|
HC LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX
|
Facility
|
IP
|
$577.42
|
|
|
Service Code
|
CPT 31505
|
| Hospital Charge Code |
76100411
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$254.06 |
| Max. Negotiated Rate |
$519.68 |
| Rate for Payer: Aetna American Axle |
$375.32
|
| Rate for Payer: Aetna Commercial |
$490.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.32
|
| Rate for Payer: Cash Price |
$461.94
|
| Rate for Payer: Cofinity Advantage |
$404.19
|
| Rate for Payer: Cofinity Commercial |
$496.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.94
|
| Rate for Payer: Healthscope Commercial |
$519.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$404.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$433.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$433.06
|
| Rate for Payer: PHP Commercial |
$490.81
|
| Rate for Payer: Priority Health SBD |
$363.77
|
| Rate for Payer: UMR Bronson Commercial |
$254.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$433.06
|
|
|
HC LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX
|
Facility
|
OP
|
$577.42
|
|
|
Service Code
|
CPT 31505
|
| Hospital Charge Code |
76100411
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$94.66 |
| Max. Negotiated Rate |
$643.18 |
| Rate for Payer: Aetna American Axle |
$375.32
|
| Rate for Payer: Aetna Commercial |
$490.81
|
| Rate for Payer: Aetna Medicare |
$206.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$248.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$248.61
|
| Rate for Payer: BCBS Complete |
$109.23
|
| Rate for Payer: BCBS MAPPO |
$198.89
|
| Rate for Payer: BCBS Trust/PPO |
$94.66
|
| Rate for Payer: BCN Commercial |
$94.66
|
| Rate for Payer: BCN Medicare Advantage |
$198.89
|
| Rate for Payer: Cash Price |
$461.94
|
| Rate for Payer: Cash Price |
$461.94
|
| Rate for Payer: Cash Price |
$461.94
|
| Rate for Payer: Cofinity Advantage |
$404.19
|
| Rate for Payer: Cofinity Commercial |
$496.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.89
|
| Rate for Payer: Healthscope Commercial |
$519.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$404.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$433.06
|
| Rate for Payer: Mclaren Medicaid |
$198.89
|
| Rate for Payer: Mclaren Medicare |
$198.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.83
|
| Rate for Payer: Meridian Medicaid |
$208.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$218.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.81
|
| Rate for Payer: Nomi Health Commercial |
$596.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$433.06
|
| Rate for Payer: PACE Medicare |
$188.95
|
| Rate for Payer: PACE SWMI |
$198.89
|
| Rate for Payer: PHP Commercial |
$490.81
|
| Rate for Payer: PHP Medicare Advantage |
$198.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$643.18
|
| Rate for Payer: Priority Health Medicare |
$198.89
|
| Rate for Payer: Priority Health SBD |
$363.77
|
| Rate for Payer: Priority Health Tiered Network |
$514.54
|
| Rate for Payer: Railroad Medicare Medicare |
$198.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.32
|
| Rate for Payer: UHC Core |
$300.84
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$198.89
|
| Rate for Payer: UHC Exchange |
$226.93
|
| Rate for Payer: UHC Medicaid |
$104.02
|
| Rate for Payer: UHCCP Medicaid |
$104.02
|
| Rate for Payer: UMR Bronson Commercial |
$213.65
|
| Rate for Payer: VA VA |
$198.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$433.06
|
|
|
HC LASER CATHETER
|
Facility
|
IP
|
$5,038.11
|
|
|
Service Code
|
HCPCS C1885
|
| Hospital Charge Code |
27200054
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,216.77 |
| Max. Negotiated Rate |
$4,534.30 |
| Rate for Payer: Aetna American Axle |
$3,274.77
|
| Rate for Payer: Aetna Commercial |
$4,282.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,274.77
|
| Rate for Payer: Cash Price |
$4,030.49
|
| Rate for Payer: Cofinity Advantage |
$3,526.68
|
| Rate for Payer: Cofinity Commercial |
$4,332.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,030.49
|
| Rate for Payer: Healthscope Commercial |
$4,534.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,526.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,778.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,282.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,778.58
|
| Rate for Payer: PHP Commercial |
$4,282.39
|
| Rate for Payer: Priority Health SBD |
$3,174.01
|
| Rate for Payer: UMR Bronson Commercial |
$2,216.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,778.58
|
|
|
HC LASER CATHETER
|
Facility
|
OP
|
$5,038.11
|
|
|
Service Code
|
HCPCS C1885
|
| Hospital Charge Code |
27200054
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,864.10 |
| Max. Negotiated Rate |
$4,534.30 |
| Rate for Payer: Aetna American Axle |
$3,274.77
|
| Rate for Payer: Aetna Commercial |
$4,282.39
|
| Rate for Payer: Aetna Medicare |
$2,519.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,274.77
|
| Rate for Payer: BCBS Complete |
$2,015.24
|
| Rate for Payer: Cash Price |
