|
HC TEGRETOL FREE AND TOTAL CMPT
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
30100023
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: UMR Bronson Commercial |
$20.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC TEGRETOL FREE AND TOTAL CMPT
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
30100023
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.97 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$15.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.21
|
| Rate for Payer: BCBS Complete |
$8.37
|
| Rate for Payer: BCBS MAPPO |
$14.57
|
| Rate for Payer: BCBS Trust/PPO |
$13.11
|
| Rate for Payer: BCN Medicare Advantage |
$14.57
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.57
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Mclaren Medicaid |
$7.97
|
| Rate for Payer: Mclaren Medicare |
$14.57
|
| Rate for Payer: Meridian Medicaid |
$8.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Medicare |
$13.84
|
| Rate for Payer: PACE SWMI |
$14.57
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$14.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.98
|
| Rate for Payer: Priority Health Medicare |
$14.57
|
| Rate for Payer: Priority Health Narrow Network |
$15.98
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: Railroad Medicare Medicare |
$14.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.48
|
| Rate for Payer: UHC Core |
$24.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.57
|
| Rate for Payer: UHC Exchange |
$14.57
|
| Rate for Payer: UHC Medicare Advantage |
$15.01
|
| Rate for Payer: UMR Bronson Commercial |
$16.98
|
| Rate for Payer: VA VA |
$14.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC TEGRETOL FREE AND TOTAL LEVEL
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 80157
|
| Hospital Charge Code |
30100024
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.95 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna American Axle |
$26.52
|
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.52
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health SBD |
$25.70
|
| Rate for Payer: UMR Bronson Commercial |
$17.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC TEGRETOL FREE AND TOTAL LEVEL
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 80157
|
| Hospital Charge Code |
30100024
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna American Axle |
$26.52
|
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$13.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.56
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCBS Trust/PPO |
$11.92
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$7.25
|
| Rate for Payer: Mclaren Medicare |
$13.25
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Medicare |
$12.59
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.18
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: Priority Health Narrow Network |
$14.54
|
| Rate for Payer: Priority Health SBD |
$25.70
|
| Rate for Payer: Railroad Medicare Medicare |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.90
|
| Rate for Payer: UHC Core |
$21.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.25
|
| Rate for Payer: UHC Exchange |
$13.25
|
| Rate for Payer: UHC Medicare Advantage |
$13.65
|
| Rate for Payer: UMR Bronson Commercial |
$15.10
|
| Rate for Payer: VA VA |
$13.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC TELEHEALTH ORG SITE FACILITY
|
Facility
|
OP
|
$88.02
|
|
|
Service Code
|
HCPCS Q3014
|
| Hospital Charge Code |
78000001
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$32.57 |
| Max. Negotiated Rate |
$79.22 |
| Rate for Payer: Aetna American Axle |
$57.21
|
| Rate for Payer: Aetna Commercial |
$74.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.21
|
| Rate for Payer: BCBS Complete |
$35.21
|
| Rate for Payer: BCBS Trust/PPO |
$66.32
|
| Rate for Payer: Cash Price |
$70.42
|
| Rate for Payer: Cash Price |
$70.42
|
| Rate for Payer: Cofinity Commercial |
$75.70
|
| Rate for Payer: Cofinity Commercial |
$61.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.42
|
| Rate for Payer: Healthscope Commercial |
$79.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.82
|
| Rate for Payer: PHP Commercial |
$74.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.61
|
| Rate for Payer: Priority Health SBD |
$55.45
|
| Rate for Payer: UMR Bronson Commercial |
$32.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.02
|
|
|
HC TELEHEALTH ORG SITE FACILITY
|
Facility
|
IP
|
$88.02
|
|
|
Service Code
|
HCPCS Q3014
|
| Hospital Charge Code |
78000001
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$38.73 |
| Max. Negotiated Rate |
$79.22 |
| Rate for Payer: Aetna American Axle |
$57.21
|
| Rate for Payer: Aetna Commercial |
$74.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.21
|
| Rate for Payer: Cash Price |
$70.42
|
| Rate for Payer: Cofinity Commercial |
$61.61
|
| Rate for Payer: Cofinity Commercial |
$75.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.42
|
| Rate for Payer: Healthscope Commercial |
$79.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$74.82
|
| Rate for Payer: PHP Commercial |
$74.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.61
|
| Rate for Payer: Priority Health SBD |
$55.45
|
| Rate for Payer: UMR Bronson Commercial |
$38.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.02
|
|
|
HC TE MANUAL TX EACH 15 MIN
|
Facility
|
IP
|
$112.20
|
|
|
Service Code
|
CPT 97140
|
| Hospital Charge Code |
