|
HC ORTHOPOX (AKA MONKEY)
|
Facility
|
OP
|
$123.27
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600334
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$144.43 |
| Rate for Payer: Aetna American Axle |
$80.13
|
| Rate for Payer: Aetna Commercial |
$104.78
|
| Rate for Payer: Aetna Medicare |
$53.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: BCBS Complete |
$28.88
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$98.62
|
| Rate for Payer: Cash Price |
$98.62
|
| Rate for Payer: Cofinity Commercial |
$86.29
|
| Rate for Payer: Cofinity Commercial |
$106.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$86.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$110.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.45
|
| Rate for Payer: Mclaren Medicaid |
$27.50
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$28.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.78
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$104.78
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.13
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health SBD |
$77.66
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.31
|
| Rate for Payer: UHC Exchange |
$98.06
|
| Rate for Payer: UHC Medicare Advantage |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$27.50
|
| Rate for Payer: UMR Bronson Commercial |
$45.61
|
| Rate for Payer: VA VA |
$51.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.45
|
|
|
HC ORTHOPOX DNA, PCR
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600332
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$144.43 |
| Rate for Payer: Aetna American Axle |
$49.73
|
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: Aetna Medicare |
$53.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: BCBS Complete |
$28.88
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Cofinity Commercial |
$53.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$27.50
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$28.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health SBD |
$48.20
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.31
|
| Rate for Payer: UHC Exchange |
$98.06
|
| Rate for Payer: UHC Medicare Advantage |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$27.50
|
| Rate for Payer: UMR Bronson Commercial |
$28.30
|
| Rate for Payer: VA VA |
$51.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC ORTHOPOX DNA, PCR
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600332
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.66 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna American Axle |
$49.73
|
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.73
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$53.55
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health SBD |
$48.20
|
| Rate for Payer: UMR Bronson Commercial |
$33.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC ORTHO/PROSTH MGMT SUBSEQ EA 15 MIN
|
Facility
|
OP
|
$129.45
|
|
|
Service Code
|
CPT 97763
|
| Hospital Charge Code |
42000056
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$47.90 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$84.14
|
| Rate for Payer: Aetna Commercial |
$110.03
|
| Rate for Payer: Aetna Medicare |
$64.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.14
|
| Rate for Payer: BCBS Complete |
$51.78
|
| Rate for Payer: Cash Price |
$103.56
|
| Rate for Payer: Cash Price |
$103.56
|
| Rate for Payer: Cofinity Commercial |
$90.61
|
| Rate for Payer: Cofinity Commercial |
$111.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$90.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.56
|
| Rate for Payer: Healthscope Commercial |
$116.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.03
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$110.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.14
|
| Rate for Payer: Priority Health SBD |
$81.55
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$47.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.09
|
|
|
HC ORTHO/PROSTH MGMT SUBSEQ EA 15 MIN
|
Facility
|
IP
|
$129.45
|
|
|
Service Code
|
CPT 97763
|
| Hospital Charge Code |
42000056
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$56.96 |
| Max. Negotiated Rate |
$116.50 |
| Rate for Payer: Aetna American Axle |
$84.14
|
| Rate for Payer: Aetna Commercial |
$110.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.14
|
| Rate for Payer: Cash Price |
$103.56
|
| Rate for Payer: Cofinity Commercial |
$111.33
|
| Rate for Payer: Cofinity Commercial |
$90.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$90.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.56
|
| Rate for Payer: Healthscope Commercial |
$116.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.03
|
| Rate for Payer: PHP Commercial |
$110.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.14
|
| Rate for Payer: Priority Health SBD |
$81.55
|
| Rate for Payer: UMR Bronson Commercial |
$56.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.09
|
|
|
HC ORTHOTIC FIT/TRAIN INITIAL EA 15 MIN
|
Facility
|
OP
|
$125.37
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
42000039
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$46.39 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$81.49
|
| Rate for Payer: Aetna Commercial |
$106.56
|
| Rate for Payer: Aetna Medicare |
$62.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.49
|
| Rate for Payer: BCBS Complete |
$50.15
|
| Rate for Payer: Cash Price |
$100.30
|
| Rate for Payer: Cash Price |
