|
HC TRANSHEPATIC PORTOGRAPHY
|
Facility
|
OP
|
$3,106.01
|
|
|
Service Code
|
CPT 75887
|
| Hospital Charge Code |
32000321
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$134.91 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$2,018.91
|
| Rate for Payer: Aetna Commercial |
$2,640.11
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,018.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$139.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,484.81
|
| Rate for Payer: Cash Price |
$2,484.81
|
| Rate for Payer: Cofinity Commercial |
$2,671.17
|
| Rate for Payer: Cofinity Commercial |
$2,174.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,484.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,795.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,174.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,329.51
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,640.11
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$2,640.11
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,174.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$1,956.79
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.40
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$134.91
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,149.22
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,329.51
|
|
|
HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL
|
Facility
|
OP
|
$6,130.20
|
|
|
Service Code
|
CPT 55874
|
| Hospital Charge Code |
36100574
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.46 |
| Max. Negotiated Rate |
$14,479.04 |
| Rate for Payer: Aetna American Axle |
$3,984.63
|
| Rate for Payer: Aetna Commercial |
$5,210.67
|
| Rate for Payer: Aetna Medicare |
$4,783.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,984.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,749.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,749.21
|
| Rate for Payer: BCBS Complete |
$2,641.88
|
| Rate for Payer: BCBS MAPPO |
$4,599.37
|
| Rate for Payer: BCBS Trust/PPO |
$5,521.86
|
| Rate for Payer: BCN Medicare Advantage |
$4,599.37
|
| Rate for Payer: Cash Price |
$4,904.16
|
| Rate for Payer: Cash Price |
$4,904.16
|
| Rate for Payer: Cofinity Commercial |
$4,291.14
|
| Rate for Payer: Cofinity Commercial |
$5,271.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,904.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,599.37
|
| Rate for Payer: Healthscope Commercial |
$5,517.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,291.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,597.65
|
| Rate for Payer: Mclaren Medicaid |
$2,515.86
|
| Rate for Payer: Mclaren Medicare |
$4,599.37
|
| Rate for Payer: Meridian Medicaid |
$2,641.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,829.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,289.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,210.67
|
| Rate for Payer: PACE Medicare |
$4,369.40
|
| Rate for Payer: PACE SWMI |
$4,599.37
|
| Rate for Payer: PHP Commercial |
$5,210.67
|
| Rate for Payer: PHP Medicare Advantage |
$4,599.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,515.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,291.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,479.04
|
| Rate for Payer: Priority Health Medicare |
$4,599.37
|
| Rate for Payer: Priority Health Narrow Network |
$11,583.23
|
| Rate for Payer: Priority Health SBD |
$3,862.03
|
| Rate for Payer: Railroad Medicare Medicare |
$4,599.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,599.37
|
| Rate for Payer: UHC Exchange |
$159.46
|
| Rate for Payer: UHC Medicare Advantage |
$4,737.35
|
| Rate for Payer: UMR Bronson Commercial |
$2,268.17
|
| Rate for Payer: VA VA |
$4,599.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,597.65
|
|
|
HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL
|
Facility
|
IP
|
$6,130.20
|
|
|
Service Code
|
CPT 55874
|
| Hospital Charge Code |
36100574
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,697.29 |
| Max. Negotiated Rate |
$5,517.18 |
| Rate for Payer: Aetna American Axle |
$3,984.63
|
| Rate for Payer: Aetna Commercial |
$5,210.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,984.63
|
| Rate for Payer: Cash Price |
$4,904.16
|
| Rate for Payer: Cofinity Commercial |
$4,291.14
|
| Rate for Payer: Cofinity Commercial |
$5,271.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,904.16
|
| Rate for Payer: Healthscope Commercial |
$5,517.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,291.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,597.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,210.67
|
| Rate for Payer: PHP Commercial |
$5,210.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,291.14
|
| Rate for Payer: Priority Health SBD |
$3,862.03
|
| Rate for Payer: UMR Bronson Commercial |
$2,697.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,597.65
|
|
|
HC TRANSSEP INTRO AGILIS
|
Facility
|
OP
|
$3,621.13
|
|
|
Service Code
|
HCPCS C1766
|
| Hospital Charge Code |
