|
HC TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Facility
|
OP
|
$3,600.00
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
36100620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$308.12 |
| Max. Negotiated Rate |
$3,240.00 |
| Rate for Payer: Aetna American Axle |
$2,340.00
|
| Rate for Payer: Aetna Commercial |
$3,060.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,340.00
|
| Rate for Payer: BCBS Complete |
$1,440.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,116.73
|
| Rate for Payer: Cash Price |
$2,880.00
|
| Rate for Payer: Cash Price |
$2,880.00
|
| Rate for Payer: Cofinity Commercial |
$3,096.00
|
| Rate for Payer: Cofinity Commercial |
$2,520.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,880.00
|
| Rate for Payer: Healthscope Commercial |
$3,240.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,520.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,700.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,060.00
|
| Rate for Payer: PHP Commercial |
$3,060.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,520.00
|
| Rate for Payer: Priority Health SBD |
$2,268.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.93
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UHC Exchange |
$308.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,332.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,700.00
|
|
|
HC TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Facility
|
IP
|
$3,600.00
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
36100620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,584.00 |
| Max. Negotiated Rate |
$3,240.00 |
| Rate for Payer: Aetna American Axle |
$2,340.00
|
| Rate for Payer: Aetna Commercial |
$3,060.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,340.00
|
| Rate for Payer: Cash Price |
$2,880.00
|
| Rate for Payer: Cofinity Commercial |
$2,520.00
|
| Rate for Payer: Cofinity Commercial |
$3,096.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,880.00
|
| Rate for Payer: Healthscope Commercial |
$3,240.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,520.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,700.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,060.00
|
| Rate for Payer: PHP Commercial |
$3,060.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,520.00
|
| Rate for Payer: Priority Health SBD |
$2,268.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,584.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,700.00
|
|
|
HC TX INCOMPLETE AB ANY TRI SURG
|
Facility
|
OP
|
$7,789.74
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
76100342
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$306.16 |
| Max. Negotiated Rate |
$8,748.29 |
| Rate for Payer: Aetna American Axle |
$5,063.33
|
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: Aetna Medicare |
$2,890.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,063.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,425.00
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$5,452.82
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,452.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,748.29
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$6,998.63
|
| Rate for Payer: Priority Health SBD |
$4,907.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,778.95
|
| Rate for Payer: UHC Exchange |
$306.16
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: UMR Bronson Commercial |
$2,882.20
|
| Rate for Payer: VA VA |
$2,778.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC TX INCOMPLETE AB ANY TRI SURG
|
Facility
|
IP
|
$7,789.74
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
76100342
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,427.49 |
| Max. Negotiated Rate |
$7,010.77 |
| Rate for Payer: Aetna American Axle |
$5,063.33
|
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,063.33
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$5,452.82
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,452.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health SBD |
$4,907.54
|
| Rate for Payer: UMR Bronson Commercial |
$3,427.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC TX MISSED AB 1ST TRI SURG
|
Facility
|
IP
|
$7,789.74
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
76100343
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,427.49 |
| Max. Negotiated Rate |
$7,010.77 |
| Rate for Payer: Aetna American Axle |
$5,063.33
|
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,063.33
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$5,452.82
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,452.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health SBD |
$4,907.54
|
| Rate for Payer: UMR Bronson Commercial |
$3,427.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC TX MISSED AB 1ST TRI SURG
|
Facility
|
OP
|
$7,789.74
|
|
|
Service Code
|
CPT 59820
|
| Hospital Charge Code |
76100343
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$385.40 |
| Max. Negotiated Rate |
$8,748.29 |
| Rate for Payer: Aetna American Axle |
$5,063.33
|
| Rate for Payer: Aetna Commercial |
$6,621.28
|
| Rate for Payer: Aetna Medicare |
