|
HC MANIFOLD 5-GANG
|
Facility
|
OP
|
$84.15
|
|
| Hospital Charge Code |
27000672
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.14 |
| Max. Negotiated Rate |
$75.73 |
| Rate for Payer: Aetna American Axle |
$54.70
|
| Rate for Payer: Aetna Commercial |
$71.53
|
| Rate for Payer: Aetna Medicare |
$42.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.70
|
| Rate for Payer: BCBS Complete |
$33.66
|
| Rate for Payer: Cash Price |
$67.32
|
| Rate for Payer: Cofinity Commercial |
$58.91
|
| Rate for Payer: Cofinity Commercial |
$72.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$58.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.32
|
| Rate for Payer: Healthscope Commercial |
$75.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.53
|
| Rate for Payer: PHP Commercial |
$71.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.70
|
| Rate for Payer: Priority Health SBD |
$53.01
|
| Rate for Payer: UMR Bronson Commercial |
$31.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.11
|
|
|
HC MANIFOLD 5-GANG
|
Facility
|
IP
|
$84.15
|
|
| Hospital Charge Code |
27000672
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.03 |
| Max. Negotiated Rate |
$75.73 |
| Rate for Payer: Aetna American Axle |
$54.70
|
| Rate for Payer: Aetna Commercial |
$71.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.70
|
| Rate for Payer: Cash Price |
$67.32
|
| Rate for Payer: Cofinity Commercial |
$58.91
|
| Rate for Payer: Cofinity Commercial |
$72.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$58.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.32
|
| Rate for Payer: Healthscope Commercial |
$75.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.53
|
| Rate for Payer: PHP Commercial |
$71.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.70
|
| Rate for Payer: Priority Health SBD |
$53.01
|
| Rate for Payer: UMR Bronson Commercial |
$37.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.11
|
|
|
HC MANIPULATION FINGER JOINT UNDER ANES EACH JOINT
|
Facility
|
OP
|
$4,080.00
|
|
|
Service Code
|
CPT 26340
|
| Hospital Charge Code |
76100382
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$836.62 |
| Max. Negotiated Rate |
$4,393.64 |
| Rate for Payer: Aetna American Axle |
$2,652.00
|
| Rate for Payer: Aetna Commercial |
$3,468.00
|
| Rate for Payer: Aetna Medicare |
$1,623.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,652.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,951.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,951.06
|
| Rate for Payer: BCBS Complete |
$878.45
|
| Rate for Payer: BCBS MAPPO |
$1,560.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,560.85
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cofinity Commercial |
$3,508.80
|
| Rate for Payer: Cofinity Commercial |
$2,856.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,856.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,264.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,560.85
|
| Rate for Payer: Healthscope Commercial |
$3,672.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,856.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,060.00
|
| Rate for Payer: Mclaren Medicaid |
$836.62
|
| Rate for Payer: Mclaren Medicare |
$1,560.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,638.89
|
| Rate for Payer: Meridian Medicaid |
$878.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,794.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,468.00
|
| Rate for Payer: PACE Medicare |
$1,482.81
|
| Rate for Payer: PACE SWMI |
$1,560.85
|
| Rate for Payer: PHP Commercial |
$3,468.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,560.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$836.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,652.00
|
| Rate for Payer: Priority Health Medicare |
$1,560.85
|
| Rate for Payer: Priority Health SBD |
$2,570.40
|
| Rate for Payer: Railroad Medicare Medicare |
$1,560.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,393.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,560.85
|
| Rate for Payer: UHC Exchange |
$2,982.94
|
| Rate for Payer: UHC Medicare Advantage |
$1,560.85
|
| Rate for Payer: UHCCP Medicaid |
$836.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,509.60
|
| Rate for Payer: VA VA |
$1,560.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,060.00
|
|
|
HC MANIPULATION FINGER JOINT UNDER ANES EACH JOINT
|
Facility
|
IP
|
$4,080.00
|
|
|
Service Code
|
CPT 26340
|
| Hospital Charge Code |
76100382
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,795.20 |
| Max. Negotiated Rate |
$3,672.00 |
| Rate for Payer: Aetna American Axle |
$2,652.00
|
| Rate for Payer: Aetna Commercial |
$3,468.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,652.00
|
| Rate for Payer: Cash Price |
$3,264.00
|
| Rate for Payer: Cofinity Commercial |
$2,856.00
|
| Rate for Payer: Cofinity Commercial |
$3,508.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,856.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,264.00
|
| Rate for Payer: Healthscope Commercial |
$3,672.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,856.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,060.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,468.00
|
| Rate for Payer: PHP Commercial |
$3,468.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,652.00
|
| Rate for Payer: Priority Health SBD |
$2,570.40
|
| Rate for Payer: UMR Bronson Commercial |
$1,795.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,060.00
|
|
|
HC MANIPULAT PALMAR FAC CORD POST INJ
|
Facility
|
IP
|
$494.19
|
|
|
Service Code
|
CPT 26341
|
| Hospital Charge Code |
76100318
