|
HC LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE
|
Facility
|
OP
|
$10,480.00
|
|
|
Service Code
|
CPT 31571
|
| Hospital Charge Code |
76100432
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$238.77 |
| Max. Negotiated Rate |
$11,353.72 |
| Rate for Payer: Aetna American Axle |
$6,812.00
|
| Rate for Payer: Aetna Commercial |
$8,908.00
|
| Rate for Payer: Aetna Medicare |
$3,756.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,812.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,515.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,515.50
|
| Rate for Payer: BCBS Complete |
$2,033.06
|
| Rate for Payer: BCBS MAPPO |
$3,612.40
|
| Rate for Payer: BCBS Trust/PPO |
$4,188.72
|
| Rate for Payer: BCN Commercial |
$4,188.72
|
| Rate for Payer: BCN Medicare Advantage |
$3,612.40
|
| Rate for Payer: Cash Price |
$8,384.00
|
| Rate for Payer: Cash Price |
$8,384.00
|
| Rate for Payer: Cash Price |
$8,384.00
|
| Rate for Payer: Cofinity Commercial |
$9,012.80
|
| Rate for Payer: Cofinity Commercial |
$7,336.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,336.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,384.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,612.40
|
| Rate for Payer: Healthscope Commercial |
$9,432.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,336.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,860.00
|
| Rate for Payer: Mclaren Medicaid |
$1,936.25
|
| Rate for Payer: Mclaren Medicare |
$3,612.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,793.02
|
| Rate for Payer: Meridian Medicaid |
$2,033.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,154.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,908.00
|
| Rate for Payer: Nomi Health Commercial |
$7,586.04
|
| Rate for Payer: PACE Medicare |
$3,431.78
|
| Rate for Payer: PACE SWMI |
$3,612.40
|
| Rate for Payer: PHP Commercial |
$8,908.00
|
| Rate for Payer: PHP Medicare Advantage |
$3,612.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,936.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,812.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,353.72
|
| Rate for Payer: Priority Health Medicare |
$3,612.40
|
| Rate for Payer: Priority Health Narrow Network |
$9,082.98
|
| Rate for Payer: Priority Health SBD |
$6,602.40
|
| Rate for Payer: Railroad Medicare Medicare |
$3,612.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.65
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,612.40
|
| Rate for Payer: UHC Exchange |
$238.77
|
| Rate for Payer: UHC Medicare Advantage |
$3,612.40
|
| Rate for Payer: UHCCP Medicaid |
$1,936.25
|
| Rate for Payer: UMR Bronson Commercial |
$3,877.60
|
| Rate for Payer: VA VA |
$3,612.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,860.00
|
|
|
HC LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE
|
Facility
|
IP
|
$10,480.00
|
|
|
Service Code
|
CPT 31571
|
| Hospital Charge Code |
76100432
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,611.20 |
| Max. Negotiated Rate |
$9,432.00 |
| Rate for Payer: Aetna American Axle |
$6,812.00
|
| Rate for Payer: Aetna Commercial |
$8,908.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,812.00
|
| Rate for Payer: Cash Price |
$8,384.00
|
| Rate for Payer: Cofinity Commercial |
$7,336.00
|
| Rate for Payer: Cofinity Commercial |
$9,012.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,336.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,384.00
|
| Rate for Payer: Healthscope Commercial |
$9,432.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,336.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,860.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,908.00
|
| Rate for Payer: PHP Commercial |
$8,908.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,812.00
|
| Rate for Payer: Priority Health SBD |
$6,602.40
|
| Rate for Payer: UMR Bronson Commercial |
$4,611.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,860.00
|
|
|
HC LA RO SSB SJOGRENS AB
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200160
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$17.28
|
| Rate for Payer: BCN Commercial |
$17.28
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$14.34
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$13.01
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC LA RO SSB SJOGRENS AB
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200160