$2,890.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,063.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,223.80
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cash Price |
$6,231.79
|
| Rate for Payer: Cofinity Commercial |
$5,452.82
|
| Rate for Payer: Cofinity Commercial |
$6,699.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,231.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Healthscope Commercial |
$7,010.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,452.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,842.30
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,621.28
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Commercial |
$6,621.28
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,452.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,748.29
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$6,998.63
|
| Rate for Payer: Priority Health SBD |
$4,907.54
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,778.95
|
| Rate for Payer: UHC Exchange |
$385.40
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: UMR Bronson Commercial |
$2,882.20
|
| Rate for Payer: VA VA |
$2,778.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,842.30
|
|
|
HC TX SUPERFICIAL WOUND DEHISCENCE, SIMPLE CLOSURE
|
Facility
|
IP
|
$760.44
|
|
|
Service Code
|
CPT 12020
|
| Hospital Charge Code |
76100243
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$334.59 |
| Max. Negotiated Rate |
$684.40 |
| Rate for Payer: Aetna American Axle |
$494.29
|
| Rate for Payer: Aetna Commercial |
$646.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.29
|
| Rate for Payer: Cash Price |
$608.35
|
| Rate for Payer: Cofinity Commercial |
$532.31
|
| Rate for Payer: Cofinity Commercial |
$653.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$608.35
|
| Rate for Payer: Healthscope Commercial |
$684.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$532.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$570.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$646.37
|
| Rate for Payer: PHP Commercial |
$646.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$532.31
|
| Rate for Payer: Priority Health SBD |
$479.08
|
| Rate for Payer: UMR Bronson Commercial |
$334.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$570.33
|
|
|
HC TX SUPERFICIAL WOUND DEHISCENCE, SIMPLE CLOSURE
|
Facility
|
OP
|
$760.44
|
|
|
Service Code
|
CPT 12020
|
| Hospital Charge Code |
76100243
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$185.33 |
| Max. Negotiated Rate |
$1,757.43 |
| Rate for Payer: Aetna American Axle |
$494.29
|
| Rate for Payer: Aetna Commercial |
$646.37
|
| Rate for Payer: Aetna Medicare |
$580.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$494.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$697.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$697.82
|
| Rate for Payer: BCBS Complete |
$320.66
|
| Rate for Payer: BCBS MAPPO |
$558.26
|
| Rate for Payer: BCBS Trust/PPO |
$621.27
|
| Rate for Payer: BCN Medicare Advantage |
$558.26
|
| Rate for Payer: Cash Price |
$608.35
|
| Rate for Payer: Cash Price |
$608.35
|
| Rate for Payer: Cofinity Commercial |
$653.98
|
| Rate for Payer: Cofinity Commercial |
$532.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$608.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$558.26
|
| Rate for Payer: Healthscope Commercial |
$684.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$532.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$570.33
|
| Rate for Payer: Mclaren Medicaid |
$305.37
|
| Rate for Payer: Mclaren Medicare |
$558.26
|
| Rate for Payer: Meridian Medicaid |
$320.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$586.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$642.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$646.37
|
| Rate for Payer: PACE Medicare |
$530.35
|
| Rate for Payer: PACE SWMI |
$558.26
|
| Rate for Payer: PHP Commercial |
$646.37
|
| Rate for Payer: PHP Medicare Advantage |
$558.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$305.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$532.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,757.43
|
| Rate for Payer: Priority Health Medicare |
$558.26
|
| Rate for Payer: Priority Health Narrow Network |
$1,405.94
|
| Rate for Payer: Priority Health SBD |
$479.08
|
| Rate for Payer: Railroad Medicare Medicare |
$558.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$558.26
|
| Rate for Payer: UHC Exchange |
$185.33
|
| Rate for Payer: UHC Medicare Advantage |
$575.01
|
| Rate for Payer: UMR Bronson Commercial |
$281.36
|
| Rate for Payer: VA VA |
$558.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$570.33
|
|
|
HC TX TARSAL BONE FX, EXCEPT TALUS/CALCANEUS; W/O MANIP
|
Facility
|
OP
|
$329.46
|
|
|
Service Code
|
CPT 28450
|
| Hospital Charge Code |
76100287
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$659.87 |
| Rate for Payer: Aetna American Axle |
$214.15
|
| Rate for Payer: Aetna Commercial |
$280.04
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$262.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$262.02
|
| Rate for Payer: BCBS Complete |
$120.41
|
| Rate for Payer: BCBS MAPPO |
$209.62
|
| Rate for Payer: BCBS Trust/PPO |
$136.31
