|
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
|
|
|
HC NEG PRES WOUND TX SET SMALL
|
Facility
|
OP
|
$115.99
|
|
| Hospital Charge Code |
27200128
|
|
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 WOUND TX SET SMALL
|
Facility
|
IP
|
$115.99
|
|
| Hospital Charge Code |
27200128
|
|
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 Y CONNECTOR
|
Facility
|
OP
|
$7.86
|
|
| Hospital Charge Code |
27000174
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$7.07 |
| Rate for Payer: Aetna American Axle |
$5.11
|
| Rate for Payer: Aetna Commercial |
$6.68
|
| Rate for Payer: Aetna Medicare |
$3.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.11
|
| Rate for Payer: BCBS Complete |
$3.14
|
| Rate for Payer: Cash Price |
$6.29
|
| Rate for Payer: Cofinity Commercial |
$5.50
|
| Rate for Payer: Cofinity Commercial |
$6.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.29
|
| Rate for Payer: Healthscope Commercial |
$7.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.68
|
| Rate for Payer: PHP Commercial |
$6.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.11
|
| Rate for Payer: Priority Health SBD |
$4.95
|
| Rate for Payer: UMR Bronson Commercial |
$2.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.89
|
|
|
HC NEG PRES Y CONNECTOR
|
Facility
|
IP
|
$7.86
|
|
| Hospital Charge Code |
27000174
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$7.07 |
| Rate for Payer: Aetna American Axle |
$5.11
|
| Rate for Payer: Aetna Commercial |
$6.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.11
|
| Rate for Payer: Cash Price |
$6.29
|
| Rate for Payer: Cofinity Commercial |
$5.50
|
| Rate for Payer: Cofinity Commercial |
$6.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.29
|
| Rate for Payer: Healthscope Commercial |
$7.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.68
|
| Rate for Payer: PHP Commercial |
$6.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.11
|
| Rate for Payer: Priority Health SBD |
$4.95
|
| Rate for Payer: UMR Bronson Commercial |
$3.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.89
|
|
|
HC NEISSERIA GONORRHOEAE AMP DNA
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 87591
|
| Hospital Charge Code |
30600163
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$98.77 |
| Rate for Payer: Aetna American Axle |
$43.96
|
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Cofinity Commercial |
$47.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$67.06
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$25.02
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC NEISSERIA GONORRHOEAE AMP DNA
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 87591
|
| Hospital Charge Code |
30600163
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna American Axle |
$43.96
|
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$47.34
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: UMR Bronson Commercial |
$29.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC NEISSERIA MENINGITITIS
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600275
|
|
Hospital Revenue Code
|
306
|
| 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 NEISSERIA MENINGITITIS
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600275
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$98.77 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| 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 |
$35.09
|
| 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 |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$67.06
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC NEONATAL VENT INIT DAY
|
Facility
|
IP
|
$1,569.06
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000037
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$690.39 |
| Max. Negotiated Rate |
$1,412.15 |
| Rate for Payer: Aetna American Axle |
$1,019.89
|
| Rate for Payer: Aetna Commercial |
$1,333.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,019.89
|
| Rate for Payer: Cash Price |
$1,255.25
|
| Rate for Payer: Cofinity Commercial |
$1,098.34
|
| Rate for Payer: Cofinity Commercial |
$1,349.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,098.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.25
|
| Rate for Payer: Healthscope Commercial |
$1,412.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,098.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.70
|
| Rate for Payer: PHP Commercial |
