29105
|
| Hospital Charge Code |
70000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$171.24 |
| Max. Negotiated Rate |
$350.27 |
| Rate for Payer: Aetna American Axle |
$252.97
|
| Rate for Payer: Aetna Commercial |
$330.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.97
|
| Rate for Payer: Cash Price |
$311.35
|
| Rate for Payer: Cofinity Commercial |
$272.43
|
| Rate for Payer: Cofinity Commercial |
$334.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.35
|
| Rate for Payer: Healthscope Commercial |
$350.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$330.81
|
| Rate for Payer: PHP Commercial |
$330.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.43
|
| Rate for Payer: Priority Health SBD |
$245.19
|
| Rate for Payer: UMR Bronson Commercial |
$171.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.89
|
|
|
HC SPLINT LONG LEG
|
Facility
|
OP
|
$350.37
|
|
|
Service Code
|
CPT 29505
|
| Hospital Charge Code |
70000012
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$51.74 |
| Max. Negotiated Rate |
$440.92 |
| Rate for Payer: Aetna American Axle |
$227.74
|
| Rate for Payer: Aetna Commercial |
$297.81
|
| Rate for Payer: Aetna Medicare |
$145.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.08
|
| Rate for Payer: BCBS Complete |
$80.45
|
| Rate for Payer: BCBS MAPPO |
$140.06
|
| Rate for Payer: BCBS Trust/PPO |
$125.57
|
| Rate for Payer: BCN Medicare Advantage |
$140.06
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$245.26
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$315.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.78
|
| Rate for Payer: Mclaren Medicaid |
$76.61
|
| Rate for Payer: Mclaren Medicare |
$140.06
|
| Rate for Payer: Meridian Medicaid |
$80.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.81
|
| Rate for Payer: PACE Medicare |
$133.06
|
| Rate for Payer: PACE SWMI |
$140.06
|
| Rate for Payer: PHP Commercial |
$297.81
|
| Rate for Payer: PHP Medicare Advantage |
$140.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$440.92
|
| Rate for Payer: Priority Health Medicare |
$140.06
|
| Rate for Payer: Priority Health Narrow Network |
$352.74
|
| Rate for Payer: Priority Health SBD |
$220.73
|
| Rate for Payer: Railroad Medicare Medicare |
$140.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.06
|
| Rate for Payer: UHC Exchange |
$51.74
|
| Rate for Payer: UHC Medicare Advantage |
$144.26
|
| Rate for Payer: UMR Bronson Commercial |
$129.64
|
| Rate for Payer: VA VA |
$140.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.78
|
|
|
HC SPLINT LONG LEG
|
Facility
|
IP
|
$350.37
|
|
|
Service Code
|
CPT 29505
|
| Hospital Charge Code |
70000012
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$154.16 |
| Max. Negotiated Rate |
$315.33 |
| Rate for Payer: Aetna American Axle |
$227.74
|
| Rate for Payer: Aetna Commercial |
$297.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.74
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$245.26
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Healthscope Commercial |
$315.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.81
|
| Rate for Payer: PHP Commercial |
$297.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.26
|
| Rate for Payer: Priority Health SBD |
$220.73
|
| Rate for Payer: UMR Bronson Commercial |
$154.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.78
|
|
|
HC SPLINT SHORT ARM DYNAMIC
|
Facility
|
IP
|
$541.49
|
|
|
Service Code
|
CPT 29126
|
| Hospital Charge Code |
43000003
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$238.26 |
| Max. Negotiated Rate |
$487.34 |
| Rate for Payer: Aetna American Axle |
$351.97
|
| Rate for Payer: Aetna Commercial |
$460.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$351.97
|
| Rate for Payer: Cash Price |
$433.19
|
| Rate for Payer: Cofinity Commercial |
$379.04
|
| Rate for Payer: Cofinity Commercial |
$465.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.19
|
| Rate for Payer: Healthscope Commercial |
$487.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$379.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$460.27
|
| Rate for Payer: PHP Commercial |
$460.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.04
|
| Rate for Payer: Priority Health SBD |
$341.14
|
| Rate for Payer: UMR Bronson Commercial |
$238.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.12
|
|
|
HC SPLINT SHORT ARM DYNAMIC
|
Facility
|
OP
|
$541.49
|
|
|
Service Code
|
CPT 29126
|
| Hospital Charge Code |
43000003