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$263.57
|
| Rate for Payer: Cash Price |
$263.57
|
| Rate for Payer: Cofinity Commercial |
$283.34
|
| Rate for Payer: Cofinity Commercial |
$230.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$296.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$230.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.10
|
| Rate for Payer: Mclaren Medicaid |
$114.66
|
| Rate for Payer: Mclaren Medicare |
$209.62
|
| Rate for Payer: Meridian Medicaid |
$120.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$220.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.04
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$280.04
|
| Rate for Payer: PHP Medicare Advantage |
$209.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$659.87
|
| Rate for Payer: Priority Health Medicare |
$209.62
|
| Rate for Payer: Priority Health Narrow Network |
$527.90
|
| Rate for Payer: Priority Health SBD |
$207.56
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Exchange |
$194.50
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$121.90
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.10
|
|
|
HC TX TARSAL BONE FX, EXCEPT TALUS/CALCANEUS; W/O MANIP
|
Facility
|
IP
|
$329.46
|
|
|
Service Code
|
CPT 28450
|
| Hospital Charge Code |
76100287
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.96 |
| Max. Negotiated Rate |
$296.51 |
| Rate for Payer: Aetna American Axle |
$214.15
|
| Rate for Payer: Aetna Commercial |
$280.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.15
|
| Rate for Payer: Cash Price |
$263.57
|
| Rate for Payer: Cofinity Commercial |
$230.62
|
| Rate for Payer: Cofinity Commercial |
$283.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.57
|
| Rate for Payer: Healthscope Commercial |
$296.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$230.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.04
|
| Rate for Payer: PHP Commercial |
$280.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$230.62
|
| Rate for Payer: Priority Health SBD |
$207.56
|
| Rate for Payer: UMR Bronson Commercial |
$144.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.10
|
|
|
HC TYMPANOMETRY
|
Facility
|
IP
|
$28.56
|
|
|
Service Code
|
CPT 92567
|
| Hospital Charge Code |
47100008
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$12.57 |
| Max. Negotiated Rate |
$25.70 |
| Rate for Payer: Aetna American Axle |
$18.56
|
| Rate for Payer: Aetna Commercial |
$24.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.56
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$19.99
|
| Rate for Payer: Cofinity Commercial |
$24.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.85
|
| Rate for Payer: Healthscope Commercial |
$25.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.28
|
| Rate for Payer: PHP Commercial |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.99
|
| Rate for Payer: Priority Health SBD |
$17.99
|
| Rate for Payer: UMR Bronson Commercial |
$12.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.42
|
|
|
HC TYMPANOMETRY
|
Facility
|
OP
|
$28.56
|
|
|
Service Code
|
CPT 92567
|
| Hospital Charge Code |
47100008
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$10.48 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$18.56
|
| Rate for Payer: Aetna Commercial |
$24.28
|
| Rate for Payer: Aetna Medicare |
$37.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.56
|
| Rate for Payer: BCBS Complete |
$20.48
|
| Rate for Payer: BCBS MAPPO |
$35.65
|
| Rate for Payer: BCBS Trust/PPO |
$46.91
|
| Rate for Payer: BCN Medicare Advantage |
$35.65
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cash Price |
$22.85
|
| Rate for Payer: Cofinity Commercial |
$19.99
|
| Rate for Payer: Cofinity Commercial |
$24.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.65
|
| Rate for Payer: Healthscope Commercial |
$25.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.42
|
| Rate for Payer: Mclaren Medicaid |
$19.50
|
| Rate for Payer: Mclaren Medicare |
$35.65
|
| Rate for Payer: Meridian Medicaid |
$20.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.28
|
| Rate for Payer: PACE Medicare |
$33.87
|
| Rate for Payer: PACE SWMI |
$35.65
|
| Rate for Payer: PHP Commercial |
$24.28
|
| Rate for Payer: PHP Medicare Advantage |
$35.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.22
|
| Rate for Payer: Priority Health Medicare |
$35.65
|
| Rate for Payer: Priority Health Narrow Network |
$89.78
|
| Rate for Payer: Priority Health SBD |
$17.99
|
| Rate for Payer: Railroad Medicare Medicare |
$35.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.53
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.65
|
| Rate for Payer: UHC Exchange |
$10.48
|
| Rate for Payer: UHC Medicare Advantage |
$36.72
|
| Rate for Payer: UMR Bronson Commercial |
$10.57
|
| Rate for Payer: VA VA |
$35.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.42
|
|
|
HC TYMPANOMETRY & REFLEX THRESH
|
Facility
|
OP
|
$146.00
|
|
|
Service Code
|
CPT 92550
|
| Hospital Charge Code |
76100503
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$21.28 |
| Max. Negotiated Rate |
$437.09 |
| Rate for Payer: Aetna American Axle |
$94.90
|
| Rate for Payer: Aetna Commercial |
$124.10
