|
HC NEG PRESSURE WND TX DME UP TO 50 SQ CM
|
Facility
|
OP
|
$436.89
|
|
|
Service Code
|
CPT 97605
|
| Hospital Charge Code |
76100008
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.17 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna American Axle |
$283.98
|
| Rate for Payer: Aetna Commercial |
$371.36
|
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$103.17
|
| Rate for Payer: BCN Commercial |
$103.17
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$349.51
|
| Rate for Payer: Cash Price |
$349.51
|
| Rate for Payer: Cash Price |
$349.51
|
| Rate for Payer: Cofinity Advantage |
$305.82
|
| Rate for Payer: Cofinity Commercial |
$375.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$393.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$305.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.67
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$209.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.36
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.67
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$371.36
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.50
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health SBD |
$275.24
|
| Rate for Payer: Priority Health Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.98
|
| Rate for Payer: UHC Core |
$227.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$171.70
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: UMR Bronson Commercial |
$161.65
|
| Rate for Payer: VA VA |
$199.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.67
|
|
|
HC NEG PRES TRAC PAD
|
Facility
|
IP
|
$75.29
|
|
| Hospital Charge Code |
27000158
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$33.13 |
| Max. Negotiated Rate |
$67.76 |
| Rate for Payer: Aetna American Axle |
$48.94
|
| Rate for Payer: Aetna Commercial |
$64.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.94
|
| Rate for Payer: Cash Price |
$60.23
|
| Rate for Payer: Cofinity Advantage |
$52.70
|
| Rate for Payer: Cofinity Commercial |
$64.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.23
|
| Rate for Payer: Healthscope Commercial |
$67.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.47
|
| Rate for Payer: PHP Commercial |
$64.00
|
| Rate for Payer: Priority Health SBD |
$47.43
|
| Rate for Payer: UMR Bronson Commercial |
$33.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.47
|
|
|
HC NEG PRES TRAC PAD
|
Facility
|
OP
|
$75.29
|
|
| Hospital Charge Code |
27000158
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.86 |
| Max. Negotiated Rate |
$67.76 |
| Rate for Payer: Aetna American Axle |
$48.94
|
| Rate for Payer: Aetna Commercial |
$64.00
|
| Rate for Payer: Aetna Medicare |
$37.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.94
|
| Rate for Payer: BCBS Complete |
$30.12
|
| Rate for Payer: Cash Price |
$60.23
|
| Rate for Payer: Cofinity Advantage |
$52.70
|
| Rate for Payer: Cofinity Commercial |
$64.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.23
|
| Rate for Payer: Healthscope Commercial |
$67.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.47
|
| Rate for Payer: PHP Commercial |
$64.00
|
| Rate for Payer: Priority Health SBD |
$47.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.94
|
| Rate for Payer: UHC Core |
$39.23
|
| Rate for Payer: UHC Exchange |
$29.59
|
| Rate for Payer: UMR Bronson Commercial |
$27.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.47
|
|
|
HC NEG PRES VF CASSETTE
|
Facility
|
IP
|
$217.13
|
|
| Hospital Charge Code |
27200230
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$95.54 |
| Max. Negotiated Rate |
$195.42 |
| Rate for Payer: Aetna American Axle |
$141.13
|
| Rate for Payer: Aetna Commercial |
$184.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.13
|
| Rate for Payer: Cash Price |
$173.70
|
| Rate for Payer: Cofinity Advantage |
$151.99
|
| Rate for Payer: Cofinity Commercial |
$186.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.70
|
| Rate for Payer: Healthscope Commercial |
$195.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$151.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.85
|
| Rate for Payer: PHP Commercial |
$184.56
|
| Rate for Payer: Priority Health SBD |
$136.79
|
| Rate for Payer: UMR Bronson Commercial |
$95.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.85
