|
HC MYOBLOC PER 100U (RIMABOTULINUMTOXINB)
|
Facility
|
IP
|
$34.70
|
|
|
Service Code
|
HCPCS J0587
|
| Hospital Charge Code |
63600172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.27 |
| Max. Negotiated Rate |
$31.23 |
| Rate for Payer: Aetna American Axle |
$22.55
|
| Rate for Payer: Aetna Commercial |
$29.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.55
|
| Rate for Payer: Cash Price |
$27.76
|
| Rate for Payer: Cofinity Commercial |
$24.29
|
| Rate for Payer: Cofinity Commercial |
$29.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.76
|
| Rate for Payer: Healthscope Commercial |
$31.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.50
|
| Rate for Payer: PHP Commercial |
$29.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.55
|
| Rate for Payer: Priority Health SBD |
$21.86
|
| Rate for Payer: UMR Bronson Commercial |
$15.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.02
|
|
|
HC MYOGLOBIN SERUM
|
Facility
|
OP
|
$145.96
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$131.36 |
| Rate for Payer: Aetna American Axle |
$94.87
|
| Rate for Payer: Aetna Commercial |
$124.07
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.15
|
| Rate for Payer: BCBS Complete |
$7.27
|
| Rate for Payer: BCBS MAPPO |
$12.92
|
| Rate for Payer: BCN Medicare Advantage |
$12.92
|
| Rate for Payer: Cash Price |
$116.77
|
| Rate for Payer: Cash Price |
$116.77
|
| Rate for Payer: Cofinity Commercial |
$125.53
|
| Rate for Payer: Cofinity Commercial |
$102.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$102.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.92
|
| Rate for Payer: Healthscope Commercial |
$131.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.47
|
| Rate for Payer: Mclaren Medicaid |
$6.93
|
| Rate for Payer: Mclaren Medicare |
$12.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.57
|
| Rate for Payer: Meridian Medicaid |
$7.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.07
|
| Rate for Payer: PACE Medicare |
$12.27
|
| Rate for Payer: PACE SWMI |
$12.92
|
| Rate for Payer: PHP Commercial |
$124.07
|
| Rate for Payer: PHP Medicare Advantage |
$12.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.87
|
| Rate for Payer: Priority Health Medicare |
$12.92
|
| Rate for Payer: Priority Health SBD |
$91.95
|
| Rate for Payer: Railroad Medicare Medicare |
$12.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.92
|
| Rate for Payer: UHC Exchange |
$24.69
|
| Rate for Payer: UHC Medicare Advantage |
$12.92
|
| Rate for Payer: UHCCP Medicaid |
$6.93
|
| Rate for Payer: UMR Bronson Commercial |
$54.01
|
| Rate for Payer: VA VA |
$12.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.47
|
|
|
HC MYOGLOBIN SERUM
|
Facility
|
IP
|
$145.96
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.22 |
| Max. Negotiated Rate |
$131.36 |
| Rate for Payer: Aetna American Axle |
$94.87
|
| Rate for Payer: Aetna Commercial |
$124.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.87
|
| Rate for Payer: Cash Price |
$116.77
|
| Rate for Payer: Cofinity Commercial |
$102.17
|
| Rate for Payer: Cofinity Commercial |
$125.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$102.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.77
|
| Rate for Payer: Healthscope Commercial |
$131.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.07
|
| Rate for Payer: PHP Commercial |
$124.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.87
|
| Rate for Payer: Priority Health SBD |
$91.95
|
| Rate for Payer: UMR Bronson Commercial |
$64.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.47
|
|
|
HC MYOGLOBIN SERUM.
|
Facility
|
OP
|
$54.10
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100664
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna American Axle |
$35.16
|
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.15
|
| Rate for Payer: BCBS Complete |
$7.27
|
| Rate for Payer: BCBS MAPPO |
$12.92
|
| Rate for Payer: BCN Medicare Advantage |
$12.92
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Cofinity Commercial |
$37.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.92
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.58
|
| Rate for Payer: Mclaren Medicaid |
$6.93
|
| Rate for Payer: Mclaren Medicare |
$12.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.57
|
| Rate for Payer: Meridian Medicaid |
$7.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: PACE Medicare |
$12.27
|
| Rate for Payer: PACE SWMI |
$12.92
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: PHP Medicare Advantage |
$12.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health Medicare |
$12.92
|
| Rate for Payer: Priority Health SBD |
$34.08
|
| Rate for Payer: Railroad Medicare Medicare |
$12.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.92
|
| Rate for Payer: UHC Exchange |
$24.69
|
| Rate for Payer: UHC Medicare Advantage |
$12.92
|
| Rate for Payer: UHCCP Medicaid |
$6.93
|
| Rate for Payer: UMR Bronson Commercial |
$20.02
|
| Rate for Payer: VA VA |
$12.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
|
HC MYOGLOBIN SERUM.