$4,030.49
|
| Rate for Payer: Cofinity Advantage |
$3,526.68
|
| Rate for Payer: Cofinity Commercial |
$4,332.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,030.49
|
| Rate for Payer: Healthscope Commercial |
$4,534.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,526.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,778.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,030.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,282.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,778.58
|
| Rate for Payer: PHP Commercial |
$4,282.39
|
| Rate for Payer: Priority Health SBD |
$3,174.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,274.77
|
| Rate for Payer: UHC Core |
$2,624.86
|
| Rate for Payer: UHC Exchange |
$1,979.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,864.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,778.58
|
|
|
HC LATEX IGE
|
Facility
|
OP
|
$36.51
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200044
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$32.86 |
| Rate for Payer: Aetna American Axle |
$23.73
|
| Rate for Payer: Aetna Commercial |
$31.03
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$29.21
|
| Rate for Payer: Cash Price |
$29.21
|
| Rate for Payer: Cofinity Advantage |
$25.56
|
| Rate for Payer: Cofinity Commercial |
$31.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$32.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.38
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.03
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.38
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$31.03
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$23.00
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$13.51
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.38
|
|
|
HC LATEX IGE
|
Facility
|
IP
|
$36.51
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200044
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.06 |
| Max. Negotiated Rate |
$32.86 |
| Rate for Payer: Aetna American Axle |
$23.73
|
| Rate for Payer: Aetna Commercial |
$31.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.73
|
| Rate for Payer: Cash Price |
$29.21
|
| Rate for Payer: Cofinity Advantage |
$25.56
|
| Rate for Payer: Cofinity Commercial |
$31.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.21
|
| Rate for Payer: Healthscope Commercial |
$32.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.38
|
| Rate for Payer: PHP Commercial |
$31.03
|
| Rate for Payer: Priority Health SBD |
$23.00
|
| Rate for Payer: UMR Bronson Commercial |
$16.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.38
|
|
|
HC LAYR CLOS WND REST BODY <2.5 CM
|
Facility
|
IP
|
$508.61
|
|
|
Service Code
|
CPT 12041
|
| Hospital Charge Code |
76100228
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$223.79 |
| Max. Negotiated Rate |
$457.75 |
| Rate for Payer: Aetna American Axle |
$330.60
|
| Rate for Payer: Aetna Commercial |
$432.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.60
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cofinity Advantage |
$356.03
|
| Rate for Payer: Cofinity Commercial |
$437.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.89
|
| Rate for Payer: Healthscope Commercial |
$457.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$356.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.46
|
| Rate for Payer: PHP Commercial |
$432.32
|
| Rate for Payer: Priority Health SBD |
$320.42
|
| Rate for Payer: UMR Bronson Commercial |
$223.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.46
|
|
|
HC LAYR CLOS WND REST BODY <2.5 CM
|
Facility
|
OP
|
$508.61
|
|
|
Service Code
|
CPT 12041
|
| Hospital Charge Code |
76100228
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$188.19 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna American Axle |
$330.60
|
| Rate for Payer: Aetna Commercial |
$432.32
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$551.23
|
| Rate for Payer: BCN Commercial |
$551.23
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cash Price |
$406.89
|
| Rate for Payer: Cofinity Advantage |
$356.03
|
| Rate for Payer: Cofinity Commercial |
$437.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$457.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$356.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.46
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.32
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.46
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$432.32
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$320.42
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.60
|
| Rate for Payer: UHC Core |
$264.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$199.88
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: UMR Bronson Commercial |
$188.19
|
| Rate for Payer: VA VA |
$405.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.46
|
|
|
HC LC/CABG'S W INTERVENTION
|
Facility
|
IP
|
$11,233.61
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100050
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,942.79 |
| Max. Negotiated Rate |