$1,333.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.89
|
| Rate for Payer: Priority Health SBD |
$988.51
|
| Rate for Payer: UMR Bronson Commercial |
$690.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.80
|
|
|
HC NEONATAL VENT INIT DAY
|
Facility
|
OP
|
$1,569.06
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000037
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$294.00 |
| Max. Negotiated Rate |
$1,814.93 |
| Rate for Payer: Aetna American Axle |
$1,019.89
|
| Rate for Payer: Aetna Commercial |
$1,333.70
|
| Rate for Payer: Aetna Medicare |
$670.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,019.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$805.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$805.95
|
| Rate for Payer: BCBS Complete |
$362.87
|
| Rate for Payer: BCBS MAPPO |
$644.76
|
| Rate for Payer: BCN Medicare Advantage |
$644.76
|
| Rate for Payer: Cash Price |
$1,255.25
|
| Rate for Payer: Cash Price |
$1,255.25
|
| Rate for Payer: Cash Price |
$1,255.25
|
| Rate for Payer: Cofinity Commercial |
$1,098.34
|
| Rate for Payer: Cofinity Commercial |
$1,349.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,098.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,255.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.76
|
| Rate for Payer: Healthscope Commercial |
$1,412.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,098.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.80
|
| Rate for Payer: Mclaren Medicaid |
$345.59
|
| Rate for Payer: Mclaren Medicare |
$644.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$677.00
|
| Rate for Payer: Meridian Medicaid |
$362.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$741.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,333.70
|
| Rate for Payer: PACE Medicare |
$612.52
|
| Rate for Payer: PACE SWMI |
$644.76
|
| Rate for Payer: PHP Commercial |
$1,333.70
|
| Rate for Payer: PHP Medicare Advantage |
$644.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.89
|
| Rate for Payer: Priority Health Medicare |
$644.76
|
| Rate for Payer: Priority Health SBD |
$988.51
|
| Rate for Payer: Railroad Medicare Medicare |
$644.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,814.93
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.76
|
| Rate for Payer: UHC Exchange |
$1,232.20
|
| Rate for Payer: UHC Medicare Advantage |
$644.76
|
| Rate for Payer: UHCCP Medicaid |
$345.59
|
| Rate for Payer: UMR Bronson Commercial |
$580.55
|
| Rate for Payer: VA VA |
$644.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.80
|
|
|
HC NEONATAL VENT SUB DAY
|
Facility
|
IP
|
$1,197.45
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000038
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$526.88 |
| Max. Negotiated Rate |
$1,077.70 |
| Rate for Payer: Aetna American Axle |
$778.34
|
| Rate for Payer: Aetna Commercial |
$1,017.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$778.34
|
| Rate for Payer: Cash Price |
$957.96
|
| Rate for Payer: Cofinity Commercial |
$1,029.81
|
| Rate for Payer: Cofinity Commercial |
$838.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$838.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$957.96
|
| Rate for Payer: Healthscope Commercial |
$1,077.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$838.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$898.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,017.83
|
| Rate for Payer: PHP Commercial |
$1,017.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.34
|
| Rate for Payer: Priority Health SBD |
$754.39
|
| Rate for Payer: UMR Bronson Commercial |
$526.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$898.09
|
|
|
HC NEONATAL VENT SUB DAY
|
Facility
|
OP
|
$1,197.45
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000038
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$294.00 |
| Max. Negotiated Rate |
$1,814.93 |
| Rate for Payer: Aetna American Axle |
$778.34
|
| Rate for Payer: Aetna Commercial |
$1,017.83
|
| Rate for Payer: Aetna Medicare |
$670.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$778.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$805.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$805.95
|
| Rate for Payer: BCBS Complete |
$362.87
|
| Rate for Payer: BCBS MAPPO |
$644.76
|
| Rate for Payer: BCN Medicare Advantage |
$644.76
|
| Rate for Payer: Cash Price |
$957.96
|
| Rate for Payer: Cash Price |
$957.96
|
| Rate for Payer: Cash Price |
$957.96
|