42000026
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$49.37 |
| Max. Negotiated Rate |
$100.98 |
| Rate for Payer: Aetna American Axle |
$72.93
|
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.93
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$78.54
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$95.37
|
| Rate for Payer: PHP Commercial |
$95.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.54
|
| Rate for Payer: Priority Health SBD |
$70.69
|
| Rate for Payer: UMR Bronson Commercial |
$49.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.15
|
|
|
HC TE MANUAL TX EACH 15 MIN
|
Facility
|
OP
|
$112.20
|
|
|
Service Code
|
CPT 97140
|
| Hospital Charge Code |
42000026
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$72.93
|
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.93
|
| Rate for Payer: BCBS Complete |
$44.88
|
| Rate for Payer: BCBS Trust/PPO |
$19.00
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Cofinity Commercial |
$78.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$95.37
|
| Rate for Payer: PHP Commercial |
$95.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.00
|
| Rate for Payer: Priority Health Narrow Network |
$20.80
|
| Rate for Payer: Priority Health SBD |
$70.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.17
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$26.52
|
| Rate for Payer: UMR Bronson Commercial |
$41.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.15
|
|
|
HC TEMPORARY PACEMAKER
|
Facility
|
OP
|
$2,748.90
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
36100060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$154.55 |
| Max. Negotiated Rate |
$23,772.84 |
| Rate for Payer: Aetna American Axle |
$1,786.78
|
| Rate for Payer: Aetna Commercial |
$2,336.56
|
| Rate for Payer: Aetna Medicare |
$7,853.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,786.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,439.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,439.52
|
| Rate for Payer: BCBS Complete |
$4,337.65
|
| Rate for Payer: BCBS MAPPO |
$7,551.62
|
| Rate for Payer: BCBS Trust/PPO |
$7,157.55
|
| Rate for Payer: BCN Medicare Advantage |
$7,551.62
|
| Rate for Payer: Cash Price |
$2,199.12
|
| Rate for Payer: Cash Price |
$2,199.12
|
| Rate for Payer: Cofinity Commercial |
$2,364.05
|
| Rate for Payer: Cofinity Commercial |
$1,924.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,199.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,551.62
|
| Rate for Payer: Healthscope Commercial |
$2,474.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,924.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,061.68
|
| Rate for Payer: Mclaren Medicaid |
$4,130.74
|
| Rate for Payer: Mclaren Medicare |
$7,551.62
|
| Rate for Payer: Meridian Medicaid |
$4,337.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,929.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,684.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,336.56
|
| Rate for Payer: PACE Medicare |
$7,174.04
|
| Rate for Payer: PACE SWMI |
$7,551.62
|
| Rate for Payer: PHP Commercial |
$2,336.56
|
| Rate for Payer: PHP Medicare Advantage |
$7,551.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,130.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,924.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,772.84
|
| Rate for Payer: Priority Health Medicare |
$7,551.62
|
| Rate for Payer: Priority Health Narrow Network |
$19,018.27
|
| Rate for Payer: Priority Health SBD |
$1,731.81
|
| Rate for Payer: Railroad Medicare Medicare |
$7,551.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,551.62
|
| Rate for Payer: UHC Exchange |
$154.55
|
| Rate for Payer: UHC Medicare Advantage |
$7,778.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,017.09
|
| Rate for Payer: VA VA |
$7,551.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,061.68
|
|
|
HC TEMPORARY PACEMAKER
|
Facility
|
IP
|
$2,748.90
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
36100060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,209.52 |
| Max. Negotiated Rate |
$2,474.01 |
| Rate for Payer: Aetna American Axle |
$1,786.78
|
| Rate for Payer: Aetna Commercial |
$2,336.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,786.78
|
| Rate for Payer: Cash Price |
$2,199.12
|
| Rate for Payer: Cofinity Commercial |
$1,924.23
|
| Rate for Payer: Cofinity Commercial |
$2,364.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,199.12
|
| Rate for Payer: Healthscope Commercial |
$2,474.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,924.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,061.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,336.56
|
| Rate for Payer: PHP Commercial |
$2,336.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,924.23
|
| Rate for Payer: Priority Health SBD |
$1,731.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,209.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,061.68
|
|
|
HC TEMPORARY PACING WIRE
|
Facility
|
OP
|
$674.79
|
|
|
Service Code
|
HCPCS C1756
|
| Hospital Charge Code |
27200074
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$249.67 |
| Max. Negotiated Rate |
$607.31 |
| Rate for Payer: Aetna American Axle |
$438.61
|
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$438.61
|
| Rate for Payer: BCBS Complete |
$269.92
|
| Rate for Payer: Cash Price |
$539.83
|
| Rate for Payer: Cofinity Commercial |
$472.35
|
| Rate for Payer: Cofinity Commercial |
