|
HC NEG PRESSURE WND TX DME UP TO 50 SQ CM
|
Facility
|
OP
|
$428.32
|
|
|
Service Code
|
CPT 97605
|
| Hospital Charge Code |
76100008
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna American Axle |
$278.41
|
| Rate for Payer: Aetna Commercial |
$364.07
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$342.66
|
| Rate for Payer: Cash Price |
$342.66
|
| Rate for Payer: Cofinity Commercial |
$368.36
|
| Rate for Payer: Cofinity Commercial |
$299.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$299.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$385.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$299.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.24
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.07
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$364.07
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.41
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$269.84
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$370.35
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: UMR Bronson Commercial |
$158.48
|
| Rate for Payer: VA VA |
$193.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.24
|
|
|
HC NEG PRESSURE WND TX DME UP TO 50 SQ CM
|
Facility
|
IP
|
$428.32
|
|
|
Service Code
|
CPT 97605
|
| Hospital Charge Code |
76100008
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$188.46 |
| Max. Negotiated Rate |
$385.49 |
| Rate for Payer: Aetna American Axle |
$278.41
|
| Rate for Payer: Aetna Commercial |
$364.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.41
|
| Rate for Payer: Cash Price |
$342.66
|
| Rate for Payer: Cofinity Commercial |
$299.82
|
| Rate for Payer: Cofinity Commercial |
$368.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$299.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.66
|
| Rate for Payer: Healthscope Commercial |
$385.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$299.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.07
|
| Rate for Payer: PHP Commercial |
$364.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.41
|
| Rate for Payer: Priority Health SBD |
$269.84
|
| Rate for Payer: UMR Bronson Commercial |
$188.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.24
|
|
|
HC NEG PRES TRAC PAD
|
Facility
|
IP
|
$73.81
|
|
| Hospital Charge Code |
27000158
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$32.48 |
| Max. Negotiated Rate |
$66.43 |
| Rate for Payer: Aetna American Axle |
$47.98
|
| Rate for Payer: Aetna Commercial |
$62.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.98
|
| Rate for Payer: Cash Price |
$59.05
|
| Rate for Payer: Cofinity Commercial |
$51.67
|
| Rate for Payer: Cofinity Commercial |
$63.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.05
|
| Rate for Payer: Healthscope Commercial |
$66.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.74
|
| Rate for Payer: PHP Commercial |
$62.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.98
|
| Rate for Payer: Priority Health SBD |
$46.50
|
| Rate for Payer: UMR Bronson Commercial |
$32.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.36
|
|
|
HC NEG PRES TRAC PAD
|
Facility
|
OP
|
$73.81
|
|
| Hospital Charge Code |
27000158
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.31 |
| Max. Negotiated Rate |
$66.43 |
| Rate for Payer: Aetna American Axle |
$47.98
|
| Rate for Payer: Aetna Commercial |
$62.74
|
| Rate for Payer: Aetna Medicare |
$36.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.98
|
| Rate for Payer: BCBS Complete |
$29.52
|
| Rate for Payer: Cash Price |
$59.05
|
| Rate for Payer: Cofinity Commercial |
$51.67
|
| Rate for Payer: Cofinity Commercial |
$63.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.05
|
| Rate for Payer: Healthscope Commercial |
$66.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.74
|
| Rate for Payer: PHP Commercial |
$62.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.98
|
| Rate for Payer: Priority Health SBD |
$46.50
|
| Rate for Payer: UMR Bronson Commercial |
$27.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.36
|
|
|
HC NEG PRES VF CASSETTE
|
Facility
|
IP
|
$212.87
|
|
| Hospital Charge Code |
27200230
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.66 |
| Max. Negotiated Rate |
$191.58 |
| Rate for Payer: Aetna American Axle |
$138.37
|
| Rate for Payer: Aetna Commercial |
$180.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.37
|
| Rate for Payer: Cash Price |
$170.30
|
| Rate for Payer: Cofinity Commercial |
$149.01
|
| Rate for Payer: Cofinity Commercial |
$183.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.30
|
| Rate for Payer: Healthscope Commercial |
$191.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.94
|
| Rate for Payer: PHP Commercial |
$180.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.37
|
| Rate for Payer: Priority Health SBD |
$134.11
|
| Rate for Payer: UMR Bronson Commercial |
$93.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.65
|
|
|
HC NEG PRES VF CASSETTE
|
Facility
|
OP
|
$212.87
|
|
| Hospital Charge Code |
27200230
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.76 |
| Max. Negotiated Rate |