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$217.44 |
| Max. Negotiated Rate |
$444.77 |
| Rate for Payer: Aetna American Axle |
$321.22
|
| Rate for Payer: Aetna Commercial |
$420.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.22
|
| Rate for Payer: Cash Price |
$395.35
|
| Rate for Payer: Cofinity Commercial |
$345.93
|
| Rate for Payer: Cofinity Commercial |
$425.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$345.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.35
|
| Rate for Payer: Healthscope Commercial |
$444.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$345.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.06
|
| Rate for Payer: PHP Commercial |
$420.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.22
|
| Rate for Payer: Priority Health SBD |
$311.34
|
| Rate for Payer: UMR Bronson Commercial |
$217.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.64
|
|
|
HC MANIPULAT PALMAR FAC CORD POST INJ
|
Facility
|
OP
|
$494.19
|
|
|
Service Code
|
CPT 26341
|
| Hospital Charge Code |
76100318
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.40 |
| Max. Negotiated Rate |
$658.55 |
| Rate for Payer: Aetna American Axle |
$321.22
|
| Rate for Payer: Aetna Commercial |
$420.06
|
| Rate for Payer: Aetna Medicare |
$243.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| Rate for Payer: Cash Price |
$395.35
|
| Rate for Payer: Cash Price |
$395.35
|
| Rate for Payer: Cofinity Commercial |
$425.00
|
| Rate for Payer: Cofinity Commercial |
$345.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$345.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$444.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$345.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.64
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.06
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$420.06
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.22
|
| Rate for Payer: Priority Health Medicare |
$233.95
|
| Rate for Payer: Priority Health SBD |
$311.34
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$658.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$447.10
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: UMR Bronson Commercial |
$182.85
|
| Rate for Payer: VA VA |
$233.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.64
|
|
|
HC MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH
|
Facility
|
IP
|
$1,492.97
|
|
|
Service Code
|
CPT 50396
|
| Hospital Charge Code |
36100614
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$656.91 |
| Max. Negotiated Rate |
$1,343.67 |
| Rate for Payer: Aetna American Axle |
$970.43
|
| Rate for Payer: Aetna Commercial |
$1,269.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$970.43
|
| Rate for Payer: Cash Price |
$1,194.38
|
| Rate for Payer: Cofinity Commercial |
$1,045.08
|
| Rate for Payer: Cofinity Commercial |
$1,283.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,045.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,194.38
|
| Rate for Payer: Healthscope Commercial |
$1,343.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,045.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,119.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,269.02
|
| Rate for Payer: PHP Commercial |
$1,269.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$970.43
|
| Rate for Payer: Priority Health SBD |
$940.57
|
| Rate for Payer: UMR Bronson Commercial |
$656.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,119.73
|
|
|
HC MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH
|
Facility
|
OP
|
$1,492.97
|
|
|
Service Code
|
CPT 50396
|
| Hospital Charge Code |
36100614
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$348.92 |
| Max. Negotiated Rate |
$1,832.42 |
| Rate for Payer: Aetna American Axle |
$970.43
|
| Rate for Payer: Aetna Commercial |
$1,269.02
|
| Rate for Payer: Aetna Medicare |
$677.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$970.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$813.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$813.71
|
| Rate for Payer: BCBS Complete |
$366.37
|
| Rate for Payer: BCBS MAPPO |
$650.97
|
| Rate for Payer: BCN Medicare Advantage |
$650.97
|
| Rate for Payer: Cash Price |
$1,194.38
|
| Rate for Payer: Cash Price |
$1,194.38
|
| Rate for Payer: Cofinity Commercial |
$1,283.95
|
| Rate for Payer: Cofinity Commercial |
$1,045.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,045.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,194.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$650.97
|
| Rate for Payer: Healthscope Commercial |
$1,343.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,045.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,119.73
|
| Rate for Payer: Mclaren Medicaid |
$348.92
|
| Rate for Payer: Mclaren Medicare |
$650.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$683.52
|
| Rate for Payer: Meridian Medicaid |
$366.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$748.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,269.02
|
| Rate for Payer: PACE Medicare |
$618.42
|
| Rate for Payer: PACE SWMI |
$650.97
|
| Rate for Payer: PHP Commercial |
$1,269.02
|
| Rate for Payer: PHP Medicare Advantage |
$650.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$970.43
|
| Rate for Payer: Priority Health Medicare |
$650.97
|
| Rate for Payer: Priority Health SBD |
$940.57
|
| Rate for Payer: Railroad Medicare Medicare |
$650.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,832.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$650.97
|
| Rate for Payer: UHC Exchange |
$1,244.07
|
| Rate for Payer: UHC Medicare Advantage |
$650.97
|
| Rate for Payer: UHCCP Medicaid |
$348.92
|
