|
HC INCISION & DRAIN ABSCESS PERITONSILLAR
|
Facility
|
OP
|
$628.32
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100474
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.39 |
| Max. Negotiated Rate |
$637.52 |
| Rate for Payer: Aetna American Axle |
$408.41
|
| Rate for Payer: Aetna Commercial |
$534.07
|
| Rate for Payer: Aetna Medicare |
$235.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$408.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.10
|
| Rate for Payer: BCBS Complete |
$127.46
|
| Rate for Payer: BCBS MAPPO |
$226.48
|
| Rate for Payer: BCN Medicare Advantage |
$226.48
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cofinity Commercial |
$540.36
|
| Rate for Payer: Cofinity Commercial |
$439.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$439.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.48
|
| 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: Mclaren Medicaid |
$121.39
|
| Rate for Payer: Mclaren Medicare |
$226.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.80
|
| Rate for Payer: Meridian Medicaid |
$127.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.07
|
| Rate for Payer: PACE Medicare |
$215.16
|
| Rate for Payer: PACE SWMI |
$226.48
|
| Rate for Payer: PHP Commercial |
$534.07
|
| Rate for Payer: PHP Medicare Advantage |
$226.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.41
|
| Rate for Payer: Priority Health Medicare |
$226.48
|
| Rate for Payer: Priority Health SBD |
$395.84
|
| Rate for Payer: Railroad Medicare Medicare |
$226.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$637.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.48
|
| Rate for Payer: UHC Exchange |
$432.83
|
| Rate for Payer: UHC Medicare Advantage |
$226.48
|
| Rate for Payer: UHCCP Medicaid |
$121.39
|
| Rate for Payer: UMR Bronson Commercial |
$232.48
|
| Rate for Payer: VA VA |
$226.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$471.24
|
|
|
HC INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
IP
|
$7,970.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
76100528
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,506.80 |
| Max. Negotiated Rate |
$7,173.00 |
| Rate for Payer: Aetna American Axle |
$5,180.50
|
| Rate for Payer: Aetna Commercial |
$6,774.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,180.50
|
| Rate for Payer: Cash Price |
$6,376.00
|
| Rate for Payer: Cofinity Commercial |
$5,579.00
|
| Rate for Payer: Cofinity Commercial |
$6,854.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,579.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,376.00
|
| Rate for Payer: Healthscope Commercial |
$7,173.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,579.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,977.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,774.50
|
| Rate for Payer: PHP Commercial |
$6,774.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,180.50
|
| Rate for Payer: Priority Health SBD |
$5,021.10
|
| Rate for Payer: UMR Bronson Commercial |
$3,506.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,977.50
|
|
|
HC INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Facility
|
OP
|
$7,970.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
76100528
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,496.14 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$5,180.50
|
| Rate for Payer: Aetna Commercial |
$6,774.50
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,180.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$6,376.00
|
| Rate for Payer: Cash Price |
$6,376.00
|
| Rate for Payer: Cofinity Commercial |
$6,854.20
|
| Rate for Payer: Cofinity Commercial |
$5,579.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,579.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,376.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$7,173.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,579.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,977.50
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,774.50
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$6,774.50
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,180.50
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$5,021.10
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$5,334.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: UMR Bronson Commercial |
$2,948.90
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,977.50
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
IP
|
$663.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$291.72 |
| Max. Negotiated Rate |
$596.70 |
| Rate for Payer: Aetna American Axle |
$430.95
|
| Rate for Payer: Aetna Commercial |
$563.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.95
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$464.10
|
| Rate for Payer: Cofinity Commercial |
$570.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$464.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.40
|
| Rate for Payer: Healthscope Commercial |
