|
HC IMPELLA MONITORING KIT
|
Facility
|
IP
|
$339.45
|
|
| Hospital Charge Code |
27200133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$149.36 |
| Max. Negotiated Rate |
$305.50 |
| Rate for Payer: Aetna American Axle |
$220.64
|
| Rate for Payer: Aetna Commercial |
$288.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.64
|
| Rate for Payer: Cash Price |
$271.56
|
| Rate for Payer: Cofinity Commercial |
$237.62
|
| Rate for Payer: Cofinity Commercial |
$291.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$237.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.56
|
| Rate for Payer: Healthscope Commercial |
$305.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$237.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$254.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.53
|
| Rate for Payer: PHP Commercial |
$288.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.64
|
| Rate for Payer: Priority Health SBD |
$213.85
|
| Rate for Payer: UMR Bronson Commercial |
$149.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$254.59
|
|
|
HC IMPELLA MONITORING KIT
|
Facility
|
OP
|
$339.45
|
|
| Hospital Charge Code |
27200133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$125.60 |
| Max. Negotiated Rate |
$305.50 |
| Rate for Payer: Aetna American Axle |
$220.64
|
| Rate for Payer: Aetna Commercial |
$288.53
|
| Rate for Payer: Aetna Medicare |
$169.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.64
|
| Rate for Payer: BCBS Complete |
$135.78
|
| Rate for Payer: Cash Price |
$271.56
|
| Rate for Payer: Cofinity Commercial |
$237.62
|
| Rate for Payer: Cofinity Commercial |
$291.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$237.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.56
|
| Rate for Payer: Healthscope Commercial |
$305.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$237.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$254.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.53
|
| Rate for Payer: PHP Commercial |
$288.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.64
|
| Rate for Payer: Priority Health SBD |
$213.85
|
| Rate for Payer: UMR Bronson Commercial |
$125.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$254.59
|
|
|
HC IMPELLA REMOVAL
|
Facility
|
IP
|
$2,930.58
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
48100114
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,289.46 |
| Max. Negotiated Rate |
$2,637.52 |
| Rate for Payer: Aetna American Axle |
$1,904.88
|
| Rate for Payer: Aetna Commercial |
$2,490.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,904.88
|
| Rate for Payer: Cash Price |
$2,344.46
|
| Rate for Payer: Cofinity Commercial |
$2,051.41
|
| Rate for Payer: Cofinity Commercial |
$2,520.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,051.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,344.46
|
| Rate for Payer: Healthscope Commercial |
$2,637.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,051.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,197.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,490.99
|
| Rate for Payer: PHP Commercial |
$2,490.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,904.88
|
| Rate for Payer: Priority Health SBD |
$1,846.27
|
| Rate for Payer: UMR Bronson Commercial |
$1,289.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,197.93
|
|
|
HC IMPELLA REMOVAL
|
Facility
|
OP
|
$2,930.58
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
48100114
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,084.31 |
| Max. Negotiated Rate |
$2,637.52 |
| Rate for Payer: Aetna American Axle |
$1,904.88
|
| Rate for Payer: Aetna Commercial |
$2,490.99
|
| Rate for Payer: Aetna Medicare |
$1,465.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,904.88
|
| Rate for Payer: BCBS Complete |
$1,172.23
|
| Rate for Payer: Cash Price |
$2,344.46
|
| Rate for Payer: Cofinity Commercial |
$2,051.41
|
| Rate for Payer: Cofinity Commercial |
$2,520.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,051.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,344.46
|
| Rate for Payer: Healthscope Commercial |
$2,637.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,051.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,197.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,490.99
|
| Rate for Payer: PHP Commercial |
$2,490.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,904.88
|
| Rate for Payer: Priority Health SBD |
$1,846.27
|
| Rate for Payer: UMR Bronson Commercial |
$1,084.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,197.93
|
|
|
HC IMPLANTABLE PRESSURE SENSOR W ANGIO
|
Facility
|
OP
|
$6,202.63
|
|
|
Service Code
|
CPT 33289
|
| Hospital Charge Code |
48100105
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,294.97 |
| Max. Negotiated Rate |
$78,044.74 |
| Rate for Payer: Aetna American Axle |
$4,031.71
|
| Rate for Payer: Aetna Commercial |
$5,272.24
|
| Rate for Payer: Aetna Medicare |
$28,834.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,031.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34,656.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34,656.97