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$48.79 |
| Max. Negotiated Rate |
$487.34 |
| Rate for Payer: Aetna American Axle |
$351.97
|
| Rate for Payer: Aetna Commercial |
$460.27
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$351.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$89.07
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$433.19
|
| Rate for Payer: Cash Price |
$433.19
|
| Rate for Payer: Cash Price |
$433.19
|
| Rate for Payer: Cofinity Commercial |
$379.04
|
| Rate for Payer: Cofinity Commercial |
$465.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$433.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$487.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$379.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.12
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$460.27
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$460.27
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.43
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$285.94
|
| Rate for Payer: Priority Health SBD |
$341.14
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.67
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$48.79
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$200.35
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.12
|
|
|
HC SPLINT SHORT ARM STATIC
|
Facility
|
IP
|
$234.60
|
|
|
Service Code
|
CPT 29125
|
| Hospital Charge Code |
43000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$103.22 |
| Max. Negotiated Rate |
$211.14 |
| Rate for Payer: Aetna American Axle |
$152.49
|
| Rate for Payer: Aetna Commercial |
$199.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.49
|
| Rate for Payer: Cash Price |
$187.68
|
| Rate for Payer: Cofinity Commercial |
$164.22
|
| Rate for Payer: Cofinity Commercial |
$201.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.68
|
| Rate for Payer: Healthscope Commercial |
$211.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$164.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$199.41
|
| Rate for Payer: PHP Commercial |
$199.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.22
|
| Rate for Payer: Priority Health SBD |
$147.80
|
| Rate for Payer: UMR Bronson Commercial |
$103.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.95
|
|
|
HC SPLINT SHORT ARM STATIC
|
Facility
|
OP
|
$234.60
|
|
|
Service Code
|
CPT 29125
|
| Hospital Charge Code |
43000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$39.95 |
| Max. Negotiated Rate |
$357.43 |
| Rate for Payer: Aetna American Axle |
$152.49
|
| Rate for Payer: Aetna Commercial |
$199.41
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$95.40
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$187.68
|
| Rate for Payer: Cash Price |
$187.68
|
| Rate for Payer: Cofinity Commercial |
$164.22
|
| Rate for Payer: Cofinity Commercial |
$201.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$211.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$164.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.95
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$199.41
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$199.41
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.43
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$285.94
|
| Rate for Payer: Priority Health SBD |
$147.80
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$39.95
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$86.80
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.95
|
|
|
HC SPLINT SHORT LEG
|
Facility
|
IP
|
$370.34
|
|
|
Service Code
|
CPT 29515
|
| Hospital Charge Code |
70000013
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$162.95 |
| Max. Negotiated Rate |
$333.31 |
| Rate for Payer: Aetna American Axle |
$240.72
|
| Rate for Payer: Aetna Commercial |
$314.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.72
|
| Rate for Payer: Cash Price |
$296.27
|
| Rate for Payer: Cofinity Commercial |
$259.24
|
| Rate for Payer: Cofinity Commercial |
$318.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.27
|
| Rate for Payer: Healthscope Commercial |
$333.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$259.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$314.79
|
| Rate for Payer: PHP Commercial |
$314.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.24
|
| Rate for Payer: Priority Health SBD |
$233.31
|
| Rate for Payer: UMR Bronson Commercial |
$162.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.76
|
|
|
HC SPLINT SHORT LEG
|
Facility
|
OP
|
$370.34