$10,110.25 |
| Rate for Payer: Aetna American Axle |
$7,301.85
|
| Rate for Payer: Aetna Commercial |
$9,548.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,301.85
|
| Rate for Payer: Cash Price |
$8,986.89
|
| Rate for Payer: Cofinity Advantage |
$7,863.53
|
| Rate for Payer: Cofinity Commercial |
$9,660.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,986.89
|
| Rate for Payer: Healthscope Commercial |
$10,110.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,863.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,425.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,548.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,425.21
|
| Rate for Payer: PHP Commercial |
$9,548.57
|
| Rate for Payer: Priority Health SBD |
$7,077.17
|
| Rate for Payer: UMR Bronson Commercial |
$4,942.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,425.21
|
|
|
HC LC/CABG'S W INTERVENTION
|
Facility
|
OP
|
$11,233.61
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100050
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$10,446.41 |
| Rate for Payer: Aetna American Axle |
$7,301.85
|
| Rate for Payer: Aetna Commercial |
$9,548.57
|
| Rate for Payer: Aetna Medicare |
$3,359.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,301.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,144.63
|
| Rate for Payer: BCN Commercial |
$3,144.63
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$8,986.89
|
| Rate for Payer: Cash Price |
$8,986.89
|
| Rate for Payer: Cofinity Advantage |
$7,863.53
|
| Rate for Payer: Cofinity Commercial |
$9,660.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,986.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$10,110.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,863.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,425.21
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$3,391.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,548.57
|
| Rate for Payer: Nomi Health Commercial |
$9,690.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,425.21
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$9,548.57
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,446.41
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health SBD |
$7,077.17
|
| Rate for Payer: Priority Health Tiered Network |
$8,357.13
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: UMR Bronson Commercial |
$4,156.44
|
| Rate for Payer: VA VA |
$3,230.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,425.21
|
|
|
HC LDL DIRECT MEASURE
|
Facility
|
OP
|
$60.97
|
|
|
Service Code
|
CPT 83721
|
| Hospital Charge Code |
30100283
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.49 |
| Max. Negotiated Rate |
$54.87 |
| Rate for Payer: Aetna American Axle |
$39.63
|
| Rate for Payer: Aetna Commercial |
$51.82
|
| Rate for Payer: Aetna Medicare |
$10.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.12
|
| Rate for Payer: BCBS Complete |
$5.77
|
| Rate for Payer: BCBS MAPPO |
$10.50
|
| Rate for Payer: BCBS Trust/PPO |
$12.15
|
| Rate for Payer: BCN Commercial |
$12.15
|
| Rate for Payer: BCN Medicare Advantage |
$10.50
|
| Rate for Payer: Cash Price |
$48.78
|
| Rate for Payer: Cash Price |
$48.78
|
| Rate for Payer: Cofinity Advantage |
$42.68
|
| Rate for Payer: Cofinity Commercial |
$52.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.50
|
| Rate for Payer: Healthscope Commercial |
$54.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.73
|
| Rate for Payer: Mclaren Medicaid |
$10.50
|
| Rate for Payer: Mclaren Medicare |
$10.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.03
|
| Rate for Payer: Meridian Medicaid |
$11.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.82
|
| Rate for Payer: Nomi Health Commercial |
$15.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.73
|
| Rate for Payer: PACE Medicare |
$9.97
|
| Rate for Payer: PACE SWMI |
$10.50
|
| Rate for Payer: PHP Commercial |
$51.82
|
| Rate for Payer: PHP Medicare Advantage |
$10.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10.50
|
| Rate for Payer: Priority Health Medicare |
$10.50
|
| Rate for Payer: Priority Health SBD |
$38.41
|
| Rate for Payer: Priority Health Tiered Network |
$8.40
|
| Rate for Payer: Railroad Medicare Medicare |
$10.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.75
|
| Rate for Payer: UHC Core |
$15.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.50
|
| Rate for Payer: UHC Exchange |
$15.75
|
| Rate for Payer: UHC Medicaid |
$5.49
|
| Rate for Payer: UHCCP Medicaid |
$5.49
|
| Rate for Payer: UMR Bronson Commercial |
$22.56
|
| Rate for Payer: VA VA |
$10.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.73
|
|
|
HC LDL DIRECT MEASURE
|
Facility
|
IP
|
$60.97
|
|
|
Service Code
|
CPT 83721
|
| Hospital Charge Code |
30100283
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.83 |
| Max. Negotiated Rate |
$54.87 |
| Rate for Payer: Aetna American Axle |
$39.63
|
| Rate for Payer: Aetna Commercial |
$51.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.63
|
| Rate for Payer: Cash Price |
$48.78
|
| Rate for Payer: Cofinity Advantage |