$596.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$464.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$497.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.55
|
| Rate for Payer: PHP Commercial |
$563.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.95
|
| Rate for Payer: Priority Health SBD |
$417.69
|
| Rate for Payer: UMR Bronson Commercial |
$291.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$497.25
|
|
|
HC INCISION & DRAINAGE OF TONSIL ABSCESS
|
Facility
|
OP
|
$663.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
76100491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.39 |
| Max. Negotiated Rate |
$637.52 |
| Rate for Payer: Aetna American Axle |
$430.95
|
| Rate for Payer: Aetna Commercial |
$563.55
|
| Rate for Payer: Aetna Medicare |
$235.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.10
|
| Rate for Payer: BCBS Complete |
$127.46
|
| Rate for Payer: BCBS MAPPO |
$226.48
|
| Rate for Payer: BCN Medicare Advantage |
$226.48
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$570.18
|
| Rate for Payer: Cofinity Commercial |
$464.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$464.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.48
|
| Rate for Payer: Healthscope Commercial |
$596.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$464.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$497.25
|
| Rate for Payer: Mclaren Medicaid |
$121.39
|
| Rate for Payer: Mclaren Medicare |
$226.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.80
|
| Rate for Payer: Meridian Medicaid |
$127.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.55
|
| Rate for Payer: PACE Medicare |
$215.16
|
| Rate for Payer: PACE SWMI |
$226.48
|
| Rate for Payer: PHP Commercial |
$563.55
|
| Rate for Payer: PHP Medicare Advantage |
$226.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.95
|
| Rate for Payer: Priority Health Medicare |
$226.48
|
| Rate for Payer: Priority Health SBD |
$417.69
|
| Rate for Payer: Railroad Medicare Medicare |
$226.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$637.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.48
|
| Rate for Payer: UHC Exchange |
$432.83
|
| Rate for Payer: UHC Medicare Advantage |
$226.48
|
| Rate for Payer: UHCCP Medicaid |
$121.39
|
| Rate for Payer: UMR Bronson Commercial |
$245.31
|
| Rate for Payer: VA VA |
$226.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$497.25
|
|
|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
OP
|
$1,861.05
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$688.59 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna American Axle |
$1,209.68
|
| Rate for Payer: Aetna Commercial |
$1,581.89
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,209.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$1,488.84
|
| Rate for Payer: Cash Price |
$1,488.84
|
| Rate for Payer: Cofinity Commercial |
$1,600.50
|
| Rate for Payer: Cofinity Commercial |
$1,302.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,302.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,488.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$1,674.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,302.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,395.79
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,581.89
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,581.89
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,209.68
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$1,172.46
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$3,019.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: UMR Bronson Commercial |
$688.59
|
| Rate for Payer: VA VA |
$1,580.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,395.79
|
|
|
HC INCISION DRAIN HEMATOMA SEROMA
|
Facility
|
IP
|
$1,861.05
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
36100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$818.86 |
| Max. Negotiated Rate |
$1,674.94 |
| Rate for Payer: Aetna American Axle |
$1,209.68
|
| Rate for Payer: Aetna Commercial |
$1,581.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,209.68
|
| Rate for Payer: Cash Price |
$1,488.84
|
| Rate for Payer: Cofinity Commercial |
$1,302.73
|
| Rate for Payer: Cofinity Commercial |
$1,600.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,302.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,488.84
|
| Rate for Payer: Healthscope Commercial |
$1,674.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,302.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,395.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,581.89
|
| Rate for Payer: PHP Commercial |
$1,581.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,209.68
|
| Rate for Payer: Priority Health SBD |
$1,172.46
|
| Rate for Payer: UMR Bronson Commercial |
$818.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,395.79
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
OP
|
$970.69
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$359.16 |
| Max. Negotiated Rate |
$1,931.58 |
| Rate for Payer: Aetna American Axle |
