|
INDUCED ABORTION, BY DILATION AND CURETTAGE
|
Facility
|
OP
|
$8,748.29
|
|
|
Service Code
|
CPT 59840
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$221.35 |
| Max. Negotiated Rate |
$8,748.29 |
| Rate for Payer: Aetna Medicare |
$2,890.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$1,287.22
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,748.29
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$6,998.63
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.48
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,778.95
|
| Rate for Payer: UHC Exchange |
$221.35
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: VA VA |
$2,778.95
|
|
|
INDUCED ABORTION, BY DILATION AND EVACUATION
|
Facility
|
OP
|
$8,748.29
|
|
|
Service Code
|
CPT 59841
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$370.34 |
| Max. Negotiated Rate |
$8,748.29 |
| Rate for Payer: Aetna Medicare |
$2,890.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,473.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,473.69
|
| Rate for Payer: BCBS Complete |
$1,596.23
|
| Rate for Payer: BCBS MAPPO |
$2,778.95
|
| Rate for Payer: BCBS Trust/PPO |
$3,881.96
|
| Rate for Payer: BCN Medicare Advantage |
$2,778.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,778.95
|
| Rate for Payer: Mclaren Medicaid |
$1,520.09
|
| Rate for Payer: Mclaren Medicare |
$2,778.95
|
| Rate for Payer: Meridian Medicaid |
$1,596.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,917.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,195.79
|
| Rate for Payer: PACE Medicare |
$2,640.00
|
| Rate for Payer: PACE SWMI |
$2,778.95
|
| Rate for Payer: PHP Medicare Advantage |
$2,778.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,520.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,748.29
|
| Rate for Payer: Priority Health Medicare |
$2,778.95
|
| Rate for Payer: Priority Health Narrow Network |
$6,998.63
|
| Rate for Payer: Railroad Medicare Medicare |
$2,778.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.37
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,778.95
|
| Rate for Payer: UHC Exchange |
$370.34
|
| Rate for Payer: UHC Medicare Advantage |
$2,862.32
|
| Rate for Payer: VA VA |
$2,778.95
|
|
|
INEBILIZUMAB-CDON 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$118,815.92
|
|
|
Service Code
|
HCPCS J1823
|
| Hospital Charge Code |
194137
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$52,279.00 |
| Max. Negotiated Rate |
$106,934.33 |
| Rate for Payer: Aetna American Axle |
$77,230.35
|
| Rate for Payer: Aetna Commercial |
$100,993.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77,230.35
|
| Rate for Payer: Cash Price |
$95,052.74
|
| Rate for Payer: Cofinity Commercial |
$102,181.69
|
| Rate for Payer: Cofinity Commercial |
$83,171.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95,052.74
|
| Rate for Payer: Healthscope Commercial |
$106,934.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83,171.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89,111.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$100,993.53
|
| Rate for Payer: PHP Commercial |
$100,993.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83,171.14
|
| Rate for Payer: Priority Health SBD |
$74,854.03
|
| Rate for Payer: UMR Bronson Commercial |
$52,279.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89,111.94
|
|
|
INEBILIZUMAB-CDON 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$118,815.92
|
|
|
Service Code
|
HCPCS J1823
|
| Hospital Charge Code |
194137
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$259.01 |
| Max. Negotiated Rate |
$106,934.33 |
| Rate for Payer: Aetna American Axle |
$77,230.35
|
| Rate for Payer: Aetna Commercial |
$100,993.53
|
| Rate for Payer: Aetna Medicare |
$492.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77,230.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$591.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$591.89
|
| Rate for Payer: BCBS Complete |
$271.99
|
| Rate for Payer: BCBS MAPPO |
$473.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,530.15
|
| Rate for Payer: BCN Medicare Advantage |
$473.51
|
| Rate for Payer: Cash Price |
$95,052.74
|
| Rate for Payer: Cash Price |
$95,052.74
|
| Rate for Payer: Cofinity Commercial |
$83,171.14
|
| Rate for Payer: Cofinity Commercial |
$102,181.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95,052.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$473.51
|
| Rate for Payer: Healthscope Commercial |
$106,934.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83,171.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89,111.94
|
| Rate for Payer: Mclaren Medicaid |
$259.01
|
| Rate for Payer: Mclaren Medicare |
$473.51
|
| Rate for Payer: Meridian Medicaid |
