|
HC REMOVE FOREIGN BODY EYE EXTERNAL
|
Facility
|
OP
|
$116.12
|
|
|
Service Code
|
CPT 65205
|
| Hospital Charge Code |
45000015
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$42.96 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna American Axle |
$75.48
|
| Rate for Payer: Aetna Commercial |
$98.70
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$138.22
|
| Rate for Payer: BCN Commercial |
$138.22
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$92.90
|
| Rate for Payer: Cash Price |
$92.90
|
| Rate for Payer: Cash Price |
$92.90
|
| Rate for Payer: Cofinity Advantage |
$81.28
|
| Rate for Payer: Cofinity Commercial |
$99.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$104.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.09
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.70
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.09
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$98.70
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$73.16
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.48
|
| Rate for Payer: UHC Core |
$60.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$45.64
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$42.96
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.09
|
|
|
HC REMOVE INT URETERAL STENT
|
Facility
|
OP
|
$2,832.85
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
36100237
|
|
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 |
$1,490.92
|
| Rate for Payer: BCN Commercial |
$1,490.92
|
| 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 INT URETERAL STENT
|
Facility
|
IP
|
$2,832.85
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
36100237
|
|
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 INT URETRAL STENT TRANSURETHRAL
|
Facility
|
IP
|
$990.91
|
|
|
Service Code
|
CPT 50386
|
| Hospital Charge Code |
36100239
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$436.00 |
| Max. Negotiated Rate |
$891.82 |
| Rate for Payer: Aetna American Axle |
$644.09
|
| Rate for Payer: Aetna Commercial |
$842.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.09
|
| Rate for Payer: Cash Price |
$792.73
|
| Rate for Payer: Cofinity Advantage |
$693.64
|
| Rate for Payer: Cofinity Commercial |
$852.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.73
|
| Rate for Payer: Healthscope Commercial |
$891.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$693.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$842.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$743.18
|
| Rate for Payer: PHP Commercial |
$842.27
|
| Rate for Payer: Priority Health SBD |
$624.27
|
| Rate for Payer: UMR Bronson Commercial |
$436.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.18
|
|
|
HC REMOVE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
OP
|
$990.91
|
|
|
Service Code
|
CPT 50386
|
| Hospital Charge Code |
36100239
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$366.64 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna American Axle |
$644.09
|
| Rate for Payer: Aetna Commercial |
$842.27
|
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.09
|
| 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 |
$927.63
|
| Rate for Payer: BCN Commercial |
$927.63
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$792.73
|
| Rate for Payer: Cash Price |
$792.73
|
| Rate for Payer: Cash Price |
$792.73
|
| Rate for Payer: Cofinity Advantage |
$693.64
|
| Rate for Payer: Cofinity Commercial |
$852.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$792.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$891.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$693.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.18
|
| 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 |
$842.27
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$743.18
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$842.27
|
| 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 |
$624.27
|
| 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 |
$366.64
|
| Rate for Payer: VA VA |
$2,082.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.18
|
|
|
HC REMOVE NEPHROSTOMY TUBE
|
Facility
|
IP
|
$943.15
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
36100241
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$414.99 |
| Max. Negotiated Rate |
$848.84 |
| Rate for Payer: Aetna American Axle |
$613.05
|
| Rate for Payer: Aetna Commercial |
$801.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$613.05
|
| Rate for Payer: Cash Price |
$754.52
|
| Rate for Payer: Cofinity Advantage |
$660.21
|
| Rate for Payer: Cofinity Commercial |
$811.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.52
|
| Rate for Payer: Healthscope Commercial |
