|
HC INJ SELECT R VENT/ATRIAL ANGIO HRT CATH
|
Facility
|
OP
|
$683.54
|
|
|
Service Code
|
CPT 93566
|
| Hospital Charge Code |
36000110
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$23.95 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$444.30
|
| Rate for Payer: Aetna Commercial |
$581.01
|
| Rate for Payer: Aetna Medicare |
$341.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.30
|
| Rate for Payer: BCBS Complete |
$273.42
|
| Rate for Payer: BCBS Trust/PPO |
$23.95
|
| Rate for Payer: BCN Commercial |
$23.95
|
| Rate for Payer: Cash Price |
$546.83
|
| Rate for Payer: Cash Price |
$546.83
|
| Rate for Payer: Cash Price |
$546.83
|
| Rate for Payer: Cofinity Commercial |
$587.84
|
| Rate for Payer: Cofinity Commercial |
$478.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$478.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.83
|
| Rate for Payer: Healthscope Commercial |
$615.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$478.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$512.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$581.01
|
| Rate for Payer: PHP Commercial |
$581.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$444.30
|
| Rate for Payer: Priority Health SBD |
$430.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.39
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$24.90
|
| Rate for Payer: UMR Bronson Commercial |
$252.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$512.66
|
|
|
HC INJ TIXAGEVIMAB AND CILGAVIMAB
|
Facility
|
OP
|
$208.08
|
|
|
Service Code
|
HCPCS M0220
|
| Hospital Charge Code |
77100033
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$47.00 |
| Max. Negotiated Rate |
$442.38 |
| Rate for Payer: Aetna American Axle |
$135.25
|
| Rate for Payer: Aetna Commercial |
$176.87
|
| Rate for Payer: Aetna Medicare |
$153.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$184.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$184.32
|
| Rate for Payer: BCBS Complete |
$82.99
|
| Rate for Payer: BCBS MAPPO |
$147.46
|
| Rate for Payer: BCN Medicare Advantage |
$147.46
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$145.66
|
| Rate for Payer: Cofinity Commercial |
$178.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$145.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.46
|
| Rate for Payer: Healthscope Commercial |
$187.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.06
|
| Rate for Payer: Mclaren Medicaid |
$79.04
|
| Rate for Payer: Mclaren Medicare |
$147.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.83
|
| Rate for Payer: Meridian Medicaid |
$82.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$169.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: Nomi Health Commercial |
$442.38
|
| Rate for Payer: PACE Medicare |
$140.09
|
| Rate for Payer: PACE SWMI |
$147.46
|
| Rate for Payer: PHP Commercial |
$176.87
|
| Rate for Payer: PHP Medicare Advantage |
$147.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$150.50
|
| Rate for Payer: Priority Health Medicare |
$147.46
|
| Rate for Payer: Priority Health Narrow Network |
$120.40
|
| Rate for Payer: Priority Health SBD |
$131.09
|
| Rate for Payer: Railroad Medicare Medicare |
$147.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.09
|
| Rate for Payer: UHC Core |
$47.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.46
|
| Rate for Payer: UHC Exchange |
$281.81
|
| Rate for Payer: UHC Medicare Advantage |
$147.46
|
| Rate for Payer: UHCCP Medicaid |
$79.04
|
| Rate for Payer: UMR Bronson Commercial |
$76.99
|
| Rate for Payer: VA VA |
$147.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.06
|
|
|
HC INJ TIXAGEVIMAB AND CILGAVIMAB
|
Facility
|
IP
|
$208.08
|
|
|
Service Code
|
HCPCS M0220
|
| Hospital Charge Code |
77100033
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$91.56 |
| Max. Negotiated Rate |
$187.27 |
| Rate for Payer: Aetna American Axle |
$135.25
|
| Rate for Payer: Aetna Commercial |
$176.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.25
|
| Rate for Payer: Cash Price |
$166.46
|
| Rate for Payer: Cofinity Commercial |
$145.66
|
| Rate for Payer: Cofinity Commercial |
$178.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$145.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.46
|
| Rate for Payer: Healthscope Commercial |
$187.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$176.87
|
| Rate for Payer: PHP Commercial |
$176.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.25
|
| Rate for Payer: Priority Health SBD |
$131.09
|
| Rate for Payer: UMR Bronson Commercial |
$91.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.06
|
|
|
HC INJ, TRIAMCINOLONE ACETONIDE, NOT SPECIFIED, 10 MG
|
Facility
|
OP
|