$580.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$539.83
|
| Rate for Payer: Healthscope Commercial |
$607.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$472.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$506.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$573.57
|
| Rate for Payer: PHP Commercial |
$573.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.35
|
| Rate for Payer: Priority Health SBD |
$425.12
|
| Rate for Payer: UMR Bronson Commercial |
$249.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$506.09
|
|
|
HC TEMPORARY PACING WIRE
|
Facility
|
IP
|
$674.79
|
|
|
Service Code
|
HCPCS C1756
|
| Hospital Charge Code |
27200074
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$296.91 |
| Max. Negotiated Rate |
$607.31 |
| Rate for Payer: Aetna American Axle |
$438.61
|
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$438.61
|
| Rate for Payer: Cash Price |
$539.83
|
| Rate for Payer: Cofinity Commercial |
$472.35
|
| Rate for Payer: Cofinity Commercial |
$580.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$539.83
|
| Rate for Payer: Healthscope Commercial |
$607.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$472.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$506.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$573.57
|
| Rate for Payer: PHP Commercial |
$573.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.35
|
| Rate for Payer: Priority Health SBD |
$425.12
|
| Rate for Payer: UMR Bronson Commercial |
$296.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$506.09
|
|
|
HC TE NEURO EA 15 MIN
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
CPT 97112
|
| Hospital Charge Code |
42000021
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$67.63
|
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.63
|
| Rate for Payer: BCBS Complete |
$41.62
|
| Rate for Payer: BCBS Trust/PPO |
$23.69
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$72.83
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.43
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.00
|
| Rate for Payer: Priority Health Narrow Network |
$23.20
|
| Rate for Payer: Priority Health SBD |
$65.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.38
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$33.07
|
| Rate for Payer: UMR Bronson Commercial |
$38.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC TE NEURO EA 15 MIN
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 97112
|
| Hospital Charge Code |
42000021
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$45.78 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna American Axle |
$67.63
|
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.63
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$72.83
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$88.43
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.83
|
| Rate for Payer: Priority Health SBD |
$65.55
|
| Rate for Payer: UMR Bronson Commercial |
$45.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC TENOTOMY
|
Facility
|
OP
|
$2,835.96
|
|
|
Service Code
|
CPT 27605
|
| Hospital Charge Code |
36100046
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$180.75 |
| Max. Negotiated Rate |
$4,497.31 |
| Rate for Payer: Aetna American Axle |
$1,843.37
|
| Rate for Payer: Aetna Commercial |
$2,410.57
|
| Rate for Payer: Aetna Medicare |
$1,485.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,843.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.76
|
| Rate for Payer: BCBS Complete |
$820.59
|
| Rate for Payer: BCBS MAPPO |
$1,428.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.02
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.61
|
| Rate for Payer: Cash Price |
$2,268.77
|
| Rate for Payer: Cash Price |
$2,268.77
|
| Rate for Payer: Cofinity Commercial |
$1,985.17
|
| Rate for Payer: Cofinity Commercial |
$2,438.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,268.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.61
|
| Rate for Payer: Healthscope Commercial |
$2,552.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,985.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,126.97
|
| Rate for Payer: Mclaren Medicaid |
$781.45
|
| Rate for Payer: Mclaren Medicare |
$1,428.61
|
| Rate for Payer: Meridian Medicaid |
$820.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,500.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,410.57
|
| Rate for Payer: PACE Medicare |
$1,357.18
|
| Rate for Payer: PACE SWMI |
$1,428.61
|
| Rate for Payer: PHP Commercial |
$2,410.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,985.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,497.31
|
| Rate for Payer: Priority Health Medicare |
$1,428.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,597.85
|
| Rate for Payer: Priority Health SBD |
$1,786.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.82
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,428.61
|
| Rate for Payer: UHC Exchange |
$180.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,049.31
|
| Rate for Payer: VA VA |
$1,428.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,126.97
|
|
|
HC TENOTOMY
|
Facility
|
IP
|
$2,835.96
|
|
|
Service Code
|
CPT 27605
|
| Hospital Charge Code |
36100046
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,247.82 |
| Max. Negotiated Rate |
$2,552.36 |
| Rate for Payer: Aetna American Axle |
$1,843.37
|
| Rate for Payer: Aetna Commercial |