| Rate for Payer: Cofinity Commercial |
$1,029.81
|
| Rate for Payer: Cofinity Commercial |
$838.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$838.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$957.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.76
|
| Rate for Payer: Healthscope Commercial |
$1,077.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$838.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$898.09
|
| Rate for Payer: Mclaren Medicaid |
$345.59
|
| Rate for Payer: Mclaren Medicare |
$644.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$677.00
|
| Rate for Payer: Meridian Medicaid |
$362.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$741.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,017.83
|
| Rate for Payer: PACE Medicare |
$612.52
|
| Rate for Payer: PACE SWMI |
$644.76
|
| Rate for Payer: PHP Commercial |
$1,017.83
|
| Rate for Payer: PHP Medicare Advantage |
$644.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.34
|
| Rate for Payer: Priority Health Medicare |
$644.76
|
| Rate for Payer: Priority Health SBD |
$754.39
|
| Rate for Payer: Railroad Medicare Medicare |
$644.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,814.93
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.76
|
| Rate for Payer: UHC Exchange |
$1,232.20
|
| Rate for Payer: UHC Medicare Advantage |
$644.76
|
| Rate for Payer: UHCCP Medicaid |
$345.59
|
| Rate for Payer: UMR Bronson Commercial |
$443.06
|
| Rate for Payer: VA VA |
$644.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$898.09
|
|
|
HC NEPHROSTOGRAM URETEROGRAM EXISTING ACCESS
|
Facility
|
IP
|
$1,363.87
|
|
|
Service Code
|
CPT 50431
|
| Hospital Charge Code |
36100503
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$600.10 |
| Max. Negotiated Rate |
$1,227.48 |
| Rate for Payer: Aetna American Axle |
$886.52
|
| Rate for Payer: Aetna Commercial |
$1,159.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$886.52
|
| Rate for Payer: Cash Price |
$1,091.10
|
| Rate for Payer: Cofinity Commercial |
$1,172.93
|
| Rate for Payer: Cofinity Commercial |
$954.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$954.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,091.10
|
| Rate for Payer: Healthscope Commercial |
$1,227.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$954.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,022.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,159.29
|
| Rate for Payer: PHP Commercial |
$1,159.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$886.52
|
| Rate for Payer: Priority Health SBD |
$859.24
|
| Rate for Payer: UMR Bronson Commercial |
$600.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,022.90
|
|
|
HC NEPHROSTOGRAM URETEROGRAM EXISTING ACCESS
|
Facility
|
OP
|
$1,363.87
|
|
|
Service Code
|
CPT 50431
|
| Hospital Charge Code |
36100503
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$348.92 |
| Max. Negotiated Rate |
$1,832.42 |
| Rate for Payer: Aetna American Axle |
$886.52
|
| Rate for Payer: Aetna Commercial |
$1,159.29
|
| Rate for Payer: Aetna Medicare |
$677.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$886.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$813.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$813.71
|
| Rate for Payer: BCBS Complete |
$366.37
|
| Rate for Payer: BCBS MAPPO |
$650.97
|
| Rate for Payer: BCN Medicare Advantage |
$650.97
|
| Rate for Payer: Cash Price |
$1,091.10
|
| Rate for Payer: Cash Price |
$1,091.10
|
| Rate for Payer: Cofinity Commercial |
$954.71
|
| Rate for Payer: Cofinity Commercial |
$1,172.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$954.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,091.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$650.97
|
| Rate for Payer: Healthscope Commercial |
$1,227.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$954.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,022.90
|
| Rate for Payer: Mclaren Medicaid |
$348.92
|
| Rate for Payer: Mclaren Medicare |
$650.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$683.52
|
| Rate for Payer: Meridian Medicaid |
$366.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$748.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,159.29
|
| Rate for Payer: PACE Medicare |
$618.42
|
| Rate for Payer: PACE SWMI |
$650.97
|
| Rate for Payer: PHP Commercial |
$1,159.29
|
| Rate for Payer: PHP Medicare Advantage |
$650.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$886.52
