|
HC NEG PRES WOUND TX SET SMALL
|
Facility
|
OP
|
$118.31
|
|
| Hospital Charge Code |
27200128
|
|
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 SMALL
|
Facility
|
IP
|
$118.31
|
|
| Hospital Charge Code |
27200128
|
|
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 Y CONNECTOR
|
Facility
|
IP
|
$8.02
|
|
| Hospital Charge Code |
27000174
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.53 |
| Max. Negotiated Rate |
$7.22 |
| Rate for Payer: Aetna American Axle |
$5.21
|
| Rate for Payer: Aetna Commercial |
$6.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.21
|
| Rate for Payer: Cash Price |
$6.42
|
| Rate for Payer: Cofinity Advantage |
$5.61
|
| Rate for Payer: Cofinity Commercial |
$6.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.42
|
| Rate for Payer: Healthscope Commercial |
$7.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.01
|
| Rate for Payer: PHP Commercial |
$6.82
|
| Rate for Payer: Priority Health SBD |
$5.05
|
| Rate for Payer: UMR Bronson Commercial |
$3.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.01
|
|
|
HC NEG PRES Y CONNECTOR
|
Facility
|
OP
|
$8.02
|
|
| Hospital Charge Code |
27000174
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.97 |
| Max. Negotiated Rate |
$7.22 |
| Rate for Payer: Aetna American Axle |
$5.21
|
| Rate for Payer: Aetna Commercial |
$6.82
|
| Rate for Payer: Aetna Medicare |
$4.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.21
|
| Rate for Payer: BCBS Complete |
$3.21
|
| Rate for Payer: Cash Price |
$6.42
|
| Rate for Payer: Cofinity Advantage |
$5.61
|
| Rate for Payer: Cofinity Commercial |
$6.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.42
|
| Rate for Payer: Healthscope Commercial |
$7.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.01
|
| Rate for Payer: PHP Commercial |
$6.82
|
| Rate for Payer: Priority Health SBD |
$5.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.21
|
| Rate for Payer: UHC Core |
$4.18
|
| Rate for Payer: UHC Exchange |
$3.15
|
| Rate for Payer: UMR Bronson Commercial |
$2.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.01
|
|
|
HC NEISSERIA GONORRHOEAE AMP DNA
|
Facility
|
IP
|
$68.98
|
|
|
Service Code
|
CPT 87591
|
| Hospital Charge Code |
30600163
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.35 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna American Axle |
$44.84
|
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.84
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Advantage |
$48.29
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: Priority Health SBD |
$43.46
|
| Rate for Payer: UMR Bronson Commercial |
$30.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.73
|
|
|
HC NEISSERIA GONORRHOEAE AMP DNA
|
Facility
|
OP
|
$68.98
|
|
|
Service Code
|
CPT 87591
|
| Hospital Charge Code |
30600163
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna American Axle |
$44.84
|
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$40.57
|
| Rate for Payer: BCN Commercial |
$40.57
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Advantage |
$48.29
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.73
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$43.46
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: UMR Bronson Commercial |
$25.52
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.73
|
|
|
HC NEISSERIA MENINGITITIS
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600275
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$52.64 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$40.57
|
| Rate for Payer: BCN Commercial |
$40.57
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: UMR Bronson Commercial |
$19.63
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC NEISSERIA MENINGITITIS
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600275
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: UMR Bronson Commercial |
$23.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC NEONATAL VENT INIT DAY
|
Facility
|
OP
|
$1,600.44
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000037
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$80.31 |
| Max. Negotiated Rate |
$1,990.71 |
| Rate for Payer: Aetna American Axle |
$1,040.29
|
| Rate for Payer: Aetna Commercial |
$1,360.37
|
| Rate for Payer: Aetna Medicare |
$640.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$769.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$769.46
|
| Rate for Payer: BCBS Complete |
$338.07
|
| Rate for Payer: BCBS MAPPO |
$615.57
|
| Rate for Payer: BCBS Trust/PPO |
$80.31
|
| Rate for Payer: BCN Commercial |
$80.31
|
| Rate for Payer: BCN Medicare Advantage |
$615.57
|
| Rate for Payer: Cash Price |
$1,280.35
|
| Rate for Payer: Cash Price |
$1,280.35
|
| Rate for Payer: Cofinity Advantage |
$1,120.31
|
| Rate for Payer: Cofinity Commercial |
$1,376.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.57
|
| Rate for Payer: Healthscope Commercial |