$100.30
|
| Rate for Payer: Cofinity Commercial |
$87.76
|
| Rate for Payer: Cofinity Commercial |
$107.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$87.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.30
|
| Rate for Payer: Healthscope Commercial |
$112.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.56
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$106.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.49
|
| Rate for Payer: Priority Health SBD |
$78.98
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$46.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.03
|
|
|
HC ORTHOTIC FIT/TRAIN INITIAL EA 15 MIN
|
Facility
|
IP
|
$125.37
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
42000039
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$55.16 |
| Max. Negotiated Rate |
$112.83 |
| Rate for Payer: Aetna American Axle |
$81.49
|
| Rate for Payer: Aetna Commercial |
$106.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.49
|
| Rate for Payer: Cash Price |
$100.30
|
| Rate for Payer: Cofinity Commercial |
$107.82
|
| Rate for Payer: Cofinity Commercial |
$87.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$87.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.30
|
| Rate for Payer: Healthscope Commercial |
$112.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.56
|
| Rate for Payer: PHP Commercial |
$106.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.49
|
| Rate for Payer: Priority Health SBD |
$78.98
|
| Rate for Payer: UMR Bronson Commercial |
$55.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.03
|
|
|
HC OSCILLATOR INIT DAY
|
Facility
|
IP
|
$2,410.38
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000039
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,060.57 |
| Max. Negotiated Rate |
$2,169.34 |
| Rate for Payer: Aetna American Axle |
$1,566.75
|
| Rate for Payer: Aetna Commercial |
$2,048.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,566.75
|
| Rate for Payer: Cash Price |
$1,928.30
|
| Rate for Payer: Cofinity Commercial |
$1,687.27
|
| Rate for Payer: Cofinity Commercial |
$2,072.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,687.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,928.30
|
| Rate for Payer: Healthscope Commercial |
$2,169.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,687.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,807.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,048.82
|
| Rate for Payer: PHP Commercial |
$2,048.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,566.75
|
| Rate for Payer: Priority Health SBD |
$1,518.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,060.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,807.79
|
|
|
HC OSCILLATOR INIT DAY
|
Facility
|
OP
|
$2,410.38
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000039
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$294.00 |
| Max. Negotiated Rate |
$2,169.34 |
| Rate for Payer: Aetna American Axle |
$1,566.75
|
| Rate for Payer: Aetna Commercial |
$2,048.82
|
| Rate for Payer: Aetna Medicare |
$670.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,566.75
|
| 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 |
$1,928.30
|
| Rate for Payer: Cash Price |
$1,928.30
|
| Rate for Payer: Cash Price |
$1,928.30
|
| Rate for Payer: Cofinity Commercial |
$1,687.27
|
| Rate for Payer: Cofinity Commercial |
$2,072.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,687.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,928.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.76
|
| Rate for Payer: Healthscope Commercial |
$2,169.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,687.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,807.79
|
| 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 |
$2,048.82
|
| Rate for Payer: PACE Medicare |
$612.52
|
| Rate for Payer: PACE SWMI |
$644.76
|
| Rate for Payer: PHP Commercial |
$2,048.82
|
| 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 |
$1,566.75
|
| Rate for Payer: Priority Health Medicare |
$644.76
|
| Rate for Payer: Priority Health SBD |
$1,518.54
|
| 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 |
$891.84
|
| Rate for Payer: VA VA |
$644.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,807.79
|
|
|
HC OSCILLATOR SUB DAY
|
Facility
|
OP
|
$1,348.28
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000040
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$294.00 |
| Max. Negotiated Rate |
$1,814.93 |
| Rate for Payer: Aetna American Axle |
$876.38
|
| Rate for Payer: Aetna Commercial |
$1,146.04
|
| Rate for Payer: Aetna Medicare |
$670.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$876.38
|
| 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 |
$1,078.62
|
| Rate for Payer: Cash Price |
$1,078.62
|
| Rate for Payer: Cash Price |
$1,078.62
|
| Rate for Payer: Cofinity Commercial |
$1,159.52
|
| Rate for Payer: Cofinity Commercial |
$943.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$943.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,078.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.76
|
| Rate for Payer: Healthscope Commercial |
$1,213.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$943.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,011.21
|
| 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 |
$1,146.04
|
| Rate for Payer: PACE Medicare |
$612.52
|
| Rate for Payer: PACE SWMI |
$644.76
|
| Rate for Payer: PHP Commercial |
$1,146.04
|
| 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 |