$271.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$497.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$544.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$100,993.53
|
| Rate for Payer: PACE Medicare |
$449.84
|
| Rate for Payer: PACE SWMI |
$473.51
|
| Rate for Payer: PHP Commercial |
$100,993.53
|
| Rate for Payer: PHP Medicare Advantage |
$473.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$259.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83,171.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,390.65
|
| Rate for Payer: Priority Health Medicare |
$473.51
|
| Rate for Payer: Priority Health Narrow Network |
$1,112.52
|
| Rate for Payer: Priority Health SBD |
$74,854.03
|
| Rate for Payer: Railroad Medicare Medicare |
$473.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$473.51
|
| Rate for Payer: UHC Medicare Advantage |
$487.72
|
| Rate for Payer: UMR Bronson Commercial |
$43,961.89
|
| Rate for Payer: VA VA |
$473.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89,111.94
|
|
|
INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$15,141.12
|
|
|
Service Code
|
MS-DRG 758
|
| Min. Negotiated Rate |
$7,753.30 |
| Max. Negotiated Rate |
$15,141.12 |
| Rate for Payer: Aetna Medicare |
$8,487.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,201.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,201.71
|
| Rate for Payer: BCBS MAPPO |
$8,161.37
|
| Rate for Payer: BCBS Trust/PPO |
$14,288.35
|
| Rate for Payer: BCN Medicare Advantage |
$8,161.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,161.37
|
| Rate for Payer: Mclaren Medicare |
$8,161.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8,569.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,385.58
|
| Rate for Payer: PACE Medicare |
$7,753.30
|
| Rate for Payer: PACE SWMI |
$8,161.37
|
| Rate for Payer: PHP Medicare Advantage |
$8,161.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,243.73
|
| Rate for Payer: Priority Health Medicare |
$8,161.37
|
| Rate for Payer: Priority Health Narrow Network |
$11,394.98
|
| Rate for Payer: Railroad Medicare Medicare |
$8,161.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,141.12
|
| Rate for Payer: UHC Core |
$12,415.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,161.37
|
| Rate for Payer: UHC Exchange |
$9,870.41
|
| Rate for Payer: UHC Medicare Advantage |
$8,406.21
|
| Rate for Payer: VA VA |
$8,161.37
|
|
|
INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$22,752.87
|
|
|
Service Code
|
MS-DRG 757
|
| Min. Negotiated Rate |
$11,406.34 |
| Max. Negotiated Rate |
$22,752.87 |
| Rate for Payer: Aetna Medicare |
$12,486.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,008.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,008.34
|
| Rate for Payer: BCBS MAPPO |
$12,006.67
|
| Rate for Payer: BCBS Trust/PPO |
$20,919.89
|
| Rate for Payer: BCN Medicare Advantage |
$12,006.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,006.67
|
| Rate for Payer: Mclaren Medicare |
$12,006.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12,607.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,807.67
|
| Rate for Payer: PACE Medicare |
$11,406.34
|
| Rate for Payer: PACE SWMI |
$12,006.67
|
| Rate for Payer: PHP Medicare Advantage |
$12,006.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21,404.34
|
| Rate for Payer: Priority Health Medicare |
$12,006.67
|
| Rate for Payer: Priority Health Narrow Network |
$17,123.47
|
| Rate for Payer: Railroad Medicare Medicare |
$12,006.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22,752.87
|
| Rate for Payer: UHC Core |
$18,656.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,006.67
|
| Rate for Payer: UHC Exchange |
$14,832.47
|
| Rate for Payer: UHC Medicare Advantage |
$12,366.87
|
| Rate for Payer: VA VA |
$12,006.67
|
|
|
INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$13,340.99
|
|
|
Service Code
|
MS-DRG 759
|
| Min. Negotiated Rate |
$5,217.39 |
| Max. Negotiated Rate |
$13,340.99 |
| Rate for Payer: Aetna Medicare |
$5,711.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,864.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,864.99
|
| Rate for Payer: BCBS MAPPO |
$5,491.99
|
| Rate for Payer: BCBS Trust/PPO |
$13,340.99
|
| Rate for Payer: BCN Medicare Advantage |
$5,491.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,491.99
|
| Rate for Payer: Mclaren Medicare |
$5,491.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,766.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,315.79
|
| Rate for Payer: PACE Medicare |
$5,217.39
|
| Rate for Payer: PACE SWMI |
$5,491.99
|
| Rate for Payer: PHP Medicare Advantage |
$5,491.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,272.92
|