$191.58 |
| Rate for Payer: Aetna American Axle |
$138.37
|
| Rate for Payer: Aetna Commercial |
$180.94
|
| Rate for Payer: Aetna Medicare |
$106.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.37
|
| Rate for Payer: BCBS Complete |
$85.15
|
| Rate for Payer: Cash Price |
$170.30
|
| Rate for Payer: Cofinity Commercial |
$149.01
|
| Rate for Payer: Cofinity Commercial |
$183.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.30
|
| Rate for Payer: Healthscope Commercial |
$191.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.94
|
| Rate for Payer: PHP Commercial |
$180.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.37
|
| Rate for Payer: Priority Health SBD |
$134.11
|
| Rate for Payer: UMR Bronson Commercial |
$78.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.65
|
|
|
HC NEG PRES VF DRSG MED
|
Facility
|
OP
|
$445.10
|
|
| Hospital Charge Code |
27200228
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$164.69 |
| Max. Negotiated Rate |
$400.59 |
| Rate for Payer: Aetna American Axle |
$289.31
|
| Rate for Payer: Aetna Commercial |
$378.33
|
| Rate for Payer: Aetna Medicare |
$222.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.31
|
| Rate for Payer: BCBS Complete |
$178.04
|
| Rate for Payer: Cash Price |
$356.08
|
| Rate for Payer: Cofinity Commercial |
$311.57
|
| Rate for Payer: Cofinity Commercial |
$382.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$311.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.08
|
| Rate for Payer: Healthscope Commercial |
$400.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$311.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$333.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$378.33
|
| Rate for Payer: PHP Commercial |
$378.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.31
|
| Rate for Payer: Priority Health SBD |
$280.41
|
| Rate for Payer: UMR Bronson Commercial |
$164.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$333.82
|
|
|
HC NEG PRES VF DRSG MED
|
Facility
|
IP
|
$445.10
|
|
| Hospital Charge Code |
27200228
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$195.84 |
| Max. Negotiated Rate |
$400.59 |
| Rate for Payer: Aetna American Axle |
$289.31
|
| Rate for Payer: Aetna Commercial |
$378.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.31
|
| Rate for Payer: Cash Price |
$356.08
|
| Rate for Payer: Cofinity Commercial |
$311.57
|
| Rate for Payer: Cofinity Commercial |
$382.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$311.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.08
|
| Rate for Payer: Healthscope Commercial |
$400.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$311.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$333.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$378.33
|
| Rate for Payer: PHP Commercial |
$378.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$289.31
|
| Rate for Payer: Priority Health SBD |
$280.41
|
| Rate for Payer: UMR Bronson Commercial |
$195.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$333.82
|
|
|
HC NEG PRES VF DRSG SMA
|
Facility
|
OP
|
$379.30
|
|
| Hospital Charge Code |
27200227
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$140.34 |
| Max. Negotiated Rate |
$341.37 |
| Rate for Payer: Aetna American Axle |
$246.54
|
| Rate for Payer: Aetna Commercial |
$322.40
|
| Rate for Payer: Aetna Medicare |
$189.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.54
|
| Rate for Payer: BCBS Complete |
$151.72
|
| Rate for Payer: Cash Price |
$303.44
|
| Rate for Payer: Cofinity Commercial |
$265.51
|
| Rate for Payer: Cofinity Commercial |
$326.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$265.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.44
|
| Rate for Payer: Healthscope Commercial |
$341.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$265.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.40
|
| Rate for Payer: PHP Commercial |
$322.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.54
|
| Rate for Payer: Priority Health SBD |
$238.96
|
| Rate for Payer: UMR Bronson Commercial |
$140.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.48
|
|
|
HC NEG PRES VF DRSG SMA
|
Facility
|
IP
|
$379.30
|
|
| Hospital Charge Code |
27200227
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$166.89 |
| Max. Negotiated Rate |
$341.37 |
| Rate for Payer: Aetna American Axle |
$246.54
|
| Rate for Payer: Aetna Commercial |
$322.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.54
|
| Rate for Payer: Cash Price |
$303.44
|
| Rate for Payer: Cofinity Commercial |
$265.51
|
| Rate for Payer: Cofinity Commercial |
$326.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$265.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.44
|
| Rate for Payer: Healthscope Commercial |
$341.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$265.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.40
|
| Rate for Payer: PHP Commercial |
$322.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.54
|
| Rate for Payer: Priority Health SBD |
$238.96
|
| Rate for Payer: UMR Bronson Commercial |