27200075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,339.82 |
| Max. Negotiated Rate |
$3,259.02 |
| Rate for Payer: Aetna American Axle |
$2,353.73
|
| Rate for Payer: Aetna Commercial |
$3,077.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,353.73
|
| Rate for Payer: BCBS Complete |
$1,448.45
|
| Rate for Payer: Cash Price |
$2,896.90
|
| Rate for Payer: Cofinity Commercial |
$2,534.79
|
| Rate for Payer: Cofinity Commercial |
$3,114.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,896.90
|
| Rate for Payer: Healthscope Commercial |
$3,259.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,534.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,715.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,077.96
|
| Rate for Payer: PHP Commercial |
$3,077.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,534.79
|
| Rate for Payer: Priority Health SBD |
$2,281.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,339.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,715.85
|
|
|
HC TRANSSEP INTRO AGILIS
|
Facility
|
IP
|
$3,621.13
|
|
|
Service Code
|
HCPCS C1766
|
| Hospital Charge Code |
27200075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,593.30 |
| Max. Negotiated Rate |
$3,259.02 |
| Rate for Payer: Aetna American Axle |
$2,353.73
|
| Rate for Payer: Aetna Commercial |
$3,077.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,353.73
|
| Rate for Payer: Cash Price |
$2,896.90
|
| Rate for Payer: Cofinity Commercial |
$2,534.79
|
| Rate for Payer: Cofinity Commercial |
$3,114.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,896.90
|
| Rate for Payer: Healthscope Commercial |
$3,259.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,534.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,715.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,077.96
|
| Rate for Payer: PHP Commercial |
$3,077.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,534.79
|
| Rate for Payer: Priority Health SBD |
$2,281.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,593.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,715.85
|
|
|
HC TRANSSEP PUNCTURE FOR PVI
|
Facility
|
IP
|
$4,826.40
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
48100021
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,123.62 |
| Max. Negotiated Rate |
$4,343.76 |
| Rate for Payer: Aetna American Axle |
$3,137.16
|
| Rate for Payer: Aetna Commercial |
$4,102.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,137.16
|
| Rate for Payer: Cash Price |
$3,861.12
|
| Rate for Payer: Cofinity Commercial |
$4,150.70
|
| Rate for Payer: Cofinity Commercial |
$3,378.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,861.12
|
| Rate for Payer: Healthscope Commercial |
$4,343.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,378.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,619.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,102.44
|
| Rate for Payer: PHP Commercial |
$4,102.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,378.48
|
| Rate for Payer: Priority Health SBD |
$3,040.63
|
| Rate for Payer: UMR Bronson Commercial |
$2,123.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,619.80
|
|
|
HC TRANSSEP PUNCTURE FOR PVI
|
Facility
|
OP
|
$4,826.40
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
48100021
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$198.43 |
| Max. Negotiated Rate |
$4,343.76 |
| Rate for Payer: Aetna American Axle |
$3,137.16
|
| Rate for Payer: Aetna Commercial |
$4,102.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,137.16
|
| Rate for Payer: BCBS Complete |
$1,930.56
|
| Rate for Payer: BCBS Trust/PPO |
$261.38
|
| Rate for Payer: Cash Price |
$3,861.12
|
| Rate for Payer: Cash Price |
$3,861.12
|
| Rate for Payer: Cofinity Commercial |
$4,150.70
|
| Rate for Payer: Cofinity Commercial |
$3,378.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,861.12
|
| Rate for Payer: Healthscope Commercial |
$4,343.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,378.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,619.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,102.44
|
| Rate for Payer: PHP Commercial |
$4,102.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,378.48
|
| Rate for Payer: Priority Health SBD |
$3,040.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.27
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$198.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,785.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,619.80
|
|
|
HC TRANSSEPTAL INTRODUCER
|
Facility
|
IP
|
$886.66
|
|
| Hospital Charge Code |
27200154
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$390.13 |
| Max. Negotiated Rate |
$797.99 |
| Rate for Payer: Aetna American Axle |
$576.33
|
| Rate for Payer: Aetna Commercial |
$753.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.33
|
| Rate for Payer: Cash Price |
$709.33
|
| Rate for Payer: Cofinity Commercial |
$620.66
|
| Rate for Payer: Cofinity Commercial |
$762.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.33