$42.68
|
| Rate for Payer: Cofinity Commercial |
$52.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.78
|
| Rate for Payer: Healthscope Commercial |
$54.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.73
|
| Rate for Payer: PHP Commercial |
$51.82
|
| Rate for Payer: Priority Health SBD |
$38.41
|
| Rate for Payer: UMR Bronson Commercial |
$26.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.73
|
|
|
HC LD RECOVERY 0-2 HRS
|
Facility
|
OP
|
$1,499.27
|
|
| Hospital Charge Code |
71000012
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$554.73 |
| Max. Negotiated Rate |
$1,349.34 |
| Rate for Payer: Aetna American Axle |
$974.53
|
| Rate for Payer: Aetna Commercial |
$1,274.38
|
| Rate for Payer: Aetna Medicare |
$749.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.53
|
| Rate for Payer: BCBS Complete |
$599.71
|
| Rate for Payer: Cash Price |
$1,199.42
|
| Rate for Payer: Cofinity Advantage |
$1,049.49
|
| Rate for Payer: Cofinity Commercial |
$1,289.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,199.42
|
| Rate for Payer: Healthscope Commercial |
$1,349.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,049.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,124.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,199.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,274.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,124.45
|
| Rate for Payer: PHP Commercial |
$1,274.38
|
| Rate for Payer: Priority Health SBD |
$944.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$974.53
|
| Rate for Payer: UHC Core |
$781.12
|
| Rate for Payer: UHC Exchange |
$589.21
|
| Rate for Payer: UMR Bronson Commercial |
$554.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,124.45
|
|
|
HC LD RECOVERY 0-2 HRS
|
Facility
|
IP
|
$1,499.27
|
|
| Hospital Charge Code |
71000012
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$659.68 |
| Max. Negotiated Rate |
$1,349.34 |
| Rate for Payer: Aetna American Axle |
$974.53
|
| Rate for Payer: Aetna Commercial |
$1,274.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.53
|
| Rate for Payer: Cash Price |
$1,199.42
|
| Rate for Payer: Cofinity Advantage |
$1,049.49
|
| Rate for Payer: Cofinity Commercial |
$1,289.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,199.42
|
| Rate for Payer: Healthscope Commercial |
$1,349.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,049.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,124.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,274.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,124.45
|
| Rate for Payer: PHP Commercial |
$1,274.38
|
| Rate for Payer: Priority Health SBD |
$944.54
|
| Rate for Payer: UMR Bronson Commercial |
$659.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,124.45
|
|
|
HC LD RECOVERY 10 OR MORE HOURS
|
Facility
|
IP
|
$3,747.95
|
|
| Hospital Charge Code |
71000013
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,649.10 |
| Max. Negotiated Rate |
$3,373.16 |
| Rate for Payer: Aetna American Axle |
$2,436.17
|
| Rate for Payer: Aetna Commercial |
$3,185.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,436.17
|
| Rate for Payer: Cash Price |
$2,998.36
|
| Rate for Payer: Cofinity Advantage |
$2,623.57
|
| Rate for Payer: Cofinity Commercial |
$3,223.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,998.36
|
| Rate for Payer: Healthscope Commercial |
$3,373.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,623.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,810.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,185.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,810.96
|
| Rate for Payer: PHP Commercial |
$3,185.76
|
| Rate for Payer: Priority Health SBD |
$2,361.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,649.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,810.96
|
|
|
HC LD RECOVERY 10 OR MORE HOURS
|
Facility
|
OP
|
$3,747.95
|
|
| Hospital Charge Code |
71000013
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,386.74 |
| Max. Negotiated Rate |
$3,373.16 |
| Rate for Payer: Aetna American Axle |
$2,436.17
|
| Rate for Payer: Aetna Commercial |
$3,185.76
|
| Rate for Payer: Aetna Medicare |
$1,873.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,436.17
|
| Rate for Payer: BCBS Complete |
$1,499.18
|
| Rate for Payer: Cash Price |
$2,998.36
|
| Rate for Payer: Cofinity Advantage |
$2,623.57
|
| Rate for Payer: Cofinity Commercial |
$3,223.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,998.36
|
| Rate for Payer: Healthscope Commercial |
$3,373.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,623.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,810.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,998.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,185.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,810.96
|
| Rate for Payer: PHP Commercial |
$3,185.76
|
| Rate for Payer: Priority Health SBD |
$2,361.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,436.17
|
| Rate for Payer: UHC Core |
$1,952.68
|
| Rate for Payer: UHC Exchange |