$10.40
|
|
|
Service Code
|
CPT J3301
|
| Hospital Charge Code |
63600103
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$9.36 |
| Rate for Payer: Aetna American Axle |
$6.76
|
| Rate for Payer: Aetna Commercial |
$8.84
|
| Rate for Payer: Aetna Medicare |
$5.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.76
|
| Rate for Payer: BCBS Complete |
$4.16
|
| Rate for Payer: BCBS Trust/PPO |
$2.41
|
| Rate for Payer: BCN Commercial |
$2.41
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cofinity Commercial |
$7.28
|
| Rate for Payer: Cofinity Commercial |
$8.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.32
|
| Rate for Payer: Healthscope Commercial |
$9.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.84
|
| Rate for Payer: PHP Commercial |
$8.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.76
|
| Rate for Payer: Priority Health SBD |
$6.55
|
| Rate for Payer: UMR Bronson Commercial |
$3.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.80
|
|
|
HC INJ, TRIAMCINOLONE ACETONIDE, NOT SPECIFIED, 10 MG
|
Facility
|
IP
|
$10.40
|
|
|
Service Code
|
CPT J3301
|
| Hospital Charge Code |
63600103
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.58 |
| Max. Negotiated Rate |
$9.36 |
| Rate for Payer: Aetna American Axle |
$6.76
|
| Rate for Payer: Aetna Commercial |
$8.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.76
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cofinity Commercial |
$7.28
|
| Rate for Payer: Cofinity Commercial |
$8.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.32
|
| Rate for Payer: Healthscope Commercial |
$9.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.84
|
| Rate for Payer: PHP Commercial |
$8.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.76
|
| Rate for Payer: Priority Health SBD |
$6.55
|
| Rate for Payer: UMR Bronson Commercial |
$4.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.80
|
|
|
HC INJ, VIT B12 CYANCOBALAMIN, UP TO 1000MCG
|
Facility
|
IP
|
$5.20
|
|
|
Service Code
|
CPT J3420
|
| Hospital Charge Code |
63600104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$4.68 |
| Rate for Payer: Aetna American Axle |
$3.38
|
| Rate for Payer: Aetna Commercial |
$4.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.38
|
| Rate for Payer: Cash Price |
$4.16
|
| Rate for Payer: Cofinity Commercial |
$3.64
|
| Rate for Payer: Cofinity Commercial |
$4.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.16
|
| Rate for Payer: Healthscope Commercial |
$4.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.42
|
| Rate for Payer: PHP Commercial |
$4.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.38
|
| Rate for Payer: Priority Health SBD |
$3.28
|
| Rate for Payer: UMR Bronson Commercial |
$2.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.90
|
|
|
HC INJ, VIT B12 CYANCOBALAMIN, UP TO 1000MCG
|
Facility
|
OP
|
$5.20
|
|
|
Service Code
|
CPT J3420
|
| Hospital Charge Code |
63600104
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.92 |
| Max. Negotiated Rate |
$4.68 |
| Rate for Payer: Aetna American Axle |
$3.38
|
| Rate for Payer: Aetna Commercial |
$4.42
|
| Rate for Payer: Aetna Medicare |
$2.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.38
|
| Rate for Payer: BCBS Complete |
$2.08
|
| Rate for Payer: BCBS Trust/PPO |
$3.10
|
| Rate for Payer: BCN Commercial |
$3.10
|
| Rate for Payer: Cash Price |
$4.16
|
| Rate for Payer: Cash Price |
$4.16
|
| Rate for Payer: Cofinity Commercial |
$3.64
|
| Rate for Payer: Cofinity Commercial |
$4.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.16
|
| Rate for Payer: Healthscope Commercial |
$4.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.42
|
| Rate for Payer: PHP Commercial |
$4.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.38
|
| Rate for Payer: Priority Health SBD |
$3.28
|
| Rate for Payer: UMR Bronson Commercial |
$1.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.90
|
|
|
HC INSECT VENOM ALLERGY PANEL
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200115
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC INSECT VENOM ALLERGY PANEL
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200115
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC INSERT CATH COMPLICATED
|
Facility
|
IP
|
$500.32
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
45000005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$220.14 |
| Max. Negotiated Rate |
$450.29 |
| Rate for Payer: Aetna American Axle |
$325.21
|
| Rate for Payer: Aetna Commercial |
$425.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.21
|
| Rate for Payer: Cash Price |
$400.26
|
| Rate for Payer: Cofinity Commercial |
$350.22
|
| Rate for Payer: Cofinity Commercial |
