|
HC US OB DETAILED
|
Facility
|
IP
|
$571.84
|
|
|
Service Code
|
CPT 76811
|
| Hospital Charge Code |
40200019
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$251.61 |
| Max. Negotiated Rate |
$514.66 |
| Rate for Payer: Aetna American Axle |
$371.70
|
| Rate for Payer: Aetna Commercial |
$486.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$371.70
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$400.29
|
| Rate for Payer: Cofinity Commercial |
$491.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Healthscope Commercial |
$514.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$400.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$428.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PHP Commercial |
$486.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health SBD |
$360.26
|
| Rate for Payer: UMR Bronson Commercial |
$251.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$428.88
|
|
|
HC US OB DETAILED EACH ADDTL FETUS
|
Facility
|
IP
|
$381.09
|
|
|
Service Code
|
CPT 76812
|
| Hospital Charge Code |
40200020
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$167.68 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna American Axle |
$247.71
|
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.71
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$266.76
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$266.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health SBD |
$240.09
|
| Rate for Payer: UMR Bronson Commercial |
$167.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC US OB DETAILED EACH ADDTL FETUS
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 76812
|
| Hospital Charge Code |
40200020
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$141.00 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$247.71
|
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.71
|
| Rate for Payer: BCBS Complete |
$152.44
|
| Rate for Payer: BCBS Trust/PPO |
$205.25
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Cofinity Commercial |
$266.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$266.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health SBD |
$240.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.11
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Exchange |
$188.28
|
| Rate for Payer: UMR Bronson Commercial |
$141.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC US OB FETAL CARDIOVASCULAR FU
|
Facility
|
IP
|
$678.34
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
40200055
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$298.47 |
| Max. Negotiated Rate |
$610.51 |
| Rate for Payer: Aetna American Axle |
$440.92
|
| Rate for Payer: Aetna Commercial |
$576.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$440.92
|
| Rate for Payer: Cash Price |
$542.67
|
| Rate for Payer: Cofinity Commercial |
$474.84
|
| Rate for Payer: Cofinity Commercial |
$583.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$542.67
|
| Rate for Payer: Healthscope Commercial |
$610.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$474.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$508.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$576.59
|
| Rate for Payer: PHP Commercial |
$576.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$474.84
|
| Rate for Payer: Priority Health SBD |
$427.35
|
| Rate for Payer: UMR Bronson Commercial |
$298.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$508.76
|
|
|
HC US OB FETAL CARDIOVASCULAR FU
|
Facility
|
OP
|
$678.34
|
|
|
Service Code
|
CPT 76826
|
| Hospital Charge Code |
40200055
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$685.66 |
| Rate for Payer: Aetna American Axle |
$440.92
|
| Rate for Payer: Aetna Commercial |
$576.59
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$440.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$224.89
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$542.67
|
| Rate for Payer: Cash Price |
$542.67
|
| Rate for Payer: Cofinity Commercial |
$583.37
|
| Rate for Payer: Cofinity Commercial |
$474.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$542.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$610.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$474.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$508.76
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$576.59
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$576.59
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$474.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$427.35
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.29
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$153.90
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$250.99
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$508.76
|
|
|
HC US OB FU
|
Facility
|
OP
|
$476.47
|
|
|
Service Code
|
CPT 76816
|
| Hospital Charge Code |
40200024
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$428.82 |
| Rate for Payer: Aetna American Axle |
$309.71
|
| Rate for Payer: Aetna Commercial |
$405.00
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$309.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$132.39
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$381.18
|
| Rate for Payer: Cash Price |
$381.18
|
| Rate for Payer: Cofinity Commercial |
$409.76
|
| Rate for Payer: Cofinity Commercial |
$333.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$381.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$428.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$333.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$357.35
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$405.00
