|
HC XR SHOULDER 1 VW
|
Facility
|
IP
|
$130.16
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
32000063
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$57.27 |
| Max. Negotiated Rate |
$117.14 |
| Rate for Payer: Aetna American Axle |
$84.60
|
| Rate for Payer: Aetna Commercial |
$110.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.60
|
| Rate for Payer: Cash Price |
$104.13
|
| Rate for Payer: Cofinity Commercial |
$91.11
|
| Rate for Payer: Cofinity Commercial |
$111.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.13
|
| Rate for Payer: Healthscope Commercial |
$117.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$110.64
|
| Rate for Payer: PHP Commercial |
$110.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.11
|
| Rate for Payer: Priority Health SBD |
$82.00
|
| Rate for Payer: UMR Bronson Commercial |
$57.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.62
|
|
|
HC XR SHOULDER 1 VW BILATERAL
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
32000338
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$107.80 |
| Max. Negotiated Rate |
$220.50 |
| Rate for Payer: Aetna American Axle |
$159.25
|
| Rate for Payer: Aetna Commercial |
$208.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.25
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$210.70
|
| Rate for Payer: Cofinity Commercial |
$171.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.00
|
| Rate for Payer: Healthscope Commercial |
$220.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$208.25
|
| Rate for Payer: PHP Commercial |
$208.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.50
|
| Rate for Payer: Priority Health SBD |
$154.35
|
| Rate for Payer: UMR Bronson Commercial |
$107.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.75
|
|
|
HC XR SHOULDER 1 VW BILATERAL
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
32000338
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$21.28 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$159.25
|
| Rate for Payer: Aetna Commercial |
$208.25
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$27.24
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$171.50
|
| Rate for Payer: Cofinity Commercial |
$210.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$220.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.75
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$208.25
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$208.25
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$154.35
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.41
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$21.28
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$90.65
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.75
|
|
|
HC XR SHOULDER BIL 1 VW
|
Facility
|
OP
|
$171.64
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
32000064
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$21.28 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$111.57
|
| Rate for Payer: Aetna Commercial |
$145.89
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$27.24
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$137.31
|
| Rate for Payer: Cash Price |
$137.31
|
| Rate for Payer: Cofinity Commercial |
$120.15
|
| Rate for Payer: Cofinity Commercial |
$147.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$154.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$120.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.73
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$145.89
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$145.89
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$108.13
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.41
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$21.28
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$63.51
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.73
|
|
|
HC XR SHOULDER BIL 1 VW
|
Facility
|
IP
|
$171.64
|
|
|
Service Code
|
CPT 73020
|
| Hospital Charge Code |
32000064
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$75.52 |
| Max. Negotiated Rate |
$154.48 |
| Rate for Payer: Aetna American Axle |
$111.57
|
| Rate for Payer: Aetna Commercial |
$145.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.57
|
| Rate for Payer: Cash Price |
$137.31
|
| Rate for Payer: Cofinity Commercial |
$120.15
|
| Rate for Payer: Cofinity Commercial |
$147.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.31
|
| Rate for Payer: Healthscope Commercial |
$154.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$120.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$145.89
|
| Rate for Payer: PHP Commercial |
$145.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.15
|
| Rate for Payer: Priority Health SBD |
$108.13
|
| Rate for Payer: UMR Bronson Commercial |
$75.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.73
|
|
|
HC XR SHOULDER BIL MIN 2 VW
|
Facility
|
IP
|
$442.79
|
|
|
Service Code
|
CPT 73030
|
| Hospital Charge Code |
32000066
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$194.83 |
| Max. Negotiated Rate |
$398.51 |
| Rate for Payer: Aetna American Axle |
$287.81
|
| Rate for Payer: Aetna Commercial |
$376.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.81
|
| Rate for Payer: Cash Price |
$354.23
|
| Rate for Payer: Cofinity Commercial |
$309.95
|
| Rate for Payer: Cofinity Commercial |
$380.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.23
|
| Rate for Payer: Healthscope Commercial |
$398.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$309.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$332.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$376.37
