|
HC REMOVAL RIGHT HEART VENTRICULAR ASSIST DEVICE
|
Facility
|
OP
|
$1,396.37
|
|
|
Service Code
|
CPT 33997
|
| Hospital Charge Code |
48100137
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$516.66 |
| Max. Negotiated Rate |
$1,256.73 |
| Rate for Payer: Aetna American Axle |
$907.64
|
| Rate for Payer: Aetna Commercial |
$1,186.91
|
| Rate for Payer: Aetna Medicare |
$698.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$907.64
|
| Rate for Payer: BCBS Complete |
$558.55
|
| Rate for Payer: BCBS Trust/PPO |
$685.60
|
| Rate for Payer: BCN Commercial |
$685.60
|
| Rate for Payer: Cash Price |
$1,117.10
|
| Rate for Payer: Cash Price |
$1,117.10
|
| Rate for Payer: Cash Price |
$1,117.10
|
| Rate for Payer: Cofinity Advantage |
$977.46
|
| Rate for Payer: Cofinity Commercial |
$1,200.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,117.10
|
| Rate for Payer: Healthscope Commercial |
$1,256.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$977.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,047.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,117.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,186.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,047.28
|
| Rate for Payer: PHP Commercial |
$1,186.91
|
| Rate for Payer: Priority Health SBD |
$879.71
|
| Rate for Payer: UMR Bronson Commercial |
$516.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,047.28
|
|
|
HC REMOVAL SALIVARY STONE COMPLICATED
|
Facility
|
IP
|
$8,219.16
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,616.43 |
| Max. Negotiated Rate |
$7,397.24 |
| Rate for Payer: Aetna American Axle |
$5,342.45
|
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,342.45
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Advantage |
$5,753.41
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,753.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: Priority Health SBD |
$5,178.07
|
| Rate for Payer: UMR Bronson Commercial |
$3,616.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
|
HC REMOVAL SALIVARY STONE COMPLICATED
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$393.00 |
| Max. Negotiated Rate |
$10,683.35 |
| Rate for Payer: Aetna American Axle |
$5,342.45
|
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,342.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$393.00
|
| Rate for Payer: BCN Commercial |
$393.00
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Advantage |
$5,753.41
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,753.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$3,468.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,683.35
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health SBD |
$5,178.07
|
| Rate for Payer: Priority Health Tiered Network |
$8,546.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,342.45
|
| Rate for Payer: UHC Core |
$4,282.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$3,230.13
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: UMR Bronson Commercial |
$3,041.09
|
| Rate for Payer: VA VA |
$3,303.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
|
HC REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
IP
|
$5,202.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,288.88 |
| Max. Negotiated Rate |
$4,681.80 |
| Rate for Payer: Aetna American Axle |
$3,381.30
|
| Rate for Payer: Aetna Commercial |
$4,421.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,381.30
|
| Rate for Payer: Cash Price |
$4,161.60
|
| Rate for Payer: Cofinity Advantage |
$3,641.40
|
| Rate for Payer: Cofinity Commercial |
$4,473.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,161.60
|
| Rate for Payer: Healthscope Commercial |
$4,681.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,641.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,901.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,421.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,901.50
|
| Rate for Payer: PHP Commercial |
$4,421.70
|
| Rate for Payer: Priority Health SBD |
$3,277.26
|
| Rate for Payer: UMR Bronson Commercial |
$2,288.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,901.50
|
|
|
HC REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
OP
|
$5,202.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$106.12 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna American Axle |
$3,381.30
|
| Rate for Payer: Aetna Commercial |
$4,421.70
|
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,381.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$106.12
|
| Rate for Payer: BCN Commercial |
$106.12
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Cash Price |
$4,161.60
|
| Rate for Payer: Cash Price |
$4,161.60
|
| Rate for Payer: Cash Price |
$4,161.60
|
| Rate for Payer: Cofinity Advantage |
$3,641.40
|
| Rate for Payer: Cofinity Commercial |
$4,473.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,161.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Healthscope Commercial |
$4,681.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,641.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,901.50
|
| Rate for Payer: Mclaren Medicaid |
$2,055.86
