|
HC ULTRASOUND EACH 15 MIN
|
Facility
|
IP
|
$82.62
|
|
|
Service Code
|
CPT 97035
|
| Hospital Charge Code |
42000018
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$36.35 |
| Max. Negotiated Rate |
$74.36 |
| 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: Cash Price |
$66.10
|
| Rate for Payer: Cofinity Commercial |
$57.83
|
| Rate for Payer: Cofinity Commercial |
$71.05
|
| 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 SBD |
$52.05
|
| Rate for Payer: UMR Bronson Commercial |
$36.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.96
|
|
|
HC ULTRASOUND RF UTERINE FIBROID ABLATION TRANSCERVICAL
|
Facility
|
OP
|
$9,446.22
|
|
|
Service Code
|
CPT 58580
|
| Hospital Charge Code |
36100485
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$391.62 |
| Max. Negotiated Rate |
$21,144.90 |
| Rate for Payer: Aetna American Axle |
$6,140.04
|
| Rate for Payer: Aetna Commercial |
$8,029.29
|
| Rate for Payer: Aetna Medicare |
$6,985.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,140.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,396.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,396.05
|
| Rate for Payer: BCBS Complete |
$3,858.15
|
| Rate for Payer: BCBS MAPPO |
$6,716.84
|
| Rate for Payer: BCN Medicare Advantage |
$6,716.84
|
| Rate for Payer: Cash Price |
$7,556.98
|
| Rate for Payer: Cash Price |
$7,556.98
|
| Rate for Payer: Cofinity Commercial |
$8,123.75
|
| Rate for Payer: Cofinity Commercial |
$6,612.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,556.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,716.84
|
| Rate for Payer: Healthscope Commercial |
$8,501.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,612.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,084.66
|
| Rate for Payer: Mclaren Medicaid |
$3,674.11
|
| Rate for Payer: Mclaren Medicare |
$6,716.84
|
| Rate for Payer: Meridian Medicaid |
$3,858.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,052.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,724.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,029.29
|
| Rate for Payer: PACE Medicare |
$6,381.00
|
| Rate for Payer: PACE SWMI |
$6,716.84
|
| Rate for Payer: PHP Commercial |
$8,029.29
|
| Rate for Payer: PHP Medicare Advantage |
$6,716.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,674.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,612.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,144.90
|
| Rate for Payer: Priority Health Medicare |
$6,716.84
|
| Rate for Payer: Priority Health Narrow Network |
$16,915.92
|
| Rate for Payer: Priority Health SBD |
$5,951.12
|
| Rate for Payer: Railroad Medicare Medicare |
$6,716.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$430.78
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,716.84
|
| Rate for Payer: UHC Exchange |
$391.62
|
| Rate for Payer: UHC Medicare Advantage |
$6,918.35
|
| Rate for Payer: UMR Bronson Commercial |
$3,495.10
|
| Rate for Payer: VA VA |
$6,716.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,084.66
|
|
|
HC ULTRASOUND RF UTERINE FIBROID ABLATION TRANSCERVICAL
|
Facility
|
IP
|
$9,446.22
|
|
|
Service Code
|
CPT 58580
|
| Hospital Charge Code |
36100485
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,156.34 |
| Max. Negotiated Rate |
$8,501.60 |
| Rate for Payer: Aetna American Axle |
$6,140.04
|
| Rate for Payer: Aetna Commercial |
$8,029.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,140.04
|
| Rate for Payer: Cash Price |
$7,556.98
|
| Rate for Payer: Cofinity Commercial |
$6,612.35
|
| Rate for Payer: Cofinity Commercial |
$8,123.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,556.98
|
| Rate for Payer: Healthscope Commercial |
$8,501.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,612.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,084.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,029.29
|
| Rate for Payer: PHP Commercial |
$8,029.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,612.35
|
| Rate for Payer: Priority Health SBD |
$5,951.12
|
| Rate for Payer: UMR Bronson Commercial |
$4,156.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,084.66
|
|
|
HC ULTRATAG RBC PER STUDY
|
Facility
|
OP
|
$210.24
|
|
|
Service Code
|
HCPCS A9560
|
| Hospital Charge Code |
34300023
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$77.79 |
| Max. Negotiated Rate |
$189.22 |
| Rate for Payer: Aetna American Axle |
$136.66
|
| Rate for Payer: Aetna Commercial |
$178.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.66
|
| Rate for Payer: BCBS Complete |
$84.10
|
| Rate for Payer: BCBS Trust/PPO |
$134.40
|
| Rate for Payer: Cash Price |