|
| Rate for Payer: Healthscope Commercial |
$797.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$620.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$665.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$753.66
|
| Rate for Payer: PHP Commercial |
$753.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$620.66
|
| Rate for Payer: Priority Health SBD |
$558.60
|
| Rate for Payer: UMR Bronson Commercial |
$390.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.00
|
|
|
HC TRANSSEPTAL INTRODUCER
|
Facility
|
OP
|
$886.66
|
|
| Hospital Charge Code |
27200154
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$328.06 |
| Max. Negotiated Rate |
$797.99 |
| Rate for Payer: Aetna American Axle |
$576.33
|
| Rate for Payer: Aetna Commercial |
$753.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$576.33
|
| Rate for Payer: BCBS Complete |
$354.66
|
| Rate for Payer: Cash Price |
$709.33
|
| Rate for Payer: Cofinity Commercial |
$620.66
|
| Rate for Payer: Cofinity Commercial |
$762.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$709.33
|
| Rate for Payer: Healthscope Commercial |
$797.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$620.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$665.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$753.66
|
| Rate for Payer: PHP Commercial |
$753.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$620.66
|
| Rate for Payer: Priority Health SBD |
$558.60
|
| Rate for Payer: UMR Bronson Commercial |
$328.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$665.00
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BIL
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
CPT 64488
|
| Hospital Charge Code |
36100576
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$673.20 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna American Axle |
$994.50
|
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.50
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,071.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,071.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health SBD |
$963.90
|
| Rate for Payer: UMR Bronson Commercial |
$673.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BIL
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
CPT 64488
|
| Hospital Charge Code |
36100576
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$66.47 |
| Max. Negotiated Rate |
$1,389.44 |
| Rate for Payer: Aetna American Axle |
$994.50
|
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.50
|
| Rate for Payer: BCBS Complete |
$612.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,389.44
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Cofinity Commercial |
$1,071.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,071.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health SBD |
$963.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.12
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$66.47
|
| Rate for Payer: UMR Bronson Commercial |
$566.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNI
|
Facility
|
IP
|
$1,170.96
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
36100575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$515.22 |
| Max. Negotiated Rate |
$1,053.86 |
| Rate for Payer: Aetna American Axle |
$761.12
|
| Rate for Payer: Aetna Commercial |
$995.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$761.12
|
| Rate for Payer: Cash Price |
$936.77
|
| Rate for Payer: Cofinity Commercial |
$1,007.03
|
| Rate for Payer: Cofinity Commercial |
$819.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$936.77
|
| Rate for Payer: Healthscope Commercial |
$1,053.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$819.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$878.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$995.32
|
| Rate for Payer: PHP Commercial |
$995.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.67
|
| Rate for Payer: Priority Health SBD |
$737.70
|
| Rate for Payer: UMR Bronson Commercial |
$515.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$878.22
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNI
|
Facility
|
OP
|
$1,170.96
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
36100575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$53.37 |
| Max. Negotiated Rate |
$1,053.86 |
| Rate for Payer: Aetna American Axle |
$761.12
|
| Rate for Payer: Aetna Commercial |
$995.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$761.12
|
| Rate for Payer: BCBS Complete |
$468.38
|
| Rate for Payer: BCBS Trust/PPO |
$415.62
|
| Rate for Payer: Cash Price |
$936.77
|
| Rate for Payer: Cash Price |
$936.77
|
| Rate for Payer: Cofinity Commercial |
$819.67
|
| Rate for Payer: Cofinity Commercial |
$1,007.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$936.77
|
| Rate for Payer: Healthscope Commercial |
$1,053.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$819.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$878.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$995.32