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$405.00
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$300.18
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.87
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$108.06
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$176.29
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$357.35
|
|
|
HC US OB FU
|
Facility
|
IP
|
$476.47
|
|
|
Service Code
|
CPT 76816
|
| Hospital Charge Code |
40200024
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$209.65 |
| Max. Negotiated Rate |
$428.82 |
| Rate for Payer: Aetna American Axle |
$309.71
|
| Rate for Payer: Aetna Commercial |
$405.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$309.71
|
| Rate for Payer: Cash Price |
$381.18
|
| Rate for Payer: Cofinity Commercial |
$333.53
|
| Rate for Payer: Cofinity Commercial |
$409.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$381.18
|
| Rate for Payer: Healthscope Commercial |
$428.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$333.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$357.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$405.00
|
| Rate for Payer: PHP Commercial |
$405.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.53
|
| Rate for Payer: Priority Health SBD |
$300.18
|
| Rate for Payer: UMR Bronson Commercial |
$209.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$357.35
|
|
|
HC US OB GREATER THAN 14 WEEKS
|
Facility
|
IP
|
$570.58
|
|
|
Service Code
|
CPT 76805
|
| Hospital Charge Code |
40200017
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$251.06 |
| Max. Negotiated Rate |
$513.52 |
| Rate for Payer: Aetna American Axle |
$370.88
|
| Rate for Payer: Aetna Commercial |
$484.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$370.88
|
| Rate for Payer: Cash Price |
$456.46
|
| Rate for Payer: Cofinity Commercial |
$399.41
|
| Rate for Payer: Cofinity Commercial |
$490.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$456.46
|
| Rate for Payer: Healthscope Commercial |
$513.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$399.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$427.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$484.99
|
| Rate for Payer: PHP Commercial |
$484.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.41
|
| Rate for Payer: Priority Health SBD |
$359.47
|
| Rate for Payer: UMR Bronson Commercial |
$251.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$427.94
|
|
|
HC US OB GREATER THAN 14 WEEKS
|
Facility
|
OP
|
$570.58
|
|
|
Service Code
|
CPT 76805
|
| Hospital Charge Code |
40200017
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$513.52 |
| Rate for Payer: Aetna American Axle |
$370.88
|
| Rate for Payer: Aetna Commercial |
$484.99
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$370.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$169.15
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$456.46
|
| Rate for Payer: Cash Price |
$456.46
|
| Rate for Payer: Cofinity Commercial |
$399.41
|
| Rate for Payer: Cofinity Commercial |
$490.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$456.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$513.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$399.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$427.94
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$484.99
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$484.99
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$359.47
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.60
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$133.27
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$211.11
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$427.94
|
|
|
HC US OB LESS THAN 14 WEEKS
|
Facility
|
IP
|
$570.45
|
|
|
Service Code
|
CPT 76801
|
| Hospital Charge Code |
40200015
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$251.00 |
| Max. Negotiated Rate |
$513.40 |
| Rate for Payer: Aetna American Axle |
$370.79
|
| Rate for Payer: Aetna Commercial |
$484.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$370.79
|
| Rate for Payer: Cash Price |
$456.36
|
| Rate for Payer: Cofinity Commercial |
$399.32
|
| Rate for Payer: Cofinity Commercial |
$490.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$456.36
|
| Rate for Payer: Healthscope Commercial |
$513.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$399.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$427.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$484.88
|
| Rate for Payer: PHP Commercial |
$484.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.32
|
| Rate for Payer: Priority Health SBD |
$359.38
|
| Rate for Payer: UMR Bronson Commercial |
$251.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$427.84
|
|
|
HC US OB LESS THAN 14 WEEKS
|
Facility
|
OP
|
$570.45
|
|
|
Service Code
|
CPT 76801
|
| Hospital Charge Code |
40200015
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$513.40 |
| Rate for Payer: Aetna American Axle |
$370.79
|
| Rate for Payer: Aetna Commercial |
$484.88
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$370.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$135.57
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$456.36
|
| Rate for Payer: Cash Price |
$456.36
|
| Rate for Payer: Cofinity Commercial |
$399.32
|
| Rate for Payer: Cofinity Commercial |
$490.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$456.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$513.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$399.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$427.84