$876.38
|
| Rate for Payer: Priority Health Medicare |
$644.76
|
| Rate for Payer: Priority Health SBD |
$849.42
|
| 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 |
$498.86
|
| Rate for Payer: VA VA |
$644.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,011.21
|
|
|
HC OSCILLATOR SUB DAY
|
Facility
|
IP
|
$1,348.28
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000040
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$593.24 |
| Max. Negotiated Rate |
$1,213.45 |
| Rate for Payer: Aetna American Axle |
$876.38
|
| Rate for Payer: Aetna Commercial |
$1,146.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$876.38
|
| Rate for Payer: Cash Price |
$1,078.62
|
| Rate for Payer: Cofinity Commercial |
$1,159.52
|
| Rate for Payer: Cofinity Commercial |
$943.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$943.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,078.62
|
| Rate for Payer: Healthscope Commercial |
$1,213.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$943.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,011.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,146.04
|
| Rate for Payer: PHP Commercial |
$1,146.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$876.38
|
| Rate for Payer: Priority Health SBD |
$849.42
|
| Rate for Payer: UMR Bronson Commercial |
$593.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,011.21
|
|
|
HC OSMOLALITY SERUM
|
Facility
|
IP
|
$54.94
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
30100378
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.17 |
| Max. Negotiated Rate |
$49.45 |
| Rate for Payer: Aetna American Axle |
$35.71
|
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.71
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Commercial |
$38.46
|
| Rate for Payer: Cofinity Commercial |
$47.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: PHP Commercial |
$46.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.71
|
| Rate for Payer: Priority Health SBD |
$34.61
|
| Rate for Payer: UMR Bronson Commercial |
$24.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.20
|
|
|
HC OSMOLALITY SERUM
|
Facility
|
OP
|
$54.94
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
30100378
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$49.45 |
| Rate for Payer: Aetna American Axle |
$35.71
|
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: Aetna Medicare |
$6.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.26
|
| Rate for Payer: BCBS Complete |
$3.72
|
| Rate for Payer: BCBS MAPPO |
$6.61
|
| Rate for Payer: BCN Medicare Advantage |
$6.61
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Commercial |
$47.25
|
| Rate for Payer: Cofinity Commercial |
$38.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.61
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.20
|
| Rate for Payer: Mclaren Medicaid |
$3.54
|
| Rate for Payer: Mclaren Medicare |
$6.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.94
|
| Rate for Payer: Meridian Medicaid |
$3.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: PACE Medicare |
$6.28
|
| Rate for Payer: PACE SWMI |
$6.61
|
| Rate for Payer: PHP Commercial |
$46.70
|
| Rate for Payer: PHP Medicare Advantage |
$6.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.71
|
| Rate for Payer: Priority Health Medicare |
$6.61
|
| Rate for Payer: Priority Health SBD |
$34.61
|
| Rate for Payer: Railroad Medicare Medicare |
$6.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.61
|
| Rate for Payer: UHC Exchange |
$12.63
|
| Rate for Payer: UHC Medicare Advantage |
$6.61
|
| Rate for Payer: UHCCP Medicaid |
$3.54
|
| Rate for Payer: UMR Bronson Commercial |
$20.33
|
| Rate for Payer: VA VA |
$6.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.20
|
|
|
HC OSMOLALITY URINE
|
Facility
|
IP
|
$53.86
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
30100379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.70 |
| Max. Negotiated Rate |
$48.47 |
| Rate for Payer: Aetna American Axle |
$35.01
|
| Rate for Payer: Aetna Commercial |
$45.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.01
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$37.70
|
| Rate for Payer: Cofinity Commercial |
$46.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.09
|
| Rate for Payer: Healthscope Commercial |
$48.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.78
|
| Rate for Payer: PHP Commercial |
$45.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.01
|
| Rate for Payer: Priority Health SBD |
$33.93
|
| Rate for Payer: UMR Bronson Commercial |
$23.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.40
|
|
|
HC OSMOLALITY URINE
|
Facility
|
OP
|
$53.86
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
30100379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.66 |
| Max. Negotiated Rate |
$48.47 |
| Rate for Payer: Aetna American Axle |
$35.01
|
| Rate for Payer: Aetna Commercial |
$45.78
|
| Rate for Payer: Aetna Medicare |
$7.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.53
|
| Rate for Payer: BCBS Complete |
$3.84
|
| Rate for Payer: BCBS MAPPO |
$6.82
|
| Rate for Payer: BCN Medicare Advantage |
$6.82
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$46.32
|
| Rate for Payer: Cofinity Commercial |
$37.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.82
|
| Rate for Payer: Healthscope Commercial |
$48.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.40
|
| Rate for Payer: Mclaren Medicaid |
$3.66
|
| Rate for Payer: Mclaren Medicare |