$2,410.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,843.37
|
| Rate for Payer: Cash Price |
$2,268.77
|
| Rate for Payer: Cofinity Commercial |
$2,438.93
|
| Rate for Payer: Cofinity Commercial |
$1,985.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,268.77
|
| Rate for Payer: Healthscope Commercial |
$2,552.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,985.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,126.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,410.57
|
| Rate for Payer: PHP Commercial |
$2,410.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,985.17
|
| Rate for Payer: Priority Health SBD |
$1,786.65
|
| Rate for Payer: UMR Bronson Commercial |
$1,247.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,126.97
|
|
|
HC TENOTOMY ADDUCTOR OF HIP PERCUTANEOUS
|
Facility
|
OP
|
$4,194.04
|
|
| Hospital Charge Code |
36000096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,551.79 |
| Max. Negotiated Rate |
$3,774.64 |
| Rate for Payer: Aetna American Axle |
$2,726.13
|
| Rate for Payer: Aetna Commercial |
$3,564.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,726.13
|
| Rate for Payer: BCBS Complete |
$1,677.62
|
| Rate for Payer: Cash Price |
$3,355.23
|
| Rate for Payer: Cofinity Commercial |
$2,935.83
|
| Rate for Payer: Cofinity Commercial |
$3,606.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,355.23
|
| Rate for Payer: Healthscope Commercial |
$3,774.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,935.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,145.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,564.93
|
| Rate for Payer: PHP Commercial |
$3,564.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,935.83
|
| Rate for Payer: Priority Health SBD |
$2,642.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,551.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,145.53
|
|
|
HC TENOTOMY ADDUCTOR OF HIP PERCUTANEOUS
|
Facility
|
IP
|
$4,194.04
|
|
| Hospital Charge Code |
36000096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,845.38 |
| Max. Negotiated Rate |
$3,774.64 |
| Rate for Payer: Aetna American Axle |
$2,726.13
|
| Rate for Payer: Aetna Commercial |
$3,564.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,726.13
|
| Rate for Payer: Cash Price |
$3,355.23
|
| Rate for Payer: Cofinity Commercial |
$2,935.83
|
| Rate for Payer: Cofinity Commercial |
$3,606.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,355.23
|
| Rate for Payer: Healthscope Commercial |
$3,774.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,935.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,145.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,564.93
|
| Rate for Payer: PHP Commercial |
$3,564.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,935.83
|
| Rate for Payer: Priority Health SBD |
$2,642.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,845.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,145.53
|
|
|
HC TENOTOMY ELBOW LATERAL/MEDIAL PERC
|
Facility
|
OP
|
$4,406.09
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
76100408
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$416.51 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna American Axle |
$2,863.96
|
| Rate for Payer: Aetna Commercial |
$3,745.18
|
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,863.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,746.73
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$3,524.87
|
| Rate for Payer: Cash Price |
$3,524.87
|
| Rate for Payer: Cofinity Commercial |
$3,084.26
|
| Rate for Payer: Cofinity Commercial |
$3,789.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,524.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$3,965.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,084.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,304.57
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,745.18
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$3,745.18
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,084.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,057.42
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$7,245.94
|
| Rate for Payer: Priority Health SBD |
$2,775.84
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$458.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$416.51
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,630.25
|
| Rate for Payer: VA VA |
$2,877.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,304.57
|
|
|
HC TENOTOMY ELBOW LATERAL/MEDIAL PERC
|
Facility
|
IP
|
$4,406.09
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
76100408
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,938.68 |
| Max. Negotiated Rate |
$3,965.48 |
| Rate for Payer: Aetna American Axle |
$2,863.96
|
| Rate for Payer: Aetna Commercial |
$3,745.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,863.96
|
| Rate for Payer: Cash Price |
$3,524.87
|
| Rate for Payer: Cofinity Commercial |
$3,084.26
|
| Rate for Payer: Cofinity Commercial |
$3,789.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,524.87
|
| Rate for Payer: Healthscope Commercial |
$3,965.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,084.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,304.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,745.18
|
| Rate for Payer: PHP Commercial |
$3,745.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,084.26
|
| Rate for Payer: Priority Health SBD |