|
| Rate for Payer: Aetna Medicare |
$144.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$50.27
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$125.56
|
| Rate for Payer: Cofinity Commercial |
$102.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$131.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.50
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.10
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$124.10
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.09
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$349.67
|
| Rate for Payer: Priority Health SBD |
$91.98
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.41
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
| Rate for Payer: UHC Exchange |
$21.28
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: UMR Bronson Commercial |
$54.02
|
| Rate for Payer: VA VA |
$138.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.50
|
|
|
HC TYMPANOMETRY & REFLEX THRESH
|
Facility
|
IP
|
$146.00
|
|
|
Service Code
|
CPT 92550
|
| Hospital Charge Code |
76100503
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$64.24 |
| Max. Negotiated Rate |
$131.40 |
| Rate for Payer: Aetna American Axle |
$94.90
|
| Rate for Payer: Aetna Commercial |
$124.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.90
|
| Rate for Payer: Cash Price |
$116.80
|
| Rate for Payer: Cofinity Commercial |
$102.20
|
| Rate for Payer: Cofinity Commercial |
$125.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.80
|
| Rate for Payer: Healthscope Commercial |
$131.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.10
|
| Rate for Payer: PHP Commercial |
$124.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.20
|
| Rate for Payer: Priority Health SBD |
$91.98
|
| Rate for Payer: UMR Bronson Commercial |
$64.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.50
|
|
|
HC TYMPANOSTOMY LOCAL/TOPICAL ANES
|
Facility
|
IP
|
$1,316.00
|
|
|
Service Code
|
CPT 69433
|
| Hospital Charge Code |
76100486
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$579.04 |
| Max. Negotiated Rate |
$1,184.40 |
| Rate for Payer: Aetna American Axle |
$855.40
|
| Rate for Payer: Aetna Commercial |
$1,118.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$855.40
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cofinity Commercial |
$1,131.76
|
| Rate for Payer: Cofinity Commercial |
$921.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,052.80
|
| Rate for Payer: Healthscope Commercial |
$1,184.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$921.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$987.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,118.60
|
| Rate for Payer: PHP Commercial |
$1,118.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.20
|
| Rate for Payer: Priority Health SBD |
$829.08
|
| Rate for Payer: UMR Bronson Commercial |
$579.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$987.00
|
|
|
HC TYMPANOSTOMY LOCAL/TOPICAL ANES
|
Facility
|
OP
|
$1,316.00
|
|
|
Service Code
|
CPT 69433
|
| Hospital Charge Code |
76100486
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$131.63 |
| Max. Negotiated Rate |
$1,539.60 |
| Rate for Payer: Aetna American Axle |
$855.40
|
| Rate for Payer: Aetna Commercial |
$1,118.60
|
| Rate for Payer: Aetna Medicare |
$508.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$855.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$611.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$611.32
|
| Rate for Payer: BCBS Complete |
$280.92
|
| Rate for Payer: BCBS MAPPO |
$489.06
|
| Rate for Payer: BCBS Trust/PPO |
$313.62
|
| Rate for Payer: BCN Medicare Advantage |
$489.06
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cash Price |
$1,052.80
|
| Rate for Payer: Cofinity Commercial |
$921.20
|
| Rate for Payer: Cofinity Commercial |
$1,131.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,052.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.06
|
| Rate for Payer: Healthscope Commercial |
$1,184.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$921.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$987.00
|
| Rate for Payer: Mclaren Medicaid |
$267.52
|
| Rate for Payer: Mclaren Medicare |
$489.06
|
| Rate for Payer: Meridian Medicaid |
$280.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$513.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,118.60
|
| Rate for Payer: PACE Medicare |
$464.61
|
| Rate for Payer: PACE SWMI |
$489.06
|
| Rate for Payer: PHP Commercial |
$1,118.60
|
| Rate for Payer: PHP Medicare Advantage |
$489.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$921.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,539.60
|
| Rate for Payer: Priority Health Medicare |
$489.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,231.68
|
| Rate for Payer: Priority Health SBD |
$829.08
|
| Rate for Payer: Railroad Medicare Medicare |
$489.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$489.06
|
| Rate for Payer: UHC Exchange |
$131.63
|
| Rate for Payer: UHC Medicare Advantage |
$503.73
|
| Rate for Payer: UMR Bronson Commercial |
$486.92
|
| Rate for Payer: VA VA |
$489.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$987.00
|
|
|
HC TYPE & SCREEN ABO