$168.19
|
| Rate for Payer: Cash Price |
$168.19
|
| Rate for Payer: Cofinity Commercial |
$147.17
|
| Rate for Payer: Cofinity Commercial |
$180.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.19
|
| Rate for Payer: Healthscope Commercial |
$189.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$147.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$178.70
|
| Rate for Payer: PHP Commercial |
$178.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.17
|
| Rate for Payer: Priority Health SBD |
$132.45
|
| Rate for Payer: UMR Bronson Commercial |
$77.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.68
|
|
|
HC ULTRATAG RBC PER STUDY
|
Facility
|
IP
|
$210.24
|
|
|
Service Code
|
HCPCS A9560
|
| Hospital Charge Code |
34300023
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$92.51 |
| Max. Negotiated Rate |
$189.22 |
| Rate for Payer: Aetna American Axle |
$136.66
|
| Rate for Payer: Aetna Commercial |
$178.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.66
|
| Rate for Payer: Cash Price |
$168.19
|
| Rate for Payer: Cofinity Commercial |
$147.17
|
| Rate for Payer: Cofinity Commercial |
$180.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.19
|
| Rate for Payer: Healthscope Commercial |
$189.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$147.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$178.70
|
| Rate for Payer: PHP Commercial |
$178.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.17
|
| Rate for Payer: Priority Health SBD |
$132.45
|
| Rate for Payer: UMR Bronson Commercial |
$92.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.68
|
|
|
HC UMBILICAL ARTERY CATHETER
|
Facility
|
OP
|
$209.45
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
36100602
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$65.82 |
| Max. Negotiated Rate |
$1,879.00 |
| Rate for Payer: Aetna American Axle |
$136.14
|
| Rate for Payer: Aetna Commercial |
$178.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.14
|
| Rate for Payer: BCBS Complete |
$83.78
|
| Rate for Payer: BCBS Trust/PPO |
$256.60
|
| Rate for Payer: Cash Price |
$167.56
|
| Rate for Payer: Cash Price |
$167.56
|
| Rate for Payer: Cofinity Commercial |
$180.13
|
| Rate for Payer: Cofinity Commercial |
$146.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.56
|
| Rate for Payer: Healthscope Commercial |
$188.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$146.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$178.03
|
| Rate for Payer: PHP Commercial |
$178.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.62
|
| Rate for Payer: Priority Health SBD |
$131.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.40
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UHC Exchange |
$65.82
|
| Rate for Payer: UMR Bronson Commercial |
$77.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.09
|
|
|
HC UMBILICAL ARTERY CATHETER
|
Facility
|
IP
|
$209.45
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
36100602
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$92.16 |
| Max. Negotiated Rate |
$188.50 |
| Rate for Payer: Aetna American Axle |
$136.14
|
| Rate for Payer: Aetna Commercial |
$178.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.14
|
| Rate for Payer: Cash Price |
$167.56
|
| Rate for Payer: Cofinity Commercial |
$146.62
|
| Rate for Payer: Cofinity Commercial |
$180.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.56
|
| Rate for Payer: Healthscope Commercial |
$188.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$146.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$178.03
|
| Rate for Payer: PHP Commercial |
$178.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.62
|
| Rate for Payer: Priority Health SBD |
$131.95
|
| Rate for Payer: UMR Bronson Commercial |
$92.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.09
|
|
|
HC UMBILICAL VEIN CATHETER
|
Facility
|
OP
|
$209.45
|
|
|
Service Code
|
CPT 36510
|
| Hospital Charge Code |
36100584
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$51.41 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$136.14
|
| Rate for Payer: Aetna Commercial |
$178.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.14
|
| Rate for Payer: BCBS Complete |
$83.78
|
| Rate for Payer: BCBS Trust/PPO |
$297.56
|
| Rate for Payer: Cash Price |
$167.56
|
| Rate for Payer: Cash Price |
$167.56
|
| Rate for Payer: Cofinity Commercial |
$180.13
|
| Rate for Payer: Cofinity Commercial |
$146.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.56
|
| Rate for Payer: Healthscope Commercial |
$188.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$146.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$178.03