$430.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$350.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.26
|
| Rate for Payer: Healthscope Commercial |
$450.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.27
|
| Rate for Payer: PHP Commercial |
$425.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.21
|
| Rate for Payer: Priority Health SBD |
$315.20
|
| Rate for Payer: UMR Bronson Commercial |
$220.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.24
|
|
|
HC INSERT CATH COMPLICATED
|
Facility
|
OP
|
$500.32
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
45000005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$73.24 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$325.21
|
| Rate for Payer: Aetna Commercial |
$425.27
|
| Rate for Payer: Aetna Medicare |
$159.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$90.92
|
| Rate for Payer: BCN Commercial |
$90.92
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$400.26
|
| Rate for Payer: Cash Price |
$400.26
|
| Rate for Payer: Cash Price |
$400.26
|
| Rate for Payer: Cofinity Commercial |
$350.22
|
| Rate for Payer: Cofinity Commercial |
$430.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$350.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$450.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.24
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.27
|
| Rate for Payer: Nomi Health Commercial |
$459.90
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$425.27
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.80
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$385.44
|
| Rate for Payer: Priority Health SBD |
$315.20
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.56
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$73.24
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: UMR Bronson Commercial |
$185.12
|
| Rate for Payer: VA VA |
$153.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.24
|
|
|
HC INSERT CERVICAL DILATOR
|
Facility
|
OP
|
$423.24
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
36100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.95 |
| Max. Negotiated Rate |
$936.74 |
| Rate for Payer: Aetna American Axle |
$275.11
|
| Rate for Payer: Aetna Commercial |
$359.75
|
| Rate for Payer: Aetna Medicare |
$309.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$372.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$372.55
|
| Rate for Payer: BCBS Complete |
$167.74
|
| Rate for Payer: BCBS MAPPO |
$298.04
|
| Rate for Payer: BCBS Trust/PPO |
$327.46
|
| Rate for Payer: BCN Commercial |
$327.46
|
| Rate for Payer: BCN Medicare Advantage |
$298.04
|
| Rate for Payer: Cash Price |
$338.59
|
| Rate for Payer: Cash Price |
$338.59
|
| Rate for Payer: Cash Price |
$338.59
|
| Rate for Payer: Cofinity Commercial |
$363.99
|
| Rate for Payer: Cofinity Commercial |
$296.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$296.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.04
|
| Rate for Payer: Healthscope Commercial |
$380.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$296.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.43
|
| Rate for Payer: Mclaren Medicaid |
$159.75
|
| Rate for Payer: Mclaren Medicare |
$298.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$312.94
|
| Rate for Payer: Meridian Medicaid |
$167.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$342.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.75
|
| Rate for Payer: Nomi Health Commercial |
$625.88
|
| Rate for Payer: PACE Medicare |
$283.14
|
| Rate for Payer: PACE SWMI |
$298.04
|
| Rate for Payer: PHP Commercial |
$359.75
|
| Rate for Payer: PHP Medicare Advantage |
$298.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$936.74
|
| Rate for Payer: Priority Health Medicare |
$298.04
|
| Rate for Payer: Priority Health Narrow Network |
$749.39
|
| Rate for Payer: Priority Health SBD |
$266.64
|
| Rate for Payer: Railroad Medicare Medicare |
$298.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.34
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.04
|
| Rate for Payer: UHC Exchange |
$43.95
|
| Rate for Payer: UHC Medicare Advantage |
$298.04
|
| Rate for Payer: UHCCP Medicaid |
$159.75
|
| Rate for Payer: UMR Bronson Commercial |
$156.60
|
| Rate for Payer: VA VA |
$298.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.43
|
|
|
HC INSERT CERVICAL DILATOR
|
Facility
|
IP
|
$423.24
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
36100397
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$186.23 |
| Max. Negotiated Rate |
$380.92 |
| Rate for Payer: Aetna American Axle |
$275.11
|
| Rate for Payer: Aetna Commercial |
$359.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$275.11