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.47 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: UMR Bronson Commercial |
$15.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC LARYNGOSCOPY
|
Facility
|
IP
|
$2,564.80
|
|
| Hospital Charge Code |
36000113
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,128.51 |
| Max. Negotiated Rate |
$2,308.32 |
| Rate for Payer: Aetna American Axle |
$1,667.12
|
| Rate for Payer: Aetna Commercial |
$2,180.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,667.12
|
| Rate for Payer: Cash Price |
$2,051.84
|
| Rate for Payer: Cofinity Commercial |
$1,795.36
|
| Rate for Payer: Cofinity Commercial |
$2,205.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,795.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,051.84
|
| Rate for Payer: Healthscope Commercial |
$2,308.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,795.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,923.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,180.08
|
| Rate for Payer: PHP Commercial |
$2,180.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,667.12
|
| Rate for Payer: Priority Health SBD |
$1,615.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,128.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,923.60
|
|
|
HC LARYNGOSCOPY
|
Facility
|
OP
|
$2,564.80
|
|
| Hospital Charge Code |
36000113
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$948.98 |
| Max. Negotiated Rate |
$2,308.32 |
| Rate for Payer: Aetna American Axle |
$1,667.12
|
| Rate for Payer: Aetna Commercial |
$2,180.08
|
| Rate for Payer: Aetna Medicare |
$1,282.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,667.12
|
| Rate for Payer: BCBS Complete |
$1,025.92
|
| Rate for Payer: Cash Price |
$2,051.84
|
| Rate for Payer: Cofinity Commercial |
$1,795.36
|
| Rate for Payer: Cofinity Commercial |
$2,205.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,795.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,051.84
|
| Rate for Payer: Healthscope Commercial |
$2,308.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,795.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,923.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,180.08
|
| Rate for Payer: PHP Commercial |
$2,180.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,667.12
|
| Rate for Payer: Priority Health SBD |
$1,615.82
|
| Rate for Payer: UMR Bronson Commercial |
$948.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,923.60
|
|
|
HC LARYNGOSCOPY DIRECT OPERATIVE W BIOPSY
|
Facility
|
IP
|
$4,795.00
|
|
|
Service Code
|
CPT 31235
|
| Hospital Charge Code |
76100522
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,109.80 |
| Max. Negotiated Rate |
$4,315.50 |
| Rate for Payer: Aetna American Axle |
$3,116.75
|
| Rate for Payer: Aetna Commercial |
$4,075.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,116.75
|
| Rate for Payer: Cash Price |
$3,836.00
|
| Rate for Payer: Cofinity Commercial |
$3,356.50
|
| Rate for Payer: Cofinity Commercial |
$4,123.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,356.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,836.00
|
| Rate for Payer: Healthscope Commercial |
$4,315.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,356.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,596.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,075.75
|
| Rate for Payer: PHP Commercial |
$4,075.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,116.75
|
| Rate for Payer: Priority Health SBD |
$3,020.85
|
| Rate for Payer: UMR Bronson Commercial |
$2,109.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,596.25
|
|
|
HC LARYNGOSCOPY DIRECT OPERATIVE W BIOPSY
|
Facility
|
OP
|
$4,795.00
|
|
|
Service Code
|
CPT 31235
|
| Hospital Charge Code |
76100522
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$153.46 |
| Max. Negotiated Rate |
$5,310.41 |
| Rate for Payer: Aetna American Axle |
$3,116.75
|
| Rate for Payer: Aetna Commercial |
$4,075.75
|
| Rate for Payer: Aetna Medicare |
$1,757.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,116.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,112.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,112.00
|
| Rate for Payer: BCBS Complete |
$950.91
|
| Rate for Payer: BCBS MAPPO |
$1,689.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,034.34
|
| Rate for Payer: BCN Commercial |
$1,034.34
|