$848.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$660.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$707.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$801.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$707.36
|
| Rate for Payer: PHP Commercial |
$801.68
|
| Rate for Payer: Priority Health SBD |
$594.18
|
| Rate for Payer: UMR Bronson Commercial |
$414.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$707.36
|
|
|
HC REMOVE NEPHROSTOMY TUBE
|
Facility
|
OP
|
$943.15
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
36100241
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$348.97 |
| Max. Negotiated Rate |
$2,246.88 |
| Rate for Payer: Aetna American Axle |
$613.05
|
| Rate for Payer: Aetna Commercial |
$801.68
|
| Rate for Payer: Aetna Medicare |
$722.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$613.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$868.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$868.49
|
| Rate for Payer: BCBS Complete |
$381.58
|
| Rate for Payer: BCBS MAPPO |
$694.79
|
| Rate for Payer: BCBS Trust/PPO |
$878.88
|
| Rate for Payer: BCN Commercial |
$878.88
|
| Rate for Payer: BCN Medicare Advantage |
$694.79
|
| Rate for Payer: Cash Price |
$754.52
|
| Rate for Payer: Cash Price |
$754.52
|
| Rate for Payer: Cash Price |
$754.52
|
| Rate for Payer: Cofinity Advantage |
$660.21
|
| Rate for Payer: Cofinity Commercial |
$811.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$754.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$694.79
|
| Rate for Payer: Healthscope Commercial |
$848.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$660.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$707.36
|
| Rate for Payer: Mclaren Medicaid |
$694.79
|
| Rate for Payer: Mclaren Medicare |
$694.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$729.53
|
| Rate for Payer: Meridian Medicaid |
$729.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$799.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$764.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$801.68
|
| Rate for Payer: Nomi Health Commercial |
$2,084.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$707.36
|
| Rate for Payer: PACE Medicare |
$660.05
|
| Rate for Payer: PACE SWMI |
$694.79
|
| Rate for Payer: PHP Commercial |
$801.68
|
| Rate for Payer: PHP Medicare Advantage |
$694.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$363.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,246.88
|
| Rate for Payer: Priority Health Medicare |
$694.79
|
| Rate for Payer: Priority Health SBD |
$594.18
|
| Rate for Payer: Priority Health Tiered Network |
$1,797.50
|
| Rate for Payer: Railroad Medicare Medicare |
$694.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$694.79
|
| Rate for Payer: UHC Medicaid |
$363.38
|
| Rate for Payer: UHCCP Medicaid |
$363.38
|
| Rate for Payer: UMR Bronson Commercial |
$348.97
|
| Rate for Payer: VA VA |
$694.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$707.36
|
|
|
HC REMOVE REPLACE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
OP
|
$2,967.49
|
|
|
Service Code
|
CPT 50385
|
| Hospital Charge Code |
36100238
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna American Axle |
$1,928.87
|
| Rate for Payer: Aetna Commercial |
$2,522.37
|
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,928.87
|
| 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 |
$2,138.60
|
| Rate for Payer: BCN Commercial |
$2,138.60
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$2,373.99
|
| Rate for Payer: Cash Price |
$2,373.99
|
| Rate for Payer: Cash Price |
$2,373.99
|
| Rate for Payer: Cofinity Advantage |
$2,077.24
|
| Rate for Payer: Cofinity Commercial |
$2,552.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,373.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$2,670.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,077.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,225.62
|
| 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 |
$2,522.37
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,225.62
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$2,522.37
|
| 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 |
$1,869.52
|
| 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 |
$1,097.97
|
| Rate for Payer: VA VA |
$2,082.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,225.62
|
|
|
HC REMOVE REPLACE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
IP
|
$2,967.49
|
|
|
Service Code
|
CPT 50385
|
| Hospital Charge Code |
36100238
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,305.70 |
| Max. Negotiated Rate |
$2,670.74 |
| Rate for Payer: Aetna American Axle |
$1,928.87
|
| Rate for Payer: Aetna Commercial |