|
| Rate for Payer: Cash Price |
$338.59
|
| Rate for Payer: Cofinity Commercial |
$296.27
|
| Rate for Payer: Cofinity Commercial |
$363.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$296.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$338.59
|
| Rate for Payer: Healthscope Commercial |
$380.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$296.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$317.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.75
|
| Rate for Payer: PHP Commercial |
$359.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.11
|
| Rate for Payer: Priority Health SBD |
$266.64
|
| Rate for Payer: UMR Bronson Commercial |
$186.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$317.43
|
|
|
HC INSERT EMERGENCY AIRWAY
|
Facility
|
OP
|
$576.31
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
45000012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$121.95 |
| Max. Negotiated Rate |
$715.11 |
| Rate for Payer: Aetna American Axle |
$374.60
|
| Rate for Payer: Aetna Commercial |
$489.86
|
| Rate for Payer: Aetna Medicare |
$236.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$284.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$284.40
|
| Rate for Payer: BCBS Complete |
$128.05
|
| Rate for Payer: BCBS MAPPO |
$227.52
|
| Rate for Payer: BCBS Trust/PPO |
$233.10
|
| Rate for Payer: BCN Commercial |
$233.10
|
| Rate for Payer: BCN Medicare Advantage |
$227.52
|
| Rate for Payer: Cash Price |
$461.05
|
| Rate for Payer: Cash Price |
$461.05
|
| Rate for Payer: Cash Price |
$461.05
|
| Rate for Payer: Cofinity Commercial |
$495.63
|
| Rate for Payer: Cofinity Commercial |
$403.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$403.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.52
|
| Rate for Payer: Healthscope Commercial |
$518.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$403.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.23
|
| Rate for Payer: Mclaren Medicaid |
$121.95
|
| Rate for Payer: Mclaren Medicare |
$227.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.90
|
| Rate for Payer: Meridian Medicaid |
$128.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.86
|
| Rate for Payer: Nomi Health Commercial |
$477.79
|
| Rate for Payer: PACE Medicare |
$216.14
|
| Rate for Payer: PACE SWMI |
$227.52
|
| Rate for Payer: PHP Commercial |
$489.86
|
| Rate for Payer: PHP Medicare Advantage |
$227.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$715.11
|
| Rate for Payer: Priority Health Medicare |
$227.52
|
| Rate for Payer: Priority Health Narrow Network |
$572.09
|
| Rate for Payer: Priority Health SBD |
$363.08
|
| Rate for Payer: Railroad Medicare Medicare |
$227.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.50
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.52
|
| Rate for Payer: UHC Exchange |
$136.82
|
| Rate for Payer: UHC Medicare Advantage |
$227.52
|
| Rate for Payer: UHCCP Medicaid |
$121.95
|
| Rate for Payer: UMR Bronson Commercial |
$213.23
|
| Rate for Payer: VA VA |
$227.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.23
|
|
|
HC INSERT EMERGENCY AIRWAY
|
Facility
|
IP
|
$576.31
|
|
|
Service Code
|
CPT 31500
|
| Hospital Charge Code |
45000012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$253.58 |
| Max. Negotiated Rate |
$518.68 |
| Rate for Payer: Aetna American Axle |
$374.60
|
| Rate for Payer: Aetna Commercial |
$489.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.60
|
| Rate for Payer: Cash Price |
$461.05
|
| Rate for Payer: Cofinity Commercial |
$403.42
|
| Rate for Payer: Cofinity Commercial |
$495.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$403.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.05
|
| Rate for Payer: Healthscope Commercial |
$518.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$403.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.86
|
| Rate for Payer: PHP Commercial |
$489.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.60
|
| Rate for Payer: Priority Health SBD |
$363.08
|
| Rate for Payer: UMR Bronson Commercial |
$253.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.23
|
|
|
HC INSERT INDWELLING CATH
|
Facility
|
IP
|
$199.25
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
45000004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$87.67 |
| Max. Negotiated Rate |
$179.32 |
| Rate for Payer: Aetna American Axle |
$129.51
|
| Rate for Payer: Aetna Commercial |
$169.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.51
|
| Rate for Payer: Cash Price |
$159.40
|
| Rate for Payer: Cofinity Commercial |
$139.48
|
| Rate for Payer: Cofinity Commercial |
$171.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$139.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.40