|
| Rate for Payer: PHP Commercial |
$995.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.67
|
| Rate for Payer: Priority Health SBD |
$737.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.71
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$53.37
|
| Rate for Payer: UMR Bronson Commercial |
$433.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$878.22
|
|
|
HC TRANURETH DESTR PROST TISS RF WVT
|
Facility
|
IP
|
$4,807.00
|
|
|
Service Code
|
CPT 53854
|
| Hospital Charge Code |
76100306
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,115.08 |
| Max. Negotiated Rate |
$4,326.30 |
| Rate for Payer: Aetna American Axle |
$3,124.55
|
| Rate for Payer: Aetna Commercial |
$4,085.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,124.55
|
| Rate for Payer: Cash Price |
$3,845.60
|
| Rate for Payer: Cofinity Commercial |
$3,364.90
|
| Rate for Payer: Cofinity Commercial |
$4,134.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,845.60
|
| Rate for Payer: Healthscope Commercial |
$4,326.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,364.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,605.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,085.95
|
| Rate for Payer: PHP Commercial |
$4,085.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,364.90
|
| Rate for Payer: Priority Health SBD |
$3,028.41
|
| Rate for Payer: UMR Bronson Commercial |
$2,115.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,605.25
|
|
|
HC TRANURETH DESTR PROST TISS RF WVT
|
Facility
|
OP
|
$4,807.00
|
|
|
Service Code
|
CPT 53854
|
| Hospital Charge Code |
76100306
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$375.90 |
| Max. Negotiated Rate |
$9,755.07 |
| Rate for Payer: Aetna American Axle |
$3,124.55
|
| Rate for Payer: Aetna Commercial |
$4,085.95
|
| Rate for Payer: Aetna Medicare |
$3,222.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,124.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,873.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,873.46
|
| Rate for Payer: BCBS Complete |
$1,779.93
|
| Rate for Payer: BCBS MAPPO |
$3,098.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,296.18
|
| Rate for Payer: BCN Medicare Advantage |
$3,098.77
|
| Rate for Payer: Cash Price |
$3,845.60
|
| Rate for Payer: Cash Price |
$3,845.60
|
| Rate for Payer: Cofinity Commercial |
$3,364.90
|
| Rate for Payer: Cofinity Commercial |
$4,134.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,845.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,098.77
|
| Rate for Payer: Healthscope Commercial |
$4,326.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,364.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,605.25
|
| Rate for Payer: Mclaren Medicaid |
$1,695.03
|
| Rate for Payer: Mclaren Medicare |
$3,098.77
|
| Rate for Payer: Meridian Medicaid |
$1,779.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,253.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,563.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,085.95
|
| Rate for Payer: PACE Medicare |
$2,943.83
|
| Rate for Payer: PACE SWMI |
$3,098.77
|
| Rate for Payer: PHP Commercial |
$4,085.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,098.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,364.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,755.07
|
| Rate for Payer: Priority Health Medicare |
$3,098.77
|
| Rate for Payer: Priority Health Narrow Network |
$7,804.06
|
| Rate for Payer: Priority Health SBD |
$3,028.41
|
| Rate for Payer: Railroad Medicare Medicare |
$3,098.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$413.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,098.77
|
| Rate for Payer: UHC Exchange |
$375.90
|
| Rate for Payer: UHC Medicare Advantage |
$3,191.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,778.59
|
| Rate for Payer: VA VA |
$3,098.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,605.25
|
|
|
HC TREAT FINGER FRACTURE WITH MANIP EA
|
Facility
|
OP
|
$4,160.11
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
76100386
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$341.85 |
| Max. Negotiated Rate |
$4,497.31 |
| Rate for Payer: Aetna American Axle |
$2,704.07
|
| Rate for Payer: Aetna Commercial |
$3,536.09
|
| Rate for Payer: Aetna Medicare |
$1,485.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,704.07
|
| 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 |
$942.69
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.61
|
| Rate for Payer: Cash Price |
$3,328.09
|
| Rate for Payer: Cash Price |
$3,328.09
|
| Rate for Payer: Cofinity Commercial |
$2,912.08
|
| Rate for Payer: Cofinity Commercial |
$3,577.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,328.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.61
|
| Rate for Payer: Healthscope Commercial |
$3,744.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,912.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,120.08
|
| 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 |