|
| Rate for Payer: Priority Health Medicare |
$650.97
|
| Rate for Payer: Priority Health SBD |
$859.24
|
| Rate for Payer: Railroad Medicare Medicare |
$650.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,832.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$650.97
|
| Rate for Payer: UHC Exchange |
$1,244.07
|
| Rate for Payer: UHC Medicare Advantage |
$650.97
|
| Rate for Payer: UHCCP Medicaid |
$348.92
|
| Rate for Payer: UMR Bronson Commercial |
$504.63
|
| Rate for Payer: VA VA |
$650.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,022.90
|
|
|
HC NEPHROSTOGRAM URETEROGRAM NEW ACCESS
|
Facility
|
OP
|
$1,204.40
|
|
|
Service Code
|
CPT 50430
|
| Hospital Charge Code |
36100502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$348.92 |
| Max. Negotiated Rate |
$1,832.42 |
| Rate for Payer: Aetna American Axle |
$782.86
|
| Rate for Payer: Aetna Commercial |
$1,023.74
|
| Rate for Payer: Aetna Medicare |
$677.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$782.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$813.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$813.71
|
| Rate for Payer: BCBS Complete |
$366.37
|
| Rate for Payer: BCBS MAPPO |
$650.97
|
| Rate for Payer: BCN Medicare Advantage |
$650.97
|
| Rate for Payer: Cash Price |
$963.52
|
| Rate for Payer: Cash Price |
$963.52
|
| Rate for Payer: Cofinity Commercial |
$843.08
|
| Rate for Payer: Cofinity Commercial |
$1,035.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$843.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$650.97
|
| Rate for Payer: Healthscope Commercial |
$1,083.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$843.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.30
|
| Rate for Payer: Mclaren Medicaid |
$348.92
|
| Rate for Payer: Mclaren Medicare |
$650.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$683.52
|
| Rate for Payer: Meridian Medicaid |
$366.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$748.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,023.74
|
| Rate for Payer: PACE Medicare |
$618.42
|
| Rate for Payer: PACE SWMI |
$650.97
|
| Rate for Payer: PHP Commercial |
$1,023.74
|
| Rate for Payer: PHP Medicare Advantage |
$650.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.86
|
| Rate for Payer: Priority Health Medicare |
$650.97
|
| Rate for Payer: Priority Health SBD |
$758.77
|
| Rate for Payer: Railroad Medicare Medicare |
$650.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,832.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$650.97
|
| Rate for Payer: UHC Exchange |
$1,244.07
|
| Rate for Payer: UHC Medicare Advantage |
$650.97
|
| Rate for Payer: UHCCP Medicaid |
$348.92
|
| Rate for Payer: UMR Bronson Commercial |
$445.63
|
| Rate for Payer: VA VA |
$650.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.30
|
|
|
HC NEPHROSTOGRAM URETEROGRAM NEW ACCESS
|
Facility
|
IP
|
$1,204.40
|
|
|
Service Code
|
CPT 50430
|
| Hospital Charge Code |
36100502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$529.94 |
| Max. Negotiated Rate |
$1,083.96 |
| Rate for Payer: Aetna American Axle |
$782.86
|
| Rate for Payer: Aetna Commercial |
$1,023.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$782.86
|
| Rate for Payer: Cash Price |
$963.52
|
| Rate for Payer: Cofinity Commercial |
$1,035.78
|
| Rate for Payer: Cofinity Commercial |
$843.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$843.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$963.52
|
| Rate for Payer: Healthscope Commercial |
$1,083.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$843.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,023.74
|
| Rate for Payer: PHP Commercial |
$1,023.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$782.86
|
| Rate for Payer: Priority Health SBD |
$758.77
|
| Rate for Payer: UMR Bronson Commercial |
$529.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.30
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL EA ADDL LEVEL
|
Facility
|
OP
|
$1,491.41
|
|
|
Service Code
|
CPT 64421
|
| Hospital Charge Code |
36100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$465.40 |
| Max. Negotiated Rate |
$2,444.12 |
| Rate for Payer: Aetna American Axle |
$969.42
|
| Rate for Payer: Aetna Commercial |
$1,267.70
|
| Rate for Payer: Aetna Medicare |
$903.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$969.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,085.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,085.35