|
|
|
Service Code
|
CPT 29515
|
| Hospital Charge Code |
70000013
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$49.12 |
| Max. Negotiated Rate |
$440.92 |
| Rate for Payer: Aetna American Axle |
$240.72
|
| Rate for Payer: Aetna Commercial |
$314.79
|
| Rate for Payer: Aetna Medicare |
$145.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.08
|
| Rate for Payer: BCBS Complete |
$80.45
|
| Rate for Payer: BCBS MAPPO |
$140.06
|
| Rate for Payer: BCBS Trust/PPO |
$105.25
|
| Rate for Payer: BCN Medicare Advantage |
$140.06
|
| Rate for Payer: Cash Price |
$296.27
|
| Rate for Payer: Cash Price |
$296.27
|
| Rate for Payer: Cofinity Commercial |
$318.49
|
| Rate for Payer: Cofinity Commercial |
$259.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$333.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$259.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.76
|
| Rate for Payer: Mclaren Medicaid |
$76.61
|
| Rate for Payer: Mclaren Medicare |
$140.06
|
| Rate for Payer: Meridian Medicaid |
$80.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$314.79
|
| Rate for Payer: PACE Medicare |
$133.06
|
| Rate for Payer: PACE SWMI |
$140.06
|
| Rate for Payer: PHP Commercial |
$314.79
|
| Rate for Payer: PHP Medicare Advantage |
$140.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$440.92
|
| Rate for Payer: Priority Health Medicare |
$140.06
|
| Rate for Payer: Priority Health Narrow Network |
$352.74
|
| Rate for Payer: Priority Health SBD |
$233.31
|
| Rate for Payer: Railroad Medicare Medicare |
$140.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.06
|
| Rate for Payer: UHC Exchange |
$49.12
|
| Rate for Payer: UHC Medicare Advantage |
$144.26
|
| Rate for Payer: UMR Bronson Commercial |
$137.03
|
| Rate for Payer: VA VA |
$140.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.76
|
|
|
HC SPLITTING BLOOD/BLOOD PROD EA UNIT
|
Facility
|
IP
|
$95.20
|
|
|
Service Code
|
CPT 86985
|
| Hospital Charge Code |
39000029
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$41.89 |
| Max. Negotiated Rate |
$85.68 |
| Rate for Payer: Aetna American Axle |
$61.88
|
| Rate for Payer: Aetna Commercial |
$80.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.88
|
| Rate for Payer: Cash Price |
$76.16
|
| Rate for Payer: Cofinity Commercial |
$66.64
|
| Rate for Payer: Cofinity Commercial |
$81.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.16
|
| Rate for Payer: Healthscope Commercial |
$85.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.92
|
| Rate for Payer: PHP Commercial |
$80.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.64
|
| Rate for Payer: Priority Health SBD |
$59.98
|
| Rate for Payer: UMR Bronson Commercial |
$41.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.40
|
|
|
HC SPLITTING BLOOD/BLOOD PROD EA UNIT
|
Facility
|
OP
|
$95.20
|
|
|
Service Code
|
CPT 86985
|
| Hospital Charge Code |
39000029
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$11.02 |
| Max. Negotiated Rate |
$477.95 |
| Rate for Payer: Aetna American Axle |
$61.88
|
| Rate for Payer: Aetna Commercial |
$80.92
|
| Rate for Payer: Aetna Medicare |
$157.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.78
|
| Rate for Payer: BCBS Complete |
$87.21
|
| Rate for Payer: BCBS MAPPO |
$151.82
|
| Rate for Payer: BCBS Trust/PPO |
$11.02
|
| Rate for Payer: BCN Medicare Advantage |
$151.82
|
| Rate for Payer: Cash Price |
$76.16
|
| Rate for Payer: Cash Price |
$76.16
|
| Rate for Payer: Cash Price |
$76.16
|
| Rate for Payer: Cofinity Commercial |
$66.64
|
| Rate for Payer: Cofinity Commercial |
$81.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.82
|
| Rate for Payer: Healthscope Commercial |
$85.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.40
|
| Rate for Payer: Mclaren Medicaid |
$83.05
|
| Rate for Payer: Mclaren Medicare |
$151.82
|
| Rate for Payer: Meridian Medicaid |
$87.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$159.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.92
|
| Rate for Payer: PACE Medicare |
$144.23
|
| Rate for Payer: PACE SWMI |
$151.82
|
| Rate for Payer: PHP Commercial |
$80.92
|
| Rate for Payer: PHP Medicare Advantage |
$151.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$477.95
|
| Rate for Payer: Priority Health Medicare |
$151.82
|
| Rate for Payer: Priority Health Narrow Network |
$382.36
|
| Rate for Payer: Priority Health SBD |
$59.98
|
| Rate for Payer: Railroad Medicare Medicare |
$151.82
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.82