| Rate for Payer: BCN Medicare Advantage |
$1,689.60
|
| Rate for Payer: Cash Price |
$3,836.00
|
| Rate for Payer: Cash Price |
$3,836.00
|
| Rate for Payer: Cash Price |
$3,836.00
|
| Rate for Payer: Cofinity Commercial |
$4,123.70
|
| Rate for Payer: Cofinity Commercial |
$3,356.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,356.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,836.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,689.60
|
| Rate for Payer: Healthscope Commercial |
$4,315.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,356.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,596.25
|
| Rate for Payer: Mclaren Medicaid |
$905.63
|
| Rate for Payer: Mclaren Medicare |
$1,689.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,774.08
|
| Rate for Payer: Meridian Medicaid |
$950.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,943.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,075.75
|
| Rate for Payer: Nomi Health Commercial |
$3,548.16
|
| Rate for Payer: PACE Medicare |
$1,605.12
|
| Rate for Payer: PACE SWMI |
$1,689.60
|
| Rate for Payer: PHP Commercial |
$4,075.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,689.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$905.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,116.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,310.41
|
| Rate for Payer: Priority Health Medicare |
$1,689.60
|
| Rate for Payer: Priority Health Narrow Network |
$4,248.33
|
| Rate for Payer: Priority Health SBD |
$3,020.85
|
| Rate for Payer: Railroad Medicare Medicare |
$1,689.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.81
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,689.60
|
| Rate for Payer: UHC Exchange |
$153.46
|
| Rate for Payer: UHC Medicare Advantage |
$1,689.60
|
| Rate for Payer: UHCCP Medicaid |
$905.63
|
| Rate for Payer: UMR Bronson Commercial |
$1,774.15
|
| Rate for Payer: VA VA |
$1,689.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,596.25
|
|
|
HC LARYNGOSCOPY FIBEROPTIC
|
Facility
|
IP
|
$372.28
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
36100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$163.80 |
| Max. Negotiated Rate |
$335.05 |
| Rate for Payer: Aetna American Axle |
$241.98
|
| Rate for Payer: Aetna Commercial |
$316.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.98
|
| Rate for Payer: Cash Price |
$297.82
|
| Rate for Payer: Cofinity Commercial |
$260.60
|
| Rate for Payer: Cofinity Commercial |
$320.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$260.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.82
|
| Rate for Payer: Healthscope Commercial |
$335.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.44
|
| Rate for Payer: PHP Commercial |
$316.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.98
|
| Rate for Payer: Priority Health SBD |
$234.54
|
| Rate for Payer: UMR Bronson Commercial |
$163.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.21
|
|
|
HC LARYNGOSCOPY FIBEROPTIC
|
Facility
|
OP
|
$372.28
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
36100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.39 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$241.98
|
| Rate for Payer: Aetna Commercial |
$316.44
|
| Rate for Payer: Aetna Medicare |
$197.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$237.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$237.76
|
| Rate for Payer: BCBS Complete |
$107.05
|
| Rate for Payer: BCBS MAPPO |
$190.21
|
| Rate for Payer: BCBS Trust/PPO |
$202.06
|
| Rate for Payer: BCN Commercial |
$202.06
|
| Rate for Payer: BCN Medicare Advantage |
$190.21
|
| Rate for Payer: Cash Price |
$297.82
|
| Rate for Payer: Cash Price |
$297.82
|
| Rate for Payer: Cash Price |
$297.82
|
| Rate for Payer: Cofinity Commercial |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$260.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$260.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.21
|
| Rate for Payer: Healthscope Commercial |
$335.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.21
|
| Rate for Payer: Mclaren Medicaid |
$101.95
|
| Rate for Payer: Mclaren Medicare |
$190.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.72
|
| Rate for Payer: Meridian Medicaid |
$107.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.44
|
| Rate for Payer: Nomi Health Commercial |
$399.44
|
| Rate for Payer: PACE Medicare |