|
Facility
|
IP
|
$21.83
|
|
|
Service Code
|
CPT 86900
|
| Hospital Charge Code |
30200347
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$19.65 |
| Rate for Payer: Aetna American Axle |
$14.19
|
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.19
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cofinity Commercial |
$15.28
|
| Rate for Payer: Cofinity Commercial |
$18.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Healthscope Commercial |
$19.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.56
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.28
|
| Rate for Payer: Priority Health SBD |
$13.75
|
| Rate for Payer: UMR Bronson Commercial |
$9.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.37
|
|
|
HC TYPE & SCREEN ABO
|
Facility
|
OP
|
$21.83
|
|
|
Service Code
|
CPT 86900
|
| Hospital Charge Code |
30200347
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$357.43 |
| Rate for Payer: Aetna American Axle |
$14.19
|
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$2.69
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cofinity Commercial |
$15.28
|
| Rate for Payer: Cofinity Commercial |
$18.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$19.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.37
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.56
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.43
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$285.94
|
| Rate for Payer: Priority Health SBD |
$13.75
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.59
|
| Rate for Payer: UHC Core |
$4.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$2.99
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$8.08
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.37
|
|
|
HC TYPE & SCREEN ANTIBODY
|
Facility
|
IP
|
$37.11
|
|
|
Service Code
|
CPT 86850
|
| Hospital Charge Code |
30200340
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.33 |
| Max. Negotiated Rate |
$33.40 |
| Rate for Payer: Aetna American Axle |
$24.12
|
| Rate for Payer: Aetna Commercial |
$31.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.12
|
| Rate for Payer: Cash Price |
$29.69
|
| Rate for Payer: Cofinity Commercial |
$25.98
|
| Rate for Payer: Cofinity Commercial |
$31.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.69
|
| Rate for Payer: Healthscope Commercial |
$33.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.54
|
| Rate for Payer: PHP Commercial |
$31.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.98
|
| Rate for Payer: Priority Health SBD |
$23.38
|
| Rate for Payer: UMR Bronson Commercial |
$16.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.83
|
|
|
HC TYPE & SCREEN ANTIBODY
|
Facility
|
OP
|
$37.11
|
|
|
Service Code
|
CPT 86850
|
| Hospital Charge Code |
30200340
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$151.62 |
| Rate for Payer: Aetna American Axle |
$24.12
|
| Rate for Payer: Aetna Commercial |
$31.54
|
| Rate for Payer: Aetna Medicare |
$50.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.21
|
| Rate for Payer: BCBS Complete |
$27.67
|
| Rate for Payer: BCBS MAPPO |
$48.17
|
| Rate for Payer: BCBS Trust/PPO |
$8.79
|
| Rate for Payer: BCN Medicare Advantage |
$48.17
|
| Rate for Payer: Cash Price |
$29.69
|
| Rate for Payer: Cash Price |
$29.69
|
| Rate for Payer: Cofinity Commercial |
$25.98
|
| Rate for Payer: Cofinity Commercial |
$31.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.17
|
| Rate for Payer: Healthscope Commercial |
$33.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.83
|
| Rate for Payer: Mclaren Medicaid |
$26.35
|
| Rate for Payer: Mclaren Medicare |
$48.17
|
| Rate for Payer: Meridian Medicaid |
$27.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.54
|
| Rate for Payer: PACE Medicare |
$45.76
|
| Rate for Payer: PACE SWMI |
$48.17
|
| Rate for Payer: PHP Commercial |
$31.54
|
| Rate for Payer: PHP Medicare Advantage |
$48.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.62
|
| Rate for Payer: Priority Health Medicare |
$48.17
|
| Rate for Payer: Priority Health Narrow Network |
$121.30
|
| Rate for Payer: Priority Health SBD |
$23.38
|
| Rate for Payer: Railroad Medicare Medicare |
$48.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.72
|
| Rate for Payer: UHC Core |
$21.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.17
|
| Rate for Payer: UHC Exchange |
$9.77
|
| Rate for Payer: UHC Medicare Advantage |
$49.62
|
| Rate for Payer: UMR Bronson Commercial |
$13.73
|
| Rate for Payer: VA VA |
$48.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.83
|
|
|
HC TYRX ANTIBACTERIAL POUCH
|
Facility
|
IP
|
$2,750.00
|
|
| Hospital Charge Code |
27800115
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,210.00 |
| Max. Negotiated Rate |
$2,475.00 |
| Rate for Payer: Aetna American Axle |
$1,787.50
|
| Rate for Payer: Aetna Commercial |
$2,337.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,787.50
|
| Rate for Payer: Cash Price |
$2,200.00
|
| Rate for Payer: Cofinity Commercial |
$1,925.00
|
| Rate for Payer: Cofinity Commercial |
$2,365.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,200.00
|
| Rate for Payer: Healthscope Commercial |