$630.95
|
| Rate for Payer: Aetna Commercial |
$825.09
|
| Rate for Payer: Aetna Medicare |
$713.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cofinity Commercial |
$834.79
|
| Rate for Payer: Cofinity Commercial |
$679.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$679.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$776.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$873.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$679.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.02
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.09
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$825.09
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.95
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health SBD |
$611.53
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,931.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,311.40
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: UMR Bronson Commercial |
$359.16
|
| Rate for Payer: VA VA |
$686.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.02
|
|
|
HC INCISION & DRAIN PILONIDAL CYST COMPL
|
Facility
|
IP
|
$970.69
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
76100314
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$427.10 |
| Max. Negotiated Rate |
$873.62 |
| Rate for Payer: Aetna American Axle |
$630.95
|
| Rate for Payer: Aetna Commercial |
$825.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$630.95
|
| Rate for Payer: Cash Price |
$776.55
|
| Rate for Payer: Cofinity Commercial |
$679.48
|
| Rate for Payer: Cofinity Commercial |
$834.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$679.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$776.55
|
| Rate for Payer: Healthscope Commercial |
$873.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$679.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$728.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$825.09
|
| Rate for Payer: PHP Commercial |
$825.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.95
|
| Rate for Payer: Priority Health SBD |
$611.53
|
| Rate for Payer: UMR Bronson Commercial |
$427.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$728.02
|
|
|
HC INCISION EXT THROMBOSED HEMORRHOID
|
Facility
|
OP
|
$297.93
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
45000066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$110.23 |
| Max. Negotiated Rate |
$667.69 |
| Rate for Payer: Aetna American Axle |
$193.65
|
| Rate for Payer: Aetna Commercial |
$253.24
|
| Rate for Payer: Aetna Medicare |
$246.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.50
|
| Rate for Payer: BCBS Complete |
$133.50
|
| Rate for Payer: BCBS MAPPO |
$237.20
|
| Rate for Payer: BCN Medicare Advantage |
$237.20
|
| Rate for Payer: Cash Price |
$238.34
|
| Rate for Payer: Cash Price |
$238.34
|
| Rate for Payer: Cofinity Commercial |
$256.22
|
| Rate for Payer: Cofinity Commercial |
$208.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$208.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.20
|
| Rate for Payer: Healthscope Commercial |
$268.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.45
|
| Rate for Payer: Mclaren Medicaid |
$127.14
|
| Rate for Payer: Mclaren Medicare |
$237.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.06
|
| Rate for Payer: Meridian Medicaid |
$133.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.24
|
| Rate for Payer: PACE Medicare |
$225.34
|
| Rate for Payer: PACE SWMI |
$237.20
|
| Rate for Payer: PHP Commercial |
$253.24
|
| Rate for Payer: PHP Medicare Advantage |
$237.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.65
|
| Rate for Payer: Priority Health Medicare |
$237.20
|
| Rate for Payer: Priority Health SBD |
$187.70
|
| Rate for Payer: Railroad Medicare Medicare |
$237.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.20
|
| Rate for Payer: UHC Exchange |
$453.31
|
| Rate for Payer: UHC Medicare Advantage |
$237.20
|
| Rate for Payer: UHCCP Medicaid |
$127.14
|
| Rate for Payer: UMR Bronson Commercial |
$110.23
|
| Rate for Payer: VA VA |
$237.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.45
|
|
|
HC INCISION EXT THROMBOSED HEMORRHOID
|
Facility
|
IP
|
$297.93
|
|
|
Service Code
|
CPT 46083
|
| Hospital Charge Code |
45000066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$131.09 |
| Max. Negotiated Rate |
$268.14 |
| Rate for Payer: Aetna American Axle |
$193.65
|
| Rate for Payer: Aetna Commercial |
$253.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.65
|
| Rate for Payer: Cash Price |
$238.34
|
| Rate for Payer: Cofinity Commercial |
$208.55
|
| Rate for Payer: Cofinity Commercial |
$256.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$208.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.34
|
| Rate for Payer: Healthscope Commercial |
$268.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.24
|
| Rate for Payer: PHP Commercial |
$253.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.65
|
| Rate for Payer: Priority Health SBD |
$187.70
|
| Rate for Payer: UMR Bronson Commercial |