$166.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.48
|
|
|
HC NEG PRES VF DUO TRAC PAD
|
Facility
|
IP
|
$290.28
|
|
| Hospital Charge Code |
27200231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$127.72 |
| Max. Negotiated Rate |
$261.25 |
| Rate for Payer: Aetna American Axle |
$188.68
|
| Rate for Payer: Aetna Commercial |
$246.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.68
|
| Rate for Payer: Cash Price |
$232.22
|
| Rate for Payer: Cofinity Commercial |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$249.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$203.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.22
|
| Rate for Payer: Healthscope Commercial |
$261.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$203.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.74
|
| Rate for Payer: PHP Commercial |
$246.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.68
|
| Rate for Payer: Priority Health SBD |
$182.88
|
| Rate for Payer: UMR Bronson Commercial |
$127.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.71
|
|
|
HC NEG PRES VF DUO TRAC PAD
|
Facility
|
OP
|
$290.28
|
|
| Hospital Charge Code |
27200231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$107.40 |
| Max. Negotiated Rate |
$261.25 |
| Rate for Payer: Aetna American Axle |
$188.68
|
| Rate for Payer: Aetna Commercial |
$246.74
|
| Rate for Payer: Aetna Medicare |
$145.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.68
|
| Rate for Payer: BCBS Complete |
$116.11
|
| Rate for Payer: Cash Price |
$232.22
|
| Rate for Payer: Cofinity Commercial |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$249.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$203.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.22
|
| Rate for Payer: Healthscope Commercial |
$261.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$203.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.74
|
| Rate for Payer: PHP Commercial |
$246.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.68
|
| Rate for Payer: Priority Health SBD |
$182.88
|
| Rate for Payer: UMR Bronson Commercial |
$107.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.71
|
|
|
HC NEG PRES WHT FOAM DRSG
|
Facility
|
IP
|
$180.10
|
|
| Hospital Charge Code |
27200158
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$79.24 |
| Max. Negotiated Rate |
$162.09 |
| Rate for Payer: Aetna American Axle |
$117.06
|
| Rate for Payer: Aetna Commercial |
$153.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.06
|
| Rate for Payer: Cash Price |
$144.08
|
| Rate for Payer: Cofinity Commercial |
$126.07
|
| Rate for Payer: Cofinity Commercial |
$154.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$126.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.08
|
| Rate for Payer: Healthscope Commercial |
$162.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.09
|
| Rate for Payer: PHP Commercial |
$153.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.06
|
| Rate for Payer: Priority Health SBD |
$113.46
|
| Rate for Payer: UMR Bronson Commercial |
$79.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.07
|
|
|
HC NEG PRES WHT FOAM DRSG
|
Facility
|
OP
|
$180.10
|
|
| Hospital Charge Code |
27200158
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.64 |
| Max. Negotiated Rate |
$162.09 |
| Rate for Payer: Aetna American Axle |
$117.06
|
| Rate for Payer: Aetna Commercial |
$153.09
|
| Rate for Payer: Aetna Medicare |
$90.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.06
|
| Rate for Payer: BCBS Complete |
$72.04
|
| Rate for Payer: Cash Price |
$144.08
|
| Rate for Payer: Cofinity Commercial |
$126.07
|
| Rate for Payer: Cofinity Commercial |
$154.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$126.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.08
|
| Rate for Payer: Healthscope Commercial |
$162.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.09
|
| Rate for Payer: PHP Commercial |
$153.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.06
|
| Rate for Payer: Priority Health SBD |
$113.46
|
| Rate for Payer: UMR Bronson Commercial |
$66.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.07
|
|
|
HC NEG PRES WND THRPY DSG EXLGE
|
Facility
|
OP
|
$381.25
|
|
| Hospital Charge Code |
27200137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$141.06 |
| Max. Negotiated Rate |
$343.12 |
| Rate for Payer: Aetna American Axle |
$247.81
|
| Rate for Payer: Aetna Commercial |
$324.06
|
| Rate for Payer: Aetna Medicare |
$190.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.81
|
| Rate for Payer: BCBS Complete |
$152.50
|
| Rate for Payer: Cash Price |
$305.00
|
| Rate for Payer: Cofinity Commercial |
$266.88
|
| Rate for Payer: Cofinity Commercial |
$327.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$266.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$305.00
|
| Rate for Payer: Healthscope Commercial |
$343.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$266.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$324.06
|
| Rate for Payer: PHP Commercial |
$324.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.81
|