| Rate for Payer: Priority Health Medicare |
$5,491.99
|
| Rate for Payer: Priority Health Narrow Network |
$7,418.34
|
| Rate for Payer: Railroad Medicare Medicare |
$5,491.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,857.13
|
| Rate for Payer: UHC Core |
$8,082.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,491.99
|
| Rate for Payer: UHC Exchange |
$6,425.81
|
| Rate for Payer: UHC Medicare Advantage |
$5,656.75
|
| Rate for Payer: VA VA |
$5,491.99
|
|
|
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$31,090.70
|
|
|
Service Code
|
MS-DRG 854
|
| Min. Negotiated Rate |
$15,407.86 |
| Max. Negotiated Rate |
$31,090.70 |
| Rate for Payer: Aetna Medicare |
$16,867.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,273.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,273.50
|
| Rate for Payer: BCBS MAPPO |
$16,218.80
|
| Rate for Payer: BCBS Trust/PPO |
$27,749.95
|
| Rate for Payer: BCN Medicare Advantage |
$16,218.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,218.80
|
| Rate for Payer: Mclaren Medicare |
$16,218.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17,029.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,651.62
|
| Rate for Payer: PACE Medicare |
$15,407.86
|
| Rate for Payer: PACE SWMI |
$16,218.80
|
| Rate for Payer: PHP Medicare Advantage |
$16,218.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29,248.01
|
| Rate for Payer: Priority Health Medicare |
$16,218.80
|
| Rate for Payer: Priority Health Narrow Network |
$23,398.41
|
| Rate for Payer: Railroad Medicare Medicare |
$16,218.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,090.70
|
| Rate for Payer: UHC Core |
$25,493.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,218.80
|
| Rate for Payer: UHC Exchange |
$20,267.86
|
| Rate for Payer: UHC Medicare Advantage |
$16,705.36
|
| Rate for Payer: VA VA |
$16,218.80
|
|
|
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$80,930.46
|
|
|
Service Code
|
MS-DRG 853
|
| Min. Negotiated Rate |
$37,085.26 |
| Max. Negotiated Rate |
$80,930.46 |
| Rate for Payer: Aetna Medicare |
$40,598.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48,796.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48,796.40
|
| Rate for Payer: BCBS MAPPO |
$39,037.12
|
| Rate for Payer: BCBS Trust/PPO |
$80,930.46
|
| Rate for Payer: BCN Medicare Advantage |
$39,037.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39,037.12
|
| Rate for Payer: Mclaren Medicare |
$39,037.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40,988.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44,892.69
|
| Rate for Payer: PACE Medicare |
$37,085.26
|
| Rate for Payer: PACE SWMI |
$39,037.12
|
| Rate for Payer: PHP Medicare Advantage |
$39,037.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71,739.56
|
| Rate for Payer: Priority Health Medicare |
$39,037.12
|
| Rate for Payer: Priority Health Narrow Network |
$57,391.65
|
| Rate for Payer: Railroad Medicare Medicare |
$39,037.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76,259.32
|
| Rate for Payer: UHC Core |
$62,531.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$39,037.12
|
| Rate for Payer: UHC Exchange |
$49,713.04
|
| Rate for Payer: UHC Medicare Advantage |
$40,208.23
|
| Rate for Payer: VA VA |
$39,037.12
|
|
|
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$25,959.26
|
|
|
Service Code
|
MS-DRG 855
|
| Min. Negotiated Rate |
$12,945.16 |
| Max. Negotiated Rate |
$25,959.26 |
| Rate for Payer: Aetna Medicare |
$14,171.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17,033.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17,033.10
|
| Rate for Payer: BCBS MAPPO |
$13,626.48
|
| Rate for Payer: BCBS Trust/PPO |
$21,965.26
|
| Rate for Payer: BCN Medicare Advantage |
$13,626.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,626.48
|
| Rate for Payer: Mclaren Medicare |
$13,626.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14,307.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,670.45
|
| Rate for Payer: PACE Medicare |
$12,945.16
|
| Rate for Payer: PACE SWMI |
$13,626.48
|
| Rate for Payer: PHP Medicare Advantage |
$13,626.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24,420.69
|
| Rate for Payer: Priority Health Medicare |
$13,626.48
|
| Rate for Payer: Priority Health Narrow Network |
$19,536.55
|
| Rate for Payer: Railroad Medicare Medicare |
$13,626.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25,959.26
|
| Rate for Payer: UHC Core |
$21,286.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,626.48
|
| Rate for Payer: UHC Exchange |
$16,922.70
|
| Rate for Payer: UHC Medicare Advantage |
$14,035.27
|
| Rate for Payer: VA VA |
$13,626.48
|
|
|
INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$24,850.07
|
|
|
Service Code
|