$1,440.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,120.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,200.33
|
| Rate for Payer: Mclaren Medicaid |
$615.57
|
| Rate for Payer: Mclaren Medicare |
$615.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$646.35
|
| Rate for Payer: Meridian Medicaid |
$646.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$707.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$677.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.37
|
| Rate for Payer: Nomi Health Commercial |
$1,846.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.33
|
| Rate for Payer: PACE Medicare |
$584.79
|
| Rate for Payer: PACE SWMI |
$615.57
|
| Rate for Payer: PHP Commercial |
$1,360.37
|
| Rate for Payer: PHP Medicare Advantage |
$615.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,990.71
|
| Rate for Payer: Priority Health Medicare |
$615.57
|
| Rate for Payer: Priority Health SBD |
$1,008.28
|
| Rate for Payer: Priority Health Tiered Network |
$1,592.57
|
| Rate for Payer: Railroad Medicare Medicare |
$615.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,040.29
|
| Rate for Payer: UHC Core |
$833.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$615.57
|
| Rate for Payer: UHC Exchange |
$628.97
|
| Rate for Payer: UHC Medicaid |
$321.94
|
| Rate for Payer: UHCCP Medicaid |
$321.94
|
| Rate for Payer: UMR Bronson Commercial |
$592.16
|
| Rate for Payer: VA VA |
$615.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,200.33
|
|
|
HC NEONATAL VENT INIT DAY
|
Facility
|
IP
|
$1,600.44
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000037
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$704.19 |
| Max. Negotiated Rate |
$1,440.40 |
| Rate for Payer: Aetna American Axle |
$1,040.29
|
| Rate for Payer: Aetna Commercial |
$1,360.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,040.29
|
| Rate for Payer: Cash Price |
$1,280.35
|
| Rate for Payer: Cofinity Advantage |
$1,120.31
|
| Rate for Payer: Cofinity Commercial |
$1,376.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,280.35
|
| Rate for Payer: Healthscope Commercial |
$1,440.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,120.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,200.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,360.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,200.33
|
| Rate for Payer: PHP Commercial |
$1,360.37
|
| Rate for Payer: Priority Health SBD |
$1,008.28
|
| Rate for Payer: UMR Bronson Commercial |
$704.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,200.33
|
|
|
HC NEONATAL VENT SUB DAY
|
Facility
|
OP
|
$1,221.40
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000038
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$59.18 |
| Max. Negotiated Rate |
$1,990.71 |
| Rate for Payer: Aetna American Axle |
$793.91
|
| Rate for Payer: Aetna Commercial |
$1,038.19
|
| Rate for Payer: Aetna Medicare |
$640.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$793.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$769.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$769.46
|
| Rate for Payer: BCBS Complete |
$338.07
|
| Rate for Payer: BCBS MAPPO |
$615.57
|
| Rate for Payer: BCBS Trust/PPO |
$59.18
|
| Rate for Payer: BCN Commercial |
$59.18
|
| Rate for Payer: BCN Medicare Advantage |
$615.57
|
| Rate for Payer: Cash Price |
$977.12
|
| Rate for Payer: Cash Price |
$977.12
|
| Rate for Payer: Cofinity Advantage |
$854.98
|
| Rate for Payer: Cofinity Commercial |
$1,050.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$977.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.57
|
| Rate for Payer: Healthscope Commercial |
$1,099.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$854.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$916.05
|
| Rate for Payer: Mclaren Medicaid |
$615.57
|
| Rate for Payer: Mclaren Medicare |
$615.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$646.35
|
| Rate for Payer: Meridian Medicaid |
$646.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$707.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$677.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,038.19
|
| Rate for Payer: Nomi Health Commercial |
$1,846.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$916.05
|
| Rate for Payer: PACE Medicare |
$584.79
|
| Rate for Payer: PACE SWMI |
$615.57
|
| Rate for Payer: PHP Commercial |
$1,038.19
|
| Rate for Payer: PHP Medicare Advantage |
$615.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,990.71
|
| Rate for Payer: Priority Health Medicare |
$615.57
|
| Rate for Payer: Priority Health SBD |
$769.48
|
| Rate for Payer: Priority Health Tiered Network |
$1,592.57
|
| Rate for Payer: Railroad Medicare Medicare |
$615.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$793.91
|
| Rate for Payer: UHC Core |
$636.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$615.57
|
| Rate for Payer: UHC Exchange |