|
| Rate for Payer: Healthscope Commercial |
$179.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$139.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.36
|
| Rate for Payer: PHP Commercial |
$169.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.51
|
| Rate for Payer: Priority Health SBD |
$125.53
|
| Rate for Payer: UMR Bronson Commercial |
$87.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.44
|
|
|
HC INSERT INDWELLING CATH
|
Facility
|
OP
|
$199.25
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
45000004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$24.34 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$129.51
|
| Rate for Payer: Aetna Commercial |
$169.36
|
| Rate for Payer: Aetna Medicare |
$131.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$253.95
|
| Rate for Payer: BCN Commercial |
$253.95
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$159.40
|
| Rate for Payer: Cash Price |
$159.40
|
| Rate for Payer: Cash Price |
$159.40
|
| Rate for Payer: Cofinity Commercial |
$139.48
|
| Rate for Payer: Cofinity Commercial |
$171.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$139.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$179.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$139.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.44
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.36
|
| Rate for Payer: Nomi Health Commercial |
$378.87
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$169.36
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.95
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$317.56
|
| Rate for Payer: Priority Health SBD |
$125.53
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.77
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$24.34
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: UMR Bronson Commercial |
$73.72
|
| Rate for Payer: VA VA |
$126.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.44
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
OP
|
$1,073.45
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$397.18 |
| Max. Negotiated Rate |
$966.10 |
| Rate for Payer: Aetna American Axle |
$697.74
|
| Rate for Payer: Aetna Commercial |
$912.43
|
| Rate for Payer: Aetna Medicare |
$536.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.74
|
| Rate for Payer: BCBS Complete |
$429.38
|
| Rate for Payer: Cash Price |
$858.76
|
| Rate for Payer: Cofinity Commercial |
$751.42
|
| Rate for Payer: Cofinity Commercial |
$923.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$751.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.76
|
| Rate for Payer: Healthscope Commercial |
$966.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$751.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$805.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.43
|
| Rate for Payer: PHP Commercial |
$912.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.74
|
| Rate for Payer: Priority Health SBD |
$676.27
|
| Rate for Payer: UMR Bronson Commercial |
$397.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$805.09
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
IP
|
$1,073.45
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$472.32 |
| Max. Negotiated Rate |
$966.10 |
| Rate for Payer: Aetna American Axle |
$697.74
|
| Rate for Payer: Aetna Commercial |
$912.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.74
|
| Rate for Payer: Cash Price |
$858.76
|
| Rate for Payer: Cofinity Commercial |
$751.42
|
| Rate for Payer: Cofinity Commercial |
$923.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$751.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.76
|
| Rate for Payer: Healthscope Commercial |
$966.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$751.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$805.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.43
|
| Rate for Payer: PHP Commercial |
$912.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$697.74
|
| Rate for Payer: Priority Health SBD |
$676.27
|
| Rate for Payer: UMR Bronson Commercial |
$472.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$805.09
|
|
|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
IP
|
$1,470.15
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$646.87 |
| Max. Negotiated Rate |
$1,323.14 |
| Rate for Payer: Aetna American Axle |
$955.60
|
| Rate for Payer: Aetna Commercial |
$1,249.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$955.60
|
| Rate for Payer: Cash Price |
$1,176.12
|
| Rate for Payer: Cofinity Commercial |
$1,029.10
|
| Rate for Payer: Cofinity Commercial |
$1,264.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,029.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,176.12