$2,775.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,938.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,304.57
|
|
|
HC TENOTOMY ELBOW LATERAL OR MEDIAL
|
Facility
|
OP
|
$4,406.09
|
|
| Hospital Charge Code |
36000093
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,630.25 |
| Max. Negotiated Rate |
$3,965.48 |
| Rate for Payer: Aetna American Axle |
$2,863.96
|
| Rate for Payer: Aetna Commercial |
$3,745.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,863.96
|
| Rate for Payer: BCBS Complete |
$1,762.44
|
| Rate for Payer: Cash Price |
$3,524.87
|
| Rate for Payer: Cofinity Commercial |
$3,084.26
|
| Rate for Payer: Cofinity Commercial |
$3,789.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,524.87
|
| Rate for Payer: Healthscope Commercial |
$3,965.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,084.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,304.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,745.18
|
| Rate for Payer: PHP Commercial |
$3,745.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,084.26
|
| Rate for Payer: Priority Health SBD |
$2,775.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,630.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,304.57
|
|
|
HC TENOTOMY ELBOW LATERAL OR MEDIAL
|
Facility
|
IP
|
$4,406.09
|
|
| Hospital Charge Code |
36000093
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,938.68 |
| Max. Negotiated Rate |
$3,965.48 |
| Rate for Payer: Aetna American Axle |
$2,863.96
|
| Rate for Payer: Aetna Commercial |
$3,745.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,863.96
|
| Rate for Payer: Cash Price |
$3,524.87
|
| Rate for Payer: Cofinity Commercial |
$3,084.26
|
| Rate for Payer: Cofinity Commercial |
$3,789.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,524.87
|
| Rate for Payer: Healthscope Commercial |
$3,965.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,084.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,304.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,745.18
|
| Rate for Payer: PHP Commercial |
$3,745.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,084.26
|
| Rate for Payer: Priority Health SBD |
$2,775.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,938.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,304.57
|
|
|
HC TENOTOMY MULTIPLE TENDONS
|
Facility
|
OP
|
$5,133.30
|
|
| Hospital Charge Code |
36000095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,899.32 |
| Max. Negotiated Rate |
$4,619.97 |
| Rate for Payer: Aetna American Axle |
$3,336.64
|
| Rate for Payer: Aetna Commercial |
$4,363.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,336.64
|
| Rate for Payer: BCBS Complete |
$2,053.32
|
| Rate for Payer: Cash Price |
$4,106.64
|
| Rate for Payer: Cofinity Commercial |
$3,593.31
|
| Rate for Payer: Cofinity Commercial |
$4,414.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,106.64
|
| Rate for Payer: Healthscope Commercial |
$4,619.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,593.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,849.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,363.30
|
| Rate for Payer: PHP Commercial |
$4,363.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,593.31
|
| Rate for Payer: Priority Health SBD |
$3,233.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,899.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,849.98
|
|
|
HC TENOTOMY MULTIPLE TENDONS
|
Facility
|
IP
|
$5,133.30
|
|
| Hospital Charge Code |
36000095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,258.65 |
| Max. Negotiated Rate |
$4,619.97 |
| Rate for Payer: Aetna American Axle |
$3,336.64
|
| Rate for Payer: Aetna Commercial |
$4,363.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,336.64
|
| Rate for Payer: Cash Price |
$4,106.64
|
| Rate for Payer: Cofinity Commercial |
$3,593.31
|
| Rate for Payer: Cofinity Commercial |
$4,414.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,106.64
|
| Rate for Payer: Healthscope Commercial |
$4,619.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,593.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,849.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,363.30
|
| Rate for Payer: PHP Commercial |
$4,363.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,593.31
|
| Rate for Payer: Priority Health SBD |
$3,233.98
|
| Rate for Payer: UMR Bronson Commercial |
$2,258.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,849.98
|
|
|
HC TENOTOMY PERCUTANEOUS ACHILLES TENDON
|
Facility
|
IP
|
$3,664.59
|
|
| Hospital Charge Code |
36000097
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,612.42 |
| Max. Negotiated Rate |
$3,298.13 |
| Rate for Payer: Aetna American Axle |
$2,381.98
|
| Rate for Payer: Aetna Commercial |
$3,114.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,381.98
|
| Rate for Payer: Cash Price |
$2,931.67
|
| Rate for Payer: Cofinity Commercial |
$2,565.21
|
| Rate for Payer: Cofinity Commercial |
$3,151.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,931.67
|
| Rate for Payer: Healthscope Commercial |
$3,298.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,565.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,748.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,114.90
|
| Rate for Payer: PHP Commercial |
$3,114.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,565.21
|
| Rate for Payer: Priority Health SBD |
$2,308.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,612.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,748.44
|
|