$2,475.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,925.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,062.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,337.50
|
| Rate for Payer: PHP Commercial |
$2,337.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,925.00
|
| Rate for Payer: Priority Health SBD |
$1,732.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,210.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,062.50
|
|
|
HC TYRX ANTIBACTERIAL POUCH
|
Facility
|
OP
|
$2,750.00
|
|
| Hospital Charge Code |
27800115
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,017.50 |
| Max. Negotiated Rate |
$2,475.00 |
| Rate for Payer: Aetna American Axle |
$1,787.50
|
| Rate for Payer: Aetna Commercial |
$2,337.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,787.50
|
| Rate for Payer: BCBS Complete |
$1,100.00
|
| Rate for Payer: Cash Price |
$2,200.00
|
| Rate for Payer: Cofinity Commercial |
$1,925.00
|
| Rate for Payer: Cofinity Commercial |
$2,365.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,200.00
|
| Rate for Payer: Healthscope Commercial |
$2,475.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,925.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,062.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,337.50
|
| Rate for Payer: PHP Commercial |
$2,337.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,925.00
|
| Rate for Payer: Priority Health SBD |
$1,732.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,017.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,062.50
|
|
|
HC UA - KETONE
|
Facility
|
OP
|
$12.24
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
30700009
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.90 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna American Axle |
$7.96
|
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: Aetna Medicare |
$3.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.35
|
| Rate for Payer: BCBS Complete |
$2.00
|
| Rate for Payer: BCBS MAPPO |
$3.48
|
| Rate for Payer: BCBS Trust/PPO |
$3.13
|
| Rate for Payer: BCN Medicare Advantage |
$3.48
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Commercial |
$8.57
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.48
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: Mclaren Medicaid |
$1.90
|
| Rate for Payer: Mclaren Medicare |
$3.48
|
| Rate for Payer: Meridian Medicaid |
$2.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.40
|
| Rate for Payer: PACE Medicare |
$3.31
|
| Rate for Payer: PACE SWMI |
$3.48
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: PHP Medicare Advantage |
$3.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.50
|
| Rate for Payer: Priority Health Medicare |
$3.48
|
| Rate for Payer: Priority Health Narrow Network |
$2.80
|
| Rate for Payer: Priority Health SBD |
$7.71
|
| Rate for Payer: Railroad Medicare Medicare |
$3.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.18
|
| Rate for Payer: UHC Core |
$4.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.48
|
| Rate for Payer: UHC Exchange |
$3.48
|
| Rate for Payer: UHC Medicare Advantage |
$3.58
|
| Rate for Payer: UMR Bronson Commercial |
$4.53
|
| Rate for Payer: VA VA |
$3.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
HC UA - KETONE
|
Facility
|
IP
|
$12.24
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
30700009
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$11.02 |
| Rate for Payer: Aetna American Axle |
$7.96
|
| Rate for Payer: Aetna Commercial |
$10.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.96
|
| Rate for Payer: Cash Price |
$9.79
|
| Rate for Payer: Cofinity Commercial |
$10.53
|
| Rate for Payer: Cofinity Commercial |
$8.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.79
|
| Rate for Payer: Healthscope Commercial |
$11.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.40
|
| Rate for Payer: PHP Commercial |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.57
|
| Rate for Payer: Priority Health SBD |
$7.71
|
| Rate for Payer: UMR Bronson Commercial |
$5.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.18
|
|
|
HC ULTRASOUND EACH 15 MIN
|
Facility
|
OP
|
$82.62
|
|
|
Service Code
|
CPT 97035
|
| Hospital Charge Code |
42000018
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$53.70
|
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.70
|
| Rate for Payer: BCBS Complete |
$33.05
|
| Rate for Payer: BCBS Trust/PPO |
$10.09
|
| Rate for Payer: Cash Price |
$66.10
|
| Rate for Payer: Cash Price |
$66.10
|
| Rate for Payer: Cash Price |
$66.10
|
| Rate for Payer: Cofinity Commercial |
$71.05
|
| Rate for Payer: Cofinity Commercial |
$57.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.10
|
| Rate for Payer: Healthscope Commercial |
$74.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.23
|
| Rate for Payer: PHP Commercial |
$70.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.00
|
| Rate for Payer: Priority Health Narrow Network |
$9.60
|
| Rate for Payer: Priority Health SBD |
$52.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.12
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$13.75
|
| Rate for Payer: UMR Bronson Commercial |
$30.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.96
|
|