|
| Rate for Payer: BCBS Complete |
$15,603.96
|
| Rate for Payer: BCBS MAPPO |
$27,725.58
|
| Rate for Payer: BCN Medicare Advantage |
$27,725.58
|
| Rate for Payer: Cash Price |
$4,962.10
|
| Rate for Payer: Cash Price |
$4,962.10
|
| Rate for Payer: Cofinity Commercial |
$5,334.26
|
| Rate for Payer: Cofinity Commercial |
$4,341.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,341.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,962.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27,725.58
|
| Rate for Payer: Healthscope Commercial |
$5,582.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,341.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,651.97
|
| Rate for Payer: Mclaren Medicaid |
$14,860.91
|
| Rate for Payer: Mclaren Medicare |
$27,725.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29,111.86
|
| Rate for Payer: Meridian Medicaid |
$15,603.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31,884.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,272.24
|
| Rate for Payer: PACE Medicare |
$26,339.30
|
| Rate for Payer: PACE SWMI |
$27,725.58
|
| Rate for Payer: PHP Commercial |
$5,272.24
|
| Rate for Payer: PHP Medicare Advantage |
$27,725.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,860.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,031.71
|
| Rate for Payer: Priority Health Medicare |
$27,725.58
|
| Rate for Payer: Priority Health SBD |
$3,907.66
|
| Rate for Payer: Railroad Medicare Medicare |
$27,725.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78,044.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$27,725.58
|
| Rate for Payer: UHC Exchange |
$52,986.36
|
| Rate for Payer: UHC Medicare Advantage |
$27,725.58
|
| Rate for Payer: UHCCP Medicaid |
$14,860.91
|
| Rate for Payer: UMR Bronson Commercial |
$2,294.97
|
| Rate for Payer: VA VA |
$27,725.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,651.97
|
|
|
HC IMPLANTABLE PRESSURE SENSOR W ANGIO
|
Facility
|
IP
|
$6,202.63
|
|
|
Service Code
|
CPT 33289
|
| Hospital Charge Code |
48100105
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,729.16 |
| Max. Negotiated Rate |
$5,582.37 |
| Rate for Payer: Aetna American Axle |
$4,031.71
|
| Rate for Payer: Aetna Commercial |
$5,272.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,031.71
|
| Rate for Payer: Cash Price |
$4,962.10
|
| Rate for Payer: Cofinity Commercial |
$4,341.84
|
| Rate for Payer: Cofinity Commercial |
$5,334.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,341.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,962.10
|
| Rate for Payer: Healthscope Commercial |
$5,582.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,341.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,651.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,272.24
|
| Rate for Payer: PHP Commercial |
$5,272.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,031.71
|
| Rate for Payer: Priority Health SBD |
$3,907.66
|
| Rate for Payer: UMR Bronson Commercial |
$2,729.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,651.97
|
|
|
HC IMPLANTABLE PRESSURE SENSOR WO LEAD
|
Facility
|
OP
|
$72,139.89
|
|
|
Service Code
|
HCPCS C2624
|
| Hospital Charge Code |
27800103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26,691.76 |
| Max. Negotiated Rate |
$64,925.90 |
| Rate for Payer: Aetna American Axle |
$46,890.93
|
| Rate for Payer: Aetna Commercial |
$61,318.91
|
| Rate for Payer: Aetna Medicare |
$36,069.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46,890.93
|
| Rate for Payer: BCBS Complete |
$28,855.96
|
| Rate for Payer: Cash Price |
$57,711.91
|
| Rate for Payer: Cofinity Commercial |
$50,497.92
|
| Rate for Payer: Cofinity Commercial |
$62,040.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$50,497.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57,711.91
|
| Rate for Payer: Healthscope Commercial |
$64,925.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50,497.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54,104.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,318.91
|
| Rate for Payer: PHP Commercial |
$61,318.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46,890.93
|
| Rate for Payer: Priority Health SBD |
$45,448.13
|
| Rate for Payer: UMR Bronson Commercial |
$26,691.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54,104.92
|
|
|
HC IMPLANTABLE PRESSURE SENSOR WO LEAD
|
Facility
|
IP
|
$72,139.89
|
|
|
Service Code
|
HCPCS C2624
|
| Hospital Charge Code |
27800103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31,741.55 |
| Max. Negotiated Rate |
$64,925.90 |
| Rate for Payer: Aetna American Axle |
$46,890.93
|
| Rate for Payer: Aetna Commercial |
$61,318.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46,890.93
|
| Rate for Payer: Cash Price |
$57,711.91
|
| Rate for Payer: Cofinity Commercial |
$50,497.92
|
| Rate for Payer: Cofinity Commercial |
$62,040.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$50,497.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57,711.91
|