MS-DRG 727
|
| Min. Negotiated Rate |
$12,353.65 |
| Max. Negotiated Rate |
$24,850.07 |
| Rate for Payer: Aetna Medicare |
$13,523.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16,254.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16,254.80
|
| Rate for Payer: BCBS MAPPO |
$13,003.84
|
| Rate for Payer: BCBS Trust/PPO |
$24,850.07
|
| Rate for Payer: BCN Medicare Advantage |
$13,003.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13,003.84
|
| Rate for Payer: Mclaren Medicare |
$13,003.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13,654.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,954.42
|
| Rate for Payer: PACE Medicare |
$12,353.65
|
| Rate for Payer: PACE SWMI |
$13,003.84
|
| Rate for Payer: PHP Medicare Advantage |
$13,003.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,261.22
|
| Rate for Payer: Priority Health Medicare |
$13,003.84
|
| Rate for Payer: Priority Health Narrow Network |
$18,608.98
|
| Rate for Payer: Railroad Medicare Medicare |
$13,003.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24,726.73
|
| Rate for Payer: UHC Core |
$20,275.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$13,003.84
|
| Rate for Payer: UHC Exchange |
$16,119.22
|
| Rate for Payer: UHC Medicare Advantage |
$13,393.96
|
| Rate for Payer: VA VA |
$13,003.84
|
|
|
INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC
|
Facility
|
IP
|
$12,204.73
|
|
|
Service Code
|
MS-DRG 728
|
| Min. Negotiated Rate |
$6,344.05 |
| Max. Negotiated Rate |
$12,204.73 |
| Rate for Payer: Aetna Medicare |
$6,945.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,347.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,347.44
|
| Rate for Payer: BCBS MAPPO |
$6,677.95
|
| Rate for Payer: BCBS Trust/PPO |
$10,828.09
|
| Rate for Payer: BCN Medicare Advantage |
$6,677.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,677.95
|
| Rate for Payer: Mclaren Medicare |
$6,677.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,011.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,679.64
|
| Rate for Payer: PACE Medicare |
$6,344.05
|
| Rate for Payer: PACE SWMI |
$6,677.95
|
| Rate for Payer: PHP Medicare Advantage |
$6,677.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,481.37
|
| Rate for Payer: Priority Health Medicare |
$6,677.95
|
| Rate for Payer: Priority Health Narrow Network |
$9,185.10
|
| Rate for Payer: Railroad Medicare Medicare |
$6,677.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,204.73
|
| Rate for Payer: UHC Core |
$10,007.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,677.95
|
| Rate for Payer: UHC Exchange |
$7,956.19
|
| Rate for Payer: UHC Medicare Advantage |
$6,878.29
|
| Rate for Payer: VA VA |
$6,677.95
|
|
|
INFLAMMATORY BOWEL DISEASE WITH CC
|
Facility
|
IP
|
$19,618.21
|
|
|
Service Code
|
MS-DRG 386
|
| Min. Negotiated Rate |
$7,599.55 |
| Max. Negotiated Rate |
$19,618.21 |
| Rate for Payer: Aetna Medicare |
$8,319.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,999.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,999.41
|
| Rate for Payer: BCBS MAPPO |
$7,999.53
|
| Rate for Payer: BCBS Trust/PPO |
$19,618.21
|
| Rate for Payer: BCN Medicare Advantage |
$7,999.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,999.53
|
| Rate for Payer: Mclaren Medicare |
$7,999.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8,399.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,199.46
|
| Rate for Payer: PACE Medicare |
$7,599.55
|
| Rate for Payer: PACE SWMI |
$7,999.53
|
| Rate for Payer: PHP Medicare Advantage |
$7,999.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13,942.38
|
| Rate for Payer: Priority Health Medicare |
$7,999.53
|
| Rate for Payer: Priority Health Narrow Network |
$11,153.90
|
| Rate for Payer: Railroad Medicare Medicare |
$7,999.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,820.79
|
| Rate for Payer: UHC Core |
$12,152.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,999.53
|
| Rate for Payer: UHC Exchange |
$9,661.59
|
| Rate for Payer: UHC Medicare Advantage |
$8,239.52
|
| Rate for Payer: VA VA |
$7,999.53
|
|
|
INFLAMMATORY BOWEL DISEASE WITH MCC
|
Facility
|
IP
|
$26,269.86
|
|
|
Service Code
|
MS-DRG 385
|
| Min. Negotiated Rate |
$11,957.58 |
| Max. Negotiated Rate |
$26,269.86 |
| Rate for Payer: Aetna Medicare |
$13,090.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15,733.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15,733.66
|
| Rate for Payer: BCBS MAPPO |
$12,586.93
|
| Rate for Payer: BCBS Trust/PPO |
$26,269.86
|
| Rate for Payer: BCN Medicare Advantage |
$12,586.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12,586.93
|
| Rate for Payer: Mclaren Medicare |
$12,586.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13,216.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,474.97