$480.01
|
| Rate for Payer: UHC Medicaid |
$321.94
|
| Rate for Payer: UHCCP Medicaid |
$321.94
|
| Rate for Payer: UMR Bronson Commercial |
$451.92
|
| Rate for Payer: VA VA |
$615.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$916.05
|
|
|
HC NEONATAL VENT SUB DAY
|
Facility
|
IP
|
$1,221.40
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000038
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$537.42 |
| Max. Negotiated Rate |
$1,099.26 |
| Rate for Payer: Aetna American Axle |
$793.91
|
| Rate for Payer: Aetna Commercial |
$1,038.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$793.91
|
| Rate for Payer: Cash Price |
$977.12
|
| Rate for Payer: Cofinity Advantage |
$854.98
|
| Rate for Payer: Cofinity Commercial |
$1,050.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$977.12
|
| Rate for Payer: Healthscope Commercial |
$1,099.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$854.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$916.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,038.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$916.05
|
| Rate for Payer: PHP Commercial |
$1,038.19
|
| Rate for Payer: Priority Health SBD |
$769.48
|
| Rate for Payer: UMR Bronson Commercial |
$537.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$916.05
|
|
|
HC NEPHROSTOGRAM URETEROGRAM EXISTING ACCESS
|
Facility
|
IP
|
$1,432.06
|
|
|
Service Code
|
CPT 50431
|
| Hospital Charge Code |
36100503
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$630.11 |
| Max. Negotiated Rate |
$1,288.85 |
| Rate for Payer: Aetna American Axle |
$930.84
|
| Rate for Payer: Aetna Commercial |
$1,217.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$930.84
|
| Rate for Payer: Cash Price |
$1,145.65
|
| Rate for Payer: Cofinity Advantage |
$1,002.44
|
| Rate for Payer: Cofinity Commercial |
$1,231.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,145.65
|
| Rate for Payer: Healthscope Commercial |
$1,288.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,002.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,074.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,217.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,074.05
|
| Rate for Payer: PHP Commercial |
$1,217.25
|
| Rate for Payer: Priority Health SBD |
$902.20
|
| Rate for Payer: UMR Bronson Commercial |
$630.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,074.05
|
|
|
HC NEPHROSTOGRAM URETEROGRAM EXISTING ACCESS
|
Facility
|
OP
|
$1,432.06
|
|
|
Service Code
|
CPT 50431
|
| Hospital Charge Code |
36100503
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$363.38 |
| Max. Negotiated Rate |
$2,246.88 |
| Rate for Payer: Aetna American Axle |
$930.84
|
| Rate for Payer: Aetna Commercial |
$1,217.25
|
| Rate for Payer: Aetna Medicare |
$722.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$930.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$868.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$868.49
|
| Rate for Payer: BCBS Complete |
$381.58
|
| Rate for Payer: BCBS MAPPO |
$694.79
|
| Rate for Payer: BCBS Trust/PPO |
$847.34
|
| Rate for Payer: BCN Commercial |
$847.34
|
| Rate for Payer: BCN Medicare Advantage |
$694.79
|
| Rate for Payer: Cash Price |
$1,145.65
|
| Rate for Payer: Cash Price |
$1,145.65
|
| Rate for Payer: Cash Price |
$1,145.65
|
| Rate for Payer: Cofinity Advantage |
$1,002.44
|
| Rate for Payer: Cofinity Commercial |
$1,231.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,145.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.79
|
| Rate for Payer: Healthscope Commercial |
$1,288.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,002.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,074.05
|
| Rate for Payer: Mclaren Medicaid |
$694.79
|
| Rate for Payer: Mclaren Medicare |
$694.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.53
|
| Rate for Payer: Meridian Medicaid |
$729.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$799.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$764.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,217.25
|
| Rate for Payer: Nomi Health Commercial |
$2,084.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,074.05
|
| Rate for Payer: PACE Medicare |
$660.05
|
| Rate for Payer: PACE SWMI |
$694.79
|
| Rate for Payer: PHP Commercial |
$1,217.25
|
| Rate for Payer: PHP Medicare Advantage |
$694.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,246.88
|
| Rate for Payer: Priority Health Medicare |
$694.79
|
| Rate for Payer: Priority Health SBD |
$902.20
|
| Rate for Payer: Priority Health Tiered Network |
$1,797.50
|
| Rate for Payer: Railroad Medicare Medicare |
$694.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$694.79
|
| Rate for Payer: UHC Medicaid |
$363.38
|
| Rate for Payer: UHCCP Medicaid |
$363.38
|
| Rate for Payer: UMR Bronson Commercial |
$529.86
|
| Rate for Payer: VA VA |
$694.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,074.05