|
| Rate for Payer: BCBS Complete |
$488.67
|
| Rate for Payer: BCBS MAPPO |
$868.28
|
| Rate for Payer: BCN Medicare Advantage |
$868.28
|
| Rate for Payer: Cash Price |
$1,193.13
|
| Rate for Payer: Cash Price |
$1,193.13
|
| Rate for Payer: Cofinity Commercial |
$1,282.61
|
| Rate for Payer: Cofinity Commercial |
$1,043.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,043.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$868.28
|
| Rate for Payer: Healthscope Commercial |
$1,342.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,043.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,118.56
|
| Rate for Payer: Mclaren Medicaid |
$465.40
|
| Rate for Payer: Mclaren Medicare |
$868.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$911.69
|
| Rate for Payer: Meridian Medicaid |
$488.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$998.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,267.70
|
| Rate for Payer: PACE Medicare |
$824.87
|
| Rate for Payer: PACE SWMI |
$868.28
|
| Rate for Payer: PHP Commercial |
$1,267.70
|
| Rate for Payer: PHP Medicare Advantage |
$868.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$465.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$969.42
|
| Rate for Payer: Priority Health Medicare |
$868.28
|
| Rate for Payer: Priority Health SBD |
$939.59
|
| Rate for Payer: Railroad Medicare Medicare |
$868.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,444.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$868.28
|
| Rate for Payer: UHC Exchange |
$1,659.37
|
| Rate for Payer: UHC Medicare Advantage |
$868.28
|
| Rate for Payer: UHCCP Medicaid |
$465.40
|
| Rate for Payer: UMR Bronson Commercial |
$551.82
|
| Rate for Payer: VA VA |
$868.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,118.56
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL EA ADDL LEVEL
|
Facility
|
IP
|
$1,491.41
|
|
|
Service Code
|
CPT 64421
|
| Hospital Charge Code |
36100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$656.22 |
| Max. Negotiated Rate |
$1,342.27 |
| Rate for Payer: Aetna American Axle |
$969.42
|
| Rate for Payer: Aetna Commercial |
$1,267.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$969.42
|
| Rate for Payer: Cash Price |
$1,193.13
|
| Rate for Payer: Cofinity Commercial |
$1,043.99
|
| Rate for Payer: Cofinity Commercial |
$1,282.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,043.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.13
|
| Rate for Payer: Healthscope Commercial |
$1,342.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,043.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,118.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,267.70
|
| Rate for Payer: PHP Commercial |
$1,267.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$969.42
|
| Rate for Payer: Priority Health SBD |
$939.59
|
| Rate for Payer: UMR Bronson Commercial |
$656.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,118.56
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL SINGLE
|
Facility
|
OP
|
$758.70
|
|
|
Service Code
|
CPT 64420
|
| Hospital Charge Code |
36100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$280.72 |
| Max. Negotiated Rate |
$1,901.18 |
| Rate for Payer: Aetna American Axle |
$493.15
|
| Rate for Payer: Aetna Commercial |
$644.89
|
| Rate for Payer: Aetna Medicare |
$702.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$493.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$844.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$844.25
|
| Rate for Payer: BCBS Complete |
$380.12
|
| Rate for Payer: BCBS MAPPO |
$675.40
|
| Rate for Payer: BCN Medicare Advantage |
$675.40
|
| Rate for Payer: Cash Price |
$606.96
|
| Rate for Payer: Cash Price |
$606.96
|
| Rate for Payer: Cofinity Commercial |
$652.48
|
| Rate for Payer: Cofinity Commercial |
$531.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$531.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$606.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.40
|
| Rate for Payer: Healthscope Commercial |
$682.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$531.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$569.02
|
| Rate for Payer: Mclaren Medicaid |
$362.01
|
| Rate for Payer: Mclaren Medicare |
$675.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.17
|
| Rate for Payer: Meridian Medicaid |