$1,472.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,386.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,810.96
|
|
|
HC LD RECOVERY 2-4 HRS
|
Facility
|
OP
|
$2,998.26
|
|
| Hospital Charge Code |
71000014
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,109.36 |
| Max. Negotiated Rate |
$2,698.43 |
| Rate for Payer: Aetna American Axle |
$1,948.87
|
| Rate for Payer: Aetna Commercial |
$2,548.52
|
| Rate for Payer: Aetna Medicare |
$1,499.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,948.87
|
| Rate for Payer: BCBS Complete |
$1,199.30
|
| Rate for Payer: Cash Price |
$2,398.61
|
| Rate for Payer: Cofinity Advantage |
$2,098.78
|
| Rate for Payer: Cofinity Commercial |
$2,578.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,398.61
|
| Rate for Payer: Healthscope Commercial |
$2,698.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,098.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,248.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,398.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,548.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,248.70
|
| Rate for Payer: PHP Commercial |
$2,548.52
|
| Rate for Payer: Priority Health SBD |
$1,888.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,948.87
|
| Rate for Payer: UHC Core |
$1,562.09
|
| Rate for Payer: UHC Exchange |
$1,178.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,109.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,248.70
|
|
|
HC LD RECOVERY 2-4 HRS
|
Facility
|
IP
|
$2,998.26
|
|
| Hospital Charge Code |
71000014
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,319.23 |
| Max. Negotiated Rate |
$2,698.43 |
| Rate for Payer: Aetna American Axle |
$1,948.87
|
| Rate for Payer: Aetna Commercial |
$2,548.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,948.87
|
| Rate for Payer: Cash Price |
$2,398.61
|
| Rate for Payer: Cofinity Advantage |
$2,098.78
|
| Rate for Payer: Cofinity Commercial |
$2,578.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,398.61
|
| Rate for Payer: Healthscope Commercial |
$2,698.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,098.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,248.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,548.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,248.70
|
| Rate for Payer: PHP Commercial |
$2,548.52
|
| Rate for Payer: Priority Health SBD |
$1,888.90
|
| Rate for Payer: UMR Bronson Commercial |
$1,319.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,248.70
|
|
|
HC LD RECOVERY 4-6 HRS
|
Facility
|
OP
|
$3,331.45
|
|
| Hospital Charge Code |
71000015
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,232.64 |
| Max. Negotiated Rate |
$2,998.30 |
| Rate for Payer: Aetna American Axle |
$2,165.44
|
| Rate for Payer: Aetna Commercial |
$2,831.73
|
| Rate for Payer: Aetna Medicare |
$1,665.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,165.44
|
| Rate for Payer: BCBS Complete |
$1,332.58
|
| Rate for Payer: Cash Price |
$2,665.16
|
| Rate for Payer: Cofinity Advantage |
$2,332.01
|
| Rate for Payer: Cofinity Commercial |
$2,865.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,665.16
|
| Rate for Payer: Healthscope Commercial |
$2,998.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,332.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,498.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,665.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,831.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,498.59
|
| Rate for Payer: PHP Commercial |
$2,831.73
|
| Rate for Payer: Priority Health SBD |
$2,098.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,165.44
|
| Rate for Payer: UHC Core |
$1,735.69
|
| Rate for Payer: UHC Exchange |
$1,309.26
|
| Rate for Payer: UMR Bronson Commercial |
$1,232.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,498.59
|
|
|
HC LD RECOVERY 4-6 HRS
|
Facility
|
IP
|
$3,331.45
|
|
| Hospital Charge Code |
71000015
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,465.84 |
| Max. Negotiated Rate |
$2,998.30 |
| Rate for Payer: Aetna American Axle |
$2,165.44
|
| Rate for Payer: Aetna Commercial |
$2,831.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,165.44
|
| Rate for Payer: Cash Price |
$2,665.16
|
| Rate for Payer: Cofinity Advantage |
$2,332.01
|
| Rate for Payer: Cofinity Commercial |
$2,865.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,665.16
|
| Rate for Payer: Healthscope Commercial |
$2,998.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,332.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,498.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,831.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,498.59
|
| Rate for Payer: PHP Commercial |
$2,831.73
|
| Rate for Payer: Priority Health SBD |
$2,098.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,465.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,498.59
|
|
|
HC LD RECOVERY 6-8 HRS
|
Facility
|
IP
|
$1,236.61
|
|
| Hospital Charge Code |
71000016
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$544.11 |
| Max. Negotiated Rate |