$2,522.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,928.87
|
| Rate for Payer: Cash Price |
$2,373.99
|
| Rate for Payer: Cofinity Advantage |
$2,077.24
|
| Rate for Payer: Cofinity Commercial |
$2,552.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,373.99
|
| Rate for Payer: Healthscope Commercial |
$2,670.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,077.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,225.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,522.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,225.62
|
| Rate for Payer: PHP Commercial |
$2,522.37
|
| Rate for Payer: Priority Health SBD |
$1,869.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,305.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,225.62
|
|
|
HC REMOVE & REPLACE SUBSTERN IMPLANT DEFIB PG
|
Facility
|
OP
|
$50,503.93
|
|
|
Service Code
|
CPT 0614T
|
| Hospital Charge Code |
48100135
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,591.56 |
| Max. Negotiated Rate |
$71,675.05 |
| Rate for Payer: Aetna American Axle |
$32,827.55
|
| Rate for Payer: Aetna Commercial |
$42,928.34
|
| Rate for Payer: Aetna Medicare |
$23,050.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32,827.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,704.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,704.49
|
| Rate for Payer: BCBS Complete |
$12,172.24
|
| Rate for Payer: BCBS MAPPO |
$22,163.59
|
| Rate for Payer: BCBS Trust/PPO |
$35,802.28
|
| Rate for Payer: BCN Commercial |
$35,802.28
|
| Rate for Payer: BCN Medicare Advantage |
$22,163.59
|
| Rate for Payer: Cash Price |
$40,403.14
|
| Rate for Payer: Cash Price |
$40,403.14
|
| Rate for Payer: Cash Price |
$40,403.14
|
| Rate for Payer: Cofinity Advantage |
$35,352.75
|
| Rate for Payer: Cofinity Commercial |
$43,433.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,403.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22,163.59
|
| Rate for Payer: Healthscope Commercial |
$45,453.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,352.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,877.95
|
| Rate for Payer: Mclaren Medicaid |
$22,163.59
|
| Rate for Payer: Mclaren Medicare |
$22,163.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23,271.77
|
| Rate for Payer: Meridian Medicaid |
$23,271.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,488.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$24,379.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,928.34
|
| Rate for Payer: Nomi Health Commercial |
$66,490.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37,877.95
|
| Rate for Payer: PACE Medicare |
$21,055.41
|
| Rate for Payer: PACE SWMI |
$22,163.59
|
| Rate for Payer: PHP Commercial |
$42,928.34
|
| Rate for Payer: PHP Medicare Advantage |
$22,163.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,591.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$71,675.05
|
| Rate for Payer: Priority Health Medicare |
$22,163.59
|
| Rate for Payer: Priority Health SBD |
$31,817.48
|
| Rate for Payer: Priority Health Tiered Network |
$57,340.04
|
| Rate for Payer: Railroad Medicare Medicare |
$22,163.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22,163.59
|
| Rate for Payer: UHC Medicaid |
$11,591.56
|
| Rate for Payer: UHCCP Medicaid |
$11,591.56
|
| Rate for Payer: UMR Bronson Commercial |
$18,686.45
|
| Rate for Payer: VA VA |
$22,163.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,877.95
|
|
|
HC REMOVE & REPLACE SUBSTERN IMPLANT DEFIB PG
|
Facility
|
IP
|
$50,503.93
|
|
|
Service Code
|
CPT 0614T
|
| Hospital Charge Code |
48100135
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$22,221.73 |
| Max. Negotiated Rate |
$45,453.54 |
| Rate for Payer: Aetna American Axle |
$32,827.55
|
| Rate for Payer: Aetna Commercial |
$42,928.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32,827.55
|
| Rate for Payer: Cash Price |
$40,403.14
|
| Rate for Payer: Cofinity Advantage |
$35,352.75
|
| Rate for Payer: Cofinity Commercial |
$43,433.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,403.14
|
| Rate for Payer: Healthscope Commercial |
$45,453.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,352.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,877.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,928.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37,877.95
|
| Rate for Payer: PHP Commercial |
$42,928.34
|
| Rate for Payer: Priority Health SBD |
$31,817.48
|
| Rate for Payer: UMR Bronson Commercial |
$22,221.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,877.95
|
|
|
HC REMOVE SESAMOID BONE 1ST TOE
|
Facility
|
OP
|
$8,531.28
|
|
|
Service Code
|
CPT 28315
|
| Hospital Charge Code |
76100368