| Rate for Payer: Healthscope Commercial |
$64,925.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50,497.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54,104.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61,318.91
|
| Rate for Payer: PHP Commercial |
$61,318.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46,890.93
|
| Rate for Payer: Priority Health SBD |
$45,448.13
|
| Rate for Payer: UMR Bronson Commercial |
$31,741.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54,104.92
|
|
|
HC IMPLANT HORMONE SUBCUTANEOUS
|
Facility
|
IP
|
$543.33
|
|
|
Service Code
|
CPT 11980
|
| Hospital Charge Code |
76100178
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$239.07 |
| Max. Negotiated Rate |
$489.00 |
| Rate for Payer: Aetna American Axle |
$353.16
|
| Rate for Payer: Aetna Commercial |
$461.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.16
|
| Rate for Payer: Cash Price |
$434.66
|
| Rate for Payer: Cofinity Commercial |
$380.33
|
| Rate for Payer: Cofinity Commercial |
$467.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$380.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.66
|
| Rate for Payer: Healthscope Commercial |
$489.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$380.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$407.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.83
|
| Rate for Payer: PHP Commercial |
$461.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.16
|
| Rate for Payer: Priority Health SBD |
$342.30
|
| Rate for Payer: UMR Bronson Commercial |
$239.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$407.50
|
|
|
HC IMPLANT HORMONE SUBCUTANEOUS
|
Facility
|
OP
|
$543.33
|
|
|
Service Code
|
CPT 11980
|
| Hospital Charge Code |
76100178
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.03 |
| Max. Negotiated Rate |
$1,095.50 |
| Rate for Payer: Aetna American Axle |
$353.16
|
| Rate for Payer: Aetna Commercial |
$461.83
|
| Rate for Payer: Aetna Medicare |
$404.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$486.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$486.48
|
| Rate for Payer: BCBS Complete |
$219.03
|
| Rate for Payer: BCBS MAPPO |
$389.18
|
| Rate for Payer: BCN Medicare Advantage |
$389.18
|
| Rate for Payer: Cash Price |
$434.66
|
| Rate for Payer: Cash Price |
$434.66
|
| Rate for Payer: Cofinity Commercial |
$467.26
|
| Rate for Payer: Cofinity Commercial |
$380.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$380.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.18
|
| Rate for Payer: Healthscope Commercial |
$489.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$380.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$407.50
|
| Rate for Payer: Mclaren Medicaid |
$208.60
|
| Rate for Payer: Mclaren Medicare |
$389.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$408.64
|
| Rate for Payer: Meridian Medicaid |
$219.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$447.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.83
|
| Rate for Payer: PACE Medicare |
$369.72
|
| Rate for Payer: PACE SWMI |
$389.18
|
| Rate for Payer: PHP Commercial |
$461.83
|
| Rate for Payer: PHP Medicare Advantage |
$389.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.16
|
| Rate for Payer: Priority Health Medicare |
$389.18
|
| Rate for Payer: Priority Health SBD |
$342.30
|
| Rate for Payer: Railroad Medicare Medicare |
$389.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,095.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.18
|
| Rate for Payer: UHC Exchange |
$743.76
|
| Rate for Payer: UHC Medicare Advantage |
$389.18
|
| Rate for Payer: UHCCP Medicaid |
$208.60
|
| Rate for Payer: UMR Bronson Commercial |
$201.03
|
| Rate for Payer: VA VA |
$389.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$407.50
|
|
|
HC IMRT PLAN
|
Facility
|
OP
|
$7,125.70
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
33300006
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$715.26 |
| Max. Negotiated Rate |
$6,413.13 |
| Rate for Payer: Aetna American Axle |
$4,631.70
|
| Rate for Payer: Aetna Commercial |
$6,056.85
|
| Rate for Payer: Aetna Medicare |
$1,387.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,631.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,668.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,668.05
|
| Rate for Payer: BCBS Complete |
$751.02
|
| Rate for Payer: BCBS MAPPO |
$1,334.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,334.44
|
| Rate for Payer: Cash Price |
$5,700.56
|
| Rate for Payer: Cash Price |
$5,700.56
|
| Rate for Payer: Cash Price |
$5,700.56
|
| Rate for Payer: Cofinity Commercial |
$4,987.99
|
| Rate for Payer: Cofinity Commercial |
$6,128.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,987.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,700.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,334.44
|
| Rate for Payer: Healthscope Commercial |
$6,413.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,987.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,344.27
|
| Rate for Payer: Mclaren Medicaid |