|
| Rate for Payer: PACE Medicare |
$11,957.58
|
| Rate for Payer: PACE SWMI |
$12,586.93
|
| Rate for Payer: PHP Medicare Advantage |
$12,586.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22,484.89
|
| Rate for Payer: Priority Health Medicare |
$12,586.93
|
| Rate for Payer: Priority Health Narrow Network |
$17,987.91
|
| Rate for Payer: Railroad Medicare Medicare |
$12,586.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,901.49
|
| Rate for Payer: UHC Core |
$19,598.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$12,586.93
|
| Rate for Payer: UHC Exchange |
$15,581.25
|
| Rate for Payer: UHC Medicare Advantage |
$12,964.54
|
| Rate for Payer: VA VA |
$12,586.93
|
|
|
INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC
|
Facility
|
IP
|
$13,386.22
|
|
|
Service Code
|
MS-DRG 387
|
| Min. Negotiated Rate |
$5,494.86 |
| Max. Negotiated Rate |
$13,386.22 |
| Rate for Payer: Aetna Medicare |
$6,015.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,230.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,230.08
|
| Rate for Payer: BCBS MAPPO |
$5,784.06
|
| Rate for Payer: BCBS Trust/PPO |
$13,386.22
|
| Rate for Payer: BCN Medicare Advantage |
$5,784.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,784.06
|
| Rate for Payer: Mclaren Medicare |
$5,784.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,073.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,651.67
|
| Rate for Payer: PACE Medicare |
$5,494.86
|
| Rate for Payer: PACE SWMI |
$5,784.06
|
| Rate for Payer: PHP Medicare Advantage |
$5,784.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,816.78
|
| Rate for Payer: Priority Health Medicare |
$5,784.06
|
| Rate for Payer: Priority Health Narrow Network |
$7,853.42
|
| Rate for Payer: Railroad Medicare Medicare |
$5,784.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,435.26
|
| Rate for Payer: UHC Core |
$8,556.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,784.06
|
| Rate for Payer: UHC Exchange |
$6,802.69
|
| Rate for Payer: UHC Medicare Advantage |
$5,957.58
|
| Rate for Payer: VA VA |
$5,784.06
|
|
|
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$1,481.25
|
|
|
Service Code
|
HCPCS J1745
|
| Hospital Charge Code |
23796
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$651.75 |
| Max. Negotiated Rate |
$1,333.12 |
| Rate for Payer: Aetna American Axle |
$962.81
|
| Rate for Payer: Aetna American Axle |
$2,367.17
|
| Rate for Payer: Aetna Commercial |
$3,095.53
|
| Rate for Payer: Aetna Commercial |
$1,259.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$962.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,367.17
|
| Rate for Payer: Cash Price |
$1,185.00
|
| Rate for Payer: Cash Price |
$2,913.44
|
| Rate for Payer: Cofinity Commercial |
$1,036.88
|
| Rate for Payer: Cofinity Commercial |
$2,549.26
|
| Rate for Payer: Cofinity Commercial |
$3,131.95
|
| Rate for Payer: Cofinity Commercial |
$1,273.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.44
|
| Rate for Payer: Healthscope Commercial |
$1,333.12
|
| Rate for Payer: Healthscope Commercial |
$3,277.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,036.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,549.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,731.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,110.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,095.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,259.06
|
| Rate for Payer: PHP Commercial |
$3,095.53
|
| Rate for Payer: PHP Commercial |
$1,259.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,036.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,549.26
|
| Rate for Payer: Priority Health SBD |
$2,294.33
|
| Rate for Payer: Priority Health SBD |
$933.19
|
| Rate for Payer: UMR Bronson Commercial |
$651.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,602.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,110.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,731.35
|
|
|
INFLIXIMAB 100 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$1,481.25
|
|
|
Service Code
|
HCPCS J1745
|
| Hospital Charge Code |
23796
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.59 |
| Max. Negotiated Rate |
$1,333.12 |
| Rate for Payer: Aetna American Axle |
$962.81
|
| Rate for Payer: Aetna American Axle |
$2,367.17
|
| Rate for Payer: Aetna Commercial |
$1,259.06
|
| Rate for Payer: Aetna Commercial |
$3,095.53
|
| Rate for Payer: Aetna Medicare |
$33.45
|
| Rate for Payer: Aetna Medicare |
$33.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,367.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$962.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.20
|
| Rate for Payer: BCBS Complete |