$180.70
|
| Rate for Payer: PACE SWMI |
$190.21
|
| Rate for Payer: PHP Commercial |
$316.44
|
| Rate for Payer: PHP Medicare Advantage |
$190.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$597.84
|
| Rate for Payer: Priority Health Medicare |
$190.21
|
| Rate for Payer: Priority Health Narrow Network |
$478.27
|
| Rate for Payer: Priority Health SBD |
$234.54
|
| Rate for Payer: Railroad Medicare Medicare |
$190.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.93
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.21
|
| Rate for Payer: UHC Exchange |
$65.39
|
| Rate for Payer: UHC Medicare Advantage |
$190.21
|
| Rate for Payer: UHCCP Medicaid |
$101.95
|
| Rate for Payer: UMR Bronson Commercial |
$137.74
|
| Rate for Payer: VA VA |
$190.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.21
|
|
|
HC LARYNGOSCOPY FLX/RGD TELESCOP W/STROBOSCOP
|
Facility
|
IP
|
$1,122.00
|
|
|
Service Code
|
CPT 31579
|
| Hospital Charge Code |
76100455
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$493.68 |
| Max. Negotiated Rate |
$1,009.80 |
| Rate for Payer: Aetna American Axle |
$729.30
|
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.30
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$785.40
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$785.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$785.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.70
|
| Rate for Payer: PHP Commercial |
$953.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.30
|
| Rate for Payer: Priority Health SBD |
$706.86
|
| Rate for Payer: UMR Bronson Commercial |
$493.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.50
|
|
|
HC LARYNGOSCOPY FLX/RGD TELESCOP W/STROBOSCOP
|
Facility
|
OP
|
$1,122.00
|
|
|
Service Code
|
CPT 31579
|
| Hospital Charge Code |
76100455
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.41 |
| Max. Negotiated Rate |
$1,195.78 |
| Rate for Payer: Aetna American Axle |
$729.30
|
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: Aetna Medicare |
$395.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$475.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$475.58
|
| Rate for Payer: BCBS Complete |
$214.12
|
| Rate for Payer: BCBS MAPPO |
$380.46
|
| Rate for Payer: BCBS Trust/PPO |
$306.07
|
| Rate for Payer: BCN Commercial |
$306.07
|
| Rate for Payer: BCN Medicare Advantage |
$380.46
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Cofinity Commercial |
$785.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$785.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.46
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$785.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.50
|
| Rate for Payer: Mclaren Medicaid |
$203.93
|
| Rate for Payer: Mclaren Medicare |
$380.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$399.48
|
| Rate for Payer: Meridian Medicaid |
$214.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$437.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.70
|
| Rate for Payer: Nomi Health Commercial |
$798.97
|
| Rate for Payer: PACE Medicare |
$361.44
|
| Rate for Payer: PACE SWMI |
$380.46
|
| Rate for Payer: PHP Commercial |
$953.70
|
| Rate for Payer: PHP Medicare Advantage |
$380.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$203.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,195.78
|
| Rate for Payer: Priority Health Medicare |
$380.46
|
| Rate for Payer: Priority Health Narrow Network |
$956.62
|
| Rate for Payer: Priority Health SBD |
$706.86
|
| Rate for Payer: Railroad Medicare Medicare |
$380.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.85
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$380.46
|
| Rate for Payer: UHC Exchange |
$114.41
|
| Rate for Payer: UHC Medicare Advantage |
$380.46
|
| Rate for Payer: UHCCP Medicaid |
$203.93
|
| Rate for Payer: UMR Bronson Commercial |
$415.14
|
| Rate for Payer: VA VA |
$380.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.50
|
|
|
HC LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX
|
Facility
|
IP
|
$566.10
|
|
|
Service Code
|
CPT 31505
|
| Hospital Charge Code |
76100411
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$249.08 |
| Max. Negotiated Rate |
$509.49 |
| Rate for Payer: Aetna American Axle |
$367.96
|
| Rate for Payer: Aetna Commercial |
$481.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$367.96
|
| Rate for Payer: Cash Price |