|
|
|
HC NEG PRES VF CASSETTE
|
Facility
|
OP
|
$217.13
|
|
| Hospital Charge Code |
27200230
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.34 |
| Max. Negotiated Rate |
$195.42 |
| Rate for Payer: Aetna American Axle |
$141.13
|
| Rate for Payer: Aetna Commercial |
$184.56
|
| Rate for Payer: Aetna Medicare |
$108.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.13
|
| Rate for Payer: BCBS Complete |
$86.85
|
| Rate for Payer: Cash Price |
$173.70
|
| Rate for Payer: Cofinity Advantage |
$151.99
|
| Rate for Payer: Cofinity Commercial |
$186.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.70
|
| Rate for Payer: Healthscope Commercial |
$195.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$151.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$173.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.85
|
| Rate for Payer: PHP Commercial |
$184.56
|
| Rate for Payer: Priority Health SBD |
$136.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.13
|
| Rate for Payer: UHC Core |
$113.12
|
| Rate for Payer: UHC Exchange |
$85.33
|
| Rate for Payer: UMR Bronson Commercial |
$80.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.85
|
|
|
HC NEG PRES VF DRSG MED
|
Facility
|
IP
|
$454.00
|
|
| Hospital Charge Code |
27200228
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$199.76 |
| Max. Negotiated Rate |
$408.60 |
| Rate for Payer: Aetna American Axle |
$295.10
|
| Rate for Payer: Aetna Commercial |
$385.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$295.10
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Cofinity Advantage |
$317.80
|
| Rate for Payer: Cofinity Commercial |
$390.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.20
|
| Rate for Payer: Healthscope Commercial |
$408.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$317.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$340.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$340.50
|
| Rate for Payer: PHP Commercial |
$385.90
|
| Rate for Payer: Priority Health SBD |
$286.02
|
| Rate for Payer: UMR Bronson Commercial |
$199.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$340.50
|
|
|
HC NEG PRES VF DRSG MED
|
Facility
|
OP
|
$454.00
|
|
| Hospital Charge Code |
27200228
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$167.98 |
| Max. Negotiated Rate |
$408.60 |
| Rate for Payer: Aetna American Axle |
$295.10
|
| Rate for Payer: Aetna Commercial |
$385.90
|
| Rate for Payer: Aetna Medicare |
$227.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$295.10
|
| Rate for Payer: BCBS Complete |
$181.60
|
| Rate for Payer: Cash Price |
$363.20
|
| Rate for Payer: Cofinity Advantage |
$317.80
|
| Rate for Payer: Cofinity Commercial |
$390.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$363.20
|
| Rate for Payer: Healthscope Commercial |
$408.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$317.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$340.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$363.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$385.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$340.50
|
| Rate for Payer: PHP Commercial |
$385.90
|
| Rate for Payer: Priority Health SBD |
$286.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.10
|
| Rate for Payer: UHC Core |
$236.53
|
| Rate for Payer: UHC Exchange |
$178.42
|
| Rate for Payer: UMR Bronson Commercial |
$167.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$340.50
|
|
|
HC NEG PRES VF DRSG SMA
|
Facility
|
OP
|
$386.89
|
|
| Hospital Charge Code |
27200227
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.15 |
| Max. Negotiated Rate |
$348.20 |
| Rate for Payer: Aetna American Axle |
$251.48
|
| Rate for Payer: Aetna Commercial |
$328.86
|
| Rate for Payer: Aetna Medicare |
$193.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.48
|
| Rate for Payer: BCBS Complete |
$154.76
|
| Rate for Payer: Cash Price |
$309.51
|
| Rate for Payer: Cofinity Advantage |
$270.82
|
| Rate for Payer: Cofinity Commercial |
$332.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$309.51
|
| Rate for Payer: Healthscope Commercial |
$348.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$270.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$309.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.17