$18.47
|
| Rate for Payer: BCBS Complete |
$18.47
|
| Rate for Payer: BCBS MAPPO |
$32.16
|
| Rate for Payer: BCBS MAPPO |
$32.16
|
| Rate for Payer: BCBS Trust/PPO |
$103.90
|
| Rate for Payer: BCBS Trust/PPO |
$103.90
|
| Rate for Payer: BCN Medicare Advantage |
$32.16
|
| Rate for Payer: BCN Medicare Advantage |
$32.16
|
| Rate for Payer: Cash Price |
$1,185.00
|
| Rate for Payer: Cash Price |
$2,913.44
|
| Rate for Payer: Cash Price |
$2,913.44
|
| Rate for Payer: Cash Price |
$1,185.00
|
| Rate for Payer: Cofinity Commercial |
$3,131.95
|
| Rate for Payer: Cofinity Commercial |
$1,273.88
|
| Rate for Payer: Cofinity Commercial |
$1,036.88
|
| Rate for Payer: Cofinity Commercial |
$2,549.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.16
|
| Rate for Payer: Healthscope Commercial |
$1,333.12
|
| Rate for Payer: Healthscope Commercial |
$3,277.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,036.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,549.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,110.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,731.35
|
| Rate for Payer: Mclaren Medicaid |
$17.59
|
| Rate for Payer: Mclaren Medicaid |
$17.59
|
| Rate for Payer: Mclaren Medicare |
$32.16
|
| Rate for Payer: Mclaren Medicare |
$32.16
|
| Rate for Payer: Meridian Medicaid |
$18.47
|
| Rate for Payer: Meridian Medicaid |
$18.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,259.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,095.53
|
| Rate for Payer: PACE Medicare |
$30.55
|
| Rate for Payer: PACE Medicare |
$30.55
|
| Rate for Payer: PACE SWMI |
$32.16
|
| Rate for Payer: PACE SWMI |
$32.16
|
| Rate for Payer: PHP Commercial |
$1,259.06
|
| Rate for Payer: PHP Commercial |
$3,095.53
|
| Rate for Payer: PHP Medicare Advantage |
$32.16
|
| Rate for Payer: PHP Medicare Advantage |
$32.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,549.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,036.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.85
|
| Rate for Payer: Priority Health Medicare |
$32.16
|
| Rate for Payer: Priority Health Medicare |
$32.16
|
| Rate for Payer: Priority Health Narrow Network |
$76.68
|
| Rate for Payer: Priority Health Narrow Network |
$76.68
|
| Rate for Payer: Priority Health SBD |
$2,294.33
|
| Rate for Payer: Priority Health SBD |
$933.19
|
| Rate for Payer: Railroad Medicare Medicare |
$32.16
|
| Rate for Payer: Railroad Medicare Medicare |
$32.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.16
|
| Rate for Payer: UHC Medicare Advantage |
$33.13
|
| Rate for Payer: UHC Medicare Advantage |
$33.13
|
| Rate for Payer: UMR Bronson Commercial |
$548.06
|
| Rate for Payer: UMR Bronson Commercial |
$1,347.47
|
| Rate for Payer: VA VA |
$32.16
|
| Rate for Payer: VA VA |
$32.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,110.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,731.35
|
|
|
INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$1,482.02
|
|
|
Service Code
|
HCPCS Q5104
|
| Hospital Charge Code |
184064
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.23 |
| Max. Negotiated Rate |
$1,333.82 |
| Rate for Payer: Aetna American Axle |
$963.31
|
| Rate for Payer: Aetna Commercial |
$1,259.72
|
| Rate for Payer: Aetna Medicare |
$32.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.37
|
| Rate for Payer: BCBS Complete |
$18.09
|
| Rate for Payer: BCBS MAPPO |
$31.50
|
| Rate for Payer: BCBS Trust/PPO |
$99.56
|
| Rate for Payer: BCN Medicare Advantage |
$31.50
|
| Rate for Payer: Cash Price |
$1,185.62
|
| Rate for Payer: Cash Price |
$1,185.62
|
| Rate for Payer: Cofinity Commercial |
$1,037.41
|
| Rate for Payer: Cofinity Commercial |
$1,274.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.50
|
| Rate for Payer: Healthscope Commercial |
$1,333.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,037.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,111.52
|
| Rate for Payer: Mclaren Medicaid |
$17.23
|
| Rate for Payer: Mclaren Medicare |
$31.50
|
| Rate for Payer: Meridian Medicaid |
$18.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,259.72
|
| Rate for Payer: PACE Medicare |
$29.92
|
| Rate for Payer: PACE SWMI |
$31.50
|
| Rate for Payer: PHP Commercial |
$1,259.72
|
| Rate for Payer: PHP Medicare Advantage |
$31.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,037.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.62
|
| Rate for Payer: Priority Health Medicare |
$31.50
|
| Rate for Payer: Priority Health Narrow Network |
$76.50
|
| Rate for Payer: Priority Health SBD |
$933.67
|
| Rate for Payer: Railroad Medicare Medicare |
$31.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.50
|
| Rate for Payer: UHC Medicare Advantage |
$32.44
|