$452.88
|
| Rate for Payer: Cofinity Commercial |
$396.27
|
| Rate for Payer: Cofinity Commercial |
$486.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$396.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.88
|
| Rate for Payer: Healthscope Commercial |
$509.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$396.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$424.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.18
|
| Rate for Payer: PHP Commercial |
$481.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.96
|
| Rate for Payer: Priority Health SBD |
$356.64
|
| Rate for Payer: UMR Bronson Commercial |
$249.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$424.58
|
|
|
HC LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX
|
Facility
|
OP
|
$566.10
|
|
|
Service Code
|
CPT 31505
|
| Hospital Charge Code |
76100411
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$46.91 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$367.96
|
| Rate for Payer: Aetna Commercial |
$481.18
|
| Rate for Payer: Aetna Medicare |
$197.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$367.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$237.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$237.76
|
| Rate for Payer: BCBS Complete |
$107.05
|
| Rate for Payer: BCBS MAPPO |
$190.21
|
| Rate for Payer: BCBS Trust/PPO |
$78.35
|
| Rate for Payer: BCN Commercial |
$78.35
|
| Rate for Payer: BCN Medicare Advantage |
$190.21
|
| Rate for Payer: Cash Price |
$452.88
|
| Rate for Payer: Cash Price |
$452.88
|
| Rate for Payer: Cash Price |
$452.88
|
| Rate for Payer: Cofinity Commercial |
$486.85
|
| Rate for Payer: Cofinity Commercial |
$396.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$396.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.21
|
| Rate for Payer: Healthscope Commercial |
$509.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$396.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$424.58
|
| Rate for Payer: Mclaren Medicaid |
$101.95
|
| Rate for Payer: Mclaren Medicare |
$190.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.72
|
| Rate for Payer: Meridian Medicaid |
$107.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$481.18
|
| Rate for Payer: Nomi Health Commercial |
$399.44
|
| Rate for Payer: PACE Medicare |
$180.70
|
| Rate for Payer: PACE SWMI |
$190.21
|
| Rate for Payer: PHP Commercial |
$481.18
|
| Rate for Payer: PHP Medicare Advantage |
$190.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$597.84
|
| Rate for Payer: Priority Health Medicare |
$190.21
|
| Rate for Payer: Priority Health Narrow Network |
$478.27
|
| Rate for Payer: Priority Health SBD |
$356.64
|
| Rate for Payer: Railroad Medicare Medicare |
$190.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.60
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.21
|
| Rate for Payer: UHC Exchange |
$46.91
|
| Rate for Payer: UHC Medicare Advantage |
$190.21
|
| Rate for Payer: UHCCP Medicaid |
$101.95
|
| Rate for Payer: UMR Bronson Commercial |
$209.46
|
| Rate for Payer: VA VA |
$190.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$424.58
|
|
|
HC LASER CATHETER
|
Facility
|
OP
|
$4,939.32
|
|
|
Service Code
|
HCPCS C1885
|
| Hospital Charge Code |
27200054
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,827.55 |
| Max. Negotiated Rate |
$4,445.39 |
| Rate for Payer: Aetna American Axle |
$3,210.56
|
| Rate for Payer: Aetna Commercial |
$4,198.42
|
| Rate for Payer: Aetna Medicare |
$2,469.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,210.56
|
| Rate for Payer: BCBS Complete |
$1,975.73
|
| Rate for Payer: Cash Price |
$3,951.46
|
| Rate for Payer: Cofinity Commercial |
$3,457.52
|
| Rate for Payer: Cofinity Commercial |
$4,247.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,457.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,951.46
|
| Rate for Payer: Healthscope Commercial |
$4,445.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,457.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,704.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,198.42
|
| Rate for Payer: PHP Commercial |
$4,198.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,210.56
|
| Rate for Payer: Priority Health SBD |
$3,111.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,827.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,704.49
|
|
|
HC LASER CATHETER
|
Facility