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,705.10 |
| Max. Negotiated Rate |
$10,543.31 |
| Rate for Payer: Aetna American Axle |
$5,545.33
|
| Rate for Payer: Aetna Commercial |
$7,251.59
|
| Rate for Payer: Aetna Medicare |
$3,390.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,545.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,075.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,075.29
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,293.43
|
| Rate for Payer: BCN Commercial |
$2,293.43
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Cash Price |
$6,825.02
|
| Rate for Payer: Cash Price |
$6,825.02
|
| Rate for Payer: Cash Price |
$6,825.02
|
| Rate for Payer: Cofinity Advantage |
$5,971.90
|
| Rate for Payer: Cofinity Commercial |
$7,336.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,825.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Healthscope Commercial |
$7,678.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,971.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,398.46
|
| Rate for Payer: Mclaren Medicaid |
$3,260.23
|
| Rate for Payer: Mclaren Medicare |
$3,260.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,423.24
|
| Rate for Payer: Meridian Medicaid |
$3,423.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,749.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,586.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,251.59
|
| Rate for Payer: Nomi Health Commercial |
$9,780.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,398.46
|
| Rate for Payer: PACE Medicare |
$3,097.22
|
| Rate for Payer: PACE SWMI |
$3,260.23
|
| Rate for Payer: PHP Commercial |
$7,251.59
|
| Rate for Payer: PHP Medicare Advantage |
$3,260.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,705.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,543.31
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health SBD |
$5,374.71
|
| Rate for Payer: Priority Health Tiered Network |
$8,434.65
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,545.33
|
| Rate for Payer: UHC Core |
$4,444.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,260.23
|
| Rate for Payer: UHC Exchange |
$3,352.79
|
| Rate for Payer: UHC Medicaid |
$1,705.10
|
| Rate for Payer: UHCCP Medicaid |
$1,705.10
|
| Rate for Payer: UMR Bronson Commercial |
$3,156.57
|
| Rate for Payer: VA VA |
$3,260.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,398.46
|
|
|
HC REMOVE SESAMOID BONE 1ST TOE
|
Facility
|
IP
|
$8,531.28
|
|
|
Service Code
|
CPT 28315
|
| Hospital Charge Code |
76100368
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,753.76 |
| Max. Negotiated Rate |
$7,678.15 |
| Rate for Payer: Aetna American Axle |
$5,545.33
|
| Rate for Payer: Aetna Commercial |
$7,251.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,545.33
|
| Rate for Payer: Cash Price |
$6,825.02
|
| Rate for Payer: Cofinity Advantage |
$5,971.90
|
| Rate for Payer: Cofinity Commercial |
$7,336.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,825.02
|
| Rate for Payer: Healthscope Commercial |
$7,678.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,971.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,398.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,251.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,398.46
|
| Rate for Payer: PHP Commercial |
$7,251.59
|
| Rate for Payer: Priority Health SBD |
$5,374.71
|
| Rate for Payer: UMR Bronson Commercial |
$3,753.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,398.46
|
|
|
HC REMOVE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
IP
|
$4,654.45
|
|
|
Service Code
|
CPT 63661
|
| Hospital Charge Code |
36100611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,047.96 |
| Max. Negotiated Rate |
$4,189.01 |
| Rate for Payer: Aetna American Axle |
$3,025.39
|
| Rate for Payer: Aetna Commercial |
$3,956.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,025.39
|
| Rate for Payer: Cash Price |
$3,723.56
|
| Rate for Payer: Cofinity Advantage |
$3,258.11
|
| Rate for Payer: Cofinity Commercial |
$4,002.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,723.56
|
| Rate for Payer: Healthscope Commercial |
$4,189.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,258.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,490.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,956.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,490.84
|
| Rate for Payer: PHP Commercial |
$3,956.28
|
| Rate for Payer: Priority Health SBD |
$2,932.30
|
| Rate for Payer: UMR Bronson Commercial |
$2,047.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,490.84
|
|
|
HC REMOVE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
OP
|
$4,654.45
|
|
|
Service Code
|
CPT 63661