| Rate for Payer: UMR Bronson Commercial |
$548.35
|
| Rate for Payer: VA VA |
$31.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,111.52
|
|
|
INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$1,482.02
|
|
|
Service Code
|
HCPCS Q5104
|
| Hospital Charge Code |
184064
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$652.09 |
| Max. Negotiated Rate |
$1,333.82 |
| Rate for Payer: Aetna American Axle |
$963.31
|
| Rate for Payer: Aetna Commercial |
$1,259.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$963.31
|
| Rate for Payer: Cash Price |
$1,185.62
|
| Rate for Payer: Cofinity Commercial |
$1,037.41
|
| Rate for Payer: Cofinity Commercial |
$1,274.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,185.62
|
| Rate for Payer: Healthscope Commercial |
$1,333.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,037.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,111.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,259.72
|
| Rate for Payer: PHP Commercial |
$1,259.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,037.41
|
| Rate for Payer: Priority Health SBD |
$933.67
|
| Rate for Payer: UMR Bronson Commercial |
$652.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,111.52
|
|
|
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$1,653.60
|
|
|
Service Code
|
HCPCS Q5103
|
| Hospital Charge Code |
181037
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.82 |
| Max. Negotiated Rate |
$1,488.24 |
| Rate for Payer: Aetna American Axle |
$1,074.84
|
| Rate for Payer: Aetna Commercial |
$1,405.56
|
| Rate for Payer: Aetna Medicare |
$14.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,074.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.87
|
| Rate for Payer: BCBS Complete |
$8.21
|
| Rate for Payer: BCBS MAPPO |
$14.29
|
| Rate for Payer: BCBS Trust/PPO |
$144.06
|
| Rate for Payer: BCN Medicare Advantage |
$14.29
|
| Rate for Payer: Cash Price |
$1,322.88
|
| Rate for Payer: Cash Price |
$1,322.88
|
| Rate for Payer: Cofinity Commercial |
$1,157.52
|
| Rate for Payer: Cofinity Commercial |
$1,422.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,322.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.29
|
| Rate for Payer: Healthscope Commercial |
$1,488.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,157.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,240.20
|
| Rate for Payer: Mclaren Medicaid |
$7.82
|
| Rate for Payer: Mclaren Medicare |
$14.29
|
| Rate for Payer: Meridian Medicaid |
$8.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,405.56
|
| Rate for Payer: PACE Medicare |
$13.58
|
| Rate for Payer: PACE SWMI |
$14.29
|
| Rate for Payer: PHP Commercial |
$1,405.56
|
| Rate for Payer: PHP Medicare Advantage |
$14.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,157.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.91
|
| Rate for Payer: Priority Health Medicare |
$14.29
|
| Rate for Payer: Priority Health Narrow Network |
$32.73
|
| Rate for Payer: Priority Health SBD |
$1,041.77
|
| Rate for Payer: Railroad Medicare Medicare |
$14.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.29
|
| Rate for Payer: UHC Medicare Advantage |
$14.72
|
| Rate for Payer: UMR Bronson Commercial |
$611.83
|
| Rate for Payer: VA VA |
$14.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,240.20
|
|
|
INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$1,653.60
|
|
|
Service Code
|
HCPCS Q5103
|
| Hospital Charge Code |
181037
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$727.58 |
| Max. Negotiated Rate |
$1,488.24 |
| Rate for Payer: Aetna American Axle |
$1,074.84
|
| Rate for Payer: Aetna Commercial |
$1,405.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,074.84
|
| Rate for Payer: Cash Price |
$1,322.88
|
| Rate for Payer: Cofinity Commercial |
$1,157.52
|
| Rate for Payer: Cofinity Commercial |
$1,422.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,322.88
|
| Rate for Payer: Healthscope Commercial |
$1,488.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,157.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,240.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,405.56
|
| Rate for Payer: PHP Commercial |
$1,405.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,157.52
|
| Rate for Payer: Priority Health SBD |
$1,041.77
|
| Rate for Payer: UMR Bronson Commercial |
$727.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,240.20
|
|
|
INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC
|
Facility
|
IP
|
$29,918.59
|
|
|
Service Code
|
MS-DRG 351
|
| Min. Negotiated Rate |
$11,142.80 |
| Max. Negotiated Rate |
$29,918.59 |
| Rate for Payer: Aetna Medicare |
$12,198.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,661.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,661.58