|
IP
|
$4,939.32
|
|
|
Service Code
|
HCPCS C1885
|
| Hospital Charge Code |
27200054
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,173.30 |
| Max. Negotiated Rate |
$4,445.39 |
| Rate for Payer: Aetna American Axle |
$3,210.56
|
| Rate for Payer: Aetna Commercial |
$4,198.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,210.56
|
| Rate for Payer: Cash Price |
$3,951.46
|
| Rate for Payer: Cofinity Commercial |
$3,457.52
|
| Rate for Payer: Cofinity Commercial |
$4,247.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,457.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,951.46
|
| Rate for Payer: Healthscope Commercial |
$4,445.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,457.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,704.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,198.42
|
| Rate for Payer: PHP Commercial |
$4,198.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,210.56
|
| Rate for Payer: Priority Health SBD |
$3,111.77
|
| Rate for Payer: UMR Bronson Commercial |
$2,173.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,704.49
|
|
|
HC LATEX IGE
|
Facility
|
OP
|
$35.79
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200044
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$32.21 |
| Rate for Payer: Aetna American Axle |
$23.26
|
| Rate for Payer: Aetna Commercial |
$30.42
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$28.63
|
| Rate for Payer: Cash Price |
$28.63
|
| Rate for Payer: Cofinity Commercial |
$30.78
|
| Rate for Payer: Cofinity Commercial |
$25.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$32.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.84
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.42
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$30.42
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$22.55
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$13.24
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.84
|
|
|
HC LATEX IGE
|
Facility
|
IP
|
$35.79
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200044
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.75 |
| Max. Negotiated Rate |
$32.21 |
| Rate for Payer: Aetna American Axle |
$23.26
|
| Rate for Payer: Aetna Commercial |
$30.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.26
|
| Rate for Payer: Cash Price |
$28.63
|
| Rate for Payer: Cofinity Commercial |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$30.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.63
|
| Rate for Payer: Healthscope Commercial |
$32.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.42
|
| Rate for Payer: PHP Commercial |
$30.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.26
|
| Rate for Payer: Priority Health SBD |
$22.55
|
| Rate for Payer: UMR Bronson Commercial |
$15.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.84
|
|
|
HC LAYR CLOS WND REST BODY <2.5 CM
|
Facility
|
OP
|
$498.64
|
|
|
Service Code
|
CPT 12041
|
| Hospital Charge Code |
76100228
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$138.11 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna American Axle |
$324.12
|
| Rate for Payer: Aetna Commercial |
$423.84
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$456.28
|
| Rate for Payer: BCN Commercial |
$456.28
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cofinity Commercial |
$349.05
|
| Rate for Payer: Cofinity Commercial |
$428.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$349.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$448.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$349.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$373.98
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.84
|
| Rate for Payer: Nomi Health Commercial |
$1,174.35
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$423.84
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$314.14
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.92
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Exchange |
$138.11
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$209.82
|
| Rate for Payer: UMR Bronson Commercial |
$184.50
|
| Rate for Payer: VA VA |
$391.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$373.98
|
|
|
HC LAYR CLOS WND REST BODY <2.5 CM
|
Facility
|
IP
|
$498.64
|
|
|
Service Code
|
CPT 12041
|
| Hospital Charge Code |
76100228
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$219.40 |
