|
HC NCS 9-10 STUDIES INCL F&H WAVES
|
Facility
|
IP
|
$1,806.20
|
|
|
Service Code
|
CPT 95911
|
| Hospital Charge Code |
92200031
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$794.73 |
| Max. Negotiated Rate |
$1,625.58 |
| Rate for Payer: Aetna American Axle |
$1,174.03
|
| Rate for Payer: Aetna Commercial |
$1,535.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,174.03
|
| Rate for Payer: Cash Price |
$1,444.96
|
| Rate for Payer: Cofinity Commercial |
$1,264.34
|
| Rate for Payer: Cofinity Commercial |
$1,553.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,264.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.96
|
| Rate for Payer: Healthscope Commercial |
$1,625.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,264.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,354.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,535.27
|
| Rate for Payer: PHP Commercial |
$1,535.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,174.03
|
| Rate for Payer: Priority Health SBD |
$1,137.91
|
| Rate for Payer: UMR Bronson Commercial |
$794.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,354.65
|
|
|
HC NEEDLE 14 GAUGE LONG
|
Facility
|
IP
|
$110.16
|
|
| Hospital Charge Code |
27000674
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$48.47 |
| Max. Negotiated Rate |
$99.14 |
| Rate for Payer: Aetna American Axle |
$71.60
|
| Rate for Payer: Aetna Commercial |
$93.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.60
|
| Rate for Payer: Cash Price |
$88.13
|
| Rate for Payer: Cofinity Commercial |
$77.11
|
| Rate for Payer: Cofinity Commercial |
$94.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.13
|
| Rate for Payer: Healthscope Commercial |
$99.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.64
|
| Rate for Payer: PHP Commercial |
$93.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.60
|
| Rate for Payer: Priority Health SBD |
$69.40
|
| Rate for Payer: UMR Bronson Commercial |
$48.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.62
|
|
|
HC NEEDLE 14 GAUGE LONG
|
Facility
|
OP
|
$110.16
|
|
| Hospital Charge Code |
27000674
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.76 |
| Max. Negotiated Rate |
$99.14 |
| Rate for Payer: Aetna American Axle |
$71.60
|
| Rate for Payer: Aetna Commercial |
$93.64
|
| Rate for Payer: Aetna Medicare |
$55.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.60
|
| Rate for Payer: BCBS Complete |
$44.06
|
| Rate for Payer: Cash Price |
$88.13
|
| Rate for Payer: Cofinity Commercial |
$77.11
|
| Rate for Payer: Cofinity Commercial |
$94.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.13
|
| Rate for Payer: Healthscope Commercial |
$99.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.64
|
| Rate for Payer: PHP Commercial |
$93.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.60
|
| Rate for Payer: Priority Health SBD |
$69.40
|
| Rate for Payer: UMR Bronson Commercial |
$40.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.62
|
|
|
HC NEEDLE 1 EXTREMITY NON PARASPINAL
|
Facility
|
OP
|
$252.61
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
92200009
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Aetna American Axle |
$164.20
|
| Rate for Payer: Aetna Commercial |
$214.72
|
| Rate for Payer: Aetna Medicare |
$130.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$202.09
|
| Rate for Payer: Cash Price |
$202.09
|
| Rate for Payer: Cash Price |
$202.09
|
| Rate for Payer: Cofinity Commercial |
$176.83
|
| Rate for Payer: Cofinity Commercial |
$217.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$176.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$227.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$176.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.46
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.72
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$214.72
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.20
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health SBD |
$159.14
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.86
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$240.24
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: UMR Bronson Commercial |
$93.47
|
| Rate for Payer: VA VA |
$125.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.46
|
|
|
HC NEEDLE 1 EXTREMITY NON PARASPINAL
|
Facility
|
IP
|
$252.61
|
|
|
Service Code
|
CPT 95870
|
| Hospital Charge Code |
92200009
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$111.15 |
| Max. Negotiated Rate |
$227.35 |
| Rate for Payer: Aetna American Axle |
$164.20
|
| Rate for Payer: Aetna Commercial |
$214.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.20
|
| Rate for Payer: Cash Price |
$202.09
|
| Rate for Payer: Cofinity Commercial |
$176.83
|
| Rate for Payer: Cofinity Commercial |
$217.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$176.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$202.09
|
| Rate for Payer: Healthscope Commercial |
$227.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$176.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$214.72
|
| Rate for Payer: PHP Commercial |
$214.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.20
|
| Rate for Payer: Priority Health SBD |
$159.14
|
| Rate for Payer: UMR Bronson Commercial |
$111.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.46
|
|
|
HC NEEDLE BRACHYTHERAPY EACH
|
Facility
|
IP
|
$73.90
|
|
|
Service Code
|
HCPCS C1715
|
| Hospital Charge Code |
27200247
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.52 |
| Max. Negotiated Rate |
$66.51 |
| Rate for Payer: Aetna American Axle |
$48.03
|
| Rate for Payer: Aetna Commercial |
$62.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.03
|
| Rate for Payer: Cash Price |