|
Facility
|
IP
|
$54.10
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100664
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.80 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna American Axle |
$35.16
|
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.16
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$37.87
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health SBD |
$34.08
|
| Rate for Payer: UMR Bronson Commercial |
$23.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
|
HC MYOGLOBIN URINE
|
Facility
|
IP
|
$48.90
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.52 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna American Axle |
$31.79
|
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.79
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.79
|
| Rate for Payer: Priority Health SBD |
$30.81
|
| Rate for Payer: UMR Bronson Commercial |
$21.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.67
|
|
|
HC MYOGLOBIN URINE
|
Facility
|
OP
|
$48.90
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna American Axle |
$31.79
|
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.15
|
| Rate for Payer: BCBS Complete |
$7.27
|
| Rate for Payer: BCBS MAPPO |
$12.92
|
| Rate for Payer: BCN Medicare Advantage |
$12.92
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.92
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.67
|
| Rate for Payer: Mclaren Medicaid |
$6.93
|
| Rate for Payer: Mclaren Medicare |
$12.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.57
|
| Rate for Payer: Meridian Medicaid |
$7.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: PACE Medicare |
$12.27
|
| Rate for Payer: PACE SWMI |
$12.92
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: PHP Medicare Advantage |
$12.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.79
|
| Rate for Payer: Priority Health Medicare |
$12.92
|
| Rate for Payer: Priority Health SBD |
$30.81
|
| Rate for Payer: Railroad Medicare Medicare |
$12.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.92
|
| Rate for Payer: UHC Exchange |
$24.69
|
| Rate for Payer: UHC Medicare Advantage |
$12.92
|
| Rate for Payer: UHCCP Medicaid |
$6.93
|
| Rate for Payer: UMR Bronson Commercial |
$18.09
|
| Rate for Payer: VA VA |
$12.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.67
|
|
|
HC MYOMARKER 3 CMPT
|
Facility
|
OP
|
$26.56
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$50.47 |
| Rate for Payer: Aetna American Axle |
$17.26
|
| Rate for Payer: Aetna Commercial |
$22.58
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$21.25
|
| Rate for Payer: Cash Price |
$21.25
|
| Rate for Payer: Cofinity Commercial |
$22.84
|
| Rate for Payer: Cofinity Commercial |
$18.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$23.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.92
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.58
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$22.58
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.26
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health SBD |
$16.73
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$34.27
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$9.83
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.92
|
|
|
HC MYOMARKER 3 CMPT
|
Facility
|
IP
|
$26.56
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.69 |
| Max. Negotiated Rate |
$23.90 |
| Rate for Payer: Aetna American Axle |
$17.26
|
| Rate for Payer: Aetna Commercial |
$22.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.26
|
| Rate for Payer: Cash Price |
$21.25
|
| Rate for Payer: Cofinity Commercial |
$18.59
|
| Rate for Payer: Cofinity Commercial |
$22.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.25
|
| Rate for Payer: Healthscope Commercial |
$23.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.58
|
| Rate for Payer: PHP Commercial |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.26
|
| Rate for Payer: Priority Health SBD |
$16.73
|
| Rate for Payer: UMR Bronson Commercial |
$11.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.92
|
|
|
HC MYOMARKER 3 PROFILE
|
Facility
|
IP
|
$19.91
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.76 |
| Max. Negotiated Rate |
$17.92 |
| Rate for Payer: Aetna American Axle |
$12.94
|
| Rate for Payer: Aetna Commercial |
$16.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.94
|
| Rate for Payer: Cash Price |
$15.93
|
| Rate for Payer: Cofinity Commercial |
$13.94
|
| Rate for Payer: Cofinity Commercial |
$17.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.93
|
| Rate for Payer: Healthscope Commercial |
$17.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.92
|
| Rate for Payer: PHP Commercial |
$16.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.94
|
| Rate for Payer: Priority Health SBD |
$12.54
|
| Rate for Payer: UMR Bronson Commercial |
$8.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.93
|
|
|
HC MYOMARKER 3 PROFILE
|
Facility
|
OP
|
$19.91
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$32.46 |
| Rate for Payer: Aetna American Axle |
$12.94