$131.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.45
|
|
|
HC INCISION OF LABIAL FRENUM FRENOTOMY
|
Facility
|
IP
|
$1,377.00
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
76100459
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$605.88 |
| Max. Negotiated Rate |
$1,239.30 |
| Rate for Payer: Aetna American Axle |
$895.05
|
| Rate for Payer: Aetna Commercial |
$1,170.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$895.05
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$1,184.22
|
| Rate for Payer: Cofinity Commercial |
$963.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$963.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Healthscope Commercial |
$1,239.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$963.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: PHP Commercial |
$1,170.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health SBD |
$867.51
|
| Rate for Payer: UMR Bronson Commercial |
$605.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.75
|
|
|
HC INCISION OF LABIAL FRENUM FRENOTOMY
|
Facility
|
OP
|
$1,377.00
|
|
|
Service Code
|
CPT 40806
|
| Hospital Charge Code |
76100459
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$266.21 |
| Max. Negotiated Rate |
$1,398.05 |
| Rate for Payer: Aetna American Axle |
$895.05
|
| Rate for Payer: Aetna Commercial |
$1,170.45
|
| Rate for Payer: Aetna Medicare |
$516.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$895.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$620.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$620.83
|
| Rate for Payer: BCBS Complete |
$279.52
|
| Rate for Payer: BCBS MAPPO |
$496.66
|
| Rate for Payer: BCN Medicare Advantage |
$496.66
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cash Price |
$1,101.60
|
| Rate for Payer: Cofinity Commercial |
$963.90
|
| Rate for Payer: Cofinity Commercial |
$1,184.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$963.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,101.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$496.66
|
| Rate for Payer: Healthscope Commercial |
$1,239.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$963.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,032.75
|
| Rate for Payer: Mclaren Medicaid |
$266.21
|
| Rate for Payer: Mclaren Medicare |
$496.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$521.49
|
| Rate for Payer: Meridian Medicaid |
$279.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$571.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,170.45
|
| Rate for Payer: PACE Medicare |
$471.83
|
| Rate for Payer: PACE SWMI |
$496.66
|
| Rate for Payer: PHP Commercial |
$1,170.45
|
| Rate for Payer: PHP Medicare Advantage |
$496.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$266.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$895.05
|
| Rate for Payer: Priority Health Medicare |
$496.66
|
| Rate for Payer: Priority Health SBD |
$867.51
|
| Rate for Payer: Railroad Medicare Medicare |
$496.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,398.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$496.66
|
| Rate for Payer: UHC Exchange |
$949.17
|
| Rate for Payer: UHC Medicare Advantage |
$496.66
|
| Rate for Payer: UHCCP Medicaid |
$266.21
|
| Rate for Payer: UMR Bronson Commercial |
$509.49
|
| Rate for Payer: VA VA |
$496.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,032.75
|
|
|
HC INCISION OF URETHRA
|
Facility
|
IP
|
$2,797.64
|
|
|
Service Code
|
CPT 53020
|
| Hospital Charge Code |
76100296
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,230.96 |
| Max. Negotiated Rate |
$2,517.88 |
| Rate for Payer: Aetna American Axle |
$1,818.47
|
| Rate for Payer: Aetna Commercial |
$2,377.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,818.47
|
| Rate for Payer: Cash Price |
$2,238.11
|
| Rate for Payer: Cofinity Commercial |
$1,958.35
|
| Rate for Payer: Cofinity Commercial |
$2,405.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,958.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,238.11
|
| Rate for Payer: Healthscope Commercial |
$2,517.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,958.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,098.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,377.99
|
| Rate for Payer: PHP Commercial |
$2,377.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,818.47
|
| Rate for Payer: Priority Health SBD |
$1,762.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,230.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,098.23
|
|
|
HC INCISION OF URETHRA
|
Facility
|
OP
|
$2,797.64
|
|
|
Service Code
|
CPT 53020
|
| Hospital Charge Code |
76100296
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,035.13 |
| Max. Negotiated Rate |
$5,623.80 |
| Rate for Payer: Aetna American Axle |
$1,818.47
|
| Rate for Payer: Aetna Commercial |
$2,377.99
|
| Rate for Payer: Aetna Medicare |
$2,077.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,818.47
|
| 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 |