|
| Rate for Payer: UHC Medicare Advantage |
$156.37
|
| Rate for Payer: UMR Bronson Commercial |
$35.22
|
| Rate for Payer: VA VA |
$151.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.40
|
|
|
HC SPORE CHECK
|
Facility
|
IP
|
$22.80
|
|
| Hospital Charge Code |
30600180
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.03 |
| Max. Negotiated Rate |
$20.52 |
| Rate for Payer: Aetna American Axle |
$14.82
|
| Rate for Payer: Aetna Commercial |
$19.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.82
|
| Rate for Payer: Cash Price |
$18.24
|
| Rate for Payer: Cofinity Commercial |
$15.96
|
| Rate for Payer: Cofinity Commercial |
$19.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.24
|
| Rate for Payer: Healthscope Commercial |
$20.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.38
|
| Rate for Payer: PHP Commercial |
$19.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.96
|
| Rate for Payer: Priority Health SBD |
$14.36
|
| Rate for Payer: UMR Bronson Commercial |
$10.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.10
|
|
|
HC SPORE CHECK
|
Facility
|
OP
|
$22.80
|
|
| Hospital Charge Code |
30600180
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.44 |
| Max. Negotiated Rate |
$20.52 |
| Rate for Payer: Aetna American Axle |
$14.82
|
| Rate for Payer: Aetna Commercial |
$19.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.82
|
| Rate for Payer: BCBS Complete |
$9.12
|
| Rate for Payer: Cash Price |
$18.24
|
| Rate for Payer: Cofinity Commercial |
$15.96
|
| Rate for Payer: Cofinity Commercial |
$19.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.24
|
| Rate for Payer: Healthscope Commercial |
$20.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.38
|
| Rate for Payer: PHP Commercial |
$19.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.96
|
| Rate for Payer: Priority Health SBD |
$14.36
|
| Rate for Payer: UMR Bronson Commercial |
$8.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.10
|
|
|
HC SP REMOVAL IVC FILTER
|
Facility
|
OP
|
$4,615.05
|
|
|
Service Code
|
CPT 37193
|
| Hospital Charge Code |
36100353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$330.39 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$2,999.78
|
| Rate for Payer: Aetna Commercial |
$3,922.79
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,999.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,807.08
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,692.04
|
| Rate for Payer: Cash Price |
$3,692.04
|
| Rate for Payer: Cofinity Commercial |
$3,968.94
|
| Rate for Payer: Cofinity Commercial |
$3,230.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,692.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$4,153.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,230.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,461.29
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,922.79
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,922.79
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,230.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$2,907.48
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.43
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$330.39
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,707.57
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,461.29
|
|
|
HC SP REMOVAL IVC FILTER
|
Facility
|
IP
|
$4,615.05
|
|
|
Service Code
|
CPT 37193
|
| Hospital Charge Code |
36100353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,030.62 |
| Max. Negotiated Rate |
$4,153.54 |
| Rate for Payer: Aetna American Axle |
$2,999.78
|
| Rate for Payer: Aetna Commercial |
$3,922.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,999.78
|
| Rate for Payer: Cash Price |
$3,692.04
|
| Rate for Payer: Cofinity Commercial |
$3,230.54
|
| Rate for Payer: Cofinity Commercial |
$3,968.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,692.04
|
| Rate for Payer: Healthscope Commercial |
$4,153.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,230.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,461.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,922.79
|
| Rate for Payer: PHP Commercial |
$3,922.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,230.54
|
| Rate for Payer: Priority Health SBD |
$2,907.48
|
| Rate for Payer: UMR Bronson Commercial |
$2,030.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,461.29
|
|
|
HC SP REPAIR ANAL FISTULA W FIBRN GL
|
Facility
|
IP
|
$3,693.58
|
|
|
Service Code
|
CPT 46706
|