| Max. Negotiated Rate |
$448.78 |
| Rate for Payer: Aetna American Axle |
$324.12
|
| Rate for Payer: Aetna Commercial |
$423.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.12
|
| Rate for Payer: Cash Price |
$398.91
|
| Rate for Payer: Cofinity Commercial |
$349.05
|
| Rate for Payer: Cofinity Commercial |
$428.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$349.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.91
|
| Rate for Payer: Healthscope Commercial |
$448.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$349.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$373.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$423.84
|
| Rate for Payer: PHP Commercial |
$423.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$324.12
|
| Rate for Payer: Priority Health SBD |
$314.14
|
| Rate for Payer: UMR Bronson Commercial |
$219.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$373.98
|
|
|
HC LC/CABG'S W INTERVENTION
|
Facility
|
OP
|
$11,013.34
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100050
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,016.47 |
| Max. Negotiated Rate |
$9,912.01 |
| Rate for Payer: Aetna American Axle |
$7,158.67
|
| Rate for Payer: Aetna Commercial |
$9,361.34
|
| Rate for Payer: Aetna Medicare |
$3,277.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,158.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,939.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,939.21
|
| Rate for Payer: BCBS Complete |
$1,773.59
|
| Rate for Payer: BCBS MAPPO |
$3,151.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,292.52
|
| Rate for Payer: BCN Commercial |
$3,292.52
|
| Rate for Payer: BCN Medicare Advantage |
$3,151.37
|
| Rate for Payer: Cash Price |
$8,810.67
|
| Rate for Payer: Cash Price |
$8,810.67
|
| Rate for Payer: Cash Price |
$8,810.67
|
| Rate for Payer: Cofinity Commercial |
$9,471.47
|
| Rate for Payer: Cofinity Commercial |
$7,709.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,709.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,810.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,151.37
|
| Rate for Payer: Healthscope Commercial |
$9,912.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,709.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,260.00
|
| Rate for Payer: Mclaren Medicaid |
$1,689.13
|
| Rate for Payer: Mclaren Medicare |
$3,151.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,308.94
|
| Rate for Payer: Meridian Medicaid |
$1,773.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,624.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,361.34
|
| Rate for Payer: Nomi Health Commercial |
$6,617.88
|
| Rate for Payer: PACE Medicare |
$2,993.80
|
| Rate for Payer: PACE SWMI |
$3,151.37
|
| Rate for Payer: PHP Commercial |
$9,361.34
|
| Rate for Payer: PHP Medicare Advantage |
$3,151.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,158.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,904.74
|
| Rate for Payer: Priority Health Medicare |
$3,151.37
|
| Rate for Payer: Priority Health Narrow Network |
$7,923.79
|
| Rate for Payer: Priority Health SBD |
$6,938.40
|
| Rate for Payer: Railroad Medicare Medicare |
$3,151.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,118.12
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,151.37
|
| Rate for Payer: UHC Exchange |
$1,016.47
|
| Rate for Payer: UHC Medicare Advantage |
$3,151.37
|
| Rate for Payer: UHCCP Medicaid |
$1,689.13
|
| Rate for Payer: UMR Bronson Commercial |
$4,074.94
|
| Rate for Payer: VA VA |
$3,151.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,260.00
|
|
|
HC LC/CABG'S W INTERVENTION
|
Facility
|
IP
|
$11,013.34
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100050
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,845.87 |
| Max. Negotiated Rate |
$9,912.01 |
| Rate for Payer: Aetna American Axle |
$7,158.67
|
| Rate for Payer: Aetna Commercial |
$9,361.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,158.67
|
| Rate for Payer: Cash Price |
$8,810.67
|
| Rate for Payer: Cofinity Commercial |
$7,709.34
|
| Rate for Payer: Cofinity Commercial |
$9,471.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,709.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,810.67
|
| Rate for Payer: Healthscope Commercial |
$9,912.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,709.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,260.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,361.34