$2,238.11
|
| Rate for Payer: Cash Price |
$2,238.11
|
| Rate for Payer: Cofinity Commercial |
$2,405.97
|
| Rate for Payer: Cofinity Commercial |
$1,958.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,958.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,238.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$2,517.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,958.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,098.23
|
| 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 |
$2,377.99
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$2,377.99
|
| 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 |
$1,818.47
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health SBD |
$1,762.51
|
| 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 |
$1,035.13
|
| Rate for Payer: VA VA |
$1,997.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,098.23
|
|
|
HC INDIRECT CALORIMETRY
|
Facility
|
OP
|
$1,166.29
|
|
|
Service Code
|
CPT 94690
|
| Hospital Charge Code |
46000008
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$1,049.66 |
| Rate for Payer: Aetna American Axle |
$758.09
|
| Rate for Payer: Aetna Commercial |
$991.35
|
| Rate for Payer: Aetna Medicare |
$60.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$933.03
|
| Rate for Payer: Cash Price |
$933.03
|
| Rate for Payer: Cash Price |
$933.03
|
| Rate for Payer: Cofinity Commercial |
$1,003.01
|
| Rate for Payer: Cofinity Commercial |
$816.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$816.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$1,049.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$816.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$874.72
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$991.35
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$991.35
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$758.09
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health SBD |
$734.76
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.07
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$110.71
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: UMR Bronson Commercial |
$431.53
|
| Rate for Payer: VA VA |
$57.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$874.72
|
|
|
HC INDIRECT CALORIMETRY
|
Facility
|
IP
|
$1,166.29
|
|
|
Service Code
|
CPT 94690
|
| Hospital Charge Code |
46000008
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$513.17 |
| Max. Negotiated Rate |
$1,049.66 |
| Rate for Payer: Aetna American Axle |
$758.09
|
| Rate for Payer: Aetna Commercial |
$991.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$758.09
|
| Rate for Payer: Cash Price |
$933.03
|
| Rate for Payer: Cofinity Commercial |
$1,003.01
|
| Rate for Payer: Cofinity Commercial |
$816.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$816.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$933.03
|
| Rate for Payer: Healthscope Commercial |
$1,049.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$816.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$874.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$991.35
|
| Rate for Payer: PHP Commercial |
$991.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$758.09
|
| Rate for Payer: Priority Health SBD |
$734.76
|
| Rate for Payer: UMR Bronson Commercial |
$513.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$874.72
|
|
|
HC INDIUM 111 DTPA PER MCI
|
Facility
|
IP
|
$583.28
|
|
|
Service Code
|
HCPCS A9548
|
| Hospital Charge Code |
34300015
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$256.64 |
| Max. Negotiated Rate |
$524.95 |
| Rate for Payer: Aetna American Axle |
$379.13
|
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.13
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$408.30
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$408.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$408.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health SBD |
$367.47
|
| Rate for Payer: UMR Bronson Commercial |
$256.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC INDIUM 111 DTPA PER MCI
|
Facility
|
OP
|
$583.28
|
|
|
Service Code
|
HCPCS A9548
|
| Hospital Charge Code |
34300015
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$215.81 |
| Max. Negotiated Rate |
$2,013.47 |
| Rate for Payer: Aetna American Axle |
$379.13
|
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: Aetna Medicare |
$743.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$894.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$894.11
|
| Rate for Payer: BCBS Complete |
$402.57
|
| Rate for Payer: BCBS MAPPO |
$715.29
|
| Rate for Payer: BCN Medicare Advantage |
$715.29
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Cofinity Commercial |
$408.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$408.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$715.29
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$408.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Mclaren Medicaid |
$383.40
|
| Rate for Payer: Mclaren Medicare |