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$2,158.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,421.70
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,901.50
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Commercial |
$4,421.70
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,648.46
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health SBD |
$3,277.26
|
| Rate for Payer: Priority Health Tiered Network |
$5,318.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,381.30
|
| Rate for Payer: UHC Core |
$2,710.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Exchange |
$2,044.39
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,924.74
|
| Rate for Payer: VA VA |
$2,055.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,901.50
|
|
|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
IP
|
$1,147.51
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$504.90 |
| Max. Negotiated Rate |
$1,032.76 |
| Rate for Payer: Aetna American Axle |
$745.88
|
| Rate for Payer: Aetna Commercial |
$975.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$745.88
|
| Rate for Payer: Cash Price |
$918.01
|
| Rate for Payer: Cofinity Advantage |
$803.26
|
| Rate for Payer: Cofinity Commercial |
$986.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$918.01
|
| Rate for Payer: Healthscope Commercial |
$1,032.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$803.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$860.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$975.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.63
|
| Rate for Payer: PHP Commercial |
$975.38
|
| Rate for Payer: Priority Health SBD |
$722.93
|
| Rate for Payer: UMR Bronson Commercial |
$504.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$860.63
|
|
|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
OP
|
$1,147.51
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$326.90 |
| Max. Negotiated Rate |
$2,021.35 |
| Rate for Payer: Aetna American Axle |
$745.88
|
| Rate for Payer: Aetna Commercial |
$975.38
|
| Rate for Payer: Aetna Medicare |
$650.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$745.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.31
|
| Rate for Payer: BCBS Complete |
$343.28
|
| Rate for Payer: BCBS MAPPO |
$625.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,029.61
|
| Rate for Payer: BCN Commercial |
$1,029.61
|
| Rate for Payer: BCN Medicare Advantage |
$625.05
|
| Rate for Payer: Cash Price |
$918.01
|
| Rate for Payer: Cash Price |
$918.01
|
| Rate for Payer: Cash Price |
$918.01
|
| Rate for Payer: Cofinity Advantage |
$803.26
|
| Rate for Payer: Cofinity Commercial |
$986.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$918.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.05
|
| Rate for Payer: Healthscope Commercial |
$1,032.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$803.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$860.63
|
| Rate for Payer: Mclaren Medicaid |
$625.05
|
| Rate for Payer: Mclaren Medicare |
$625.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.30
|
| Rate for Payer: Meridian Medicaid |
$656.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$718.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$687.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$975.38
|
| Rate for Payer: Nomi Health Commercial |
$1,875.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$860.63
|
| Rate for Payer: PACE Medicare |
$593.80
|
| Rate for Payer: PACE SWMI |
$625.05
|
| Rate for Payer: PHP Commercial |
$975.38
|
| Rate for Payer: PHP Medicare Advantage |
$625.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,021.35
|
| Rate for Payer: Priority Health Medicare |
$625.05
|
| Rate for Payer: Priority Health SBD |
$722.93
|
| Rate for Payer: Priority Health Tiered Network |
$1,617.08
|
| Rate for Payer: Railroad Medicare Medicare |
$625.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$745.88
|
| Rate for Payer: UHC Core |
$597.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.05
|
| Rate for Payer: UHC Exchange |
$450.97
|
| Rate for Payer: UHC Medicaid |
$326.90
|
| Rate for Payer: UHCCP Medicaid |
$326.90
|
| Rate for Payer: UMR Bronson Commercial |
$424.58
|
| Rate for Payer: VA VA |
$625.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$860.63
|
|
|
HC REMOVAL TUNNELED INTRAPERI CATHETER
|
Facility
|
IP
|
$3,358.70
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
36100221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,477.83 |
| Max. Negotiated Rate |
$3,022.83 |
| Rate for Payer: Aetna American Axle |
$2,183.16
|
| Rate for Payer: Aetna Commercial |
$2,854.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,183.16
|
| Rate for Payer: Cash Price |
$2,686.96
|
| Rate for Payer: Cofinity Advantage |
$2,351.09
|
| Rate for Payer: Cofinity Commercial |
$2,888.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,686.96
|
| Rate for Payer: Healthscope Commercial |
$3,022.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,351.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,519.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,854.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,519.03