|
| Rate for Payer: PHP Commercial |
$9,361.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,158.67
|
| Rate for Payer: Priority Health SBD |
$6,938.40
|
| Rate for Payer: UMR Bronson Commercial |
$4,845.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,260.00
|
|
|
HC LDL DIRECT MEASURE
|
Facility
|
IP
|
$59.77
|
|
|
Service Code
|
CPT 83721
|
| Hospital Charge Code |
30100283
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.30 |
| Max. Negotiated Rate |
$53.79 |
| Rate for Payer: Aetna American Axle |
$38.85
|
| Rate for Payer: Aetna Commercial |
$50.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.85
|
| Rate for Payer: Cash Price |
$47.82
|
| Rate for Payer: Cofinity Commercial |
$41.84
|
| Rate for Payer: Cofinity Commercial |
$51.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.82
|
| Rate for Payer: Healthscope Commercial |
$53.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.80
|
| Rate for Payer: PHP Commercial |
$50.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.85
|
| Rate for Payer: Priority Health SBD |
$37.66
|
| Rate for Payer: UMR Bronson Commercial |
$26.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.83
|
|
|
HC LDL DIRECT MEASURE
|
Facility
|
OP
|
$59.77
|
|
|
Service Code
|
CPT 83721
|
| Hospital Charge Code |
30100283
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.63 |
| Max. Negotiated Rate |
$53.79 |
| Rate for Payer: VA VA |
$10.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.83
|
| Rate for Payer: Aetna American Axle |
$38.85
|
| Rate for Payer: Aetna Commercial |
$50.80
|
| Rate for Payer: Aetna Medicare |
$10.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.12
|
| Rate for Payer: BCBS Complete |
$5.91
|
| Rate for Payer: BCBS MAPPO |
$10.50
|
| Rate for Payer: BCBS Trust/PPO |
$10.12
|
| Rate for Payer: BCN Commercial |
$10.12
|
| Rate for Payer: BCN Medicare Advantage |
$10.50
|
| Rate for Payer: Cash Price |
$47.82
|
| Rate for Payer: Cash Price |
$47.82
|
| Rate for Payer: Cofinity Commercial |
$51.40
|
| Rate for Payer: Cofinity Commercial |
$41.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.50
|
| Rate for Payer: Healthscope Commercial |
$53.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.83
|
| Rate for Payer: Mclaren Medicaid |
$5.63
|
| Rate for Payer: Mclaren Medicare |
$10.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.02
|
| Rate for Payer: Meridian Medicaid |
$5.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.80
|
| Rate for Payer: Nomi Health Commercial |
$15.75
|
| Rate for Payer: PACE Medicare |
$9.98
|
| Rate for Payer: PACE SWMI |
$10.50
|
| Rate for Payer: PHP Commercial |
$50.80
|
| Rate for Payer: PHP Medicare Advantage |
$10.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.50
|
| Rate for Payer: Priority Health Medicare |
$10.50
|
| Rate for Payer: Priority Health Narrow Network |
$8.40
|
| Rate for Payer: Priority Health SBD |
$37.66
|
| Rate for Payer: Railroad Medicare Medicare |
$10.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.50
|
| Rate for Payer: UHC Exchange |
$10.50
|
| Rate for Payer: UHC Medicare Advantage |
$10.50
|
| Rate for Payer: UHCCP Medicaid |
$5.63
|
| Rate for Payer: UMR Bronson Commercial |
$22.11
|
|
|
HC LD RECOVERY 0-2 HRS
|
Facility
|
IP
|
$1,469.87
|
|
| Hospital Charge Code |
71000012
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$646.74 |
| Max. Negotiated Rate |
$1,322.88 |
| Rate for Payer: Aetna American Axle |
$955.42
|
| Rate for Payer: Aetna Commercial |
$1,249.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$955.42
|
| Rate for Payer: Cash Price |
$1,175.90
|
| Rate for Payer: Cofinity Commercial |
$1,028.91
|
| Rate for Payer: Cofinity Commercial |
$1,264.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,028.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,175.90
|
| Rate for Payer: Healthscope Commercial |
$1,322.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,028.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,102.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,249.39
|
| Rate for Payer: PHP Commercial |
$1,249.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$955.42
|
| Rate for Payer: Priority Health SBD |
$926.02
|
| Rate for Payer: UMR Bronson Commercial |
$646.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,102.40
|
|