$715.26
|
| Rate for Payer: Mclaren Medicare |
$1,334.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,401.16
|
| Rate for Payer: Meridian Medicaid |
$751.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,534.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,056.85
|
| Rate for Payer: PACE Medicare |
$1,267.72
|
| Rate for Payer: PACE SWMI |
$1,334.44
|
| Rate for Payer: PHP Commercial |
$6,056.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,334.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$715.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,631.70
|
| Rate for Payer: Priority Health Medicare |
$1,334.44
|
| Rate for Payer: Priority Health SBD |
$4,489.19
|
| Rate for Payer: Railroad Medicare Medicare |
$1,334.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,756.32
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,334.44
|
| Rate for Payer: UHC Exchange |
$2,550.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,334.44
|
| Rate for Payer: UHCCP Medicaid |
$715.26
|
| Rate for Payer: UMR Bronson Commercial |
$2,636.51
|
| Rate for Payer: VA VA |
$1,334.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,344.27
|
|
|
HC IMRT PLAN
|
Facility
|
IP
|
$7,125.70
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
33300006
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$3,135.31 |
| Max. Negotiated Rate |
$6,413.13 |
| Rate for Payer: Aetna American Axle |
$4,631.70
|
| Rate for Payer: Aetna Commercial |
$6,056.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,631.70
|
| Rate for Payer: Cash Price |
$5,700.56
|
| Rate for Payer: Cofinity Commercial |
$4,987.99
|
| Rate for Payer: Cofinity Commercial |
$6,128.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,987.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,700.56
|
| Rate for Payer: Healthscope Commercial |
$6,413.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,987.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,344.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,056.85
|
| Rate for Payer: PHP Commercial |
$6,056.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,631.70
|
| Rate for Payer: Priority Health SBD |
$4,489.19
|
| Rate for Payer: UMR Bronson Commercial |
$3,135.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,344.27
|
|
|
HC IN 111 AUTOLOG WBC PER STUDY
|
Facility
|
OP
|
$784.03
|
|
|
Service Code
|
HCPCS A9570
|
| Hospital Charge Code |
34300013
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$290.09 |
| Max. Negotiated Rate |
$2,903.26 |
| Rate for Payer: Aetna American Axle |
$509.62
|
| Rate for Payer: Aetna Commercial |
$666.43
|
| Rate for Payer: Aetna Medicare |
$1,072.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$509.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,289.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,289.24
|
| Rate for Payer: BCBS Complete |
$580.47
|
| Rate for Payer: BCBS MAPPO |
$1,031.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,031.39
|
| Rate for Payer: Cash Price |
$627.22
|
| Rate for Payer: Cash Price |
$627.22
|
| Rate for Payer: Cofinity Commercial |
$674.27
|
| Rate for Payer: Cofinity Commercial |
$548.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$548.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$627.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,031.39
|
| Rate for Payer: Healthscope Commercial |
$705.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$548.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$588.02
|
| Rate for Payer: Mclaren Medicaid |
$552.83
|
| Rate for Payer: Mclaren Medicare |
$1,031.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,082.96
|
| Rate for Payer: Meridian Medicaid |
$580.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,186.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$666.43
|
| Rate for Payer: PACE Medicare |
$979.82
|
| Rate for Payer: PACE SWMI |
$1,031.39
|
| Rate for Payer: PHP Commercial |
$666.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,031.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$552.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.62
|
| Rate for Payer: Priority Health Medicare |
$1,031.39
|
| Rate for Payer: Priority Health SBD |
$493.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,031.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,903.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,031.39
|
| Rate for Payer: UHC Exchange |
$1,971.09
|
| Rate for Payer: UHC Medicare Advantage |
$1,031.39
|
| Rate for Payer: UHCCP Medicaid |
$552.83
|
| Rate for Payer: UMR Bronson Commercial |
$290.09
|
| Rate for Payer: VA VA |
$1,031.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$588.02
|
|
|
HC IN 111 AUTOLOG WBC PER STUDY
|
Facility
|
IP
|
$784.03
|
|
|
Service Code
|
HCPCS A9570
|
| Hospital Charge Code |
34300013
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$344.97 |
| Max. Negotiated Rate |
$705.63 |
| Rate for Payer: Aetna American Axle |
$509.62
|
| Rate for Payer: Aetna Commercial |
$666.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$509.62
|