|
| Rate for Payer: Aetna Commercial |
$16.92
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$15.93
|
| Rate for Payer: Cash Price |
$15.93
|
| Rate for Payer: Cofinity Commercial |
$17.12
|
| Rate for Payer: Cofinity Commercial |
$13.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$17.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.93
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.92
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$16.92
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.94
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health SBD |
$12.54
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$22.03
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: UMR Bronson Commercial |
$7.37
|
| Rate for Payer: VA VA |
$11.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.93
|
|
|
HC MYRINGOPLASTY
|
Facility
|
IP
|
$9,020.00
|
|
|
Service Code
|
CPT 69620
|
| Hospital Charge Code |
76100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,968.80 |
| Max. Negotiated Rate |
$8,118.00 |
| Rate for Payer: Aetna American Axle |
$5,863.00
|
| Rate for Payer: Aetna Commercial |
$7,667.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,863.00
|
| Rate for Payer: Cash Price |
$7,216.00
|
| Rate for Payer: Cofinity Commercial |
$6,314.00
|
| Rate for Payer: Cofinity Commercial |
$7,757.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,314.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,216.00
|
| Rate for Payer: Healthscope Commercial |
$8,118.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,314.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,765.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,667.00
|
| Rate for Payer: PHP Commercial |
$7,667.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,863.00
|
| Rate for Payer: Priority Health SBD |
$5,682.60
|
| Rate for Payer: UMR Bronson Commercial |
$3,968.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,765.00
|
|
|
HC MYRINGOPLASTY
|
Facility
|
OP
|
$9,020.00
|
|
|
Service Code
|
CPT 69620
|
| Hospital Charge Code |
76100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,695.31 |
| Max. Negotiated Rate |
$8,903.25 |
| Rate for Payer: Aetna American Axle |
$5,863.00
|
| Rate for Payer: Aetna Commercial |
$7,667.00
|
| Rate for Payer: Aetna Medicare |
$3,289.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,863.00
|
| 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 |
$7,216.00
|
| Rate for Payer: Cash Price |
$7,216.00
|
| Rate for Payer: Cofinity Commercial |
$7,757.20
|
| Rate for Payer: Cofinity Commercial |
$6,314.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,314.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,216.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.90
|
| Rate for Payer: Healthscope Commercial |
$8,118.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,314.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,765.00
|
| 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 |
$7,667.00
|
| Rate for Payer: PACE Medicare |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Commercial |
$7,667.00
|
| 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 |
$5,863.00
|
| Rate for Payer: Priority Health Medicare |
$3,162.90
|
| Rate for Payer: Priority Health SBD |
$5,682.60
|
| 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 |
$3,337.40
|
| Rate for Payer: VA VA |
$3,162.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,765.00
|
|
|
HC MYRINGOTOMY ASPIR&EUSTACHIAN TUBE NFLTJ
|
Facility
|
OP
|
$628.32
|
|
|
Service Code
|
CPT 69420
|
| Hospital Charge Code |
76100484
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.39 |
| Max. Negotiated Rate |
$637.52 |
| Rate for Payer: Aetna American Axle |
$408.41
|
| Rate for Payer: Aetna Commercial |
$534.07
|
| Rate for Payer: Aetna Medicare |
$235.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$408.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.10
|
| Rate for Payer: BCBS Complete |
$127.46
|
| Rate for Payer: BCBS MAPPO |
$226.48
|
| Rate for Payer: BCN Medicare Advantage |
$226.48
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cofinity Commercial |
$540.36
|
| Rate for Payer: Cofinity Commercial |
$439.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$439.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.48
|
| Rate for Payer: Healthscope Commercial |
$565.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$439.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$471.24
|
| Rate for Payer: Mclaren Medicaid |
$121.39
|
| Rate for Payer: Mclaren Medicare |
$226.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$237.80
|
| Rate for Payer: Meridian Medicaid |
$127.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.07
|
| Rate for Payer: PACE Medicare |
$215.16
|
| Rate for Payer: PACE SWMI |
$226.48
|
| Rate for Payer: PHP Commercial |
$534.07
|
| Rate for Payer: PHP Medicare Advantage |
$226.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.41
|
| Rate for Payer: Priority Health Medicare |
$226.48
|
| Rate for Payer: Priority Health SBD |
$395.84
|