|
| Rate for Payer: PHP Commercial |
$178.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.62
|
| Rate for Payer: Priority Health SBD |
$131.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.55
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$51.41
|
| Rate for Payer: UMR Bronson Commercial |
$77.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.09
|
|
|
HC UMBILICAL VEIN CATHETER
|
Facility
|
IP
|
$209.45
|
|
|
Service Code
|
CPT 36510
|
| Hospital Charge Code |
36100584
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$92.16 |
| Max. Negotiated Rate |
$188.50 |
| Rate for Payer: Aetna American Axle |
$136.14
|
| Rate for Payer: Aetna Commercial |
$178.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.14
|
| Rate for Payer: Cash Price |
$167.56
|
| Rate for Payer: Cofinity Commercial |
$180.13
|
| Rate for Payer: Cofinity Commercial |
$146.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.56
|
| Rate for Payer: Healthscope Commercial |
$188.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$146.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$178.03
|
| Rate for Payer: PHP Commercial |
$178.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.62
|
| Rate for Payer: Priority Health SBD |
$131.95
|
| Rate for Payer: UMR Bronson Commercial |
$92.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.09
|
|
|
HC UNILATERAL SCREENING MAMM WITH CAD
|
Facility
|
OP
|
$323.87
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300007
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$80.39 |
| Max. Negotiated Rate |
$332.00 |
| Rate for Payer: Aetna American Axle |
$210.52
|
| Rate for Payer: Aetna Commercial |
$275.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.52
|
| Rate for Payer: BCBS Complete |
$129.55
|
| Rate for Payer: BCBS Trust/PPO |
$175.48
|
| Rate for Payer: BCCCP Commercial |
$130.78
|
| Rate for Payer: Cash Price |
$259.10
|
| Rate for Payer: Cash Price |
$259.10
|
| Rate for Payer: Cash Price |
$259.10
|
| Rate for Payer: Cofinity Commercial |
$226.71
|
| Rate for Payer: Cofinity Commercial |
$278.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.10
|
| Rate for Payer: Healthscope Commercial |
$291.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$226.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$242.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$275.29
|
| Rate for Payer: PHP Commercial |
$275.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.49
|
| Rate for Payer: Priority Health Narrow Network |
$80.39
|
| Rate for Payer: Priority Health SBD |
$204.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.31
|
| Rate for Payer: UHC Core |
$332.00
|
| Rate for Payer: UHC Exchange |
$125.74
|
| Rate for Payer: UMR Bronson Commercial |
$119.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$242.90
|
|
|
HC UNILATERAL SCREENING MAMM WITH CAD
|
Facility
|
IP
|
$323.87
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300007
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$142.50 |
| Max. Negotiated Rate |
$291.48 |
| Rate for Payer: Aetna American Axle |
$210.52
|
| Rate for Payer: Aetna Commercial |
$275.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.52
|
| Rate for Payer: Cash Price |
$259.10
|
| Rate for Payer: Cofinity Commercial |
$226.71
|
| Rate for Payer: Cofinity Commercial |
$278.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$259.10
|
| Rate for Payer: Healthscope Commercial |
$291.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$226.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$242.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$275.29
|
| Rate for Payer: PHP Commercial |
$275.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.71
|
| Rate for Payer: Priority Health SBD |
$204.04
|
| Rate for Payer: UMR Bronson Commercial |
$142.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$242.90
|
|
|
HC UNILATERAL TOMOSYNTHESIS
|
Facility
|
IP
|
$101.19
|
|
|
Service Code
|
CPT 77061
|
| Hospital Charge Code |
32000299
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.52 |
| Max. Negotiated Rate |
$91.07 |
| Rate for Payer: Aetna American Axle |
$65.77
|
| Rate for Payer: Aetna Commercial |
$86.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.77
|
| Rate for Payer: Cash Price |
$80.95
|
| Rate for Payer: Cofinity Commercial |
$70.83
|
| Rate for Payer: Cofinity Commercial |
$87.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.95
|
| Rate for Payer: Healthscope Commercial |
$91.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.01
|
| Rate for Payer: PHP Commercial |