$715.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$751.05
|
| Rate for Payer: Meridian Medicaid |
$402.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$822.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: PACE Medicare |
$679.53
|
| Rate for Payer: PACE SWMI |
$715.29
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: PHP Medicare Advantage |
$715.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$383.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health Medicare |
$715.29
|
| Rate for Payer: Priority Health SBD |
$367.47
|
| Rate for Payer: Railroad Medicare Medicare |
$715.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,013.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$715.29
|
| Rate for Payer: UHC Exchange |
$1,366.99
|
| Rate for Payer: UHC Medicare Advantage |
$715.29
|
| Rate for Payer: UHCCP Medicaid |
$383.40
|
| Rate for Payer: UMR Bronson Commercial |
$215.81
|
| Rate for Payer: VA VA |
$715.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC INDIUM 111 PER 0.5 MCI
|
Facility
|
IP
|
$2,661.14
|
|
|
Service Code
|
HCPCS A9547
|
| Hospital Charge Code |
63600040
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,170.90 |
| Max. Negotiated Rate |
$2,395.03 |
| Rate for Payer: Aetna American Axle |
$1,729.74
|
| Rate for Payer: Aetna Commercial |
$2,261.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,729.74
|
| Rate for Payer: Cash Price |
$2,128.91
|
| Rate for Payer: Cofinity Commercial |
$1,862.80
|
| Rate for Payer: Cofinity Commercial |
$2,288.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,862.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,128.91
|
| Rate for Payer: Healthscope Commercial |
$2,395.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,862.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,995.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,261.97
|
| Rate for Payer: PHP Commercial |
$2,261.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,729.74
|
| Rate for Payer: Priority Health SBD |
$1,676.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,170.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,995.86
|
|
|
HC INDIUM 111 PER 0.5 MCI
|
Facility
|
OP
|
$2,661.14
|
|
|
Service Code
|
HCPCS A9547
|
| Hospital Charge Code |
63600040
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$414.14 |
| Max. Negotiated Rate |
$2,395.03 |
| Rate for Payer: Aetna American Axle |
$1,729.74
|
| Rate for Payer: Aetna Commercial |
$2,261.97
|
| Rate for Payer: Aetna Medicare |
$803.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,729.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$965.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$965.80
|
| Rate for Payer: BCBS Complete |
$434.84
|
| Rate for Payer: BCBS MAPPO |
$772.64
|
| Rate for Payer: BCN Medicare Advantage |
$772.64
|
| Rate for Payer: Cash Price |
$2,128.91
|
| Rate for Payer: Cash Price |
$2,128.91
|
| Rate for Payer: Cofinity Commercial |
$2,288.58
|
| Rate for Payer: Cofinity Commercial |
$1,862.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,862.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,128.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$772.64
|
| Rate for Payer: Healthscope Commercial |
$2,395.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,862.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,995.86
|
| Rate for Payer: Mclaren Medicaid |
$414.14
|
| Rate for Payer: Mclaren Medicare |
$772.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$811.27
|
| Rate for Payer: Meridian Medicaid |
$434.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$888.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,261.97
|
| Rate for Payer: PACE Medicare |
$734.01
|
| Rate for Payer: PACE SWMI |
$772.64
|
| Rate for Payer: PHP Commercial |
$2,261.97
|
| Rate for Payer: PHP Medicare Advantage |
$772.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,729.74
|
| Rate for Payer: Priority Health Medicare |
$772.64
|
| Rate for Payer: Priority Health SBD |
$1,676.52
|
| Rate for Payer: Railroad Medicare Medicare |
$772.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,174.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$772.64
|
| Rate for Payer: UHC Exchange |
$1,476.59
|
| Rate for Payer: UHC Medicare Advantage |
$772.64
|
| Rate for Payer: UHCCP Medicaid |
$414.14
|
| Rate for Payer: UMR Bronson Commercial |
$984.62
|
| Rate for Payer: VA VA |
$772.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,995.86
|
|
|
HC INDIVIDUAL SESSION 30 MIN RD G0108
|
Facility
|
IP
|
$164.75
|
|
|
Service Code
|
HCPCS G0108
|
| Hospital Charge Code |
94200029
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$72.49 |
| Max. Negotiated Rate |
$148.28 |
| Rate for Payer: Aetna American Axle |
$107.09
|
| Rate for Payer: Aetna Commercial |
$140.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.09
|
| Rate for Payer: Cash Price |
$131.80
|
| Rate for Payer: Cofinity Commercial |
$115.33
|
| Rate for Payer: Cofinity Commercial |