|
| Rate for Payer: PHP Commercial |
$2,854.89
|
| Rate for Payer: Priority Health SBD |
$2,115.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,477.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,519.03
|
|
|
HC REMOVAL TUNNELED INTRAPERI CATHETER
|
Facility
|
OP
|
$3,358.70
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
36100221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,242.72 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$2,183.16
|
| Rate for Payer: Aetna Commercial |
$2,854.89
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,183.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,970.96
|
| Rate for Payer: BCN Commercial |
$2,970.96
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,686.96
|
| Rate for Payer: Cash Price |
$2,686.96
|
| Rate for Payer: Cash Price |
$2,686.96
|
| Rate for Payer: Cofinity Advantage |
$2,351.09
|
| Rate for Payer: Cofinity Commercial |
$2,888.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,686.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,022.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,351.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,519.03
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,854.89
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,519.03
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$2,854.89
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$2,115.98
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,242.72
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,519.03
|
|
|
HC REMOVAL TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$1,003.66
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
36100054
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$326.90 |
| Max. Negotiated Rate |
$2,021.35 |
| Rate for Payer: Aetna American Axle |
$652.38
|
| Rate for Payer: Aetna Commercial |
$853.11
|
| Rate for Payer: Aetna Medicare |
$650.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$652.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.31
|
| Rate for Payer: BCBS Complete |
$343.28
|
| Rate for Payer: BCBS MAPPO |
$625.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,009.26
|
| Rate for Payer: BCN Commercial |
$1,009.26
|
| Rate for Payer: BCN Medicare Advantage |
$625.05
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cofinity Advantage |
$702.56
|
| Rate for Payer: Cofinity Commercial |
$863.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$802.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.05
|
| Rate for Payer: Healthscope Commercial |
$903.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$702.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$752.75
|
| Rate for Payer: Mclaren Medicaid |
$625.05
|
| Rate for Payer: Mclaren Medicare |
$625.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.30
|
| Rate for Payer: Meridian Medicaid |
$656.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$718.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$687.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.11
|
| Rate for Payer: Nomi Health Commercial |
$1,875.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.75
|
| Rate for Payer: PACE Medicare |
$593.80
|
| Rate for Payer: PACE SWMI |
$625.05
|
| Rate for Payer: PHP Commercial |
$853.11
|
| Rate for Payer: PHP Medicare Advantage |
$625.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,021.35
|
| Rate for Payer: Priority Health Medicare |
$625.05
|
| Rate for Payer: Priority Health SBD |
$632.31
|
| Rate for Payer: Priority Health Tiered Network |
$1,617.08
|
| Rate for Payer: Railroad Medicare Medicare |
$625.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.05
|
| Rate for Payer: UHC Medicaid |
$326.90
|
| Rate for Payer: UHCCP Medicaid |
$326.90
|
| Rate for Payer: UMR Bronson Commercial |
$371.35
|
| Rate for Payer: VA VA |
$625.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$752.75
|
|
|
HC REMOVAL TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$1,003.66
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
36100054
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$441.61 |
| Max. Negotiated Rate |
$903.29 |
| Rate for Payer: Aetna American Axle |
$652.38
|
| Rate for Payer: Aetna Commercial |
$853.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$652.38
|
| Rate for Payer: Cash Price |
$802.93
|
| Rate for Payer: Cofinity Advantage |
$702.56
|
| Rate for Payer: Cofinity Commercial |
$863.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$802.93
|
| Rate for Payer: Healthscope Commercial |
$903.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$702.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$752.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$853.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$752.75
|
| Rate for Payer: PHP Commercial |
$853.11
|
| Rate for Payer: Priority Health SBD |
$632.31
|
| Rate for Payer: UMR Bronson Commercial |
$441.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$752.75
|
|
|
HC REMOVAL W/ REINSERT DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$554.20