|
| Hospital Charge Code |
36100611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,017.60 |
| Max. Negotiated Rate |
$6,292.24 |
| Rate for Payer: Aetna American Axle |
$3,025.39
|
| Rate for Payer: Aetna Commercial |
$3,956.28
|
| Rate for Payer: Aetna Medicare |
$2,023.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,025.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,432.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,432.12
|
| Rate for Payer: BCBS Complete |
$1,068.58
|
| Rate for Payer: BCBS MAPPO |
$1,945.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,979.19
|
| Rate for Payer: BCN Commercial |
$1,979.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,945.70
|
| Rate for Payer: Cash Price |
$3,723.56
|
| Rate for Payer: Cash Price |
$3,723.56
|
| Rate for Payer: Cash Price |
$3,723.56
|
| Rate for Payer: Cofinity Advantage |
$3,258.11
|
| Rate for Payer: Cofinity Commercial |
$4,002.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,723.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,945.70
|
| Rate for Payer: Healthscope Commercial |
$4,189.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,258.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,490.84
|
| Rate for Payer: Mclaren Medicaid |
$1,945.70
|
| Rate for Payer: Mclaren Medicare |
$1,945.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,042.98
|
| Rate for Payer: Meridian Medicaid |
$2,042.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,237.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,140.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,956.28
|
| Rate for Payer: Nomi Health Commercial |
$5,837.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,490.84
|
| Rate for Payer: PACE Medicare |
$1,848.41
|
| Rate for Payer: PACE SWMI |
$1,945.70
|
| Rate for Payer: PHP Commercial |
$3,956.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,945.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,017.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,292.24
|
| Rate for Payer: Priority Health Medicare |
$1,945.70
|
| Rate for Payer: Priority Health SBD |
$2,932.30
|
| Rate for Payer: Priority Health Tiered Network |
$5,033.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,945.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,945.70
|
| Rate for Payer: UHC Medicaid |
$1,017.60
|
| Rate for Payer: UHCCP Medicaid |
$1,017.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,722.15
|
| Rate for Payer: VA VA |
$1,945.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,490.84
|
|
|
HC REMOVE SUTURES AND STAPLES NO ANES
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 15854
|
| Hospital Charge Code |
76100371
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$16.94 |
| Max. Negotiated Rate |
$63.09 |
| Rate for Payer: Aetna American Axle |
$29.76
|
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna Medicare |
$22.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.76
|
| Rate for Payer: BCBS Complete |
$18.31
|
| Rate for Payer: BCBS Trust/PPO |
$63.09
|
| Rate for Payer: BCN Commercial |
$63.09
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Advantage |
$32.05
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.34
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: Priority Health SBD |
$28.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.76
|
| Rate for Payer: UHC Core |
$23.85
|
| Rate for Payer: UHC Exchange |
$17.99
|
| Rate for Payer: UMR Bronson Commercial |
$16.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC REMOVE SUTURES AND STAPLES NO ANES
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 15854
|
| Hospital Charge Code |
76100371
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$20.14 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna American Axle |
$29.76
|
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.76
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Advantage |
$32.05
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.34
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: Priority Health SBD |
$28.84
|
| Rate for Payer: UMR Bronson Commercial |
$20.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC REMOVE SUTURES OR STAPLES NO ANES
|
Facility
|
IP
|
$32.25
|
|
|
Service Code
|
CPT 15853
|
| Hospital Charge Code |
76100370
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$14.19 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna American Axle |
$20.96
|
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.96
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Advantage |
$22.57
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.19
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: Priority Health SBD |
$20.32
|