$141.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$115.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.80
|
| Rate for Payer: Healthscope Commercial |
$148.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.04
|
| Rate for Payer: PHP Commercial |
$140.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.09
|
| Rate for Payer: Priority Health SBD |
$103.79
|
| Rate for Payer: UMR Bronson Commercial |
$72.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.56
|
|
|
HC INDIVIDUAL SESSION 30 MIN RD G0108
|
Facility
|
OP
|
$164.75
|
|
|
Service Code
|
HCPCS G0108
|
| Hospital Charge Code |
94200029
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$60.96 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$107.09
|
| Rate for Payer: Aetna Commercial |
$140.04
|
| Rate for Payer: Aetna Medicare |
$82.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.09
|
| Rate for Payer: BCBS Complete |
$65.90
|
| Rate for Payer: Cash Price |
$131.80
|
| Rate for Payer: Cash Price |
$131.80
|
| Rate for Payer: Cofinity Commercial |
$141.69
|
| Rate for Payer: Cofinity Commercial |
$115.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$115.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.80
|
| Rate for Payer: Healthscope Commercial |
$148.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.04
|
| Rate for Payer: PHP Commercial |
$140.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.09
|
| Rate for Payer: Priority Health SBD |
$103.79
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$60.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.56
|
|
|
HC INDUCTION OF ARRHYTHMIA
|
Facility
|
OP
|
$3,753.24
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
48100036
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$634.61 |
| Max. Negotiated Rate |
$3,377.92 |
| Rate for Payer: Aetna American Axle |
$2,439.61
|
| Rate for Payer: Aetna Commercial |
$3,190.25
|
| Rate for Payer: Aetna Medicare |
$1,231.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,439.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,479.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,479.97
|
| Rate for Payer: BCBS Complete |
$666.34
|
| Rate for Payer: BCBS MAPPO |
$1,183.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,183.98
|
| Rate for Payer: Cash Price |
$3,002.59
|
| Rate for Payer: Cash Price |
$3,002.59
|
| Rate for Payer: Cofinity Commercial |
$3,227.79
|
| Rate for Payer: Cofinity Commercial |
$2,627.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,627.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,002.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,183.98
|
| Rate for Payer: Healthscope Commercial |
$3,377.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,627.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,814.93
|
| Rate for Payer: Mclaren Medicaid |
$634.61
|
| Rate for Payer: Mclaren Medicare |
$1,183.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,243.18
|
| Rate for Payer: Meridian Medicaid |
$666.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,361.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,190.25
|
| Rate for Payer: PACE Medicare |
$1,124.78
|
| Rate for Payer: PACE SWMI |
$1,183.98
|
| Rate for Payer: PHP Commercial |
$3,190.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,183.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,439.61
|
| Rate for Payer: Priority Health Medicare |
$1,183.98
|
| Rate for Payer: Priority Health SBD |
$2,364.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,183.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,332.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,183.98
|
| Rate for Payer: UHC Exchange |
$2,262.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,183.98
|
| Rate for Payer: UHCCP Medicaid |
$634.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,388.70
|
| Rate for Payer: VA VA |
$1,183.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,814.93
|
|
|
HC INDUCTION OF ARRHYTHMIA
|
Facility
|
IP
|
$3,753.24
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
48100036
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,651.43 |
| Max. Negotiated Rate |
$3,377.92 |
| Rate for Payer: Aetna American Axle |
$2,439.61
|
| Rate for Payer: Aetna Commercial |
$3,190.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,439.61
|
| Rate for Payer: Cash Price |
$3,002.59
|
| Rate for Payer: Cofinity Commercial |
$2,627.27
|
| Rate for Payer: Cofinity Commercial |
$3,227.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,627.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,002.59
|
| Rate for Payer: Healthscope Commercial |
$3,377.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,627.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,814.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,190.25
|
| Rate for Payer: PHP Commercial |
$3,190.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,439.61
|
| Rate for Payer: Priority Health SBD |
$2,364.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,651.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,814.93
|
|