$86.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.83
|
| Rate for Payer: Priority Health SBD |
$63.75
|
| Rate for Payer: UMR Bronson Commercial |
$44.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.89
|
|
|
HC UNILATERAL TOMOSYNTHESIS
|
Facility
|
OP
|
$101.19
|
|
|
Service Code
|
CPT 77061
|
| Hospital Charge Code |
32000299
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.44 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$65.77
|
| Rate for Payer: Aetna Commercial |
$86.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.77
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCBS Trust/PPO |
$49.71
|
| Rate for Payer: Cash Price |
$80.95
|
| Rate for Payer: Cash Price |
$80.95
|
| Rate for Payer: Cofinity Commercial |
$70.83
|
| Rate for Payer: Cofinity Commercial |
$87.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.95
|
| Rate for Payer: Healthscope Commercial |
$91.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.01
|
| Rate for Payer: PHP Commercial |
$86.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.11
|
| Rate for Payer: Priority Health Narrow Network |
$76.09
|
| Rate for Payer: Priority Health SBD |
$63.75
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UMR Bronson Commercial |
$37.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.89
|
|
|
HC UNILAT PERC IMPLANT NEUROSTIM ELTRD, SACRAL NERVE W/IMAG
|
Facility
|
OP
|
$9,466.31
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100247
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$296.66 |
| Max. Negotiated Rate |
$19,137.49 |
| Rate for Payer: Aetna American Axle |
$6,153.10
|
| Rate for Payer: Aetna Commercial |
$8,046.36
|
| Rate for Payer: Aetna Medicare |
$6,322.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,153.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,598.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,598.96
|
| Rate for Payer: BCBS Complete |
$3,491.88
|
| Rate for Payer: BCBS MAPPO |
$6,079.17
|
| Rate for Payer: BCBS Trust/PPO |
$7,707.23
|
| Rate for Payer: BCN Medicare Advantage |
$6,079.17
|
| Rate for Payer: Cash Price |
$7,573.05
|
| Rate for Payer: Cash Price |
$7,573.05
|
| Rate for Payer: Cofinity Commercial |
$8,141.03
|
| Rate for Payer: Cofinity Commercial |
$6,626.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,573.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,079.17
|
| Rate for Payer: Healthscope Commercial |
$8,519.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,626.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,099.73
|
| Rate for Payer: Mclaren Medicaid |
$3,325.31
|
| Rate for Payer: Mclaren Medicare |
$6,079.17
|
| Rate for Payer: Meridian Medicaid |
$3,491.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,383.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,991.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,046.36
|
| Rate for Payer: PACE Medicare |
$5,775.21
|
| Rate for Payer: PACE SWMI |
$6,079.17
|
| Rate for Payer: PHP Commercial |
$8,046.36
|
| Rate for Payer: PHP Medicare Advantage |
$6,079.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,325.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,626.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,137.49
|
| Rate for Payer: Priority Health Medicare |
$6,079.17
|
| Rate for Payer: Priority Health Narrow Network |
$15,309.99
|
| Rate for Payer: Priority Health SBD |
$5,963.78
|
| Rate for Payer: Railroad Medicare Medicare |
$6,079.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,079.17
|
| Rate for Payer: UHC Exchange |
$296.66
|
| Rate for Payer: UHC Medicare Advantage |
$6,261.55
|
| Rate for Payer: UMR Bronson Commercial |
$3,502.53
|
| Rate for Payer: VA VA |
$6,079.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,099.73
|
|
|
HC UNILAT PERC IMPLANT NEUROSTIM ELTRD, SACRAL NERVE W/IMAG
|
Facility
|
IP
|
$9,466.31
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100247
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,165.18 |
| Max. Negotiated Rate |
$8,519.68 |
| Rate for Payer: Aetna American Axle |
$6,153.10
|
| Rate for Payer: Aetna Commercial |
$8,046.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,153.10
|
| Rate for Payer: Cash Price |
$7,573.05
|
| Rate for Payer: Cofinity Commercial |
$6,626.42
|
| Rate for Payer: Cofinity Commercial |
$8,141.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,573.05
|
| Rate for Payer: Healthscope Commercial |
$8,519.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,626.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,099.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,046.36
|