| Rate for Payer: UMR Bronson Commercial |
$14.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.19
|
|
|
HC REMOVE SUTURES OR STAPLES NO ANES
|
Facility
|
OP
|
$32.25
|
|
|
Service Code
|
CPT 15853
|
| Hospital Charge Code |
76100370
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$11.93 |
| Max. Negotiated Rate |
$44.69 |
| Rate for Payer: Aetna American Axle |
$20.96
|
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna Medicare |
$16.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.96
|
| Rate for Payer: BCBS Complete |
$12.90
|
| Rate for Payer: BCBS Trust/PPO |
$44.69
|
| Rate for Payer: BCN Commercial |
$44.69
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Advantage |
$22.57
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.19
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: Priority Health SBD |
$20.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.96
|
| Rate for Payer: UHC Core |
$16.80
|
| Rate for Payer: UHC Exchange |
$12.67
|
| Rate for Payer: UMR Bronson Commercial |
$11.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.19
|
|
|
HC REMOVE SUTURES OR STAPLES REQ ANES
|
Facility
|
OP
|
$5,207.19
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$106.12 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna American Axle |
$3,384.67
|
| Rate for Payer: Aetna Commercial |
$4,426.11
|
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,384.67
|
| 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 |
$4,165.75
|
| Rate for Payer: Cash Price |
$4,165.75
|
| Rate for Payer: Cash Price |
$4,165.75
|
| Rate for Payer: Cofinity Advantage |
$3,645.03
|
| Rate for Payer: Cofinity Commercial |
$4,478.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,165.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Healthscope Commercial |
$4,686.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,645.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,905.39
|
| 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 |
$4,426.11
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,905.39
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Commercial |
$4,426.11
|
| 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 |
$3,280.53
|
| 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) |
$3,384.67
|
| Rate for Payer: UHC Core |
$2,712.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Exchange |
$2,046.43
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,926.66
|
| Rate for Payer: VA VA |
$2,055.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,905.39
|
|
|
HC REMOVE SUTURES OR STAPLES REQ ANES
|
Facility
|
IP
|
$5,207.19
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,291.16 |
| Max. Negotiated Rate |
$4,686.47 |
| Rate for Payer: Aetna American Axle |
$3,384.67
|
| Rate for Payer: Aetna Commercial |
$4,426.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,384.67
|
| Rate for Payer: Cash Price |
$4,165.75
|
| Rate for Payer: Cofinity Advantage |
$3,645.03
|
| Rate for Payer: Cofinity Commercial |
$4,478.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,165.75
|
| Rate for Payer: Healthscope Commercial |
$4,686.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,645.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,905.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,426.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,905.39
|
| Rate for Payer: PHP Commercial |
$4,426.11
|
| Rate for Payer: Priority Health SBD |
$3,280.53
|
| Rate for Payer: UMR Bronson Commercial |
$2,291.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,905.39
|
|
|
HC RENAL FUNCTION PANEL
|
Facility
|
IP
|
$36.08
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
30100016
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.88 |
| Max. Negotiated Rate |
$32.47 |
| Rate for Payer: Aetna American Axle |
$23.45
|
| Rate for Payer: Aetna Commercial |
$30.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.45
|
| Rate for Payer: Cash Price |
$28.86
|
| Rate for Payer: Cofinity Advantage |
$25.26
|
| Rate for Payer: Cofinity Commercial |
$31.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.86
|
| Rate for Payer: Healthscope Commercial |
$32.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.06
|
| Rate for Payer: PHP Commercial |
$30.67
|
| Rate for Payer: Priority Health SBD |
$22.73
|
| Rate for Payer: UMR Bronson Commercial |
$15.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.06
|
|
|
HC RENAL FUNCTION PANEL
|
Facility
|
OP
|
$36.08
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
30100016
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.54 |
| Max. Negotiated Rate |
$32.47 |
| Rate for Payer: Aetna American Axle |
$23.45
|
| Rate for Payer: Aetna Commercial |
$30.67