|
| Rate for Payer: PHP Commercial |
$328.86
|
| Rate for Payer: Priority Health SBD |
$243.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.48
|
| Rate for Payer: UHC Core |
$201.57
|
| Rate for Payer: UHC Exchange |
$152.05
|
| Rate for Payer: UMR Bronson Commercial |
$143.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.17
|
|
|
HC NEG PRES VF DRSG SMA
|
Facility
|
IP
|
$386.89
|
|
| Hospital Charge Code |
27200227
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$170.23 |
| Max. Negotiated Rate |
$348.20 |
| Rate for Payer: Aetna American Axle |
$251.48
|
| Rate for Payer: Aetna Commercial |
$328.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.48
|
| Rate for Payer: Cash Price |
$309.51
|
| Rate for Payer: Cofinity Advantage |
$270.82
|
| Rate for Payer: Cofinity Commercial |
$332.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$309.51
|
| Rate for Payer: Healthscope Commercial |
$348.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$270.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.17
|
| Rate for Payer: PHP Commercial |
$328.86
|
| Rate for Payer: Priority Health SBD |
$243.74
|
| Rate for Payer: UMR Bronson Commercial |
$170.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.17
|
|
|
HC NEG PRES VF DUO TRAC PAD
|
Facility
|
OP
|
$296.09
|
|
| Hospital Charge Code |
27200231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$109.55 |
| Max. Negotiated Rate |
$266.48 |
| Rate for Payer: Aetna American Axle |
$192.46
|
| Rate for Payer: Aetna Commercial |
$251.68
|
| Rate for Payer: Aetna Medicare |
$148.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.46
|
| Rate for Payer: BCBS Complete |
$118.44
|
| Rate for Payer: Cash Price |
$236.87
|
| Rate for Payer: Cofinity Advantage |
$207.26
|
| Rate for Payer: Cofinity Commercial |
$254.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.87
|
| Rate for Payer: Healthscope Commercial |
$266.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$207.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$236.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$222.07
|
| Rate for Payer: PHP Commercial |
$251.68
|
| Rate for Payer: Priority Health SBD |
$186.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.46
|
| Rate for Payer: UHC Core |
$154.26
|
| Rate for Payer: UHC Exchange |
$116.36
|
| Rate for Payer: UMR Bronson Commercial |
$109.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.07
|
|
|
HC NEG PRES VF DUO TRAC PAD
|
Facility
|
IP
|
$296.09
|
|
| Hospital Charge Code |
27200231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$130.28 |
| Max. Negotiated Rate |
$266.48 |
| Rate for Payer: Aetna American Axle |
$192.46
|
| Rate for Payer: Aetna Commercial |
$251.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.46
|
| Rate for Payer: Cash Price |
$236.87
|
| Rate for Payer: Cofinity Advantage |
$207.26
|
| Rate for Payer: Cofinity Commercial |
$254.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.87
|
| Rate for Payer: Healthscope Commercial |
$266.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$207.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$222.07
|
| Rate for Payer: PHP Commercial |
$251.68
|
| Rate for Payer: Priority Health SBD |
$186.54
|
| Rate for Payer: UMR Bronson Commercial |
$130.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.07
|
|
|
HC NEG PRES WHT FOAM DRSG
|
Facility
|
OP
|
$183.70
|
|
| Hospital Charge Code |
27200158
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$67.97 |
| Max. Negotiated Rate |
$165.33 |
| Rate for Payer: Aetna American Axle |
$119.41
|
| Rate for Payer: Aetna Commercial |
$156.15
|
| Rate for Payer: Aetna Medicare |
$91.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.41
|
| Rate for Payer: BCBS Complete |
$73.48
|
| Rate for Payer: Cash Price |
$146.96
|
| Rate for Payer: Cofinity Advantage |
$128.59
|
| Rate for Payer: Cofinity Commercial |
$157.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.96
|
| Rate for Payer: Healthscope Commercial |
$165.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$128.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$137.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$137.78
|
| Rate for Payer: PHP Commercial |
$156.15
|
| Rate for Payer: Priority Health SBD |
$115.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.41