|
|
|
Service Code
|
CPT 11983
|
| Hospital Charge Code |
76100180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$205.05 |
| Max. Negotiated Rate |
$1,439.47 |
| Rate for Payer: Aetna American Axle |
$360.23
|
| Rate for Payer: Aetna Commercial |
$471.07
|
| Rate for Payer: Aetna Medicare |
$462.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$360.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$556.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$556.40
|
| Rate for Payer: BCBS Complete |
$244.46
|
| Rate for Payer: BCBS MAPPO |
$445.12
|
| Rate for Payer: BCBS Trust/PPO |
$511.61
|
| Rate for Payer: BCN Commercial |
$511.61
|
| Rate for Payer: BCN Medicare Advantage |
$445.12
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cofinity Advantage |
$387.94
|
| Rate for Payer: Cofinity Commercial |
$476.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.12
|
| Rate for Payer: Healthscope Commercial |
$498.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$387.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$415.65
|
| Rate for Payer: Mclaren Medicaid |
$445.12
|
| Rate for Payer: Mclaren Medicare |
$445.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.38
|
| Rate for Payer: Meridian Medicaid |
$467.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$511.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$489.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$471.07
|
| Rate for Payer: Nomi Health Commercial |
$1,335.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.65
|
| Rate for Payer: PACE Medicare |
$422.86
|
| Rate for Payer: PACE SWMI |
$445.12
|
| Rate for Payer: PHP Commercial |
$471.07
|
| Rate for Payer: PHP Medicare Advantage |
$445.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,439.47
|
| Rate for Payer: Priority Health Medicare |
$445.12
|
| Rate for Payer: Priority Health SBD |
$349.15
|
| Rate for Payer: Priority Health Tiered Network |
$1,151.58
|
| Rate for Payer: Railroad Medicare Medicare |
$445.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.23
|
| Rate for Payer: UHC Core |
$288.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$445.12
|
| Rate for Payer: UHC Exchange |
$217.80
|
| Rate for Payer: UHC Medicaid |
$232.80
|
| Rate for Payer: UHCCP Medicaid |
$232.80
|
| Rate for Payer: UMR Bronson Commercial |
$205.05
|
| Rate for Payer: VA VA |
$445.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$415.65
|
|
|
HC REMOVAL W/ REINSERT DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$554.20
|
|
|
Service Code
|
CPT 11983
|
| Hospital Charge Code |
76100180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$243.85 |
| Max. Negotiated Rate |
$498.78 |
| Rate for Payer: Aetna American Axle |
$360.23
|
| Rate for Payer: Aetna Commercial |
$471.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$360.23
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cofinity Advantage |
$387.94
|
| Rate for Payer: Cofinity Commercial |
$476.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.36
|
| Rate for Payer: Healthscope Commercial |
$498.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$387.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$415.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$471.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.65
|
| Rate for Payer: PHP Commercial |
$471.07
|
| Rate for Payer: Priority Health SBD |
$349.15
|
| Rate for Payer: UMR Bronson Commercial |
$243.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$415.65
|
|
|
HC REMOVE ADDITIONAL NAIL PLATE
|
Facility
|
IP
|
$265.30
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
76100329
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.73 |
| Max. Negotiated Rate |
$238.77 |
| Rate for Payer: Aetna American Axle |
$172.44
|
| Rate for Payer: Aetna Commercial |
$225.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.44
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cofinity Advantage |
$185.71
|
| Rate for Payer: Cofinity Commercial |
$228.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.24
|
| Rate for Payer: Healthscope Commercial |
$238.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$185.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.97
|
| Rate for Payer: PHP Commercial |
$225.50
|
| Rate for Payer: Priority Health SBD |
$167.14
|
| Rate for Payer: UMR Bronson Commercial |
$116.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.97
|
|
|
HC REMOVE ADDITIONAL NAIL PLATE
|
Facility
|
OP
|
$265.30
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
76100329
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$98.16 |
| Max. Negotiated Rate |
$238.77 |
| Rate for Payer: Aetna American Axle |
$172.44
|
| Rate for Payer: Aetna Commercial |
$225.50
|
| Rate for Payer: Aetna Medicare |
$132.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.44
|
| Rate for Payer: BCBS Complete |
$106.12
|
| Rate for Payer: BCBS Trust/PPO |
$137.37
|
| Rate for Payer: BCN Commercial |
$137.37
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cofinity Advantage |
$185.71
|
| Rate for Payer: Cofinity Commercial |
$228.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.24