|
| Rate for Payer: PHP Commercial |
$376.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$309.95
|
| Rate for Payer: Priority Health SBD |
$278.96
|
| Rate for Payer: UMR Bronson Commercial |
$194.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$332.09
|
|
|
HC XR SHOULDER BIL MIN 2 VW
|
Facility
|
OP
|
$442.79
|
|
|
Service Code
|
CPT 73030
|
| Hospital Charge Code |
32000066
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$34.38 |
| Max. Negotiated Rate |
$398.51 |
| Rate for Payer: Aetna American Axle |
$287.81
|
| Rate for Payer: Aetna Commercial |
$376.37
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$48.78
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$354.23
|
| Rate for Payer: Cash Price |
$354.23
|
| Rate for Payer: Cofinity Commercial |
$309.95
|
| Rate for Payer: Cofinity Commercial |
$380.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$398.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$309.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$332.09
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$376.37
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$376.37
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$309.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$278.96
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.82
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$34.38
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$163.83
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$332.09
|
|
|
HC XR SHOULDER MIN 2 VW
|
Facility
|
IP
|
$400.20
|
|
|
Service Code
|
CPT 73030
|
| Hospital Charge Code |
32000065
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$176.09 |
| Max. Negotiated Rate |
$360.18 |
| Rate for Payer: Aetna American Axle |
$260.13
|
| Rate for Payer: Aetna Commercial |
$340.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.13
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$280.14
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Healthscope Commercial |
$360.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$280.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: PHP Commercial |
$340.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: Priority Health SBD |
$252.13
|
| Rate for Payer: UMR Bronson Commercial |
$176.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.15
|
|
|
HC XR SHOULDER MIN 2 VW
|
Facility
|
OP
|
$400.20
|
|
|
Service Code
|
CPT 73030
|
| Hospital Charge Code |
32000065
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$34.38 |
| Max. Negotiated Rate |
$360.18 |
| Rate for Payer: Aetna American Axle |
$260.13
|
| Rate for Payer: Aetna Commercial |
$340.17
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$48.78
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$280.14
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$360.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$280.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.15
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$340.17
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$252.13
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.82
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$34.38
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$148.07
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.15
|
|
|
HC XR SINUSES LESS THAN 3 VW
|
Facility
|
OP
|
$200.23
|
|
|
Service Code
|
CPT 70210
|
| Hospital Charge Code |
32000013
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$31.76 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$130.15
|
| Rate for Payer: Aetna Commercial |
$170.20
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$45.61
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$160.18
|
| Rate for Payer: Cash Price |
$160.18
|
| Rate for Payer: Cofinity Commercial |
$140.16
|
| Rate for Payer: Cofinity Commercial |
$172.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$180.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.17
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$170.20
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$170.20
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$126.14
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.94
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$31.76
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$74.09
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.17
|
|
|
HC XR SINUSES LESS THAN 3 VW
|
Facility
|
IP
|
$200.23
|
|
|
Service Code
|
CPT 70210
|
| Hospital Charge Code |
32000013
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$88.10 |
| Max. Negotiated Rate |
$180.21 |
| Rate for Payer: Aetna American Axle |
$130.15
|
| Rate for Payer: Aetna Commercial |
$170.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.15
|
| Rate for Payer: Cash Price |
$160.18
|
| Rate for Payer: Cofinity Commercial |
$140.16
|
| Rate for Payer: Cofinity Commercial |
$172.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.18
|
| Rate for Payer: Healthscope Commercial |
$180.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$170.20
|
| Rate for Payer: PHP Commercial |
$170.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.16
|
| Rate for Payer: Priority Health SBD |
$126.14
|
| Rate for Payer: UMR Bronson Commercial |
$88.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.17
|
|
|
HC XR SINUSES MIN 3 VW
|
Facility
|
OP
|
$350.63
|
|
|
Service Code
|
CPT 70220
|
| Hospital Charge Code |
32000015
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.00 |