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$484.88
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$484.88
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$399.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$359.38
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.79
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$115.26
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$211.07
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$427.84
|
|
|
HC US OB LTD
|
Facility
|
IP
|
$476.58
|
|
|
Service Code
|
CPT 76815
|
| Hospital Charge Code |
40200023
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$209.70 |
| Max. Negotiated Rate |
$428.92 |
| Rate for Payer: Aetna American Axle |
$309.78
|
| Rate for Payer: Aetna Commercial |
$405.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$309.78
|
| Rate for Payer: Cash Price |
$381.26
|
| Rate for Payer: Cofinity Commercial |
$333.61
|
| Rate for Payer: Cofinity Commercial |
$409.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$381.26
|
| Rate for Payer: Healthscope Commercial |
$428.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$333.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$357.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$405.09
|
| Rate for Payer: PHP Commercial |
$405.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.61
|
| Rate for Payer: Priority Health SBD |
$300.25
|
| Rate for Payer: UMR Bronson Commercial |
$209.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$357.44
|
|
|
HC US OB LTD
|
Facility
|
OP
|
$476.58
|
|
|
Service Code
|
CPT 76815
|
| Hospital Charge Code |
40200023
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$428.92 |
| Rate for Payer: Aetna American Axle |
$309.78
|
| Rate for Payer: Aetna Commercial |
$405.09
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$309.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$96.29
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$381.26
|
| Rate for Payer: Cash Price |
$381.26
|
| Rate for Payer: Cofinity Commercial |
$333.61
|
| Rate for Payer: Cofinity Commercial |
$409.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$381.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$428.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$333.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$357.44
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$405.09
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$405.09
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$333.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$300.25
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.53
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$79.57
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$176.33
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$357.44
|
|
|
HC US OB NT EACH ADDL FETUS
|
Facility
|
IP
|
$173.03
|
|
|
Service Code
|
CPT 76814
|
| Hospital Charge Code |
40200022
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.13 |
| Max. Negotiated Rate |
$155.73 |
| Rate for Payer: Aetna American Axle |
$112.47
|
| Rate for Payer: Aetna Commercial |
$147.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.47
|
| Rate for Payer: Cash Price |
$138.42
|
| Rate for Payer: Cofinity Commercial |
$121.12
|
| Rate for Payer: Cofinity Commercial |
$148.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.42
|
| Rate for Payer: Healthscope Commercial |
$155.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.08
|
| Rate for Payer: PHP Commercial |
$147.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.12
|
| Rate for Payer: Priority Health SBD |
$109.01
|
| Rate for Payer: UMR Bronson Commercial |
$76.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.77
|
|
|
HC US OB NT EACH ADDL FETUS
|
Facility
|
OP
|
$173.03
|
|
|
Service Code
|
CPT 76814
|
| Hospital Charge Code |
40200022
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$53.85 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$112.47
|
| Rate for Payer: Aetna Commercial |
$147.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.47
|
| Rate for Payer: BCBS Complete |
$69.21
|
| Rate for Payer: BCBS Trust/PPO |
$53.85
|
| Rate for Payer: Cash Price |
$138.42
|
| Rate for Payer: Cash Price |
$138.42
|
| Rate for Payer: Cofinity Commercial |
$148.81
|
| Rate for Payer: Cofinity Commercial |
$121.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.42
|
| Rate for Payer: Healthscope Commercial |
$155.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.08
|
| Rate for Payer: PHP Commercial |
$147.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.12
|
| Rate for Payer: Priority Health SBD |
$109.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.32
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Exchange |
$73.02
|
| Rate for Payer: UMR Bronson Commercial |
$64.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.77
|
|
|
HC US OB NUCHAL TRANSLUCENCY
|
Facility
|
IP
|
$449.40
|
|
|
Service Code
|
CPT 76813
|
| Hospital Charge Code |
40200021
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$197.74 |
| Max. Negotiated Rate |
$404.46 |
| Rate for Payer: Aetna American Axle |
$292.11
|
| Rate for Payer: Aetna Commercial |
$381.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.11
|
| Rate for Payer: Cash Price |
$359.52
|
| Rate for Payer: Cofinity Commercial |
$314.58
|
| Rate for Payer: Cofinity Commercial |
$386.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.52
|
| Rate for Payer: Healthscope Commercial |
$404.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$314.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$381.99
|