| Rate for Payer: Cash Price |
$627.22
|
| Rate for Payer: Cofinity Commercial |
$548.82
|
| Rate for Payer: Cofinity Commercial |
$674.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$548.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$627.22
|
| Rate for Payer: Healthscope Commercial |
$705.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$548.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$588.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$666.43
|
| Rate for Payer: PHP Commercial |
$666.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.62
|
| Rate for Payer: Priority Health SBD |
$493.94
|
| Rate for Payer: UMR Bronson Commercial |
$344.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$588.02
|
|
|
HC IN 111 OCTEO PER STUDY UP TO 6 MCI
|
Facility
|
IP
|
$5,411.53
|
|
|
Service Code
|
HCPCS A9572
|
| Hospital Charge Code |
34300014
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$2,381.07 |
| Max. Negotiated Rate |
$4,870.38 |
| Rate for Payer: Aetna American Axle |
$3,517.49
|
| Rate for Payer: Aetna Commercial |
$4,599.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,517.49
|
| Rate for Payer: Cash Price |
$4,329.22
|
| Rate for Payer: Cofinity Commercial |
$3,788.07
|
| Rate for Payer: Cofinity Commercial |
$4,653.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,788.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,329.22
|
| Rate for Payer: Healthscope Commercial |
$4,870.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,788.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,058.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,599.80
|
| Rate for Payer: PHP Commercial |
$4,599.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,517.49
|
| Rate for Payer: Priority Health SBD |
$3,409.26
|
| Rate for Payer: UMR Bronson Commercial |
$2,381.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,058.65
|
|
|
HC IN 111 OCTEO PER STUDY UP TO 6 MCI
|
Facility
|
OP
|
$5,411.53
|
|
|
Service Code
|
HCPCS A9572
|
| Hospital Charge Code |
34300014
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,026.23 |
| Max. Negotiated Rate |
$5,389.44 |
| Rate for Payer: Aetna American Axle |
$3,517.49
|
| Rate for Payer: Aetna Commercial |
$4,599.80
|
| Rate for Payer: Aetna Medicare |
$1,991.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,517.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,393.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,393.26
|
| Rate for Payer: BCBS Complete |
$1,077.54
|
| Rate for Payer: BCBS MAPPO |
$1,914.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,914.61
|
| Rate for Payer: Cash Price |
$4,329.22
|
| Rate for Payer: Cash Price |
$4,329.22
|
| Rate for Payer: Cofinity Commercial |
$4,653.92
|
| Rate for Payer: Cofinity Commercial |
$3,788.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,788.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,329.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,914.61
|
| Rate for Payer: Healthscope Commercial |
$4,870.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,788.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,058.65
|
| Rate for Payer: Mclaren Medicaid |
$1,026.23
|
| Rate for Payer: Mclaren Medicare |
$1,914.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,010.34
|
| Rate for Payer: Meridian Medicaid |
$1,077.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,201.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,599.80
|
| Rate for Payer: PACE Medicare |
$1,818.88
|
| Rate for Payer: PACE SWMI |
$1,914.61
|
| Rate for Payer: PHP Commercial |
$4,599.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,914.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,026.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,517.49
|
| Rate for Payer: Priority Health Medicare |
$1,914.61
|
| Rate for Payer: Priority Health SBD |
$3,409.26
|
| Rate for Payer: Railroad Medicare Medicare |
$1,914.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,389.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,914.61
|
| Rate for Payer: UHC Exchange |
$3,659.01
|
| Rate for Payer: UHC Medicare Advantage |
$1,914.61
|
| Rate for Payer: UHCCP Medicaid |
$1,026.23
|
| Rate for Payer: UMR Bronson Commercial |
$2,002.27
|
| Rate for Payer: VA VA |
$1,914.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,058.65
|
|
|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
IP
|
$5,517.33
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,427.63 |
| Max. Negotiated Rate |
$4,965.60 |
| Rate for Payer: Aetna American Axle |
$3,586.26
|
| Rate for Payer: Aetna Commercial |
$4,689.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,586.26
|
| Rate for Payer: Cash Price |
$4,413.86
|
| Rate for Payer: Cofinity Commercial |
$3,862.13
|
| Rate for Payer: Cofinity Commercial |
$4,744.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,862.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,413.86
|
| Rate for Payer: Healthscope Commercial |
$4,965.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,862.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,138.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,689.73