| Max. Negotiated Rate |
$315.57 |
| Rate for Payer: Aetna American Axle |
$227.91
|
| Rate for Payer: Aetna Commercial |
$298.04
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$51.95
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$280.50
|
| Rate for Payer: Cash Price |
$280.50
|
| Rate for Payer: Cofinity Commercial |
$245.44
|
| Rate for Payer: Cofinity Commercial |
$301.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$315.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.97
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$298.04
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$298.04
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$220.90
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.70
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$37.00
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$129.73
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.97
|
|
|
HC XR SINUSES MIN 3 VW
|
Facility
|
IP
|
$350.63
|
|
|
Service Code
|
CPT 70220
|
| Hospital Charge Code |
32000015
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$154.28 |
| Max. Negotiated Rate |
$315.57 |
| Rate for Payer: Aetna American Axle |
$227.91
|
| Rate for Payer: Aetna Commercial |
$298.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.91
|
| Rate for Payer: Cash Price |
$280.50
|
| Rate for Payer: Cofinity Commercial |
$245.44
|
| Rate for Payer: Cofinity Commercial |
$301.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.50
|
| Rate for Payer: Healthscope Commercial |
$315.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$298.04
|
| Rate for Payer: PHP Commercial |
$298.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.44
|
| Rate for Payer: Priority Health SBD |
$220.90
|
| Rate for Payer: UMR Bronson Commercial |
$154.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.97
|
|
|
HC XR SINUS TRACT FISTULA ABSCESS
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000014
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$58.61 |
| Max. Negotiated Rate |
$1,543.71 |
| Rate for Payer: Aetna American Axle |
$247.71
|
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: Aetna Medicare |
$509.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$612.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$612.96
|
| Rate for Payer: BCBS Complete |
$281.67
|
| Rate for Payer: BCBS MAPPO |
$490.37
|
| Rate for Payer: BCBS Trust/PPO |
$67.15
|
| Rate for Payer: BCN Medicare Advantage |
$490.37
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$266.76
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$490.37
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$266.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Mclaren Medicaid |
$268.23
|
| Rate for Payer: Mclaren Medicare |
$490.37
|
| Rate for Payer: Meridian Medicaid |
$281.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$514.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$563.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PACE Medicare |
$465.85
|
| Rate for Payer: PACE SWMI |
$490.37
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: PHP Medicare Advantage |
$490.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,543.71
|
| Rate for Payer: Priority Health Medicare |
$490.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,234.97
|
| Rate for Payer: Priority Health SBD |
$240.09
|
| Rate for Payer: Railroad Medicare Medicare |
$490.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.47
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$490.37
|
| Rate for Payer: UHC Exchange |
$58.61
|
| Rate for Payer: UHC Medicare Advantage |
$505.08
|
| Rate for Payer: UMR Bronson Commercial |
$141.00
|
| Rate for Payer: VA VA |
$490.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC XR SINUS TRACT FISTULA ABSCESS
|
Facility
|
IP
|
$381.09
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000014
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$167.68 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna American Axle |
$247.71
|
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.71
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$266.76
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$266.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health SBD |
$240.09
|
| Rate for Payer: UMR Bronson Commercial |
$167.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC XR SKULL LESS THAN 4 VW
|
Facility
|
OP
|
$350.37
|
|
|
Service Code
|
CPT 70250
|
| Hospital Charge Code |
32000017
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$35.36 |
| Max. Negotiated Rate |
$315.33 |
| Rate for Payer: Aetna American Axle |
$227.74
|
| Rate for Payer: Aetna Commercial |
$297.81
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$51.95
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Cofinity Commercial |
$245.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$315.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.78
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.81
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$297.81
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$220.73
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.90
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$35.36
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$129.64
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.78
|
|
|
HC XR SKULL LESS THAN 4 VW
|
Facility
|
IP
|
$350.37
|
|
|
Service Code
|
CPT 70250
|
| Hospital Charge Code |
32000017
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$154.16 |
| Max. Negotiated Rate |
$315.33 |