|
|
|
HC NEPHROSTOGRAM URETEROGRAM NEW ACCESS
|
Facility
|
IP
|
$1,228.49
|
|
|
Service Code
|
CPT 50430
|
| Hospital Charge Code |
36100502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$540.54 |
| Max. Negotiated Rate |
$1,105.64 |
| Rate for Payer: Aetna American Axle |
$798.52
|
| Rate for Payer: Aetna Commercial |
$1,044.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$798.52
|
| Rate for Payer: Cash Price |
$982.79
|
| Rate for Payer: Cofinity Advantage |
$859.94
|
| Rate for Payer: Cofinity Commercial |
$1,056.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$982.79
|
| Rate for Payer: Healthscope Commercial |
$1,105.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$859.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$921.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$921.37
|
| Rate for Payer: PHP Commercial |
$1,044.22
|
| Rate for Payer: Priority Health SBD |
$773.95
|
| Rate for Payer: UMR Bronson Commercial |
$540.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$921.37
|
|
|
HC NEPHROSTOGRAM URETEROGRAM NEW ACCESS
|
Facility
|
OP
|
$1,228.49
|
|
|
Service Code
|
CPT 50430
|
| Hospital Charge Code |
36100502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$363.38 |
| Max. Negotiated Rate |
$2,246.88 |
| Rate for Payer: Aetna American Axle |
$798.52
|
| Rate for Payer: Aetna Commercial |
$1,044.22
|
| Rate for Payer: Aetna Medicare |
$722.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$798.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$868.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$868.49
|
| Rate for Payer: BCBS Complete |
$381.58
|
| Rate for Payer: BCBS MAPPO |
$694.79
|
| Rate for Payer: BCBS Trust/PPO |
$619.98
|
| Rate for Payer: BCN Commercial |
$619.98
|
| Rate for Payer: BCN Medicare Advantage |
$694.79
|
| Rate for Payer: Cash Price |
$982.79
|
| Rate for Payer: Cash Price |
$982.79
|
| Rate for Payer: Cash Price |
$982.79
|
| Rate for Payer: Cofinity Advantage |
$859.94
|
| Rate for Payer: Cofinity Commercial |
$1,056.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$982.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.79
|
| Rate for Payer: Healthscope Commercial |
$1,105.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$859.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$921.37
|
| Rate for Payer: Mclaren Medicaid |
$694.79
|
| Rate for Payer: Mclaren Medicare |
$694.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.53
|
| Rate for Payer: Meridian Medicaid |
$729.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$799.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$764.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.22
|
| Rate for Payer: Nomi Health Commercial |
$2,084.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$921.37
|
| Rate for Payer: PACE Medicare |
$660.05
|
| Rate for Payer: PACE SWMI |
$694.79
|
| Rate for Payer: PHP Commercial |
$1,044.22
|
| Rate for Payer: PHP Medicare Advantage |
$694.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,246.88
|
| Rate for Payer: Priority Health Medicare |
$694.79
|
| Rate for Payer: Priority Health SBD |
$773.95
|
| Rate for Payer: Priority Health Tiered Network |
$1,797.50
|
| Rate for Payer: Railroad Medicare Medicare |
$694.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$694.79
|
| Rate for Payer: UHC Medicaid |
$363.38
|
| Rate for Payer: UHCCP Medicaid |
$363.38
|
| Rate for Payer: UMR Bronson Commercial |
$454.54
|
| Rate for Payer: VA VA |
$694.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$921.37
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL EA ADDL LEVEL
|
Facility
|
OP
|
$1,521.24
|
|
|
Service Code
|
CPT 64421
|
| Hospital Charge Code |
36100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$460.91 |
| Max. Negotiated Rate |
$2,850.01 |
| Rate for Payer: Aetna American Axle |
$988.81
|
| Rate for Payer: Aetna Commercial |
$1,293.05
|
| Rate for Payer: Aetna Medicare |
$916.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$988.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,061.62
|
| Rate for Payer: BCN Commercial |
$1,061.62
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$1,216.99
|
| Rate for Payer: Cash Price |
$1,216.99
|
| Rate for Payer: Cash Price |
$1,216.99
|
| Rate for Payer: Cofinity Advantage |
$1,064.87
|
| Rate for Payer: Cofinity Commercial |
$1,308.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,216.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,369.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,064.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,140.93
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$925.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,293.05
|
| Rate for Payer: Nomi Health Commercial |
$2,643.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,140.93
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$1,293.05
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,850.01