$59.12
|
| Rate for Payer: Cofinity Commercial |
$51.73
|
| Rate for Payer: Cofinity Commercial |
$63.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.12
|
| Rate for Payer: Healthscope Commercial |
$66.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.81
|
| Rate for Payer: PHP Commercial |
$62.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.03
|
| Rate for Payer: Priority Health SBD |
$46.56
|
| Rate for Payer: UMR Bronson Commercial |
$32.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.42
|
|
|
HC NEEDLE BRACHYTHERAPY EACH
|
Facility
|
OP
|
$73.90
|
|
|
Service Code
|
HCPCS C1715
|
| Hospital Charge Code |
27200247
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.34 |
| Max. Negotiated Rate |
$66.51 |
| Rate for Payer: Aetna American Axle |
$48.03
|
| Rate for Payer: Aetna Commercial |
$62.81
|
| Rate for Payer: Aetna Medicare |
$36.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.03
|
| Rate for Payer: BCBS Complete |
$29.56
|
| Rate for Payer: Cash Price |
$59.12
|
| Rate for Payer: Cofinity Commercial |
$51.73
|
| Rate for Payer: Cofinity Commercial |
$63.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.12
|
| Rate for Payer: Healthscope Commercial |
$66.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.81
|
| Rate for Payer: PHP Commercial |
$62.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.03
|
| Rate for Payer: Priority Health SBD |
$46.56
|
| Rate for Payer: UMR Bronson Commercial |
$27.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.42
|
|
|
HC NEEDLE INSERT W/O INJECT 1 OR 2 MUSCLES
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
76100364
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: UMR Bronson Commercial |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC NEEDLE INSERT W/O INJECT 1 OR 2 MUSCLES
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
76100364
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$67.22 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$24.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.85
|
| Rate for Payer: BCBS Complete |
$13.44
|
| Rate for Payer: BCBS MAPPO |
$23.88
|
| Rate for Payer: BCN Medicare Advantage |
$23.88
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.88
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$12.80
|
| Rate for Payer: Mclaren Medicare |
$23.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.07
|
| Rate for Payer: Meridian Medicaid |
$13.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PACE Medicare |
$22.69
|
| Rate for Payer: PACE SWMI |
$23.88
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$23.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health Medicare |
$23.88
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$23.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.88
|
| Rate for Payer: UHC Exchange |
$45.64
|
| Rate for Payer: UHC Medicare Advantage |
$23.88
|
| Rate for Payer: UHCCP Medicaid |
$12.80
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$23.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC NEEDLE INSERT W/O INJECTION, 1 OR 2 MUSCLES
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
42000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$11.32 |
| Max. Negotiated Rate |
$67.22 |
| Rate for Payer: Aetna American Axle |
$19.89
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$24.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.85
|
| Rate for Payer: BCBS Complete |
$13.44
|
| Rate for Payer: BCBS MAPPO |
$23.88
|
| Rate for Payer: BCN Medicare Advantage |
$23.88
|
| 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: Health Alliance Plan Medicare Advantage |
$23.88
|
| 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: Mclaren Medicaid |
$12.80
|
| Rate for Payer: Mclaren Medicare |
$23.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.07
|
| Rate for Payer: Meridian Medicaid |
$13.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: PACE Medicare |
$22.69
|
| Rate for Payer: PACE SWMI |
$23.88
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$23.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health Medicare |
$23.88
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: Railroad Medicare Medicare |
$23.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.88
|
| Rate for Payer: UHC Exchange |
$45.64
|
| Rate for Payer: UHC Medicare Advantage |
$23.88
|
| Rate for Payer: UHCCP Medicaid |
$12.80
|
| Rate for Payer: UMR Bronson Commercial |
$11.32
|
| Rate for Payer: VA VA |
$23.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC NEEDLE INSERT W/O INJECTION, 1 OR 2 MUSCLES
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 20560
|
| Hospital Charge Code |
42000060
|
|
Hospital Revenue Code
|
761
|
| 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 NEEDLE INSERT W/O INJECTION, 3 OR MORE MUSCLES
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 20561
|
| Hospital Charge Code |
42000061
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$67.22 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$24.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.85
|
| Rate for Payer: BCBS Complete |
$13.44
|
| Rate for Payer: BCBS MAPPO |
$23.88
|
| Rate for Payer: BCN Medicare Advantage |
$23.88
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.88
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$12.80
|
| Rate for Payer: Mclaren Medicare |
$23.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.07
|
| Rate for Payer: Meridian Medicaid |
$13.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: PACE Medicare |
$22.69
|
| Rate for Payer: PACE SWMI |
$23.88
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$23.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health Medicare |
$23.88