| Rate for Payer: Railroad Medicare Medicare |
$226.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$637.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.48
|
| Rate for Payer: UHC Exchange |
$432.83
|
| Rate for Payer: UHC Medicare Advantage |
$226.48
|
| Rate for Payer: UHCCP Medicaid |
$121.39
|
| Rate for Payer: UMR Bronson Commercial |
$232.48
|
| Rate for Payer: VA VA |
$226.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$471.24
|
|
|
HC MYRINGOTOMY ASPIR&EUSTACHIAN TUBE NFLTJ
|
Facility
|
IP
|
$628.32
|
|
|
Service Code
|
CPT 69420
|
| Hospital Charge Code |
76100484
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$276.46 |
| Max. Negotiated Rate |
$565.49 |
| Rate for Payer: Aetna American Axle |
$408.41
|
| Rate for Payer: Aetna Commercial |
$534.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$408.41
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cofinity Commercial |
$439.82
|
| Rate for Payer: Cofinity Commercial |
$540.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$439.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.66
|
| Rate for Payer: Healthscope Commercial |
$565.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$439.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$471.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.07
|
| Rate for Payer: PHP Commercial |
$534.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.41
|
| Rate for Payer: Priority Health SBD |
$395.84
|
| Rate for Payer: UMR Bronson Commercial |
$276.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$471.24
|
|
|
HC NAIL BED REPAIR
|
Facility
|
IP
|
$757.63
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
45000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$333.36 |
| Max. Negotiated Rate |
$681.87 |
| Rate for Payer: Aetna American Axle |
$492.46
|
| Rate for Payer: Aetna Commercial |
$643.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$492.46
|
| Rate for Payer: Cash Price |
$606.10
|
| Rate for Payer: Cofinity Commercial |
$530.34
|
| Rate for Payer: Cofinity Commercial |
$651.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$530.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$606.10
|
| Rate for Payer: Healthscope Commercial |
$681.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$530.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$568.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$643.99
|
| Rate for Payer: PHP Commercial |
$643.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$492.46
|
| Rate for Payer: Priority Health SBD |
$477.31
|
| Rate for Payer: UMR Bronson Commercial |
$333.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$568.22
|
|
|
HC NAIL BED REPAIR
|
Facility
|
OP
|
$757.63
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
45000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$280.32 |
| Max. Negotiated Rate |
$1,680.50 |
| Rate for Payer: Aetna American Axle |
$492.46
|
| Rate for Payer: Aetna Commercial |
$643.99
|
| Rate for Payer: Aetna Medicare |
$620.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$492.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$746.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$746.25
|
| Rate for Payer: BCBS Complete |
$335.99
|
| Rate for Payer: BCBS MAPPO |
$597.00
|
| Rate for Payer: BCN Medicare Advantage |
$597.00
|
| Rate for Payer: Cash Price |
$606.10
|
| Rate for Payer: Cash Price |
$606.10
|
| Rate for Payer: Cofinity Commercial |
$651.56
|
| Rate for Payer: Cofinity Commercial |
$530.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$530.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$606.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.00
|
| Rate for Payer: Healthscope Commercial |
$681.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$530.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$568.22
|
| Rate for Payer: Mclaren Medicaid |
$319.99
|
| Rate for Payer: Mclaren Medicare |
$597.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$626.85
|
| Rate for Payer: Meridian Medicaid |
$335.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$686.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$643.99
|
| Rate for Payer: PACE Medicare |
$567.15
|
| Rate for Payer: PACE SWMI |
$597.00
|
| Rate for Payer: PHP Commercial |
$643.99
|
| Rate for Payer: PHP Medicare Advantage |
$597.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$492.46
|
| Rate for Payer: Priority Health Medicare |
$597.00
|
| Rate for Payer: Priority Health SBD |
$477.31
|
| Rate for Payer: Railroad Medicare Medicare |
$597.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,680.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$597.00
|
| Rate for Payer: UHC Exchange |
$1,140.93
|
| Rate for Payer: UHC Medicare Advantage |
$597.00
|
| Rate for Payer: UHCCP Medicaid |
$319.99
|
| Rate for Payer: UMR Bronson Commercial |
$280.32
|
| Rate for Payer: VA VA |
$597.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$568.22
|
|
|
HC NAIL PROCEDURE
|
Facility
|
OP
|
$271.81
|
|
| Hospital Charge Code |
45000047
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$100.57 |