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health SBD |
$958.38
|
| Rate for Payer: Priority Health Tiered Network |
$2,280.01
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$988.81
|
| Rate for Payer: UHC Core |
$792.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Exchange |
$597.85
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: UMR Bronson Commercial |
$562.86
|
| Rate for Payer: VA VA |
$881.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,140.93
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL EA ADDL LEVEL
|
Facility
|
IP
|
$1,521.24
|
|
|
Service Code
|
CPT 64421
|
| Hospital Charge Code |
36100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$669.35 |
| Max. Negotiated Rate |
$1,369.12 |
| Rate for Payer: Aetna American Axle |
$988.81
|
| Rate for Payer: Aetna Commercial |
$1,293.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$988.81
|
| Rate for Payer: Cash Price |
$1,216.99
|
| Rate for Payer: Cofinity Advantage |
$1,064.87
|
| Rate for Payer: Cofinity Commercial |
$1,308.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,216.99
|
| Rate for Payer: Healthscope Commercial |
$1,369.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,064.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,140.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,293.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,140.93
|
| Rate for Payer: PHP Commercial |
$1,293.05
|
| Rate for Payer: Priority Health SBD |
$958.38
|
| Rate for Payer: UMR Bronson Commercial |
$669.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,140.93
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL SINGLE
|
Facility
|
OP
|
$1,160.81
|
|
|
Service Code
|
CPT 64420
|
| Hospital Charge Code |
36100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$2,274.56 |
| Rate for Payer: Aetna American Axle |
$754.53
|
| Rate for Payer: Aetna American Axle |
$503.02
|
| Rate for Payer: Aetna Commercial |
$986.69
|
| Rate for Payer: Aetna Commercial |
$657.79
|
| Rate for Payer: Aetna Medicare |
$731.47
|
| Rate for Payer: Aetna Medicare |
$731.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$754.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$503.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$863.85
|
| Rate for Payer: BCBS Trust/PPO |
$863.85
|
| Rate for Payer: BCN Commercial |
$863.85
|
| Rate for Payer: BCN Commercial |
$863.85
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$619.10
|
| Rate for Payer: Cash Price |
$928.65
|
| Rate for Payer: Cash Price |
$619.10
|
| Rate for Payer: Cash Price |
$928.65
|
| Rate for Payer: Cash Price |
$928.65
|
| Rate for Payer: Cash Price |
$619.10
|
| Rate for Payer: Cofinity Advantage |
$812.57
|
| Rate for Payer: Cofinity Advantage |
$541.71
|
| Rate for Payer: Cofinity Commercial |
$665.53
|
| Rate for Payer: Cofinity Commercial |
$998.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$619.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$696.48
|
| Rate for Payer: Healthscope Commercial |
$1,044.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$541.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$812.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$870.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$580.40
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$738.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$657.79
|
| Rate for Payer: Nomi Health Commercial |
$2,110.02
|
| Rate for Payer: Nomi Health Commercial |
$2,110.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$580.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$870.61
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$657.79
|
| Rate for Payer: PHP Commercial |
$986.69
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,274.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,274.56
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health SBD |
$487.54
|
| Rate for Payer: Priority Health SBD |
$731.31
|
| Rate for Payer: Priority Health Tiered Network |
$1,819.65
|
| Rate for Payer: Priority Health Tiered Network |
$1,819.65
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$503.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$754.53
|
| Rate for Payer: UHC Core |
$403.19
|
| Rate for Payer: UHC Core |
$604.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$304.13
|
| Rate for Payer: UHC Exchange |
$456.20
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UMR Bronson Commercial |
$429.50
|
| Rate for Payer: UMR Bronson Commercial |
$286.33
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$580.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$870.61
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL SINGLE
|
Facility
|
IP
|
$1,160.81
|
|
|
Service Code
|
CPT 64420
|
| Hospital Charge Code |
36100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$510.76 |
| Max. Negotiated Rate |
$1,044.73 |
| Rate for Payer: Aetna American Axle |