$3,536.09
|
| Rate for Payer: PACE Medicare |
$1,357.18
|
| Rate for Payer: PACE SWMI |
$1,428.61
|
| Rate for Payer: PHP Commercial |
$3,536.09
|
| 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 |
$2,912.08
|
| 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 |
$2,620.87
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$376.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,428.61
|
| Rate for Payer: UHC Exchange |
$341.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,539.24
|
| Rate for Payer: VA VA |
$1,428.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,120.08
|
|
|
HC TREAT FINGER FRACTURE WITH MANIP EA
|
Facility
|
IP
|
$4,160.11
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
76100386
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,830.45 |
| Max. Negotiated Rate |
$3,744.10 |
| Rate for Payer: Aetna American Axle |
$2,704.07
|
| Rate for Payer: Aetna Commercial |
$3,536.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,704.07
|
| Rate for Payer: Cash Price |
$3,328.09
|
| Rate for Payer: Cofinity Commercial |
$2,912.08
|
| Rate for Payer: Cofinity Commercial |
$3,577.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,328.09
|
| Rate for Payer: Healthscope Commercial |
$3,744.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,912.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,120.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,536.09
|
| Rate for Payer: PHP Commercial |
$3,536.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,912.08
|
| Rate for Payer: Priority Health SBD |
$2,620.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,830.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,120.08
|
|
|
HC TREPONEMA PALLIDUM AB TOTAL AND RPR
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 0064U
|
| Hospital Charge Code |
30200436
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna American Axle |
$16.25
|
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.25
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$17.50
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.25
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health SBD |
$15.75
|
| Rate for Payer: UMR Bronson Commercial |
$11.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.75
|
|
|
HC TREPONEMA PALLIDUM AB TOTAL AND RPR
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 0064U
|
| Hospital Charge Code |
30200436
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.25 |
| Max. Negotiated Rate |
$39.16 |
| Rate for Payer: Aetna American Axle |
$16.25
|
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: Aetna Medicare |
$32.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.16
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS MAPPO |
$31.33
|
| Rate for Payer: BCBS Trust/PPO |
$28.18
|
| Rate for Payer: BCN Medicare Advantage |
$31.33
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$17.50
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.33
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.75
|
| Rate for Payer: Mclaren Medicaid |
$17.14
|
| Rate for Payer: Mclaren Medicare |
$31.33
|
| Rate for Payer: Meridian Medicaid |
$18.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.25
|
| Rate for Payer: PACE Medicare |
$29.76
|
| Rate for Payer: PACE SWMI |
$31.33
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: PHP Medicare Advantage |
$31.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.80
|
| Rate for Payer: Priority Health Medicare |
$31.33
|
| Rate for Payer: Priority Health Narrow Network |
$26.24
|
| Rate for Payer: Priority Health SBD |
$15.75
|
| Rate for Payer: Railroad Medicare Medicare |
$31.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.60
|
| Rate for Payer: UHC Core |
$37.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.33
|
| Rate for Payer: UHC Exchange |
$31.33
|
| Rate for Payer: UHC Medicare Advantage |
$32.27
|
| Rate for Payer: UMR Bronson Commercial |
$9.25
|
| Rate for Payer: VA VA |
$31.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.75
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY
|
Facility
|
OP
|
$24.00
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$21.84 |
| Rate for Payer: Aetna American Axle |
$15.60
|
| Rate for Payer: Aetna Commercial |
$20.40
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$11.91
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$20.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$21.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.00
|
| Rate for Payer: Mclaren Medicaid |
$7.24
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.40
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$20.40
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.97
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health Narrow Network |
$12.78
|
| Rate for Payer: Priority Health SBD |
$15.12
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.89
|
| Rate for Payer: UHC Core |
$21.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.24
|