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: Railroad Medicare Medicare |
$23.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.88
|
| Rate for Payer: UHC Exchange |
$45.64
|
| Rate for Payer: UHC Medicare Advantage |
$23.88
|
| Rate for Payer: UHCCP Medicaid |
$12.80
|
| Rate for Payer: UMR Bronson Commercial |
$18.87
|
| Rate for Payer: VA VA |
$23.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC NEEDLE INSERT W/O INJECTION, 3 OR MORE MUSCLES
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 20561
|
| Hospital Charge Code |
42000061
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$22.44 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: UMR Bronson Commercial |
$22.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC NEEDLE LOC WIRE
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
HCPCS C1819
|
| Hospital Charge Code |
27200323
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.63 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$26.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: BCBS Complete |
$21.22
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: UMR Bronson Commercial |
$19.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC NEEDLE LOC WIRE
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
HCPCS C1819
|
| Hospital Charge Code |
27200323
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: UMR Bronson Commercial |
$23.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC NEG PRES CANIST 1000CC
|
Facility
|
OP
|
$233.19
|
|
| Hospital Charge Code |
27200232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$86.28 |
| Max. Negotiated Rate |
$209.87 |
| Rate for Payer: Aetna American Axle |
$151.57
|
| Rate for Payer: Aetna Commercial |
$198.21
|
| Rate for Payer: Aetna Medicare |
$116.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.57
|
| Rate for Payer: BCBS Complete |
$93.28
|
| Rate for Payer: Cash Price |
$186.55
|
| Rate for Payer: Cofinity Commercial |
$163.23
|
| Rate for Payer: Cofinity Commercial |
$200.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$163.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.55
|
| Rate for Payer: Healthscope Commercial |
$209.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$163.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.21
|
| Rate for Payer: PHP Commercial |
$198.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.57
|
| Rate for Payer: Priority Health SBD |
$146.91
|
| Rate for Payer: UMR Bronson Commercial |
$86.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.89
|
|
|
HC NEG PRES CANIST 1000CC
|
Facility
|
IP
|
$233.19
|
|
| Hospital Charge Code |
27200232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$102.60 |
| Max. Negotiated Rate |
$209.87 |
| Rate for Payer: Aetna American Axle |
$151.57
|
| Rate for Payer: Aetna Commercial |
$198.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.57
|
| Rate for Payer: Cash Price |
$186.55
|
| Rate for Payer: Cofinity Commercial |
$163.23
|
| Rate for Payer: Cofinity Commercial |
$200.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$163.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.55
|
| Rate for Payer: Healthscope Commercial |
$209.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$163.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.21
|
| Rate for Payer: PHP Commercial |
$198.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.57
|
| Rate for Payer: Priority Health SBD |
$146.91
|
| Rate for Payer: UMR Bronson Commercial |
$102.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.89
|
|
|
HC NEG PRES CANIST 500CC
|
Facility
|
IP
|
$151.46
|
|
| Hospital Charge Code |
27200136
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.64 |
| Max. Negotiated Rate |
$136.31 |
| Rate for Payer: Aetna American Axle |
$98.45
|
| Rate for Payer: Aetna Commercial |
$128.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.45
|
| Rate for Payer: Cash Price |
$121.17
|
| Rate for Payer: Cofinity Commercial |
$106.02
|
| Rate for Payer: Cofinity Commercial |
$130.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$106.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.17
|
| Rate for Payer: Healthscope Commercial |
$136.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.74
|
| Rate for Payer: PHP Commercial |
$128.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.45
|
| Rate for Payer: Priority Health SBD |
$95.42
|
| Rate for Payer: UMR Bronson Commercial |
$66.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.59
|
|
|
HC NEG PRES CANIST 500CC
|
Facility
|
OP
|
$151.46
|
|
| Hospital Charge Code |
27200136
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$56.04 |
| Max. Negotiated Rate |
$136.31 |
| Rate for Payer: Aetna American Axle |
$98.45
|
| Rate for Payer: Aetna Commercial |
$128.74
|
| Rate for Payer: Aetna Medicare |
$75.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.45
|
| Rate for Payer: BCBS Complete |
$60.58
|
| Rate for Payer: Cash Price |
$121.17
|
| Rate for Payer: Cofinity Commercial |
$106.02
|
| Rate for Payer: Cofinity Commercial |
$130.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$106.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.17
|
| Rate for Payer: Healthscope Commercial |
$136.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.74
|
| Rate for Payer: PHP Commercial |
$128.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.45
|
| Rate for Payer: Priority Health SBD |
$95.42
|
| Rate for Payer: UMR Bronson Commercial |
$56.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.59
|
|
|
HC NEG PRES CLEANSE DRSG MED
|
Facility
|
OP
|
$510.90
|
|
| Hospital Charge Code |
27200229
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$189.03 |
| Max. Negotiated Rate |
$459.81 |
| Rate for Payer: Aetna American Axle |