|
| Rate for Payer: UHC Core |
$95.71
|
| Rate for Payer: UHC Exchange |
$72.19
|
| Rate for Payer: UMR Bronson Commercial |
$67.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$137.78
|
|
|
HC NEG PRES WHT FOAM DRSG
|
Facility
|
IP
|
$183.70
|
|
| Hospital Charge Code |
27200158
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.83 |
| Max. Negotiated Rate |
$165.33 |
| Rate for Payer: Aetna American Axle |
$119.41
|
| Rate for Payer: Aetna Commercial |
$156.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.41
|
| Rate for Payer: Cash Price |
$146.96
|
| Rate for Payer: Cofinity Advantage |
$128.59
|
| Rate for Payer: Cofinity Commercial |
$157.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.96
|
| Rate for Payer: Healthscope Commercial |
$165.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$128.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$137.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$137.78
|
| Rate for Payer: PHP Commercial |
$156.15
|
| Rate for Payer: Priority Health SBD |
$115.73
|
| Rate for Payer: UMR Bronson Commercial |
$80.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$137.78
|
|
|
HC NEG PRES WND THRPY DSG EXLGE
|
Facility
|
IP
|
$388.88
|
|
| Hospital Charge Code |
27200137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$171.11 |
| Max. Negotiated Rate |
$349.99 |
| Rate for Payer: Aetna American Axle |
$252.77
|
| Rate for Payer: Aetna Commercial |
$330.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.77
|
| Rate for Payer: Cash Price |
$311.10
|
| Rate for Payer: Cofinity Advantage |
$272.22
|
| Rate for Payer: Cofinity Commercial |
$334.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.10
|
| Rate for Payer: Healthscope Commercial |
$349.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$291.66
|
| Rate for Payer: PHP Commercial |
$330.55
|
| Rate for Payer: Priority Health SBD |
$244.99
|
| Rate for Payer: UMR Bronson Commercial |
$171.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.66
|
|
|
HC NEG PRES WND THRPY DSG EXLGE
|
Facility
|
OP
|
$388.88
|
|
| Hospital Charge Code |
27200137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.89 |
| Max. Negotiated Rate |
$349.99 |
| Rate for Payer: Aetna American Axle |
$252.77
|
| Rate for Payer: Aetna Commercial |
$330.55
|
| Rate for Payer: Aetna Medicare |
$194.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.77
|
| Rate for Payer: BCBS Complete |
$155.55
|
| Rate for Payer: Cash Price |
$311.10
|
| Rate for Payer: Cofinity Advantage |
$272.22
|
| Rate for Payer: Cofinity Commercial |
$334.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.10
|
| Rate for Payer: Healthscope Commercial |
$349.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$311.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$291.66
|
| Rate for Payer: PHP Commercial |
$330.55
|
| Rate for Payer: Priority Health SBD |
$244.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.77
|
| Rate for Payer: UHC Core |
$202.61
|
| Rate for Payer: UHC Exchange |
$152.83
|
| Rate for Payer: UMR Bronson Commercial |
$143.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.66
|
|
|
HC NEG PRES WND THRPY DSG SET LAR
|
Facility
|
OP
|
$206.60
|
|
| Hospital Charge Code |
27200138
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$76.44 |
| Max. Negotiated Rate |
$185.94 |
| Rate for Payer: Aetna American Axle |
$134.29
|
| Rate for Payer: Aetna Commercial |
$175.61
|
| Rate for Payer: Aetna Medicare |
$103.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.29
|
| Rate for Payer: BCBS Complete |
$82.64
|
| Rate for Payer: Cash Price |
$165.28
|
| Rate for Payer: Cofinity Advantage |
$144.62
|
| Rate for Payer: Cofinity Commercial |
$177.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.28
|
| Rate for Payer: Healthscope Commercial |
$185.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$144.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$154.95
|
| Rate for Payer: PHP Commercial |
$175.61
|
| Rate for Payer: Priority Health SBD |
$130.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.29
|
| Rate for Payer: UHC Core |
$107.64
|
| Rate for Payer: UHC Exchange |
$81.19
|
| Rate for Payer: UMR Bronson Commercial |
$76.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.95
|
|
|
HC NEG PRES WND THRPY DSG SET LAR