| Rate for Payer: UMR Bronson Commercial |
$552.40
|
| Rate for Payer: VA VA |
$650.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,119.73
|
|
|
HC MANTIS CLIP
|
Facility
|
OP
|
$1,156.68
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27200356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$427.97 |
| Max. Negotiated Rate |
$1,041.01 |
| Rate for Payer: Aetna American Axle |
$751.84
|
| Rate for Payer: Aetna Commercial |
$983.18
|
| Rate for Payer: Aetna Medicare |
$578.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$751.84
|
| Rate for Payer: BCBS Complete |
$462.67
|
| Rate for Payer: Cash Price |
$925.34
|
| Rate for Payer: Cofinity Commercial |
$809.68
|
| Rate for Payer: Cofinity Commercial |
$994.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$809.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$925.34
|
| Rate for Payer: Healthscope Commercial |
$1,041.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$809.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$867.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$983.18
|
| Rate for Payer: PHP Commercial |
$983.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$751.84
|
| Rate for Payer: Priority Health SBD |
$728.71
|
| Rate for Payer: UMR Bronson Commercial |
$427.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$867.51
|
|
|
HC MANTIS CLIP
|
Facility
|
IP
|
$1,156.68
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27200356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$508.94 |
| Max. Negotiated Rate |
$1,041.01 |
| Rate for Payer: Aetna American Axle |
$751.84
|
| Rate for Payer: Aetna Commercial |
$983.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$751.84
|
| Rate for Payer: Cash Price |
$925.34
|
| Rate for Payer: Cofinity Commercial |
$809.68
|
| Rate for Payer: Cofinity Commercial |
$994.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$809.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$925.34
|
| Rate for Payer: Healthscope Commercial |
$1,041.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$809.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$867.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$983.18
|
| Rate for Payer: PHP Commercial |
$983.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$751.84
|
| Rate for Payer: Priority Health SBD |
$728.71
|
| Rate for Payer: UMR Bronson Commercial |
$508.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$867.51
|
|
|
HC MANUAL DIFFERENTIAL
|
Facility
|
IP
|
$46.31
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
30500002
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$20.38 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna American Axle |
$30.10
|
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.10
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$32.42
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health SBD |
$29.18
|
| Rate for Payer: UMR Bronson Commercial |
$20.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.73
|
|
|
HC MANUAL DIFFERENTIAL
|
Facility
|
OP
|
$46.31
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
30500002
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.04 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna American Axle |
$30.10
|
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: Aetna Medicare |
$3.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.75
|
| Rate for Payer: BCBS Complete |
$2.14
|
| Rate for Payer: BCBS MAPPO |
$3.80
|
| Rate for Payer: BCN Medicare Advantage |
$3.80
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Cofinity Commercial |
$32.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.80
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.73
|
| Rate for Payer: Mclaren Medicaid |
$2.04
|
| Rate for Payer: Mclaren Medicare |
$3.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.99
|
| Rate for Payer: Meridian Medicaid |
$2.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: PACE Medicare |
$3.61
|
| Rate for Payer: PACE SWMI |
$3.80
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: PHP Medicare Advantage |
$3.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health Medicare |
$3.80
|
| Rate for Payer: Priority Health SBD |
$29.18
|
| Rate for Payer: Railroad Medicare Medicare |
$3.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.80
|
| Rate for Payer: UHC Exchange |
$7.26
|
| Rate for Payer: UHC Medicare Advantage |
$3.80
|
| Rate for Payer: UHCCP Medicaid |
$2.04
|
| Rate for Payer: UMR Bronson Commercial |
$17.13
|
| Rate for Payer: VA VA |
$3.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.73
|
|
|
HC MAPLE IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200046
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| 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 |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| 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 |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| 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 |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$9.98
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC MAPLE IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200046
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC MAPPING W/INTRACARDIAC 3D
|
Facility
|
OP
|
$6,169.57
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
48100035
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,282.74 |
| Max. Negotiated Rate |
$5,552.61 |
| Rate for Payer: Aetna American Axle |
$4,010.22
|
| Rate for Payer: Aetna Commercial |
$5,244.13
|
| Rate for Payer: Aetna Medicare |
$3,084.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,010.22
|
| Rate for Payer: BCBS Complete |