| Rate for Payer: PHP Commercial |
$381.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$314.58
|
| Rate for Payer: Priority Health SBD |
$283.12
|
| Rate for Payer: UMR Bronson Commercial |
$197.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.05
|
|
|
HC US OB NUCHAL TRANSLUCENCY
|
Facility
|
OP
|
$449.40
|
|
|
Service Code
|
CPT 76813
|
| Hospital Charge Code |
40200021
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$404.46 |
| Rate for Payer: Aetna American Axle |
$292.11
|
| Rate for Payer: Aetna Commercial |
$381.99
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$116.56
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$359.52
|
| Rate for Payer: Cash Price |
$359.52
|
| Rate for Payer: Cofinity Commercial |
$314.58
|
| Rate for Payer: Cofinity Commercial |
$386.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$404.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$314.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.05
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$381.99
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$381.99
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$314.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$283.12
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.98
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$113.62
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$166.28
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.05
|
|
|
HC US OB TRANSVAG ONLY
|
Facility
|
OP
|
$390.46
|
|
|
Service Code
|
CPT 76817
|
| Hospital Charge Code |
40200025
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$253.80
|
| Rate for Payer: Aetna Commercial |
$331.89
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$108.96
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$312.37
|
| Rate for Payer: Cash Price |
$312.37
|
| Rate for Payer: Cofinity Commercial |
$335.80
|
| Rate for Payer: Cofinity Commercial |
$273.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$351.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$273.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.84
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$331.89
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$331.89
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$245.99
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.13
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$91.03
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$144.47
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.84
|
|
|
HC US OB TRANSVAG ONLY
|
Facility
|
IP
|
$390.46
|
|
|
Service Code
|
CPT 76817
|
| Hospital Charge Code |
40200025
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$171.80 |
| Max. Negotiated Rate |
$351.41 |
| Rate for Payer: Aetna American Axle |
$253.80
|
| Rate for Payer: Aetna Commercial |
$331.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.80
|
| Rate for Payer: Cash Price |
$312.37
|
| Rate for Payer: Cofinity Commercial |
$273.32
|
| Rate for Payer: Cofinity Commercial |
$335.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.37
|
| Rate for Payer: Healthscope Commercial |
$351.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$273.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$331.89
|
| Rate for Payer: PHP Commercial |
$331.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.32
|
| Rate for Payer: Priority Health SBD |
$245.99
|
| Rate for Payer: UMR Bronson Commercial |
$171.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.84
|
|
|
HC US OB UNLISTED PROCEDURE
|
Facility
|
IP
|
$1,067.65
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
36100260
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$469.77 |
| Max. Negotiated Rate |
$960.88 |
| Rate for Payer: Aetna American Axle |
$693.97
|
| Rate for Payer: Aetna Commercial |
$907.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$693.97
|
| Rate for Payer: Cash Price |
$854.12
|
| Rate for Payer: Cofinity Commercial |
$747.36
|
| Rate for Payer: Cofinity Commercial |
$918.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$854.12
|
| Rate for Payer: Healthscope Commercial |
$960.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$747.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$800.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$907.50
|
| Rate for Payer: PHP Commercial |
$907.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$747.36
|
| Rate for Payer: Priority Health SBD |
$672.62
|
| Rate for Payer: UMR Bronson Commercial |
$469.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$800.74
|
|
|
HC US OB UNLISTED PROCEDURE
|
Facility
|
OP
|
$1,067.65
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
36100260
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$96.88 |
| Max. Negotiated Rate |
$960.88 |
| Rate for Payer: Aetna American Axle |
$693.97
|
| Rate for Payer: Aetna Commercial |
$907.50
|
| Rate for Payer: Aetna Medicare |
$184.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$693.97
|
| 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 |
$854.12
|
| Rate for Payer: Cash Price |
$854.12
|
| Rate for Payer: Cofinity Commercial |
$918.18
|
| Rate for Payer: Cofinity Commercial |
$747.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$854.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.12
|
| Rate for Payer: Healthscope Commercial |
$960.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$747.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$800.74
|
| 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 |
$907.50
|
| Rate for Payer: PACE Medicare |
$168.26
|
| Rate for Payer: PACE SWMI |
$177.12
|