$380.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$776.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$644.89
|
| Rate for Payer: PACE Medicare |
$641.63
|
| Rate for Payer: PACE SWMI |
$675.40
|
| Rate for Payer: PHP Commercial |
$644.89
|
| Rate for Payer: PHP Medicare Advantage |
$675.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$493.15
|
| Rate for Payer: Priority Health Medicare |
$675.40
|
| Rate for Payer: Priority Health SBD |
$477.98
|
| Rate for Payer: Railroad Medicare Medicare |
$675.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,901.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.40
|
| Rate for Payer: UHC Exchange |
$1,290.76
|
| Rate for Payer: UHC Medicare Advantage |
$675.40
|
| Rate for Payer: UHCCP Medicaid |
$362.01
|
| Rate for Payer: UMR Bronson Commercial |
$280.72
|
| Rate for Payer: VA VA |
$675.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$569.02
|
|
|
HC NERVE ROOT BLOCK INTERCOSTAL SINGLE
|
Facility
|
IP
|
$758.70
|
|
|
Service Code
|
CPT 64420
|
| Hospital Charge Code |
36100403
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$333.83 |
| Max. Negotiated Rate |
$682.83 |
| Rate for Payer: Aetna American Axle |
$493.15
|
| Rate for Payer: Aetna Commercial |
$644.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$493.15
|
| Rate for Payer: Cash Price |
$606.96
|
| Rate for Payer: Cofinity Commercial |
$531.09
|
| Rate for Payer: Cofinity Commercial |
$652.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$531.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$606.96
|
| Rate for Payer: Healthscope Commercial |
$682.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$531.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$569.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$644.89
|
| Rate for Payer: PHP Commercial |
$644.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$493.15
|
| Rate for Payer: Priority Health SBD |
$477.98
|
| Rate for Payer: UMR Bronson Commercial |
$333.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$569.02
|
|
|
HC NETTLE IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200049
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC NETTLE IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200049
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$9.98
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM EA ADDL HR
|
Facility
|
IP
|
$135.25
|
|
|
Service Code
|
CPT 96121
|
| Hospital Charge Code |
91800006
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$59.51 |
| Max. Negotiated Rate |
$121.72 |
| Rate for Payer: Aetna American Axle |
$87.91
|
| Rate for Payer: Aetna Commercial |
$114.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.91
|
| Rate for Payer: Cash Price |
$108.20
|
| Rate for Payer: Cofinity Commercial |
$116.31
|
| Rate for Payer: Cofinity Commercial |
$94.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$94.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.20
|
| Rate for Payer: Healthscope Commercial |
$121.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.96
|
| Rate for Payer: PHP Commercial |
$114.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.91
|
| Rate for Payer: Priority Health SBD |
$85.21
|
| Rate for Payer: UMR Bronson Commercial |
$59.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.44
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM EA ADDL HR
|
Facility
|
OP
|
$135.25
|
|
|
Service Code
|
CPT 96121
|
| Hospital Charge Code |
91800006
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$50.04 |
| Max. Negotiated Rate |
$491.00 |
| Rate for Payer: Aetna American Axle |
$87.91
|
| Rate for Payer: Aetna Commercial |
$114.96
|
| Rate for Payer: Aetna Medicare |
$67.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.91
|
| Rate for Payer: BCBS Complete |
$54.10
|
| Rate for Payer: Cash Price |
$108.20
|
| Rate for Payer: Cash Price |
$108.20
|
| Rate for Payer: Cofinity Commercial |
$94.67
|
| Rate for Payer: Cofinity Commercial |
$116.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$94.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.20
|
| Rate for Payer: Healthscope Commercial |
$121.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.96
|
| Rate for Payer: PHP Commercial |
$114.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.91
|
| Rate for Payer: Priority Health SBD |
$85.21
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UMR Bronson Commercial |
$50.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.44
|
|