$2,467.83
|
| Rate for Payer: Cash Price |
$4,935.66
|
| Rate for Payer: Cofinity Commercial |
$4,318.70
|
| Rate for Payer: Cofinity Commercial |
$5,305.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,318.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,935.66
|
| Rate for Payer: Healthscope Commercial |
$5,552.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,318.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,627.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,244.13
|
| Rate for Payer: PHP Commercial |
$5,244.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,010.22
|
| Rate for Payer: Priority Health SBD |
$3,886.83
|
| Rate for Payer: UMR Bronson Commercial |
$2,282.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,627.18
|
|
|
HC MAPPING W/INTRACARDIAC 3D
|
Facility
|
IP
|
$6,169.57
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
48100035
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,714.61 |
| Max. Negotiated Rate |
$5,552.61 |
| Rate for Payer: Aetna American Axle |
$4,010.22
|
| Rate for Payer: Aetna Commercial |
$5,244.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,010.22
|
| Rate for Payer: Cash Price |
$4,935.66
|
| Rate for Payer: Cofinity Commercial |
$4,318.70
|
| Rate for Payer: Cofinity Commercial |
$5,305.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,318.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,935.66
|
| Rate for Payer: Healthscope Commercial |
$5,552.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,318.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,627.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,244.13
|
| Rate for Payer: PHP Commercial |
$5,244.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,010.22
|
| Rate for Payer: Priority Health SBD |
$3,886.83
|
| Rate for Payer: UMR Bronson Commercial |
$2,714.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,627.18
|
|
|
HC MAPPING W/OUT INTRACARDIAC 3D
|
Facility
|
OP
|
$4,398.08
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
48100032
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,627.29 |
| Max. Negotiated Rate |
$3,958.27 |
| Rate for Payer: Aetna American Axle |
$2,858.75
|
| Rate for Payer: Aetna Commercial |
$3,738.37
|
| Rate for Payer: Aetna Medicare |
$2,199.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,858.75
|
| Rate for Payer: BCBS Complete |
$1,759.23
|
| Rate for Payer: Cash Price |
$3,518.46
|
| Rate for Payer: Cofinity Commercial |
$3,078.66
|
| Rate for Payer: Cofinity Commercial |
$3,782.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,078.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,518.46
|
| Rate for Payer: Healthscope Commercial |
$3,958.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,078.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,298.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,738.37
|
| Rate for Payer: PHP Commercial |
$3,738.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,858.75
|
| Rate for Payer: Priority Health SBD |
$2,770.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,627.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,298.56
|
|
|
HC MAPPING W/OUT INTRACARDIAC 3D
|
Facility
|
IP
|
$4,398.08
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
48100032
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,935.16 |
| Max. Negotiated Rate |
$3,958.27 |
| Rate for Payer: Aetna American Axle |
$2,858.75
|
| Rate for Payer: Aetna Commercial |
$3,738.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,858.75
|
| Rate for Payer: Cash Price |
$3,518.46
|
| Rate for Payer: Cofinity Commercial |
$3,078.66
|
| Rate for Payer: Cofinity Commercial |
$3,782.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,078.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,518.46
|
| Rate for Payer: Healthscope Commercial |
$3,958.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,078.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,298.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,738.37
|
| Rate for Payer: PHP Commercial |
$3,738.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,858.75
|
| Rate for Payer: Priority Health SBD |
$2,770.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,935.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,298.56
|
|
|
HC MARS BARTHOLINS GLAND CYST
|
Facility
|
OP
|
$7,945.53
|
|
|
Service Code
|
CPT 56440
|
| Hospital Charge Code |
76100331
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,662.10 |
| Max. Negotiated Rate |
$8,728.81 |
| Rate for Payer: Aetna American Axle |
$5,164.59
|
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: Aetna Medicare |
$3,224.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,164.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,876.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,876.16
|
| Rate for Payer: BCBS Complete |
$1,745.20
|
| Rate for Payer: BCBS MAPPO |
$3,100.93
|
| Rate for Payer: BCN Medicare Advantage |
$3,100.93
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Cofinity Commercial |
$5,561.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,561.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,100.93
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,561.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Mclaren Medicaid |
$1,662.10
|
| Rate for Payer: Mclaren Medicare |
$3,100.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,255.98
|
| Rate for Payer: Meridian Medicaid |
$1,745.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,566.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: PACE Medicare |
$2,945.88
|
| Rate for Payer: PACE SWMI |
$3,100.93