|
| Rate for Payer: Healthscope Commercial |
$1,323.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,029.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,102.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,249.63
|
| Rate for Payer: PHP Commercial |
$1,249.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$955.60
|
| Rate for Payer: Priority Health SBD |
$926.19
|
| Rate for Payer: UMR Bronson Commercial |
$646.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,102.61
|
|
|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
OP
|
$1,470.15
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$194.53 |
| Max. Negotiated Rate |
$3,630.90 |
| Rate for Payer: Aetna American Axle |
$955.60
|
| Rate for Payer: Aetna Commercial |
$1,249.63
|
| Rate for Payer: Aetna Medicare |
$1,201.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$955.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,444.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,444.05
|
| Rate for Payer: BCBS Complete |
$650.17
|
| Rate for Payer: BCBS MAPPO |
$1,155.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,084.69
|
| Rate for Payer: BCN Commercial |
$1,084.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,155.24
|
| Rate for Payer: Cash Price |
$1,176.12
|
| Rate for Payer: Cash Price |
$1,176.12
|
| Rate for Payer: Cash Price |
$1,176.12
|
| Rate for Payer: Cofinity Commercial |
$1,264.33
|
| Rate for Payer: Cofinity Commercial |
$1,029.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,029.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,176.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,155.24
|
| Rate for Payer: Healthscope Commercial |
$1,323.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,029.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,102.61
|
| Rate for Payer: Mclaren Medicaid |
$619.21
|
| Rate for Payer: Mclaren Medicare |
$1,155.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,213.00
|
| Rate for Payer: Meridian Medicaid |
$650.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,328.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,249.63
|
| Rate for Payer: Nomi Health Commercial |
$2,426.00
|
| Rate for Payer: PACE Medicare |
$1,097.48
|
| Rate for Payer: PACE SWMI |
$1,155.24
|
| Rate for Payer: PHP Commercial |
$1,249.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,155.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$619.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$955.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,630.90
|
| Rate for Payer: Priority Health Medicare |
$1,155.24
|
| Rate for Payer: Priority Health Narrow Network |
$2,904.72
|
| Rate for Payer: Priority Health SBD |
$926.19
|
| Rate for Payer: Railroad Medicare Medicare |
$1,155.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.98
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,155.24
|
| Rate for Payer: UHC Exchange |
$194.53
|
| Rate for Payer: UHC Medicare Advantage |
$1,155.24
|
| Rate for Payer: UHCCP Medicaid |
$619.21
|
| Rate for Payer: UMR Bronson Commercial |
$543.96
|
| Rate for Payer: VA VA |
$1,155.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,102.61
|
|
|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
OP
|
$1,521.35
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$229.56 |
| Max. Negotiated Rate |
$5,841.66 |
| Rate for Payer: Aetna American Axle |
$988.88
|
| Rate for Payer: Aetna Commercial |
$1,293.15
|
| Rate for Payer: Aetna Medicare |
$1,932.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$988.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,323.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,323.29
|
| Rate for Payer: BCBS Complete |
$1,046.04
|
| Rate for Payer: BCBS MAPPO |
$1,858.63
|
| Rate for Payer: BCBS Trust/PPO |
$947.27
|
| Rate for Payer: BCN Commercial |
$947.27
|
| Rate for Payer: BCN Medicare Advantage |
$1,858.63
|
| Rate for Payer: Cash Price |
$1,217.08
|
| Rate for Payer: Cash Price |
$1,217.08
|
| Rate for Payer: Cash Price |
$1,217.08
|
| Rate for Payer: Cofinity Commercial |
$1,308.36
|
| Rate for Payer: Cofinity Commercial |
$1,064.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,064.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,217.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,858.63
|
| Rate for Payer: Healthscope Commercial |
$1,369.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,064.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,141.01
|
| Rate for Payer: Mclaren Medicaid |
$996.23
|
| Rate for Payer: Mclaren Medicare |
$1,858.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,951.56
|
| Rate for Payer: Meridian Medicaid |