| Rate for Payer: UHC Exchange |
$13.24
|
| Rate for Payer: UHC Medicare Advantage |
$13.64
|
| Rate for Payer: UMR Bronson Commercial |
$8.88
|
| Rate for Payer: VA VA |
$13.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.00
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY
|
Facility
|
IP
|
$24.00
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.56 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Aetna American Axle |
$15.60
|
| Rate for Payer: Aetna Commercial |
$20.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.60
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$20.64
|
| Rate for Payer: Cofinity Commercial |
$16.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.20
|
| Rate for Payer: Healthscope Commercial |
$21.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.40
|
| Rate for Payer: PHP Commercial |
$20.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
| Rate for Payer: Priority Health SBD |
$15.12
|
| Rate for Payer: UMR Bronson Commercial |
$10.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.00
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY FT
|
Facility
|
IP
|
$69.00
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200325
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.36 |
| Max. Negotiated Rate |
$62.10 |
| Rate for Payer: Aetna American Axle |
$44.85
|
| Rate for Payer: Aetna Commercial |
$58.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.85
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$48.30
|
| Rate for Payer: Cofinity Commercial |
$59.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.20
|
| Rate for Payer: Healthscope Commercial |
$62.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.65
|
| Rate for Payer: PHP Commercial |
$58.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.30
|
| Rate for Payer: Priority Health SBD |
$43.47
|
| Rate for Payer: UMR Bronson Commercial |
$30.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.75
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY FT
|
Facility
|
OP
|
$69.00
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200325
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$62.10 |
| Rate for Payer: Aetna American Axle |
$44.85
|
| Rate for Payer: Aetna Commercial |
$58.65
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$11.91
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$48.30
|
| Rate for Payer: Cofinity Commercial |
$59.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$62.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.75
|
| Rate for Payer: Mclaren Medicaid |
$7.24
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.65
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$58.65
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.97
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health Narrow Network |
$12.78
|
| Rate for Payer: Priority Health SBD |
$43.47
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.89
|
| Rate for Payer: UHC Core |
$21.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.24
|
| Rate for Payer: UHC Exchange |
$13.24
|
| Rate for Payer: UHC Medicare Advantage |
$13.64
|
| Rate for Payer: UMR Bronson Commercial |
$25.53
|
| Rate for Payer: VA VA |
$13.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.75
|
|
|
HC TRIAD CREAM
|
Facility
|
OP
|
$27.16
|
|
| Hospital Charge Code |
27000605
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$24.44 |
| Rate for Payer: Aetna American Axle |
$17.65
|
| Rate for Payer: Aetna Commercial |
$23.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.65
|
| Rate for Payer: BCBS Complete |
$10.86
|
| Rate for Payer: Cash Price |
$21.73
|
| Rate for Payer: Cofinity Commercial |
$19.01
|
| Rate for Payer: Cofinity Commercial |
$23.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.73
|
| Rate for Payer: Healthscope Commercial |
$24.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.09
|
| Rate for Payer: PHP Commercial |
$23.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.01
|
| Rate for Payer: Priority Health SBD |
$17.11
|
| Rate for Payer: UMR Bronson Commercial |
$10.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.37
|
|
|
HC TRIAD CREAM
|
Facility
|
IP
|
$27.16
|
|
| Hospital Charge Code |
27000605
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.95 |
| Max. Negotiated Rate |
$24.44 |
| Rate for Payer: Aetna American Axle |
$17.65
|
| Rate for Payer: Aetna Commercial |
$23.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.65
|
| Rate for Payer: Cash Price |
$21.73
|
| Rate for Payer: Cofinity Commercial |
$19.01
|
| Rate for Payer: Cofinity Commercial |
$23.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.73
|
| Rate for Payer: Healthscope Commercial |
$24.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.09
|
| Rate for Payer: PHP Commercial |
$23.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.01
|
| Rate for Payer: Priority Health SBD |
$17.11
|
| Rate for Payer: UMR Bronson Commercial |
$11.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.37
|
|