|
| Rate for Payer: Aetna Medicare |
$9.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.85
|
| Rate for Payer: BCBS Complete |
$4.77
|
| Rate for Payer: BCBS MAPPO |
$8.68
|
| Rate for Payer: BCBS Trust/PPO |
$16.71
|
| Rate for Payer: BCN Commercial |
$16.71
|
| Rate for Payer: BCN Medicare Advantage |
$8.68
|
| Rate for Payer: Cash Price |
$28.86
|
| Rate for Payer: Cash Price |
$28.86
|
| Rate for Payer: Cofinity Advantage |
$25.26
|
| Rate for Payer: Cofinity Commercial |
$31.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.68
|
| Rate for Payer: Healthscope Commercial |
$32.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.06
|
| Rate for Payer: Mclaren Medicaid |
$8.68
|
| Rate for Payer: Mclaren Medicare |
$8.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.11
|
| Rate for Payer: Meridian Medicaid |
$9.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.67
|
| Rate for Payer: Nomi Health Commercial |
$13.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.06
|
| Rate for Payer: PACE Medicare |
$8.25
|
| Rate for Payer: PACE SWMI |
$8.68
|
| Rate for Payer: PHP Commercial |
$30.67
|
| Rate for Payer: PHP Medicare Advantage |
$8.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.68
|
| Rate for Payer: Priority Health Medicare |
$8.68
|
| Rate for Payer: Priority Health SBD |
$22.73
|
| Rate for Payer: Priority Health Tiered Network |
$6.94
|
| Rate for Payer: Railroad Medicare Medicare |
$8.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.02
|
| Rate for Payer: UHC Core |
$13.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.68
|
| Rate for Payer: UHC Exchange |
$13.02
|
| Rate for Payer: UHC Medicaid |
$4.54
|
| Rate for Payer: UHCCP Medicaid |
$4.54
|
| Rate for Payer: UMR Bronson Commercial |
$13.35
|
| Rate for Payer: VA VA |
$8.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.06
|
|
|
HC RENIN
|
Facility
|
OP
|
$42.34
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
30100419
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$38.11 |
| Rate for Payer: Aetna American Axle |
$27.52
|
| Rate for Payer: Aetna Commercial |
$35.99
|
| Rate for Payer: Aetna Medicare |
$22.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.49
|
| Rate for Payer: BCBS Complete |
$12.08
|
| Rate for Payer: BCBS MAPPO |
$21.99
|
| Rate for Payer: BCBS Trust/PPO |
$25.42
|
| Rate for Payer: BCN Commercial |
$25.42
|
| Rate for Payer: BCN Medicare Advantage |
$21.99
|
| Rate for Payer: Cash Price |
$33.87
|
| Rate for Payer: Cash Price |
$33.87
|
| Rate for Payer: Cofinity Advantage |
$29.64
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.99
|
| Rate for Payer: Healthscope Commercial |
$38.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.75
|
| Rate for Payer: Mclaren Medicaid |
$21.99
|
| Rate for Payer: Mclaren Medicare |
$21.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.09
|
| Rate for Payer: Meridian Medicaid |
$23.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.99
|
| Rate for Payer: Nomi Health Commercial |
$32.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.75
|
| Rate for Payer: PACE Medicare |
$20.89
|
| Rate for Payer: PACE SWMI |
$21.99
|
| Rate for Payer: PHP Commercial |
$35.99
|
| Rate for Payer: PHP Medicare Advantage |
$21.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.99
|
| Rate for Payer: Priority Health Medicare |
$21.99
|
| Rate for Payer: Priority Health SBD |
$26.67
|
| Rate for Payer: Priority Health Tiered Network |
$17.59
|
| Rate for Payer: Railroad Medicare Medicare |
$21.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.99
|
| Rate for Payer: UHC Core |
$32.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.99
|
| Rate for Payer: UHC Exchange |
$32.99
|
| Rate for Payer: UHC Medicaid |
$11.50
|
| Rate for Payer: UHCCP Medicaid |
$11.50
|
| Rate for Payer: UMR Bronson Commercial |
$15.67
|
| Rate for Payer: VA VA |
$21.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.75
|
|
|
HC RENIN
|
Facility
|
IP
|
$42.34
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
30100419
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.63 |
| Max. Negotiated Rate |
$38.11 |
| Rate for Payer: Aetna American Axle |
$27.52
|
| Rate for Payer: Aetna Commercial |
$35.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.52
|
| Rate for Payer: Cash Price |
$33.87
|
| Rate for Payer: Cofinity Advantage |
$29.64
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.87
|
| Rate for Payer: Healthscope Commercial |
$38.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.75
|
| Rate for Payer: PHP Commercial |
$35.99
|
| Rate for Payer: Priority Health SBD |
$26.67
|
| Rate for Payer: UMR Bronson Commercial |
$18.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.75
|
|