| Hospital Charge Code |
36100316
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,625.18 |
| Max. Negotiated Rate |
$3,324.22 |
| Rate for Payer: Aetna American Axle |
$2,400.83
|
| Rate for Payer: Aetna Commercial |
$3,139.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,400.83
|
| Rate for Payer: Cash Price |
$2,954.86
|
| Rate for Payer: Cofinity Commercial |
$2,585.51
|
| Rate for Payer: Cofinity Commercial |
$3,176.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,954.86
|
| Rate for Payer: Healthscope Commercial |
$3,324.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,585.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,139.54
|
| Rate for Payer: PHP Commercial |
$3,139.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,585.51
|
| Rate for Payer: Priority Health SBD |
$2,326.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,625.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.18
|
|
|
HC SP REPAIR ANAL FISTULA W FIBRN GL
|
Facility
|
OP
|
$3,693.58
|
|
|
Service Code
|
CPT 46706
|
| Hospital Charge Code |
36100316
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$178.46 |
| Max. Negotiated Rate |
$7,856.86 |
| Rate for Payer: Aetna American Axle |
$2,400.83
|
| Rate for Payer: Aetna Commercial |
$3,139.54
|
| Rate for Payer: Aetna Medicare |
$2,595.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,400.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,119.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,119.72
|
| Rate for Payer: BCBS Complete |
$1,433.58
|
| Rate for Payer: BCBS MAPPO |
$2,495.78
|
| Rate for Payer: BCBS Trust/PPO |
$1,654.43
|
| Rate for Payer: BCN Medicare Advantage |
$2,495.78
|
| Rate for Payer: Cash Price |
$2,954.86
|
| Rate for Payer: Cash Price |
$2,954.86
|
| Rate for Payer: Cofinity Commercial |
$2,585.51
|
| Rate for Payer: Cofinity Commercial |
$3,176.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,954.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,495.78
|
| Rate for Payer: Healthscope Commercial |
$3,324.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,585.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.18
|
| Rate for Payer: Mclaren Medicaid |
$1,365.19
|
| Rate for Payer: Mclaren Medicare |
$2,495.78
|
| Rate for Payer: Meridian Medicaid |
$1,433.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,620.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,870.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,139.54
|
| Rate for Payer: PACE Medicare |
$2,370.99
|
| Rate for Payer: PACE SWMI |
$2,495.78
|
| Rate for Payer: PHP Commercial |
$3,139.54
|
| Rate for Payer: PHP Medicare Advantage |
$2,495.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,365.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,585.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,856.86
|
| Rate for Payer: Priority Health Medicare |
$2,495.78
|
| Rate for Payer: Priority Health Narrow Network |
$6,285.49
|
| Rate for Payer: Priority Health SBD |
$2,326.96
|
| Rate for Payer: Railroad Medicare Medicare |
$2,495.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.31
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,495.78
|
| Rate for Payer: UHC Exchange |
$178.46
|
| Rate for Payer: UHC Medicare Advantage |
$2,570.65
|
| Rate for Payer: UMR Bronson Commercial |
$1,366.62
|
| Rate for Payer: VA VA |
$2,495.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.18
|
|
|
HC SP REPOSITION IVC FILTER
|
Facility
|
IP
|
$4,195.50
|
|
|
Service Code
|
CPT 37192
|
| Hospital Charge Code |
36100352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,846.02 |
| Max. Negotiated Rate |
$3,775.95 |
| Rate for Payer: Aetna American Axle |
$2,727.08
|
| Rate for Payer: Aetna Commercial |
$3,566.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,727.08
|
| Rate for Payer: Cash Price |
$3,356.40
|
| Rate for Payer: Cofinity Commercial |
$2,936.85
|
| Rate for Payer: Cofinity Commercial |
$3,608.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,356.40
|
| Rate for Payer: Healthscope Commercial |
$3,775.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,936.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,146.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,566.18
|
| Rate for Payer: PHP Commercial |
$3,566.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,936.85
|
| Rate for Payer: Priority Health SBD |
$2,643.16
|
| Rate for Payer: UMR Bronson Commercial |
$1,846.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,146.62
|
|