$1,112.95 |
| Rate for Payer: Aetna American Axle |
$803.80
|
| Rate for Payer: Aetna Commercial |
$1,051.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.80
|
| Rate for Payer: Cash Price |
$989.29
|
| Rate for Payer: Cofinity Advantage |
$865.63
|
| Rate for Payer: Cofinity Commercial |
$1,063.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$989.29
|
| Rate for Payer: Healthscope Commercial |
$1,112.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$865.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$927.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,051.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$927.46
|
| Rate for Payer: PHP Commercial |
$1,051.12
|
| Rate for Payer: Priority Health SBD |
$779.06
|
| Rate for Payer: UMR Bronson Commercial |
$544.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$927.46
|
|
|
HC LD RECOVERY 6-8 HRS
|
Facility
|
OP
|
$1,236.61
|
|
| Hospital Charge Code |
71000016
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$457.55 |
| Max. Negotiated Rate |
$1,112.95 |
| Rate for Payer: Aetna American Axle |
$803.80
|
| Rate for Payer: Aetna Commercial |
$1,051.12
|
| Rate for Payer: Aetna Medicare |
$618.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.80
|
| Rate for Payer: BCBS Complete |
$494.64
|
| Rate for Payer: Cash Price |
$989.29
|
| Rate for Payer: Cofinity Advantage |
$865.63
|
| Rate for Payer: Cofinity Commercial |
$1,063.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$989.29
|
| Rate for Payer: Healthscope Commercial |
$1,112.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$865.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$927.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$989.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,051.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$927.46
|
| Rate for Payer: PHP Commercial |
$1,051.12
|
| Rate for Payer: Priority Health SBD |
$779.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$803.80
|
| Rate for Payer: UHC Core |
$644.27
|
| Rate for Payer: UHC Exchange |
$485.99
|
| Rate for Payer: UMR Bronson Commercial |
$457.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$927.46
|
|
|
HC LD RECOVERY 8-10 HRS
|
Facility
|
OP
|
$1,484.78
|
|
| Hospital Charge Code |
71000017
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$549.37 |
| Max. Negotiated Rate |
$1,336.30 |
| Rate for Payer: Aetna American Axle |
$965.11
|
| Rate for Payer: Aetna Commercial |
$1,262.06
|
| Rate for Payer: Aetna Medicare |
$742.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$965.11
|
| Rate for Payer: BCBS Complete |
$593.91
|
| Rate for Payer: Cash Price |
$1,187.82
|
| Rate for Payer: Cofinity Advantage |
$1,039.35
|
| Rate for Payer: Cofinity Commercial |
$1,276.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,187.82
|
| Rate for Payer: Healthscope Commercial |
$1,336.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,039.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,113.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,262.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,113.59
|
| Rate for Payer: PHP Commercial |
$1,262.06
|
| Rate for Payer: Priority Health SBD |
$935.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$965.11
|
| Rate for Payer: UHC Core |
$773.57
|
| Rate for Payer: UHC Exchange |
$583.52
|
| Rate for Payer: UMR Bronson Commercial |
$549.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,113.59
|
|
|
HC LD RECOVERY 8-10 HRS
|
Facility
|
IP
|
$1,484.78
|
|
| Hospital Charge Code |
71000017
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$653.30 |
| Max. Negotiated Rate |
$1,336.30 |
| Rate for Payer: Aetna American Axle |
$965.11
|
| Rate for Payer: Aetna Commercial |
$1,262.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$965.11
|
| Rate for Payer: Cash Price |
$1,187.82
|
| Rate for Payer: Cofinity Advantage |
$1,039.35
|
| Rate for Payer: Cofinity Commercial |
$1,276.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,187.82
|
| Rate for Payer: Healthscope Commercial |
$1,336.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,039.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,113.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,262.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,113.59
|
| Rate for Payer: PHP Commercial |
$1,262.06
|
| Rate for Payer: Priority Health SBD |
$935.41
|
| Rate for Payer: UMR Bronson Commercial |
$653.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,113.59
|
|
|
HC LEAD
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100275
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.14 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna American Axle |
$29.76
|
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.76
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Advantage |
$32.05
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.34
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: Priority Health SBD |
$28.84
|
| Rate for Payer: UMR Bronson Commercial |
$20.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