| Rate for Payer: Aetna American Axle |
$227.74
|
| Rate for Payer: Aetna Commercial |
$297.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.74
|
| Rate for Payer: Cash Price |
$280.30
|
| Rate for Payer: Cofinity Commercial |
$245.26
|
| Rate for Payer: Cofinity Commercial |
$301.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.30
|
| Rate for Payer: Healthscope Commercial |
$315.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.81
|
| Rate for Payer: PHP Commercial |
$297.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.26
|
| Rate for Payer: Priority Health SBD |
$220.73
|
| Rate for Payer: UMR Bronson Commercial |
$154.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.78
|
|
|
HC XR SKULL MIN 4 VW
|
Facility
|
IP
|
$400.20
|
|
|
Service Code
|
CPT 70260
|
| Hospital Charge Code |
32000018
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$176.09 |
| Max. Negotiated Rate |
$360.18 |
| Rate for Payer: Aetna American Axle |
$260.13
|
| Rate for Payer: Aetna Commercial |
$340.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.13
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Cofinity Commercial |
$280.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Healthscope Commercial |
$360.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$280.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: PHP Commercial |
$340.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: Priority Health SBD |
$252.13
|
| Rate for Payer: UMR Bronson Commercial |
$176.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.15
|
|
|
HC XR SKULL MIN 4 VW
|
Facility
|
OP
|
$400.20
|
|
|
Service Code
|
CPT 70260
|
| Hospital Charge Code |
32000018
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$360.18 |
| Rate for Payer: Aetna American Axle |
$260.13
|
| Rate for Payer: Aetna Commercial |
$340.17
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$59.55
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$280.14
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$360.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$280.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.15
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$340.17
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$252.13
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.27
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$43.88
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$148.07
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.15
|
|
|
HC XR SMALL BOWEL
|
Facility
|
IP
|
$600.55
|
|
|
Service Code
|
CPT 74250
|
| Hospital Charge Code |
32000144
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$264.24 |
| Max. Negotiated Rate |
$540.50 |
| Rate for Payer: Aetna American Axle |
$390.36
|
| Rate for Payer: Aetna Commercial |
$510.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.36
|
| Rate for Payer: Cash Price |
$480.44
|
| Rate for Payer: Cofinity Commercial |
$420.38
|
| Rate for Payer: Cofinity Commercial |
$516.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.44
|
| Rate for Payer: Healthscope Commercial |
$540.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.47
|
| Rate for Payer: PHP Commercial |
$510.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.38
|
| Rate for Payer: Priority Health SBD |
$378.35
|
| Rate for Payer: UMR Bronson Commercial |
$264.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.41
|
|
|
HC XR SMALL BOWEL
|
Facility
|
OP
|
$600.55
|
|
|
Service Code
|
CPT 74250
|
| Hospital Charge Code |
32000144
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$540.50 |
| Rate for Payer: Aetna American Axle |
$390.36
|
| Rate for Payer: Aetna Commercial |
$510.47
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$163.44
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$480.44
|
| Rate for Payer: Cash Price |
$480.44
|
| Rate for Payer: Cofinity Commercial |
$420.38
|
| Rate for Payer: Cofinity Commercial |
$516.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$540.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.41
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.47
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$510.47
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.13
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$411.30
|
| Rate for Payer: Priority Health SBD |
$378.35
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.47
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$119.52
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$222.20
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.41
|
|
|
HC XR SMALL BOWEL.
|
Facility
|
IP
|
$278.77
|
|
|
Service Code
|
CPT 74248
|
| Hospital Charge Code |
32000331
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$122.66 |
| Max. Negotiated Rate |
$250.89 |
| Rate for Payer: Aetna American Axle |
$181.20
|
| Rate for Payer: Aetna Commercial |
$236.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.20
|
| Rate for Payer: Cash Price |
$223.02
|
| Rate for Payer: Cofinity Commercial |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$239.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.02
|
| Rate for Payer: Healthscope Commercial |
$250.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$195.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$236.95
|
| Rate for Payer: PHP Commercial |
$236.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.14
|
| Rate for Payer: Priority Health SBD |
$175.63
|
| Rate for Payer: UMR Bronson Commercial |
$122.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.08
|
|
|
HC XR SMALL BOWEL.