|
| Rate for Payer: PHP Commercial |
$4,689.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,586.26
|
| Rate for Payer: Priority Health SBD |
$3,475.92
|
| Rate for Payer: UMR Bronson Commercial |
$2,427.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,138.00
|
|
|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
OP
|
$5,517.33
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,070.86 |
| Max. Negotiated Rate |
$5,623.80 |
| Rate for Payer: Aetna American Axle |
$3,586.26
|
| Rate for Payer: Aetna Commercial |
$4,689.73
|
| Rate for Payer: Aetna Medicare |
$2,077.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,586.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$4,413.86
|
| Rate for Payer: Cash Price |
$4,413.86
|
| Rate for Payer: Cofinity Commercial |
$4,744.90
|
| Rate for Payer: Cofinity Commercial |
$3,862.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,862.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,413.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$4,965.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,862.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,138.00
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,689.73
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$4,689.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,586.26
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health SBD |
$3,475.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,623.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Exchange |
$3,818.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,070.86
|
| Rate for Payer: UMR Bronson Commercial |
$2,041.41
|
| Rate for Payer: VA VA |
$1,997.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,138.00
|
|
|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$111.32
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$41.19 |
| Max. Negotiated Rate |
$100.19 |
| Rate for Payer: Aetna American Axle |
$72.36
|
| Rate for Payer: Aetna Commercial |
$94.62
|
| Rate for Payer: Aetna Medicare |
$55.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.36
|
| Rate for Payer: BCBS Complete |
$44.53
|
| Rate for Payer: Cash Price |
$89.06
|
| Rate for Payer: Cofinity Commercial |
$77.92
|
| Rate for Payer: Cofinity Commercial |
$95.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.06
|
| Rate for Payer: Healthscope Commercial |
$100.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.62
|
| Rate for Payer: PHP Commercial |
$94.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.36
|
| Rate for Payer: Priority Health SBD |
$70.13
|
| Rate for Payer: UMR Bronson Commercial |
$41.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.49
|
|
|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$111.32
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$48.98 |
| Max. Negotiated Rate |
$100.19 |
| Rate for Payer: Aetna American Axle |
$72.36
|
| Rate for Payer: Aetna Commercial |
$94.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.36
|
| Rate for Payer: Cash Price |
$89.06
|
| Rate for Payer: Cofinity Commercial |
$77.92
|
| Rate for Payer: Cofinity Commercial |
$95.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.06
|
| Rate for Payer: Healthscope Commercial |
$100.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.62
|
| Rate for Payer: PHP Commercial |
$94.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.36
|
| Rate for Payer: Priority Health SBD |
$70.13
|
| Rate for Payer: UMR Bronson Commercial |
$48.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.49
|
|
|
HC INCISIONAL BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$490.03
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$215.61 |
| Max. Negotiated Rate |
$441.03 |
| Rate for Payer: Aetna American Axle |
$318.52
|
| Rate for Payer: Aetna Commercial |
$416.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.52
|
| Rate for Payer: Cash Price |
$392.02
|
| Rate for Payer: Cofinity Commercial |
$343.02
|
| Rate for Payer: Cofinity Commercial |
$421.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$343.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.02
|
| Rate for Payer: Healthscope Commercial |
$441.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$343.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.53
|
| Rate for Payer: PHP Commercial |
$416.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.52
|
| Rate for Payer: Priority Health SBD |
$308.72
|
| Rate for Payer: UMR Bronson Commercial |
$215.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.52
|
|
|
HC INCISIONAL BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$490.03
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
76100152
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$181.31 |
| Max. Negotiated Rate |
$1,680.50 |
| Rate for Payer: Aetna American Axle |
$318.52
|
| Rate for Payer: Aetna Commercial |
$416.53
|
| Rate for Payer: Aetna Medicare |
$620.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$746.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$746.25