$1,046.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,137.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,293.15
|
| Rate for Payer: Nomi Health Commercial |
$3,903.12
|
| Rate for Payer: PACE Medicare |
$1,765.70
|
| Rate for Payer: PACE SWMI |
$1,858.63
|
| Rate for Payer: PHP Commercial |
$1,293.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,858.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$996.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$988.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,841.66
|
| Rate for Payer: Priority Health Medicare |
$1,858.63
|
| Rate for Payer: Priority Health Narrow Network |
$4,673.33
|
| Rate for Payer: Priority Health SBD |
$958.45
|
| Rate for Payer: Railroad Medicare Medicare |
$1,858.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.52
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,858.63
|
| Rate for Payer: UHC Exchange |
$229.56
|
| Rate for Payer: UHC Medicare Advantage |
$1,858.63
|
| Rate for Payer: UHCCP Medicaid |
$996.23
|
| Rate for Payer: UMR Bronson Commercial |
$562.90
|
| Rate for Payer: VA VA |
$1,858.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,141.01
|
|
|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
IP
|
$1,521.35
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$669.39 |
| Max. Negotiated Rate |
$1,369.22 |
| Rate for Payer: Aetna American Axle |
$988.88
|
| Rate for Payer: Aetna Commercial |
$1,293.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$988.88
|
| Rate for Payer: Cash Price |
$1,217.08
|
| Rate for Payer: Cofinity Commercial |
$1,064.94
|
| Rate for Payer: Cofinity Commercial |
$1,308.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,064.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,217.08
|
| Rate for Payer: Healthscope Commercial |
$1,369.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,064.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,141.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,293.15
|
| Rate for Payer: PHP Commercial |
$1,293.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$988.88
|
| Rate for Payer: Priority Health SBD |
$958.45
|
| Rate for Payer: UMR Bronson Commercial |
$669.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,141.01
|
|
|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$166.19
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$60.91 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$108.02
|
| Rate for Payer: Aetna Commercial |
$141.26
|
| Rate for Payer: Aetna Medicare |
$131.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$130.23
|
| Rate for Payer: BCN Commercial |
$130.23
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$132.95
|
| Rate for Payer: Cash Price |
$132.95
|
| Rate for Payer: Cash Price |
$132.95
|
| Rate for Payer: Cofinity Commercial |
$116.33
|
| Rate for Payer: Cofinity Commercial |
$142.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$116.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$149.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$116.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.64
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.26
|
| Rate for Payer: Nomi Health Commercial |
$378.87
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$141.26
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.95
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$317.56
|
| Rate for Payer: Priority Health SBD |
$104.70
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.00
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$60.91
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: UMR Bronson Commercial |
$61.49
|
| Rate for Payer: VA VA |
$126.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.64
|
|
|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$166.19
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$73.12 |
| Max. Negotiated Rate |
$149.57 |
| Rate for Payer: Aetna American Axle |
$108.02
|
| Rate for Payer: Aetna Commercial |
$141.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.02
|
| Rate for Payer: Cash Price |
$132.95
|
| Rate for Payer: Cofinity Commercial |
$116.33
|
| Rate for Payer: Cofinity Commercial |
$142.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$116.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.95
|
| Rate for Payer: Healthscope Commercial |
$149.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$116.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.26
|
| Rate for Payer: PHP Commercial |
$141.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.02
|
| Rate for Payer: Priority Health SBD |
$104.70
|
| Rate for Payer: UMR Bronson Commercial |
$73.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.64
|
|