| Rate for Payer: Priority Health SBD |
$240.19
|
| Rate for Payer: UMR Bronson Commercial |
$141.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.94
|
|
|
HC NEG PRES WND THRPY DSG EXLGE
|
Facility
|
IP
|
$381.25
|
|
| Hospital Charge Code |
27200137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$167.75 |
| Max. Negotiated Rate |
$343.12 |
| Rate for Payer: Aetna American Axle |
$247.81
|
| Rate for Payer: Aetna Commercial |
$324.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.81
|
| Rate for Payer: Cash Price |
$305.00
|
| Rate for Payer: Cofinity Commercial |
$266.88
|
| Rate for Payer: Cofinity Commercial |
$327.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$266.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$305.00
|
| Rate for Payer: Healthscope Commercial |
$343.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$266.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$324.06
|
| Rate for Payer: PHP Commercial |
$324.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.81
|
| Rate for Payer: Priority Health SBD |
$240.19
|
| Rate for Payer: UMR Bronson Commercial |
$167.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.94
|
|
|
HC NEG PRES WND THRPY DSG SET LAR
|
Facility
|
OP
|
$202.55
|
|
| Hospital Charge Code |
27200138
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.94 |
| Max. Negotiated Rate |
$182.29 |
| Rate for Payer: Aetna American Axle |
$131.66
|
| Rate for Payer: Aetna Commercial |
$172.17
|
| Rate for Payer: Aetna Medicare |
$101.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.66
|
| Rate for Payer: BCBS Complete |
$81.02
|
| Rate for Payer: Cash Price |
$162.04
|
| Rate for Payer: Cofinity Commercial |
$141.78
|
| Rate for Payer: Cofinity Commercial |
$174.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$141.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.04
|
| Rate for Payer: Healthscope Commercial |
$182.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$141.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.17
|
| Rate for Payer: PHP Commercial |
$172.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.66
|
| Rate for Payer: Priority Health SBD |
$127.61
|
| Rate for Payer: UMR Bronson Commercial |
$74.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.91
|
|
|
HC NEG PRES WND THRPY DSG SET LAR
|
Facility
|
IP
|
$202.55
|
|
| Hospital Charge Code |
27200138
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$89.12 |
| Max. Negotiated Rate |
$182.29 |
| Rate for Payer: Aetna American Axle |
$131.66
|
| Rate for Payer: Aetna Commercial |
$172.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.66
|
| Rate for Payer: Cash Price |
$162.04
|
| Rate for Payer: Cofinity Commercial |
$141.78
|
| Rate for Payer: Cofinity Commercial |
$174.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$141.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.04
|
| Rate for Payer: Healthscope Commercial |
$182.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$141.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$151.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.17
|
| Rate for Payer: PHP Commercial |
$172.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.66
|
| Rate for Payer: Priority Health SBD |
$127.61
|
| Rate for Payer: UMR Bronson Commercial |
$89.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$151.91
|
|
|
HC NEG PRES WND THRPY DSG SET MED
|
Facility
|
OP
|
$145.92
|
|
| Hospital Charge Code |
27200139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.99 |
| Max. Negotiated Rate |
$131.33 |
| Rate for Payer: Aetna American Axle |
$94.85
|
| Rate for Payer: Aetna Commercial |
$124.03
|
| Rate for Payer: Aetna Medicare |
$72.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.85
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$102.14
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$102.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Healthscope Commercial |
$131.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.03
|
| Rate for Payer: PHP Commercial |
$124.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.85
|
| Rate for Payer: Priority Health SBD |
$91.93
|
| Rate for Payer: UMR Bronson Commercial |
$53.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.44
|
|
|
HC NEG PRES WND THRPY DSG SET MED
|
Facility
|
IP
|
$145.92
|
|
| Hospital Charge Code |
27200139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$64.20 |
| Max. Negotiated Rate |
$131.33 |
| Rate for Payer: Aetna American Axle |
$94.85
|
| Rate for Payer: Aetna Commercial |
$124.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.85
|
| Rate for Payer: Cash Price |
$116.74
|
| Rate for Payer: Cofinity Commercial |
$102.14
|
| Rate for Payer: Cofinity Commercial |
$125.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$102.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.74
|
| Rate for Payer: Healthscope Commercial |
$131.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.03
|
| Rate for Payer: PHP Commercial |
$124.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.85
|
| Rate for Payer: Priority Health SBD |
$91.93
|