|
| Rate for Payer: Healthscope Commercial |
$238.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$185.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.97
|
| Rate for Payer: PHP Commercial |
$225.50
|
| Rate for Payer: Priority Health SBD |
$167.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.44
|
| Rate for Payer: UHC Core |
$138.22
|
| Rate for Payer: UHC Exchange |
$104.26
|
| Rate for Payer: UMR Bronson Commercial |
$98.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.97
|
|
|
HC REMOVE AND REPLACE INT URETERAL STENT
|
Facility
|
OP
|
$2,832.85
|
|
|
Service Code
|
CPT 50382
|
| Hospital Charge Code |
36100236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,048.15 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna American Axle |
$1,841.35
|
| Rate for Payer: Aetna Commercial |
$2,407.92
|
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,841.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,801.50
|
| Rate for Payer: BCN Commercial |
$1,801.50
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$2,266.28
|
| Rate for Payer: Cash Price |
$2,266.28
|
| Rate for Payer: Cash Price |
$2,266.28
|
| Rate for Payer: Cofinity Advantage |
$1,982.99
|
| Rate for Payer: Cofinity Commercial |
$2,436.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,266.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$2,549.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,982.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,124.64
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$2,187.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,407.92
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,124.64
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$2,407.92
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,735.82
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health SBD |
$1,784.70
|
| Rate for Payer: Priority Health Tiered Network |
$5,388.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,048.15
|
| Rate for Payer: VA VA |
$2,082.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,124.64
|
|
|
HC REMOVE AND REPLACE INT URETERAL STENT
|
Facility
|
IP
|
$2,832.85
|
|
|
Service Code
|
CPT 50382
|
| Hospital Charge Code |
36100236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,246.45 |
| Max. Negotiated Rate |
$2,549.57 |
| Rate for Payer: Aetna American Axle |
$1,841.35
|
| Rate for Payer: Aetna Commercial |
$2,407.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,841.35
|
| Rate for Payer: Cash Price |
$2,266.28
|
| Rate for Payer: Cofinity Advantage |
$1,982.99
|
| Rate for Payer: Cofinity Commercial |
$2,436.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,266.28
|
| Rate for Payer: Healthscope Commercial |
$2,549.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,982.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,124.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,407.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,124.64
|
| Rate for Payer: PHP Commercial |
$2,407.92
|
| Rate for Payer: Priority Health SBD |
$1,784.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,246.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,124.64
|
|
|
HC REMOVE BILIARY DRAIN CATH
|
Facility
|
OP
|
$878.37
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
36100494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$325.00 |
| Max. Negotiated Rate |
$2,922.56 |
| Rate for Payer: Aetna American Axle |
$570.94
|
| Rate for Payer: Aetna Commercial |
$746.61
|
| Rate for Payer: Aetna Medicare |
$939.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$570.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,129.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,129.65
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$711.54
|
| Rate for Payer: BCN Commercial |
$711.54
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$702.70
|
| Rate for Payer: Cash Price |
$702.70
|
| Rate for Payer: Cash Price |
$702.70
|
| Rate for Payer: Cofinity Advantage |
$614.86
|
| Rate for Payer: Cofinity Commercial |
$755.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$702.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$790.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$614.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$658.78
|
| Rate for Payer: Mclaren Medicaid |
$903.72
|
| Rate for Payer: Mclaren Medicare |
$903.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.91
|
| Rate for Payer: Meridian Medicaid |
$948.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,039.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$746.61
|
| Rate for Payer: Nomi Health Commercial |
$2,711.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$658.78
|
| Rate for Payer: PACE Medicare |
$858.53
|
| Rate for Payer: PACE SWMI |
$903.72
|
| Rate for Payer: PHP Commercial |
$746.61
|
| Rate for Payer: PHP Medicare Advantage |
$903.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,922.56
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health SBD |
$553.37
|
| Rate for Payer: Priority Health Tiered Network |
$2,338.05
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$903.72