| Rate for Payer: PHP Commercial |
$8,046.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,626.42
|
| Rate for Payer: Priority Health SBD |
$5,963.78
|
| Rate for Payer: UMR Bronson Commercial |
$4,165.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,099.73
|
|
|
HC UNLISTED FEMALE GENITAL SYSTEM
|
Facility
|
IP
|
$1,103.27
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
36100387
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$485.44 |
| Max. Negotiated Rate |
$992.94 |
| Rate for Payer: Aetna American Axle |
$717.13
|
| Rate for Payer: Aetna Commercial |
$937.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$717.13
|
| Rate for Payer: Cash Price |
$882.62
|
| Rate for Payer: Cofinity Commercial |
$772.29
|
| Rate for Payer: Cofinity Commercial |
$948.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$882.62
|
| Rate for Payer: Healthscope Commercial |
$992.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$772.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$827.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$937.78
|
| Rate for Payer: PHP Commercial |
$937.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.29
|
| Rate for Payer: Priority Health SBD |
$695.06
|
| Rate for Payer: UMR Bronson Commercial |
$485.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$827.45
|
|
|
HC UNLISTED FEMALE GENITAL SYSTEM
|
Facility
|
OP
|
$1,103.27
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
36100387
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$96.88 |
| Max. Negotiated Rate |
$992.94 |
| Rate for Payer: Aetna American Axle |
$717.13
|
| Rate for Payer: Aetna Commercial |
$937.78
|
| Rate for Payer: Aetna Medicare |
$184.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$717.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.40
|
| Rate for Payer: BCBS Complete |
$101.74
|
| Rate for Payer: BCBS MAPPO |
$177.12
|
| Rate for Payer: BCBS Trust/PPO |
$135.54
|
| Rate for Payer: BCN Medicare Advantage |
$177.12
|
| Rate for Payer: Cash Price |
$882.62
|
| Rate for Payer: Cash Price |
$882.62
|
| Rate for Payer: Cofinity Commercial |
$772.29
|
| Rate for Payer: Cofinity Commercial |
$948.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$882.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.12
|
| Rate for Payer: Healthscope Commercial |
$992.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$772.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$827.45
|
| Rate for Payer: Mclaren Medicaid |
$96.88
|
| Rate for Payer: Mclaren Medicare |
$177.12
|
| Rate for Payer: Meridian Medicaid |
$101.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$185.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$937.78
|
| Rate for Payer: PACE Medicare |
$168.26
|
| Rate for Payer: PACE SWMI |
$177.12
|
| Rate for Payer: PHP Commercial |
$937.78
|
| Rate for Payer: PHP Medicare Advantage |
$177.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$772.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$557.61
|
| Rate for Payer: Priority Health Medicare |
$177.12
|
| Rate for Payer: Priority Health Narrow Network |
$446.09
|
| Rate for Payer: Priority Health SBD |
$695.06
|
| Rate for Payer: Railroad Medicare Medicare |
$177.12
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.12
|
| Rate for Payer: UHC Medicare Advantage |
$182.43
|
| Rate for Payer: UMR Bronson Commercial |
$408.21
|
| Rate for Payer: VA VA |
$177.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$827.45
|
|
|
HC UNLISTED PROCEDURE NERVOUS SYSTEM 64999
|
Facility
|
IP
|
$712.41
|
|
|
Service Code
|
CPT 64999
|
| Hospital Charge Code |
36100437
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$313.46 |
| Max. Negotiated Rate |
$641.17 |
| Rate for Payer: Aetna American Axle |
$463.07
|
| Rate for Payer: Aetna Commercial |
$605.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$463.07
|
| Rate for Payer: Cash Price |
$569.93
|
| Rate for Payer: Cofinity Commercial |
$498.69
|
| Rate for Payer: Cofinity Commercial |
$612.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$569.93
|
| Rate for Payer: Healthscope Commercial |
$641.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$498.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$534.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$605.55
|
| Rate for Payer: PHP Commercial |
$605.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$498.69
|
| Rate for Payer: Priority Health SBD |
$448.82
|
| Rate for Payer: UMR Bronson Commercial |
$313.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$534.31
|
|
|
HC UNLISTED PROCEDURE NERVOUS SYSTEM 64999
|
Facility
|
OP
|
$712.41
|
|
|