| Max. Negotiated Rate |
$244.63 |
| Rate for Payer: Aetna American Axle |
$176.68
|
| Rate for Payer: Aetna Commercial |
$231.04
|
| Rate for Payer: Aetna Medicare |
$135.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.68
|
| Rate for Payer: BCBS Complete |
$108.72
|
| Rate for Payer: Cash Price |
$217.45
|
| Rate for Payer: Cofinity Commercial |
$190.27
|
| Rate for Payer: Cofinity Commercial |
$233.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$190.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.45
|
| Rate for Payer: Healthscope Commercial |
$244.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.04
|
| Rate for Payer: PHP Commercial |
$231.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.68
|
| Rate for Payer: Priority Health SBD |
$171.24
|
| Rate for Payer: UMR Bronson Commercial |
$100.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.86
|
|
|
HC NAIL PROCEDURE
|
Facility
|
IP
|
$271.81
|
|
| Hospital Charge Code |
45000047
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$244.63 |
| Rate for Payer: Aetna American Axle |
$176.68
|
| Rate for Payer: Aetna Commercial |
$231.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.68
|
| Rate for Payer: Cash Price |
$217.45
|
| Rate for Payer: Cofinity Commercial |
$190.27
|
| Rate for Payer: Cofinity Commercial |
$233.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$190.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.45
|
| Rate for Payer: Healthscope Commercial |
$244.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.04
|
| Rate for Payer: PHP Commercial |
$231.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.68
|
| Rate for Payer: Priority Health SBD |
$171.24
|
| Rate for Payer: UMR Bronson Commercial |
$119.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.86
|
|
|
HC NA PHOSPHATE PER MCI
|
Facility
|
OP
|
$328.09
|
|
|
Service Code
|
HCPCS A9563
|
| Hospital Charge Code |
34400004
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$96.01 |
| Max. Negotiated Rate |
$504.20 |
| Rate for Payer: Aetna American Axle |
$213.26
|
| Rate for Payer: Aetna Commercial |
$278.88
|
| Rate for Payer: Aetna Medicare |
$186.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$223.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$223.90
|
| Rate for Payer: BCBS Complete |
$100.81
|
| Rate for Payer: BCBS MAPPO |
$179.12
|
| Rate for Payer: BCN Medicare Advantage |
$179.12
|
| Rate for Payer: Cash Price |
$262.47
|
| Rate for Payer: Cash Price |
$262.47
|
| Rate for Payer: Cofinity Commercial |
$282.16
|
| Rate for Payer: Cofinity Commercial |
$229.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$229.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.12
|
| Rate for Payer: Healthscope Commercial |
$295.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$229.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.07
|
| Rate for Payer: Mclaren Medicaid |
$96.01
|
| Rate for Payer: Mclaren Medicare |
$179.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.08
|
| Rate for Payer: Meridian Medicaid |
$100.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$205.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.88
|
| Rate for Payer: PACE Medicare |
$170.16
|
| Rate for Payer: PACE SWMI |
$179.12
|
| Rate for Payer: PHP Commercial |
$278.88
|
| Rate for Payer: PHP Medicare Advantage |
$179.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.26
|
| Rate for Payer: Priority Health Medicare |
$179.12
|
| Rate for Payer: Priority Health SBD |
$206.70
|
| Rate for Payer: Railroad Medicare Medicare |
$179.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.12
|
| Rate for Payer: UHC Exchange |
$342.32
|
| Rate for Payer: UHC Medicare Advantage |
$179.12
|
| Rate for Payer: UHCCP Medicaid |
$96.01
|
| Rate for Payer: UMR Bronson Commercial |
$121.39
|
| Rate for Payer: VA VA |
$179.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.07
|
|
|
HC NA PHOSPHATE PER MCI
|
Facility
|
IP
|
$328.09
|
|
|
Service Code
|
HCPCS A9563
|
| Hospital Charge Code |
34400004
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$144.36 |
| Max. Negotiated Rate |
$295.28 |
| Rate for Payer: Aetna American Axle |
$213.26
|
| Rate for Payer: Aetna Commercial |
$278.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.26
|
| Rate for Payer: Cash Price |
$262.47
|
| Rate for Payer: Cofinity Commercial |
$229.66
|
| Rate for Payer: Cofinity Commercial |
$282.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$229.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.47
|
| Rate for Payer: Healthscope Commercial |
$295.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$229.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.88
|
| Rate for Payer: PHP Commercial |
$278.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.26
|
| Rate for Payer: Priority Health SBD |
$206.70
|
| Rate for Payer: UMR Bronson Commercial |
$144.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.07
|
|
|
HC NASAL BONES COMP MIN 3 VW
|
Facility
|
OP
|
$198.81
|
|
|
Service Code
|
CPT 70160
|
| Hospital Charge Code |
32000011