|
| Rate for Payer: UHC Medicaid |
$472.65
|
| Rate for Payer: UHCCP Medicaid |
$472.65
|
| Rate for Payer: UMR Bronson Commercial |
$325.00
|
| Rate for Payer: VA VA |
$903.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$658.78
|
|
|
HC REMOVE BILIARY DRAIN CATH
|
Facility
|
IP
|
$878.37
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
36100494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$386.48 |
| Max. Negotiated Rate |
$790.53 |
| Rate for Payer: Aetna American Axle |
$570.94
|
| Rate for Payer: Aetna Commercial |
$746.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$570.94
|
| Rate for Payer: Cash Price |
$702.70
|
| Rate for Payer: Cofinity Advantage |
$614.86
|
| Rate for Payer: Cofinity Commercial |
$755.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$702.70
|
| Rate for Payer: Healthscope Commercial |
$790.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$614.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$658.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$746.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$658.78
|
| Rate for Payer: PHP Commercial |
$746.61
|
| Rate for Payer: Priority Health SBD |
$553.37
|
| Rate for Payer: UMR Bronson Commercial |
$386.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$658.78
|
|
|
HC REMOVE/BIVALVE ARM/LEG
|
Facility
|
IP
|
$177.26
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
70000015
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$77.99 |
| Max. Negotiated Rate |
$159.53 |
| Rate for Payer: Aetna American Axle |
$115.22
|
| Rate for Payer: Aetna Commercial |
$150.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.22
|
| Rate for Payer: Cash Price |
$141.81
|
| Rate for Payer: Cofinity Advantage |
$124.08
|
| Rate for Payer: Cofinity Commercial |
$152.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.81
|
| Rate for Payer: Healthscope Commercial |
$159.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$124.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.94
|
| Rate for Payer: PHP Commercial |
$150.67
|
| Rate for Payer: Priority Health SBD |
$111.67
|
| Rate for Payer: UMR Bronson Commercial |
$77.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.94
|
|
|
HC REMOVE/BIVALVE ARM/LEG
|
Facility
|
OP
|
$177.26
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
70000015
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$65.59 |
| Max. Negotiated Rate |
$901.26 |
| Rate for Payer: Aetna American Axle |
$115.22
|
| Rate for Payer: Aetna Commercial |
$150.67
|
| Rate for Payer: Aetna Medicare |
$289.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.36
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$325.08
|
| Rate for Payer: BCN Commercial |
$325.08
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$141.81
|
| Rate for Payer: Cash Price |
$141.81
|
| Rate for Payer: Cash Price |
$141.81
|
| Rate for Payer: Cofinity Advantage |
$124.08
|
| Rate for Payer: Cofinity Commercial |
$152.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$159.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$124.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.94
|
| Rate for Payer: Mclaren Medicaid |
$278.69
|
| Rate for Payer: Mclaren Medicare |
$278.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.62
|
| Rate for Payer: Meridian Medicaid |
$292.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.67
|
| Rate for Payer: Nomi Health Commercial |
$836.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.94
|
| Rate for Payer: PACE Medicare |
$264.76
|
| Rate for Payer: PACE SWMI |
$278.69
|
| Rate for Payer: PHP Commercial |
$150.67
|
| Rate for Payer: PHP Medicare Advantage |
$278.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$901.26
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health SBD |
$111.67
|
| Rate for Payer: Priority Health Tiered Network |
$721.01
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.22
|
| Rate for Payer: UHC Core |
$92.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.69
|
| Rate for Payer: UHC Exchange |
$69.66
|
| Rate for Payer: UHC Medicaid |
$145.75
|
| Rate for Payer: UHCCP Medicaid |
$145.75
|
| Rate for Payer: UMR Bronson Commercial |
$65.59
|
| Rate for Payer: VA VA |
$278.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.94
|
|
|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
IP
|
$197.79
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$87.03 |
| Max. Negotiated Rate |
$178.01 |
| Rate for Payer: Aetna American Axle |
$128.56
|
| Rate for Payer: Aetna Commercial |
$168.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.56
|
| Rate for Payer: Cash Price |
$158.23
|
| Rate for Payer: Cofinity Advantage |
$138.45
|
| Rate for Payer: Cofinity Commercial |
$170.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.23
|
| Rate for Payer: Healthscope Commercial |
$178.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$138.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.34
|
| Rate for Payer: PHP Commercial |
$168.12
|
| Rate for Payer: Priority Health SBD |
$124.61
|
| Rate for Payer: UMR Bronson Commercial |