| Rate for Payer: UMR Bronson Commercial |
$64.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.44
|
|
|
HC NEG PRES WND THRPY DSG SET SIL
|
Facility
|
OP
|
$272.48
|
|
| Hospital Charge Code |
27200140
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.82 |
| Max. Negotiated Rate |
$245.23 |
| Rate for Payer: Aetna American Axle |
$177.11
|
| Rate for Payer: Aetna Commercial |
$231.61
|
| Rate for Payer: Aetna Medicare |
$136.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.11
|
| Rate for Payer: BCBS Complete |
$108.99
|
| Rate for Payer: Cash Price |
$217.98
|
| Rate for Payer: Cofinity Commercial |
$190.74
|
| Rate for Payer: Cofinity Commercial |
$234.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$190.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.98
|
| Rate for Payer: Healthscope Commercial |
$245.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.61
|
| Rate for Payer: PHP Commercial |
$231.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.11
|
| Rate for Payer: Priority Health SBD |
$171.66
|
| Rate for Payer: UMR Bronson Commercial |
$100.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.36
|
|
|
HC NEG PRES WND THRPY DSG SET SIL
|
Facility
|
IP
|
$272.48
|
|
| Hospital Charge Code |
27200140
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$119.89 |
| Max. Negotiated Rate |
$245.23 |
| Rate for Payer: Aetna American Axle |
$177.11
|
| Rate for Payer: Aetna Commercial |
$231.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.11
|
| Rate for Payer: Cash Price |
$217.98
|
| Rate for Payer: Cofinity Commercial |
$190.74
|
| Rate for Payer: Cofinity Commercial |
$234.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$190.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.98
|
| Rate for Payer: Healthscope Commercial |
$245.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.61
|
| Rate for Payer: PHP Commercial |
$231.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.11
|
| Rate for Payer: Priority Health SBD |
$171.66
|
| Rate for Payer: UMR Bronson Commercial |
$119.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.36
|
|
|
HC NEG PRES WND THRPY DSG SET SMA
|
Facility
|
OP
|
$115.99
|
|
| Hospital Charge Code |
27200141
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.92 |
| Max. Negotiated Rate |
$104.39 |
| Rate for Payer: Aetna American Axle |
$75.39
|
| Rate for Payer: Aetna Commercial |
$98.59
|
| Rate for Payer: Aetna Medicare |
$57.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.39
|
| Rate for Payer: BCBS Complete |
$46.40
|
| Rate for Payer: Cash Price |
$92.79
|
| Rate for Payer: Cofinity Commercial |
$81.19
|
| Rate for Payer: Cofinity Commercial |
$99.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$81.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.79
|
| Rate for Payer: Healthscope Commercial |
$104.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.59
|
| Rate for Payer: PHP Commercial |
$98.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.39
|
| Rate for Payer: Priority Health SBD |
$73.07
|
| Rate for Payer: UMR Bronson Commercial |
$42.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.99
|
|
|
HC NEG PRES WND THRPY DSG SET SMA
|
Facility
|
IP
|
$115.99
|
|
| Hospital Charge Code |
27200141
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.04 |
| Max. Negotiated Rate |
$104.39 |
| Rate for Payer: Aetna American Axle |
$75.39
|
| Rate for Payer: Aetna Commercial |
$98.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.39
|
| Rate for Payer: Cash Price |
$92.79
|
| Rate for Payer: Cofinity Commercial |
$81.19
|
| Rate for Payer: Cofinity Commercial |
$99.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$81.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.79
|
| Rate for Payer: Healthscope Commercial |
$104.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.59
|
| Rate for Payer: PHP Commercial |
$98.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.39
|
| Rate for Payer: Priority Health SBD |
$73.07
|
| Rate for Payer: UMR Bronson Commercial |
$51.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.99
|
|
|
HC NEG PRES WOUND TX SET MED
|
Facility
|
OP
|
$79.99
|
|
| Hospital Charge Code |
27200127
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.60 |
| Max. Negotiated Rate |
$71.99 |
| Rate for Payer: Aetna American Axle |
$51.99
|
| Rate for Payer: Aetna Commercial |
$67.99
|
| Rate for Payer: Aetna Medicare |
$39.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.99
|
| Rate for Payer: BCBS Complete |
$32.00
|
| Rate for Payer: Cash Price |
$63.99
|
| Rate for Payer: Cofinity Commercial |
$55.99
|
| Rate for Payer: Cofinity Commercial |
$68.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$55.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.99
|
| Rate for Payer: Healthscope Commercial |
$71.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.99
|
| Rate for Payer: PHP Commercial |
$67.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.99
|
| Rate for Payer: Priority Health SBD |
$50.39
|
| Rate for Payer: UMR Bronson Commercial |
$29.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.99
|
|