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$129.23
|
| Rate for Payer: Aetna Commercial |
$168.99
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$159.05
|
| Rate for Payer: Cash Price |
$159.05
|
| Rate for Payer: Cofinity Commercial |
$170.98
|
| Rate for Payer: Cofinity Commercial |
$139.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$139.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$178.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$139.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.11
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.99
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$168.99
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.23
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$125.25
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$73.56
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.11
|
|
|
HC NASAL BONES COMP MIN 3 VW
|
Facility
|
IP
|
$198.81
|
|
|
Service Code
|
CPT 70160
|
| Hospital Charge Code |
32000011
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$87.48 |
| Max. Negotiated Rate |
$178.93 |
| Rate for Payer: Aetna American Axle |
$129.23
|
| Rate for Payer: Aetna Commercial |
$168.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.23
|
| Rate for Payer: Cash Price |
$159.05
|
| Rate for Payer: Cofinity Commercial |
$139.17
|
| Rate for Payer: Cofinity Commercial |
$170.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$139.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.05
|
| Rate for Payer: Healthscope Commercial |
$178.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$139.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.99
|
| Rate for Payer: PHP Commercial |
$168.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.23
|
| Rate for Payer: Priority Health SBD |
$125.25
|
| Rate for Payer: UMR Bronson Commercial |
$87.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.11
|
|
|
HC NASAL ENDOSCOPY DX
|
Facility
|
OP
|
$255.90
|
|
|
Service Code
|
CPT 31231
|
| Hospital Charge Code |
76100183
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$94.68 |
| Max. Negotiated Rate |
$532.97 |
| Rate for Payer: Aetna American Axle |
$166.34
|
| Rate for Payer: Aetna Commercial |
$217.51
|
| Rate for Payer: Aetna Medicare |
$196.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.68
|
| Rate for Payer: BCBS Complete |
$106.56
|
| Rate for Payer: BCBS MAPPO |
$189.34
|
| Rate for Payer: BCN Medicare Advantage |
$189.34
|
| Rate for Payer: Cash Price |
$204.72
|
| Rate for Payer: Cash Price |
$204.72
|
| Rate for Payer: Cofinity Commercial |
$220.07
|
| Rate for Payer: Cofinity Commercial |
$179.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$179.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.34
|
| Rate for Payer: Healthscope Commercial |
$230.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$179.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.93
|
| Rate for Payer: Mclaren Medicaid |
$101.49
|
| Rate for Payer: Mclaren Medicare |
$189.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.81
|
| Rate for Payer: Meridian Medicaid |
$106.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$217.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.51
|
| Rate for Payer: PACE Medicare |
$179.87
|
| Rate for Payer: PACE SWMI |
$189.34
|
| Rate for Payer: PHP Commercial |
$217.51
|
| Rate for Payer: PHP Medicare Advantage |
$189.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$101.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.34
|
| Rate for Payer: Priority Health Medicare |
$189.34
|
| Rate for Payer: Priority Health SBD |
$161.22
|
| Rate for Payer: Railroad Medicare Medicare |
$189.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$532.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.34
|
| Rate for Payer: UHC Exchange |
$361.85
|
| Rate for Payer: UHC Medicare Advantage |
$189.34
|
| Rate for Payer: UHCCP Medicaid |
$101.49
|
| Rate for Payer: UMR Bronson Commercial |
$94.68
|
| Rate for Payer: VA VA |
$189.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.93
|
|
|
HC NASAL ENDOSCOPY DX
|
Facility
|
IP
|
$255.90
|
|
|
Service Code
|
CPT 31231
|
| Hospital Charge Code |
76100183
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$112.60 |
| Max. Negotiated Rate |
$230.31 |
| Rate for Payer: Aetna American Axle |
$166.34
|
| Rate for Payer: Aetna Commercial |
$217.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.34
|
| Rate for Payer: Cash Price |
$204.72
|
| Rate for Payer: Cofinity Commercial |
$179.13
|
| Rate for Payer: Cofinity Commercial |
$220.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$179.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.72
|
| Rate for Payer: Healthscope Commercial |
$230.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$179.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.51
|
| Rate for Payer: PHP Commercial |
$217.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.34
|
| Rate for Payer: Priority Health SBD |
$161.22
|
| Rate for Payer: UMR Bronson Commercial |
$112.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.93
|
|