Service Code
|
CPT 64999
|
| Hospital Charge Code |
36100437
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$144.01 |
| Max. Negotiated Rate |
$828.79 |
| Rate for Payer: Aetna American Axle |
$463.07
|
| Rate for Payer: Aetna Commercial |
$605.55
|
| Rate for Payer: Aetna Medicare |
$273.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$463.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$205.70
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$569.93
|
| Rate for Payer: Cash Price |
$569.93
|
| Rate for Payer: Cofinity Commercial |
$498.69
|
| Rate for Payer: Cofinity Commercial |
$612.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$569.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$641.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$498.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$534.31
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$605.55
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$605.55
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$498.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$828.79
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$663.03
|
| Rate for Payer: Priority Health SBD |
$448.82
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.27
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: UMR Bronson Commercial |
$263.59
|
| Rate for Payer: VA VA |
$263.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$534.31
|
|
|
HC UNLISTED PROCEDURE NOSE
|
Facility
|
OP
|
$650.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
76100453
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.76 |
| Max. Negotiated Rate |
$683.51 |
| Rate for Payer: Aetna American Axle |
$422.50
|
| Rate for Payer: Aetna Commercial |
$552.50
|
| Rate for Payer: Aetna Medicare |
$225.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.40
|
| Rate for Payer: BCBS Complete |
$124.71
|
| Rate for Payer: BCBS MAPPO |
$217.12
|
| Rate for Payer: BCBS Trust/PPO |
$157.70
|
| Rate for Payer: BCN Medicare Advantage |
$217.12
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$455.00
|
| Rate for Payer: Cofinity Commercial |
$559.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.12
|
| Rate for Payer: Healthscope Commercial |
$585.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$455.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.50
|
| Rate for Payer: Mclaren Medicaid |
$118.76
|
| Rate for Payer: Mclaren Medicare |
$217.12
|
| Rate for Payer: Meridian Medicaid |
$124.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$227.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.50
|
| Rate for Payer: PACE Medicare |
$206.26
|
| Rate for Payer: PACE SWMI |
$217.12
|
| Rate for Payer: PHP Commercial |
$552.50
|
| Rate for Payer: PHP Medicare Advantage |
$217.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$683.51
|
| Rate for Payer: Priority Health Medicare |
$217.12
|
| Rate for Payer: Priority Health Narrow Network |
$546.81
|
| Rate for Payer: Priority Health SBD |
$409.50
|
| Rate for Payer: Railroad Medicare Medicare |
$217.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.12
|
| Rate for Payer: UHC Medicare Advantage |
$223.63
|
| Rate for Payer: UMR Bronson Commercial |
$240.50
|
| Rate for Payer: VA VA |
$217.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.50
|
|
|
HC UNLISTED PROCEDURE NOSE
|
Facility
|
IP
|
$650.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
76100453
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$286.00 |
| Max. Negotiated Rate |
$585.00 |
| Rate for Payer: Aetna American Axle |
$422.50
|
| Rate for Payer: Aetna Commercial |
$552.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.50
|
| Rate for Payer: Cash Price |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$455.00
|
| Rate for Payer: Cofinity Commercial |
$559.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.00
|
| Rate for Payer: Healthscope Commercial |
$585.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$455.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$552.50
|
| Rate for Payer: PHP Commercial |
$552.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.00
|
| Rate for Payer: Priority Health SBD |
$409.50
|
| Rate for Payer: UMR Bronson Commercial |
$286.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.50
|
|
|
HC UNLISTED PROCEDURE SPINE
|
Facility
|
IP
|
$2,847.42
|
|
|
Service Code
|
CPT 22899
|
| Hospital Charge Code |
36100036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,252.86 |
| Max. Negotiated Rate |
$2,562.68 |
| Rate for Payer: Aetna American Axle |
$1,850.82
|
| Rate for Payer: Aetna Commercial |