|
| Rate for Payer: BCBS MAPPO |
$11,729.26
|
| Rate for Payer: BCBS Trust/PPO |
$29,918.59
|
| Rate for Payer: BCN Medicare Advantage |
$11,729.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,729.26
|
| Rate for Payer: Mclaren Medicare |
$11,729.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12,315.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,488.65
|
| Rate for Payer: PACE Medicare |
$11,142.80
|
| Rate for Payer: PACE SWMI |
$11,729.26
|
| Rate for Payer: PHP Medicare Advantage |
$11,729.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,887.74
|
| Rate for Payer: Priority Health Medicare |
$11,729.26
|
| Rate for Payer: Priority Health Narrow Network |
$16,710.19
|
| Rate for Payer: Railroad Medicare Medicare |
$11,729.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22,203.72
|
| Rate for Payer: UHC Core |
$18,206.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,729.26
|
| Rate for Payer: UHC Exchange |
$14,474.49
|
| Rate for Payer: UHC Medicare Advantage |
$12,081.14
|
| Rate for Payer: VA VA |
$11,729.26
|
|
|
INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC
|
Facility
|
IP
|
$36,609.60
|
|
|
Service Code
|
MS-DRG 350
|
| Min. Negotiated Rate |
$18,056.49 |
| Max. Negotiated Rate |
$36,609.60 |
| Rate for Payer: Aetna Medicare |
$19,767.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,758.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,758.54
|
| Rate for Payer: BCBS MAPPO |
$19,006.83
|
| Rate for Payer: BCBS Trust/PPO |
$34,818.74
|
| Rate for Payer: BCN Medicare Advantage |
$19,006.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19,006.83
|
| Rate for Payer: Mclaren Medicare |
$19,006.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19,957.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,857.85
|
| Rate for Payer: PACE Medicare |
$18,056.49
|
| Rate for Payer: PACE SWMI |
$19,006.83
|
| Rate for Payer: PHP Medicare Advantage |
$19,006.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34,439.81
|
| Rate for Payer: Priority Health Medicare |
$19,006.83
|
| Rate for Payer: Priority Health Narrow Network |
$27,551.85
|
| Rate for Payer: Railroad Medicare Medicare |
$19,006.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36,609.60
|
| Rate for Payer: UHC Core |
$30,019.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$19,006.83
|
| Rate for Payer: UHC Exchange |
$23,865.60
|
| Rate for Payer: UHC Medicare Advantage |
$19,577.03
|
| Rate for Payer: VA VA |
$19,006.83
|
|
|
INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$29,564.27
|
|
|
Service Code
|
MS-DRG 352
|
| Min. Negotiated Rate |
$8,605.43 |
| Max. Negotiated Rate |
$29,564.27 |
| Rate for Payer: Aetna Medicare |
$9,420.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,322.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,322.94
|
| Rate for Payer: BCBS MAPPO |
$9,058.35
|
| Rate for Payer: BCBS Trust/PPO |
$29,564.27
|
| Rate for Payer: BCN Medicare Advantage |
$9,058.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,058.35
|
| Rate for Payer: Mclaren Medicare |
$9,058.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,511.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,417.10
|
| Rate for Payer: PACE Medicare |
$8,605.43
|
| Rate for Payer: PACE SWMI |
$9,058.35
|
| Rate for Payer: PHP Medicare Advantage |
$9,058.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,914.06
|
| Rate for Payer: Priority Health Medicare |
$9,058.35
|
| Rate for Payer: Priority Health Narrow Network |
$12,731.25
|
| Rate for Payer: Railroad Medicare Medicare |
$9,058.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,916.69
|
| Rate for Payer: UHC Core |
$13,871.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,058.35
|
| Rate for Payer: UHC Exchange |
$11,027.90
|
| Rate for Payer: UHC Medicare Advantage |
$9,330.10
|
| Rate for Payer: VA VA |
$9,058.35
|
|
|
INHALATIONAL SPACING DEVICE
|
Facility
|
IP
|
$29.35
|
|
|
Service Code
|
NDC 8373-077478
|
| Hospital Charge Code |
113188
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$26.42 |
| Rate for Payer: Aetna American Axle |
$19.08
|
| Rate for Payer: Aetna Commercial |
$24.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.08
|
| Rate for Payer: Cash Price |
$23.48
|
| Rate for Payer: Cofinity Commercial |
$20.54
|
| Rate for Payer: Cofinity Commercial |
$25.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.48
|
| Rate for Payer: Healthscope Commercial |
$26.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.95
|
| Rate for Payer: PHP Commercial |
$24.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.54
|
| Rate for Payer: Priority Health SBD |
$18.49
|
| Rate for Payer: UMR Bronson Commercial |
$12.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.01
|
|