|
Facility
|
IP
|
$206.60
|
|
| Hospital Charge Code |
27200138
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.90 |
| Max. Negotiated Rate |
$185.94 |
| Rate for Payer: Aetna American Axle |
$134.29
|
| Rate for Payer: Aetna Commercial |
$175.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.29
|
| Rate for Payer: Cash Price |
$165.28
|
| Rate for Payer: Cofinity Advantage |
$144.62
|
| Rate for Payer: Cofinity Commercial |
$177.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.28
|
| Rate for Payer: Healthscope Commercial |
$185.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$144.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$154.95
|
| Rate for Payer: PHP Commercial |
$175.61
|
| Rate for Payer: Priority Health SBD |
$130.16
|
| Rate for Payer: UMR Bronson Commercial |
$90.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.95
|
|
|
HC NEG PRES WND THRPY DSG SET MED
|
Facility
|
OP
|
$148.84
|
|
| Hospital Charge Code |
27200139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$55.07 |
| Max. Negotiated Rate |
$133.96 |
| Rate for Payer: Aetna American Axle |
$96.75
|
| Rate for Payer: Aetna Commercial |
$126.51
|
| Rate for Payer: Aetna Medicare |
$74.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.75
|
| Rate for Payer: BCBS Complete |
$59.54
|
| Rate for Payer: Cash Price |
$119.07
|
| Rate for Payer: Cofinity Advantage |
$104.19
|
| Rate for Payer: Cofinity Commercial |
$128.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.07
|
| Rate for Payer: Healthscope Commercial |
$133.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.63
|
| Rate for Payer: PHP Commercial |
$126.51
|
| Rate for Payer: Priority Health SBD |
$93.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.75
|
| Rate for Payer: UHC Core |
$77.55
|
| Rate for Payer: UHC Exchange |
$58.49
|
| Rate for Payer: UMR Bronson Commercial |
$55.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.63
|
|
|
HC NEG PRES WND THRPY DSG SET MED
|
Facility
|
IP
|
$148.84
|
|
| Hospital Charge Code |
27200139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$65.49 |
| Max. Negotiated Rate |
$133.96 |
| Rate for Payer: Aetna American Axle |
$96.75
|
| Rate for Payer: Aetna Commercial |
$126.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.75
|
| Rate for Payer: Cash Price |
$119.07
|
| Rate for Payer: Cofinity Advantage |
$104.19
|
| Rate for Payer: Cofinity Commercial |
$128.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.07
|
| Rate for Payer: Healthscope Commercial |
$133.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.63
|
| Rate for Payer: PHP Commercial |
$126.51
|
| Rate for Payer: Priority Health SBD |
$93.77
|
| Rate for Payer: UMR Bronson Commercial |
$65.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.63
|
|
|
HC NEG PRES WND THRPY DSG SET SIL
|
Facility
|
IP
|
$277.93
|
|
| Hospital Charge Code |
27200140
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$122.29 |
| Max. Negotiated Rate |
$250.14 |
| Rate for Payer: Aetna American Axle |
$180.65
|
| Rate for Payer: Aetna Commercial |
$236.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.65
|
| Rate for Payer: Cash Price |
$222.34
|
| Rate for Payer: Cofinity Advantage |
$194.55
|
| Rate for Payer: Cofinity Commercial |
$239.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.34
|
| Rate for Payer: Healthscope Commercial |
$250.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$194.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.45
|
| Rate for Payer: PHP Commercial |
$236.24
|
| Rate for Payer: Priority Health SBD |
$175.10
|
| Rate for Payer: UMR Bronson Commercial |
$122.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.45
|
|
|
HC NEG PRES WND THRPY DSG SET SIL
|
Facility
|
OP
|
$277.93
|
|
| Hospital Charge Code |
27200140
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$102.83 |
| Max. Negotiated Rate |
$250.14 |
| Rate for Payer: Aetna American Axle |
$180.65
|
| Rate for Payer: Aetna Commercial |
$236.24
|
| Rate for Payer: Aetna Medicare |
$138.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.65
|
| Rate for Payer: BCBS Complete |
$111.17
|
| Rate for Payer: Cash Price |
$222.34
|
| Rate for Payer: Cofinity Advantage |
$194.55
|
| Rate for Payer: Cofinity Commercial |
$239.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.34