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,100.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,662.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health Medicare |
$3,100.93
|
| Rate for Payer: Priority Health SBD |
$5,005.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,100.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,728.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,100.93
|
| Rate for Payer: UHC Exchange |
$5,926.19
|
| Rate for Payer: UHC Medicare Advantage |
$3,100.93
|
| Rate for Payer: UHCCP Medicaid |
$1,662.10
|
| Rate for Payer: UMR Bronson Commercial |
$2,939.85
|
| Rate for Payer: VA VA |
$3,100.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC MARS BARTHOLINS GLAND CYST
|
Facility
|
IP
|
$7,945.53
|
|
|
Service Code
|
CPT 56440
|
| Hospital Charge Code |
76100331
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,496.03 |
| Max. Negotiated Rate |
$7,150.98 |
| Rate for Payer: Aetna American Axle |
$5,164.59
|
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,164.59
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$5,561.87
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,561.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,561.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health SBD |
$5,005.68
|
| Rate for Payer: UMR Bronson Commercial |
$3,496.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC MARSUPIALIZ SUBLNGL SALIVARY CYST RANULA
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 42409
|
| Hospital Charge Code |
76100472
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,695.31 |
| Max. Negotiated Rate |
$8,903.25 |
| Rate for Payer: Aetna American Axle |
$5,237.70
|
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna Medicare |
$3,289.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,237.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,953.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,953.62
|
| Rate for Payer: BCBS Complete |
$1,780.08
|
| Rate for Payer: BCBS MAPPO |
$3,162.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.90
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Cofinity Commercial |
$5,640.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,640.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.90
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,640.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,043.50
|
| Rate for Payer: Mclaren Medicaid |
$1,695.31
|
| Rate for Payer: Mclaren Medicare |
$3,162.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,321.05
|
| Rate for Payer: Meridian Medicaid |
$1,780.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,637.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: PACE Medicare |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health Medicare |
$3,162.90
|
| Rate for Payer: Priority Health SBD |
$5,076.54
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,903.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.90
|
| Rate for Payer: UHC Exchange |
$6,044.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,162.90
|
| Rate for Payer: UHCCP Medicaid |
$1,695.31
|
| Rate for Payer: UMR Bronson Commercial |
$2,981.46
|
| Rate for Payer: VA VA |
$3,162.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
|
HC MARSUPIALIZ SUBLNGL SALIVARY CYST RANULA
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 42409
|
| Hospital Charge Code |
76100472
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,545.52 |
| Max. Negotiated Rate |
$7,252.20 |
| Rate for Payer: Aetna American Axle |
$5,237.70
|
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,237.70
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$5,640.60
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,640.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,640.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,043.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health SBD |
$5,076.54
|
| Rate for Payer: UMR Bronson Commercial |
$3,545.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
|
HC MASSAGE THERAPY
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 97124
|
| Hospital Charge Code |
42000024
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$11.32 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$19.89
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: BCBS Complete |
$12.24
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC MASSAGE THERAPY
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 97124
|
| Hospital Charge Code |
42000024
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$13.46 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna American Axle |
$19.89
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: UMR Bronson Commercial |
$13.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC MASTECTOMY SLEEVE EA $100
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
HCPCS L8010
|
| Hospital Charge Code |
96000004
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.74 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Aetna American Axle |
$66.30
|
| Rate for Payer: Aetna Commercial |
$86.70
|
| Rate for Payer: Aetna Medicare |
$51.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.30
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$71.40
|
| Rate for Payer: Cofinity Commercial |
$87.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.60
|
| Rate for Payer: Healthscope Commercial |
$91.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.70
|
| Rate for Payer: PHP Commercial |
$86.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health SBD |
$64.26
|
| Rate for Payer: UMR Bronson Commercial |
$37.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.50
|
|