$332.08
|
| Rate for Payer: Aetna Commercial |
$434.26
|
| Rate for Payer: Aetna Medicare |
$255.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$332.08
|
| Rate for Payer: BCBS Complete |
$204.36
|
| Rate for Payer: Cash Price |
$408.72
|
| Rate for Payer: Cofinity Commercial |
$357.63
|
| Rate for Payer: Cofinity Commercial |
$439.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$357.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.72
|
| Rate for Payer: Healthscope Commercial |
$459.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$357.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$383.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$434.26
|
| Rate for Payer: PHP Commercial |
$434.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.08
|
| Rate for Payer: Priority Health SBD |
$321.87
|
| Rate for Payer: UMR Bronson Commercial |
$189.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$383.18
|
|
|
HC NEG PRES CLEANSE DRSG MED
|
Facility
|
IP
|
$510.90
|
|
| Hospital Charge Code |
27200229
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$224.80 |
| Max. Negotiated Rate |
$459.81 |
| Rate for Payer: Aetna American Axle |
$332.08
|
| Rate for Payer: Aetna Commercial |
$434.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$332.08
|
| Rate for Payer: Cash Price |
$408.72
|
| Rate for Payer: Cofinity Commercial |
$357.63
|
| Rate for Payer: Cofinity Commercial |
$439.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$357.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.72
|
| Rate for Payer: Healthscope Commercial |
$459.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$357.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$383.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$434.26
|
| Rate for Payer: PHP Commercial |
$434.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.08
|
| Rate for Payer: Priority Health SBD |
$321.87
|
| Rate for Payer: UMR Bronson Commercial |
$224.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$383.18
|
|
|
HC NEG PRESSURE DERMATAC DRAPE
|
Facility
|
IP
|
$64.50
|
|
| Hospital Charge Code |
27200374
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.38 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna American Axle |
$41.92
|
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.92
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$45.15
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.92
|
| Rate for Payer: Priority Health SBD |
$40.63
|
| Rate for Payer: UMR Bronson Commercial |
$28.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.38
|
|
|
HC NEG PRESSURE DERMATAC DRAPE
|
Facility
|
OP
|
$64.50
|
|
| Hospital Charge Code |
27200374
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna American Axle |
$41.92
|
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: Aetna Medicare |
$32.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.92
|
| Rate for Payer: BCBS Complete |
$25.80
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$45.15
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$45.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.92
|
| Rate for Payer: Priority Health SBD |
$40.63
|
| Rate for Payer: UMR Bronson Commercial |
$23.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.38
|
|
|
HC NEG PRESSURE WND TX DME GT 50 SQ CM
|
Facility
|
IP
|
$540.83
|
|
|
Service Code
|
CPT 97606
|
| Hospital Charge Code |
76100009
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$237.97 |
| Max. Negotiated Rate |
$486.75 |
| Rate for Payer: Aetna American Axle |
$351.54
|
| Rate for Payer: Aetna Commercial |
$459.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$351.54
|
| Rate for Payer: Cash Price |
$432.66
|
| Rate for Payer: Cofinity Commercial |
$378.58
|
| Rate for Payer: Cofinity Commercial |
$465.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$378.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$432.66
|
| Rate for Payer: Healthscope Commercial |
$486.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$378.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$405.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$459.71
|
| Rate for Payer: PHP Commercial |
$459.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$351.54
|
| Rate for Payer: Priority Health SBD |
$340.72
|
| Rate for Payer: UMR Bronson Commercial |
$237.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$405.62
|
|
|
HC NEG PRESSURE WND TX DME GT 50 SQ CM
|
Facility
|
OP
|
$540.83
|
|
|
Service Code
|
CPT 97606
|
| Hospital Charge Code |
76100009
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$200.11 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna American Axle |
$351.54
|
| Rate for Payer: Aetna Commercial |
$459.71
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$351.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$432.66
|
| Rate for Payer: Cash Price |
$432.66
|
| Rate for Payer: Cofinity Commercial |
$465.11
|
| Rate for Payer: Cofinity Commercial |
$378.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$378.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$432.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$486.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$378.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$405.62
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$459.71
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$459.71
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$351.54
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$340.72
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$744.66
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: UMR Bronson Commercial |
$200.11
|
| Rate for Payer: VA VA |
$389.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$405.62
|
|