|
| Rate for Payer: Healthscope Commercial |
$250.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$194.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.45
|
| Rate for Payer: PHP Commercial |
$236.24
|
| Rate for Payer: Priority Health SBD |
$175.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.65
|
| Rate for Payer: UHC Core |
$144.80
|
| Rate for Payer: UHC Exchange |
$109.23
|
| Rate for Payer: UMR Bronson Commercial |
$102.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.45
|
|
|
HC NEG PRES WND THRPY DSG SET SMA
|
Facility
|
IP
|
$118.31
|
|
| Hospital Charge Code |
27200141
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.06 |
| Max. Negotiated Rate |
$106.48 |
| Rate for Payer: Aetna American Axle |
$76.90
|
| Rate for Payer: Aetna Commercial |
$100.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.90
|
| Rate for Payer: Cash Price |
$94.65
|
| Rate for Payer: Cofinity Advantage |
$82.82
|
| Rate for Payer: Cofinity Commercial |
$101.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.65
|
| Rate for Payer: Healthscope Commercial |
$106.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.73
|
| Rate for Payer: PHP Commercial |
$100.56
|
| Rate for Payer: Priority Health SBD |
$74.54
|
| Rate for Payer: UMR Bronson Commercial |
$52.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.73
|
|
|
HC NEG PRES WND THRPY DSG SET SMA
|
Facility
|
OP
|
$118.31
|
|
| Hospital Charge Code |
27200141
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.77 |
| Max. Negotiated Rate |
$106.48 |
| Rate for Payer: Aetna American Axle |
$76.90
|
| Rate for Payer: Aetna Commercial |
$100.56
|
| Rate for Payer: Aetna Medicare |
$59.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.90
|
| Rate for Payer: BCBS Complete |
$47.32
|
| Rate for Payer: Cash Price |
$94.65
|
| Rate for Payer: Cofinity Advantage |
$82.82
|
| Rate for Payer: Cofinity Commercial |
$101.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.65
|
| Rate for Payer: Healthscope Commercial |
$106.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.73
|
| Rate for Payer: PHP Commercial |
$100.56
|
| Rate for Payer: Priority Health SBD |
$74.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.90
|
| Rate for Payer: UHC Core |
$61.64
|
| Rate for Payer: UHC Exchange |
$46.50
|
| Rate for Payer: UMR Bronson Commercial |
$43.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.73
|
|
|
HC NEG PRES WOUND TX SET MED
|
Facility
|
IP
|
$81.59
|
|
| Hospital Charge Code |
27200127
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.90 |
| Max. Negotiated Rate |
$73.43 |
| Rate for Payer: Aetna American Axle |
$53.03
|
| Rate for Payer: Aetna Commercial |
$69.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.03
|
| Rate for Payer: Cash Price |
$65.27
|
| Rate for Payer: Cofinity Advantage |
$57.11
|
| Rate for Payer: Cofinity Commercial |
$70.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.27
|
| Rate for Payer: Healthscope Commercial |
$73.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.19
|
| Rate for Payer: PHP Commercial |
$69.35
|
| Rate for Payer: Priority Health SBD |
$51.40
|
| Rate for Payer: UMR Bronson Commercial |
$35.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.19
|
|
|
HC NEG PRES WOUND TX SET MED
|
Facility
|
OP
|
$81.59
|
|
| Hospital Charge Code |
27200127
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.19 |
| Max. Negotiated Rate |
$73.43 |
| Rate for Payer: Aetna American Axle |
$53.03
|
| Rate for Payer: Aetna Commercial |
$69.35
|
| Rate for Payer: Aetna Medicare |
$40.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.03
|
| Rate for Payer: BCBS Complete |
$32.64
|
| Rate for Payer: Cash Price |
$65.27
|
| Rate for Payer: Cofinity Advantage |
$57.11
|
| Rate for Payer: Cofinity Commercial |
$70.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.27
|
| Rate for Payer: Healthscope Commercial |
$73.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.19
|
| Rate for Payer: PHP Commercial |
$69.35
|
| Rate for Payer: Priority Health SBD |
$51.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.03
|
| Rate for Payer: UHC Core |
$42.51
|
| Rate for Payer: UHC Exchange |
$32.06
|
| Rate for Payer: UMR Bronson Commercial |
$30.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.19
|
|