| Rate for Payer: PHP Commercial |
$907.50
|
| 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 |
$747.36
|
| 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 |
$672.62
|
| 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 |
$395.03
|
| Rate for Payer: VA VA |
$177.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$800.74
|
|
|
HC US PARACENTESIS
|
Facility
|
OP
|
$1,342.18
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
36100346
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$102.16 |
| Max. Negotiated Rate |
$2,536.56 |
| Rate for Payer: Aetna American Axle |
$872.42
|
| Rate for Payer: Aetna Commercial |
$1,140.85
|
| Rate for Payer: Aetna Medicare |
$837.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,007.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,007.19
|
| Rate for Payer: BCBS Complete |
$462.82
|
| Rate for Payer: BCBS MAPPO |
$805.75
|
| Rate for Payer: BCBS Trust/PPO |
$698.66
|
| Rate for Payer: BCN Medicare Advantage |
$805.75
|
| Rate for Payer: Cash Price |
$1,073.74
|
| Rate for Payer: Cash Price |
$1,073.74
|
| Rate for Payer: Cofinity Commercial |
$939.53
|
| Rate for Payer: Cofinity Commercial |
$1,154.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,073.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$805.75
|
| Rate for Payer: Healthscope Commercial |
$1,207.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$939.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,006.64
|
| Rate for Payer: Mclaren Medicaid |
$440.75
|
| Rate for Payer: Mclaren Medicare |
$805.75
|
| Rate for Payer: Meridian Medicaid |
$462.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$846.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$926.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,140.85
|
| Rate for Payer: PACE Medicare |
$765.46
|
| Rate for Payer: PACE SWMI |
$805.75
|
| Rate for Payer: PHP Commercial |
$1,140.85
|
| Rate for Payer: PHP Medicare Advantage |
$805.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,536.56
|
| Rate for Payer: Priority Health Medicare |
$805.75
|
| Rate for Payer: Priority Health Narrow Network |
$2,029.25
|
| Rate for Payer: Priority Health SBD |
$845.57
|
| Rate for Payer: Railroad Medicare Medicare |
$805.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.38
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$805.75
|
| Rate for Payer: UHC Exchange |
$102.16
|
| Rate for Payer: UHC Medicare Advantage |
$829.92
|
| Rate for Payer: UMR Bronson Commercial |
$496.61
|
| Rate for Payer: VA VA |
$805.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,006.64
|
|
|
HC US PARACENTESIS
|
Facility
|
IP
|
$1,342.18
|
|
|
Service Code
|
CPT 49083
|
| Hospital Charge Code |
36100346
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$590.56 |
| Max. Negotiated Rate |
$1,207.96 |
| Rate for Payer: Aetna American Axle |
$872.42
|
| Rate for Payer: Aetna Commercial |
$1,140.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.42
|
| Rate for Payer: Cash Price |
$1,073.74
|
| Rate for Payer: Cofinity Commercial |
$1,154.27
|
| Rate for Payer: Cofinity Commercial |
$939.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,073.74
|
| Rate for Payer: Healthscope Commercial |
$1,207.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$939.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,006.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,140.85
|
| Rate for Payer: PHP Commercial |
$1,140.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$939.53
|
| Rate for Payer: Priority Health SBD |
$845.57
|
| Rate for Payer: UMR Bronson Commercial |
$590.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,006.64
|
|
|
HC US PELVIS LTD
|
Facility
|
IP
|
$500.38
|
|
|
Service Code
|
CPT 76857
|
| Hospital Charge Code |
40200034
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$220.17 |
| Max. Negotiated Rate |
$450.34 |
| Rate for Payer: Aetna American Axle |
$325.25
|
| Rate for Payer: Aetna Commercial |
$425.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.25
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cofinity Commercial |
$350.27
|
| Rate for Payer: Cofinity Commercial |
$430.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.30
|
| Rate for Payer: Healthscope Commercial |
$450.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.32
|
| Rate for Payer: PHP Commercial |
$425.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.27
|
| Rate for Payer: Priority Health SBD |
$315.24
|
| Rate for Payer: UMR Bronson Commercial |
$220.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.28
|
|
|
HC US PELVIS LTD
|
Facility
|
OP
|
$500.38
|
|
|
Service Code
|
CPT 76857
|
| Hospital Charge Code |
40200034
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$48.14 |
| Max. Negotiated Rate |
$450.34 |
| Rate for Payer: Aetna American Axle |
$325.25
|
| Rate for Payer: Aetna Commercial |
$425.32
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$48.14
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cash Price |
$400.30
|
| Rate for Payer: Cofinity Commercial |
$350.27
|
| Rate for Payer: Cofinity Commercial |
$430.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$450.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.28
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.32
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$425.32
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$315.24
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.31
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$48.46
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$185.14
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.28
|
|