$87.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.34
|
|
|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
OP
|
$197.79
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$65.41 |
| Max. Negotiated Rate |
$901.26 |
| Rate for Payer: Aetna American Axle |
$128.56
|
| Rate for Payer: Aetna Commercial |
$168.12
|
| Rate for Payer: Aetna Medicare |
$289.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.36
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$65.41
|
| Rate for Payer: BCN Commercial |
$65.41
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$158.23
|
| Rate for Payer: Cash Price |
$158.23
|
| Rate for Payer: Cash Price |
$158.23
|
| Rate for Payer: Cofinity Advantage |
$138.45
|
| Rate for Payer: Cofinity Commercial |
$170.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$178.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$138.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.34
|
| Rate for Payer: Mclaren Medicaid |
$278.69
|
| Rate for Payer: Mclaren Medicare |
$278.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.62
|
| Rate for Payer: Meridian Medicaid |
$292.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.12
|
| Rate for Payer: Nomi Health Commercial |
$836.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.34
|
| Rate for Payer: PACE Medicare |
$264.76
|
| Rate for Payer: PACE SWMI |
$278.69
|
| Rate for Payer: PHP Commercial |
$168.12
|
| Rate for Payer: PHP Medicare Advantage |
$278.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$901.26
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health SBD |
$124.61
|
| Rate for Payer: Priority Health Tiered Network |
$721.01
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.56
|
| Rate for Payer: UHC Core |
$103.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.69
|
| Rate for Payer: UHC Exchange |
$77.73
|
| Rate for Payer: UHC Medicaid |
$145.75
|
| Rate for Payer: UHCCP Medicaid |
$145.75
|
| Rate for Payer: UMR Bronson Commercial |
$73.18
|
| Rate for Payer: VA VA |
$278.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.34
|
|
|
HC REMOVE/BIVALVE SPICA
|
Facility
|
IP
|
$359.13
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$158.02 |
| Max. Negotiated Rate |
$323.22 |
| Rate for Payer: Aetna American Axle |
$233.43
|
| Rate for Payer: Aetna Commercial |
$305.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.43
|
| Rate for Payer: Cash Price |
$287.30
|
| Rate for Payer: Cofinity Advantage |
$251.39
|
| Rate for Payer: Cofinity Commercial |
$308.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.30
|
| Rate for Payer: Healthscope Commercial |
$323.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.35
|
| Rate for Payer: PHP Commercial |
$305.26
|
| Rate for Payer: Priority Health SBD |
$226.25
|
| Rate for Payer: UMR Bronson Commercial |
$158.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.35
|
|
|
HC REMOVE/BIVALVE SPICA
|
Facility
|
OP
|
$359.13
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$107.29 |
| Max. Negotiated Rate |
$901.26 |
| Rate for Payer: Aetna American Axle |
$233.43
|
| Rate for Payer: Aetna Commercial |
$305.26
|
| Rate for Payer: Aetna Medicare |
$289.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.36
|
| Rate for Payer: BCBS Complete |
$153.06
|
| Rate for Payer: BCBS MAPPO |
$278.69
|
| Rate for Payer: BCBS Trust/PPO |
$107.29
|
| Rate for Payer: BCN Commercial |
$107.29
|
| Rate for Payer: BCN Medicare Advantage |
$278.69
|
| Rate for Payer: Cash Price |
$287.30
|
| Rate for Payer: Cash Price |
$287.30
|
| Rate for Payer: Cash Price |
$287.30
|
| Rate for Payer: Cofinity Advantage |
$251.39
|
| Rate for Payer: Cofinity Commercial |
$308.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$278.69
|
| Rate for Payer: Healthscope Commercial |
$323.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.35
|
| Rate for Payer: Mclaren Medicaid |
$278.69
|
| Rate for Payer: Mclaren Medicare |
$278.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$292.62
|
| Rate for Payer: Meridian Medicaid |
$292.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$306.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.26
|
| Rate for Payer: Nomi Health Commercial |
$836.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.35
|
| Rate for Payer: PACE Medicare |
$264.76
|
| Rate for Payer: PACE SWMI |
$278.69
|
| Rate for Payer: PHP Commercial |
$305.26
|
| Rate for Payer: PHP Medicare Advantage |
$278.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$901.26
|
| Rate for Payer: Priority Health Medicare |
$278.69
|
| Rate for Payer: Priority Health SBD |
$226.25
|
| Rate for Payer: Priority Health Tiered Network |
$721.01
|
| Rate for Payer: Railroad Medicare Medicare |
$278.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.43
|
| Rate for Payer: UHC Core |
$187.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$278.69
|
| Rate for Payer: UHC Exchange |
$141.14
|
| Rate for Payer: UHC Medicaid |
$145.75
|
| Rate for Payer: UHCCP Medicaid |
$145.75
|
| Rate for Payer: UMR Bronson Commercial |
$132.88
|
| Rate for Payer: VA VA |
$278.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.35
|
|