$754.53
|
| Rate for Payer: Aetna American Axle |
$503.02
|
| Rate for Payer: Aetna Commercial |
$986.69
|
| Rate for Payer: Aetna Commercial |
$657.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$754.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$503.02
|
| Rate for Payer: Cash Price |
$928.65
|
| Rate for Payer: Cash Price |
$619.10
|
| Rate for Payer: Cofinity Advantage |
$541.71
|
| Rate for Payer: Cofinity Advantage |
$812.57
|
| Rate for Payer: Cofinity Commercial |
$665.53
|
| Rate for Payer: Cofinity Commercial |
$998.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$928.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$619.10
|
| Rate for Payer: Healthscope Commercial |
$1,044.73
|
| Rate for Payer: Healthscope Commercial |
$696.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$541.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$812.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$870.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$580.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$986.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$657.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$870.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$580.40
|
| Rate for Payer: PHP Commercial |
$986.69
|
| Rate for Payer: PHP Commercial |
$657.79
|
| Rate for Payer: Priority Health SBD |
$487.54
|
| Rate for Payer: Priority Health SBD |
$731.31
|
| Rate for Payer: UMR Bronson Commercial |
$510.76
|
| Rate for Payer: UMR Bronson Commercial |
$340.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$870.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$580.40
|
|
|
HC NETTLE IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200049
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| 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 |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC NETTLE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200049
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM EA ADDL HR
|
Facility
|
IP
|
$137.96
|
|
|
Service Code
|
CPT 96121
|
| Hospital Charge Code |
91800006
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$60.70 |
| Max. Negotiated Rate |
$124.16 |
| Rate for Payer: Aetna American Axle |
$89.67
|
| Rate for Payer: Aetna Commercial |
$117.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.67
|
| Rate for Payer: Cash Price |
$110.37
|
| Rate for Payer: Cofinity Advantage |
$96.57
|
| Rate for Payer: Cofinity Commercial |
$118.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.37
|
| Rate for Payer: Healthscope Commercial |
$124.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.47
|
| Rate for Payer: PHP Commercial |
$117.27
|
| Rate for Payer: Priority Health SBD |
$86.91
|
| Rate for Payer: UMR Bronson Commercial |
$60.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.47
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM EA ADDL HR
|
Facility
|
OP
|
$137.96
|
|
|
Service Code
|
CPT 96121
|
| Hospital Charge Code |
91800006
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$51.05 |
| Max. Negotiated Rate |
$124.16 |
| Rate for Payer: Aetna American Axle |
$89.67
|
| Rate for Payer: Aetna Commercial |
$117.27
|
| Rate for Payer: Aetna Medicare |
$68.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.67
|
| Rate for Payer: BCBS Complete |
$55.18
|
| Rate for Payer: Cash Price |
$110.37
|
| Rate for Payer: Cofinity Advantage |
$96.57
|
| Rate for Payer: Cofinity Commercial |
$118.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.37
|
| Rate for Payer: Healthscope Commercial |
$124.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.47
|
| Rate for Payer: PHP Commercial |
$117.27
|
| Rate for Payer: Priority Health SBD |
$86.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.67
|
| Rate for Payer: UHC Core |
$71.88
|
| Rate for Payer: UHC Exchange |
$54.22
|
| Rate for Payer: UMR Bronson Commercial |
$51.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.47
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM FIRST HOUR
|
Facility
|
IP
|
$280.60
|
|
|
Service Code
|
CPT 96116
|
| Hospital Charge Code |
91800001
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$123.46 |
| Max. Negotiated Rate |
$252.54 |
| Rate for Payer: Aetna American Axle |
$182.39
|
| Rate for Payer: Aetna Commercial |
$238.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.39
|
| Rate for Payer: Cash Price |
$224.48
|
| Rate for Payer: Cofinity Advantage |
$196.42
|
| Rate for Payer: Cofinity Commercial |
$241.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.48
|
| Rate for Payer: Healthscope Commercial |
$252.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$196.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.45
|
| Rate for Payer: PHP Commercial |
$238.51
|
| Rate for Payer: Priority Health SBD |
$176.78
|
| Rate for Payer: UMR Bronson Commercial |
$123.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.45
|
|