$2,420.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,850.82
|
| Rate for Payer: Cash Price |
$2,277.94
|
| Rate for Payer: Cofinity Commercial |
$1,993.19
|
| Rate for Payer: Cofinity Commercial |
$2,448.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,277.94
|
| Rate for Payer: Healthscope Commercial |
$2,562.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,993.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,135.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,420.31
|
| Rate for Payer: PHP Commercial |
$2,420.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,993.19
|
| Rate for Payer: Priority Health SBD |
$1,793.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,252.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,135.56
|
|
|
HC UNLISTED PROCEDURE SPINE
|
Facility
|
OP
|
$2,847.42
|
|
|
Service Code
|
CPT 22899
|
| Hospital Charge Code |
36100036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$2,562.68 |
| Rate for Payer: Aetna American Axle |
$1,850.82
|
| Rate for Payer: Aetna Commercial |
$2,420.31
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,850.82
|
| 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 |
$177.95
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$2,277.94
|
| Rate for Payer: Cash Price |
$2,277.94
|
| Rate for Payer: Cofinity Commercial |
$2,448.78
|
| Rate for Payer: Cofinity Commercial |
$1,993.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,277.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$2,562.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,993.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,135.56
|
| 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 |
$2,420.31
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$2,420.31
|
| 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 |
$1,993.19
|
| 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 |
$1,793.87
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,053.55
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,135.56
|
|
|
HC UNLISTED PROC HAND OR FINGER
|
Facility
|
OP
|
$448.01
|
|
|
Service Code
|
CPT 26989
|
| Hospital Charge Code |
36100518
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$114.66 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$291.21
|
| Rate for Payer: Aetna Commercial |
$380.81
|
| Rate for Payer: Aetna Medicare |
$218.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.21
|
| 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 |
$177.95
|
| Rate for Payer: BCN Medicare Advantage |
$209.62
|
| Rate for Payer: Cash Price |
$358.41
|
| Rate for Payer: Cash Price |
$358.41
|
| Rate for Payer: Cofinity Commercial |
$385.29
|
| Rate for Payer: Cofinity Commercial |
$313.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.62
|
| Rate for Payer: Healthscope Commercial |
$403.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$313.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$336.01
|
| 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 |
$380.81
|
| Rate for Payer: PACE Medicare |
$199.14
|
| Rate for Payer: PACE SWMI |
$209.62
|
| Rate for Payer: PHP Commercial |
$380.81
|
| 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 |
$313.61
|
| 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 |
$282.25
|
| Rate for Payer: Railroad Medicare Medicare |
$209.62
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.62
|
| Rate for Payer: UHC Medicare Advantage |
$215.91
|
| Rate for Payer: UMR Bronson Commercial |
$165.76
|
| Rate for Payer: VA VA |
$209.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$336.01
|
|
|
HC UNLISTED PROC HAND OR FINGER
|
Facility
|
IP
|
$448.01
|
|
|
Service Code
|
CPT 26989
|
| Hospital Charge Code |
36100518
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$197.12 |
| Max. Negotiated Rate |
$403.21 |
| Rate for Payer: Aetna American Axle |
$291.21
|
| Rate for Payer: Aetna Commercial |
$380.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$291.21
|
| Rate for Payer: Cash Price |
$358.41
|
| Rate for Payer: Cofinity Commercial |
$313.61
|
| Rate for Payer: Cofinity Commercial |
$385.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.41
|
| Rate for Payer: Healthscope Commercial |
$403.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$313.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$336.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$380.81
|
| Rate for Payer: PHP Commercial |
$380.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.61
|
| Rate for Payer: Priority Health SBD |
$282.25
|
| Rate for Payer: UMR Bronson Commercial |
$197.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$336.01
|
|