|
Facility
|
OP
|
$278.77
|
|
|
Service Code
|
CPT 74248
|
| Hospital Charge Code |
32000331
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$80.88 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$181.20
|
| Rate for Payer: Aetna Commercial |
$236.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.20
|
| Rate for Payer: BCBS Complete |
$111.51
|
| Rate for Payer: BCBS Trust/PPO |
$96.29
|
| Rate for Payer: Cash Price |
$223.02
|
| Rate for Payer: Cash Price |
$223.02
|
| Rate for Payer: Cofinity Commercial |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$239.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.02
|
| Rate for Payer: Healthscope Commercial |
$250.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$195.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$236.95
|
| Rate for Payer: PHP Commercial |
$236.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.14
|
| Rate for Payer: Priority Health SBD |
$175.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.97
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Exchange |
$80.88
|
| Rate for Payer: UMR Bronson Commercial |
$103.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.08
|
|
|
HC XR SMALL BOWEL ENTEROCLYSIS TU
|
Facility
|
OP
|
$800.53
|
|
|
Service Code
|
CPT 74251
|
| Hospital Charge Code |
32000145
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$89.34 |
| Max. Negotiated Rate |
$720.48 |
| Rate for Payer: Aetna American Axle |
$520.34
|
| Rate for Payer: Aetna Commercial |
$680.45
|
| Rate for Payer: Aetna Medicare |
$169.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$520.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.15
|
| Rate for Payer: BCBS Complete |
$93.81
|
| Rate for Payer: BCBS MAPPO |
$163.32
|
| Rate for Payer: BCBS Trust/PPO |
$606.24
|
| Rate for Payer: BCN Medicare Advantage |
$163.32
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$560.37
|
| Rate for Payer: Cofinity Commercial |
$688.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.32
|
| Rate for Payer: Healthscope Commercial |
$720.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$560.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.40
|
| Rate for Payer: Mclaren Medicaid |
$89.34
|
| Rate for Payer: Mclaren Medicare |
$163.32
|
| Rate for Payer: Meridian Medicaid |
$93.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$171.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PACE Medicare |
$155.15
|
| Rate for Payer: PACE SWMI |
$163.32
|
| Rate for Payer: PHP Commercial |
$680.45
|
| Rate for Payer: PHP Medicare Advantage |
$163.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$514.13
|
| Rate for Payer: Priority Health Medicare |
$163.32
|
| Rate for Payer: Priority Health Narrow Network |
$411.30
|
| Rate for Payer: Priority Health SBD |
$504.33
|
| Rate for Payer: Railroad Medicare Medicare |
$163.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$391.52
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.32
|
| Rate for Payer: UHC Exchange |
$355.93
|
| Rate for Payer: UHC Medicare Advantage |
$168.22
|
| Rate for Payer: UMR Bronson Commercial |
$296.20
|
| Rate for Payer: VA VA |
$163.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
|
HC XR SMALL BOWEL ENTEROCLYSIS TU
|
Facility
|
IP
|
$800.53
|
|
|
Service Code
|
CPT 74251
|
| Hospital Charge Code |
32000145
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$352.23 |
| Max. Negotiated Rate |
$720.48 |
| Rate for Payer: Aetna American Axle |
$520.34
|
| Rate for Payer: Aetna Commercial |
$680.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$520.34
|
| Rate for Payer: Cash Price |
$640.42
|
| Rate for Payer: Cofinity Commercial |
$560.37
|
| Rate for Payer: Cofinity Commercial |
$688.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$640.42
|
| Rate for Payer: Healthscope Commercial |
$720.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$560.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$600.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$680.45
|
| Rate for Payer: PHP Commercial |
$680.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$560.37
|
| Rate for Payer: Priority Health SBD |
$504.33
|
| Rate for Payer: UMR Bronson Commercial |
$352.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$600.40
|
|