|
| Rate for Payer: BCBS Complete |
$335.99
|
| Rate for Payer: BCBS MAPPO |
$597.00
|
| Rate for Payer: BCN Medicare Advantage |
$597.00
|
| Rate for Payer: Cash Price |
$392.02
|
| Rate for Payer: Cash Price |
$392.02
|
| Rate for Payer: Cofinity Commercial |
$421.43
|
| Rate for Payer: Cofinity Commercial |
$343.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$343.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.00
|
| Rate for Payer: Healthscope Commercial |
$441.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$343.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.52
|
| Rate for Payer: Mclaren Medicaid |
$319.99
|
| Rate for Payer: Mclaren Medicare |
$597.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$626.85
|
| Rate for Payer: Meridian Medicaid |
$335.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$686.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.53
|
| Rate for Payer: PACE Medicare |
$567.15
|
| Rate for Payer: PACE SWMI |
$597.00
|
| Rate for Payer: PHP Commercial |
$416.53
|
| Rate for Payer: PHP Medicare Advantage |
$597.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.52
|
| Rate for Payer: Priority Health Medicare |
$597.00
|
| Rate for Payer: Priority Health SBD |
$308.72
|
| Rate for Payer: Railroad Medicare Medicare |
$597.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,680.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$597.00
|
| Rate for Payer: UHC Exchange |
$1,140.93
|
| Rate for Payer: UHC Medicare Advantage |
$597.00
|
| Rate for Payer: UHCCP Medicaid |
$319.99
|
| Rate for Payer: UMR Bronson Commercial |
$181.31
|
| Rate for Payer: VA VA |
$597.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.52
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
IP
|
$2,004.12
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$881.81 |
| Max. Negotiated Rate |
$1,803.71 |
| Rate for Payer: Aetna American Axle |
$1,302.68
|
| Rate for Payer: Aetna Commercial |
$1,703.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,302.68
|
| Rate for Payer: Cash Price |
$1,603.30
|
| Rate for Payer: Cofinity Commercial |
$1,402.88
|
| Rate for Payer: Cofinity Commercial |
$1,723.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,402.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,603.30
|
| Rate for Payer: Healthscope Commercial |
$1,803.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,402.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,503.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,703.50
|
| Rate for Payer: PHP Commercial |
$1,703.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,302.68
|
| Rate for Payer: Priority Health SBD |
$1,262.60
|
| Rate for Payer: UMR Bronson Commercial |
$881.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,503.09
|
|
|
HC INCISION AND DRAINAGE TISSUE ABSCESS SUBFACIAL
|
Facility
|
OP
|
$2,004.12
|
|
| Hospital Charge Code |
36100439
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$741.52 |
| Max. Negotiated Rate |
$1,803.71 |
| Rate for Payer: Aetna American Axle |
$1,302.68
|
| Rate for Payer: Aetna Commercial |
$1,703.50
|
| Rate for Payer: Aetna Medicare |
$1,002.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,302.68
|
| Rate for Payer: BCBS Complete |
$801.65
|
| Rate for Payer: Cash Price |
$1,603.30
|
| Rate for Payer: Cofinity Commercial |
$1,402.88
|
| Rate for Payer: Cofinity Commercial |
$1,723.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,402.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,603.30
|
| Rate for Payer: Healthscope Commercial |
$1,803.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,402.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,503.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,703.50
|
| Rate for Payer: PHP Commercial |
$1,703.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,302.68
|
| Rate for Payer: Priority Health SBD |
$1,262.60
|
| Rate for Payer: UMR Bronson Commercial |
$741.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,503.09
|
|
|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
IP
|
$628.32
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$276.46 |
| Max. Negotiated Rate |
$565.49 |
| Rate for Payer: Aetna American Axle |
$408.41
|
| Rate for Payer: Aetna Commercial |
$534.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$408.41
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cofinity Commercial |
$439.82
|
| Rate for Payer: Cofinity Commercial |
$540.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$439.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.66
|
| Rate for Payer: Healthscope Commercial |
$565.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$439.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$471.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.07
|
| Rate for Payer: PHP Commercial |
$534.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.41
|
| Rate for Payer: Priority Health SBD |
$395.84
|
| Rate for Payer: UMR Bronson Commercial |
$276.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$471.24
|
|