$6.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.16
|
| Rate for Payer: Meridian Medicaid |
$3.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.78
|
| Rate for Payer: PACE Medicare |
$6.48
|
| Rate for Payer: PACE SWMI |
$6.82
|
| Rate for Payer: PHP Commercial |
$45.78
|
| Rate for Payer: PHP Medicare Advantage |
$6.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.01
|
| Rate for Payer: Priority Health Medicare |
$6.82
|
| Rate for Payer: Priority Health SBD |
$33.93
|
| Rate for Payer: Railroad Medicare Medicare |
$6.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.82
|
| Rate for Payer: UHC Exchange |
$13.03
|
| Rate for Payer: UHC Medicare Advantage |
$6.82
|
| Rate for Payer: UHCCP Medicaid |
$3.66
|
| Rate for Payer: UMR Bronson Commercial |
$19.93
|
| Rate for Payer: VA VA |
$6.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.40
|
|
|
HC OSMOTIC FRAGILITY RBC
|
Facility
|
IP
|
$131.42
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
30500052
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$57.82 |
| Max. Negotiated Rate |
$118.28 |
| Rate for Payer: Aetna American Axle |
$85.42
|
| Rate for Payer: Aetna Commercial |
$111.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.42
|
| Rate for Payer: Cash Price |
$105.14
|
| Rate for Payer: Cofinity Commercial |
$113.02
|
| Rate for Payer: Cofinity Commercial |
$91.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.14
|
| Rate for Payer: Healthscope Commercial |
$118.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.71
|
| Rate for Payer: PHP Commercial |
$111.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.42
|
| Rate for Payer: Priority Health SBD |
$82.79
|
| Rate for Payer: UMR Bronson Commercial |
$57.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.56
|
|
|
HC OSMOTIC FRAGILITY RBC
|
Facility
|
OP
|
$131.42
|
|
|
Service Code
|
CPT 85557
|
| Hospital Charge Code |
30500052
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.16 |
| Max. Negotiated Rate |
$118.28 |
| Rate for Payer: Aetna American Axle |
$85.42
|
| Rate for Payer: Aetna Commercial |
$111.71
|
| Rate for Payer: Aetna Medicare |
$13.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.70
|
| Rate for Payer: BCBS Complete |
$7.52
|
| Rate for Payer: BCBS MAPPO |
$13.36
|
| Rate for Payer: BCN Medicare Advantage |
$13.36
|
| Rate for Payer: Cash Price |
$105.14
|
| Rate for Payer: Cash Price |
$105.14
|
| Rate for Payer: Cofinity Commercial |
$91.99
|
| Rate for Payer: Cofinity Commercial |
$113.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$118.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.56
|
| Rate for Payer: Mclaren Medicaid |
$7.16
|
| Rate for Payer: Mclaren Medicare |
$13.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.03
|
| Rate for Payer: Meridian Medicaid |
$7.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.71
|
| Rate for Payer: PACE Medicare |
$12.69
|
| Rate for Payer: PACE SWMI |
$13.36
|
| Rate for Payer: PHP Commercial |
$111.71
|
| Rate for Payer: PHP Medicare Advantage |
$13.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.42
|
| Rate for Payer: Priority Health Medicare |
$13.36
|
| Rate for Payer: Priority Health SBD |
$82.79
|
| Rate for Payer: Railroad Medicare Medicare |
$13.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.36
|
| Rate for Payer: UHC Exchange |
$25.53
|
| Rate for Payer: UHC Medicare Advantage |
$13.36
|
| Rate for Payer: UHCCP Medicaid |
$7.16
|
| Rate for Payer: UMR Bronson Commercial |
$48.63
|
| Rate for Payer: VA VA |
$13.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.56
|
|
|
HC OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Facility
|
IP
|
$8,364.00
|
|
|
Service Code
|
CPT 28111
|
| Hospital Charge Code |
76100365
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,680.16 |
| Max. Negotiated Rate |
$7,527.60 |
| Rate for Payer: Aetna American Axle |
$5,436.60
|
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,436.60
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$5,854.80
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,854.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,854.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,273.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health SBD |
$5,269.32
|
| Rate for Payer: UMR Bronson Commercial |
$3,680.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,273.00
|
|
|
HC OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Facility
|
OP
|
$8,364.00
|
|
|
Service Code
|
CPT 28111
|
| Hospital Charge Code |
76100365
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna American Axle |
$5,436.60
|
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,436.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Cofinity Commercial |
$5,854.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,854.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,854.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,273.00
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$5,269.32
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$6,047.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: UMR Bronson Commercial |
$3,094.68
|
| Rate for Payer: VA VA |
$3,164.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,273.00
|
|
|
HC OSTECTOMY COMPLETE 2,3 OR 4TH METATARSAL HEAD
|
Facility
|
OP
|
$8,364.00
|
|
|
Service Code
|
CPT 28112
|
| Hospital Charge Code |
76100366
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna American Axle |
$5,436.60
|
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,436.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Cofinity Commercial |
$5,854.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,854.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,854.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,273.00
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$5,269.32
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$6,047.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: UMR Bronson Commercial |
$3,094.68
|
| Rate for Payer: VA VA |
$3,164.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,273.00
|
|
|
HC OSTECTOMY COMPLETE 2,3 OR 4TH METATARSAL HEAD
|
Facility
|
IP
|
$8,364.00
|
|
|
Service Code
|
CPT 28112
|
| Hospital Charge Code |
76100366
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,680.16 |
| Max. Negotiated Rate |
$7,527.60 |
| Rate for Payer: Aetna American Axle |
$5,436.60
|
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,436.60
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$5,854.80
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,854.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,854.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,273.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health SBD |
$5,269.32
|
| Rate for Payer: UMR Bronson Commercial |
$3,680.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,273.00
|
|
|
HC OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Facility
|
OP
|
$8,364.00
|
|
|
Service Code
|
CPT 28113
|
| Hospital Charge Code |
76100367
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna American Axle |
$5,436.60
|
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,436.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Cofinity Commercial |
$5,854.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,854.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,854.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,273.00
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$5,269.32
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$6,047.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: UMR Bronson Commercial |
$3,094.68
|
| Rate for Payer: VA VA |
$3,164.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,273.00
|
|
|
HC OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Facility
|
IP
|
$8,364.00
|
|
|
Service Code
|
CPT 28113
|
| Hospital Charge Code |
76100367
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,680.16 |
| Max. Negotiated Rate |
$7,527.60 |
| Rate for Payer: Aetna American Axle |
$5,436.60
|
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,436.60
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$5,854.80
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,854.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,854.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,273.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health SBD |
$5,269.32
|
| Rate for Payer: UMR Bronson Commercial |
$3,680.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,273.00
|
|
|
HC OSTEOCALCIN
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
30100380
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$92.70 |
| Rate for Payer: Aetna American Axle |
$66.95
|
| Rate for Payer: Aetna Commercial |
$87.55
|
| Rate for Payer: Aetna Medicare |
$31.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.31
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCBS MAPPO |
$29.85
|
| Rate for Payer: BCN Medicare Advantage |
$29.85
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$88.58
|
| Rate for Payer: Cofinity Commercial |
$72.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.85
|
| Rate for Payer: Healthscope Commercial |
$92.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.25
|
| Rate for Payer: Mclaren Medicaid |
$16.00
|
| Rate for Payer: Mclaren Medicare |
$29.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.34
|
| Rate for Payer: Meridian Medicaid |
$16.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.55
|
| Rate for Payer: PACE Medicare |
$28.36
|
| Rate for Payer: PACE SWMI |
$29.85
|
| Rate for Payer: PHP Commercial |
$87.55
|
| Rate for Payer: PHP Medicare Advantage |
$29.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health Medicare |
$29.85
|
| Rate for Payer: Priority Health SBD |
$64.89
|
| Rate for Payer: Railroad Medicare Medicare |
$29.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.85
|
| Rate for Payer: UHC Exchange |
$57.05
|
| Rate for Payer: UHC Medicare Advantage |
$29.85
|
| Rate for Payer: UHCCP Medicaid |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$38.11
|
| Rate for Payer: VA VA |
$29.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.25
|
|
|
HC OSTEOCALCIN
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
CPT 83937
|
| Hospital Charge Code |
30100380
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.32 |
| Max. Negotiated Rate |
$92.70 |
| Rate for Payer: Aetna American Axle |
$66.95
|
| Rate for Payer: Aetna Commercial |
$87.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.95
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$72.10
|
| Rate for Payer: Cofinity Commercial |
$88.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.40
|
| Rate for Payer: Healthscope Commercial |
$92.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.55
|
| Rate for Payer: PHP Commercial |
$87.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health SBD |
$64.89
|
| Rate for Payer: UMR Bronson Commercial |
$45.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.25
|
|
