|
HC PULM REHAB W/O CONT OXIMTRY MNTR
|
Facility
|
IP
|
$186.64
|
|
|
Service Code
|
CPT 94625
|
| Hospital Charge Code |
94800003
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$82.12 |
| Max. Negotiated Rate |
$167.98 |
| Rate for Payer: Aetna American Axle |
$121.32
|
| Rate for Payer: Aetna Commercial |
$158.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.32
|
| Rate for Payer: Cash Price |
$149.31
|
| Rate for Payer: Cofinity Commercial |
$130.65
|
| Rate for Payer: Cofinity Commercial |
$160.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$130.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.31
|
| Rate for Payer: Healthscope Commercial |
$167.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$130.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$158.64
|
| Rate for Payer: PHP Commercial |
$158.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.32
|
| Rate for Payer: Priority Health SBD |
$117.58
|
| Rate for Payer: UMR Bronson Commercial |
$82.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.98
|
|
|
HC PULSE OXIMETRY MULTI DETER
|
Facility
|
IP
|
$128.24
|
|
|
Service Code
|
CPT 94761
|
| Hospital Charge Code |
46000012
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$56.43 |
| Max. Negotiated Rate |
$115.42 |
| Rate for Payer: Aetna American Axle |
$83.36
|
| Rate for Payer: Aetna Commercial |
$109.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.36
|
| Rate for Payer: Cash Price |
$102.59
|
| Rate for Payer: Cofinity Commercial |
$110.29
|
| Rate for Payer: Cofinity Commercial |
$89.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$89.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.59
|
| Rate for Payer: Healthscope Commercial |
$115.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.00
|
| Rate for Payer: PHP Commercial |
$109.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.36
|
| Rate for Payer: Priority Health SBD |
$80.79
|
| Rate for Payer: UMR Bronson Commercial |
$56.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.18
|
|
|
HC PULSE OXIMETRY MULTI DETER
|
Facility
|
OP
|
$128.24
|
|
|
Service Code
|
CPT 94761
|
| Hospital Charge Code |
46000012
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$47.45 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$83.36
|
| Rate for Payer: Aetna Commercial |
$109.00
|
| Rate for Payer: Aetna Medicare |
$64.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.36
|
| Rate for Payer: BCBS Complete |
$51.30
|
| Rate for Payer: Cash Price |
$102.59
|
| Rate for Payer: Cash Price |
$102.59
|
| Rate for Payer: Cofinity Commercial |
$89.77
|
| Rate for Payer: Cofinity Commercial |
$110.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$89.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.59
|
| Rate for Payer: Healthscope Commercial |
$115.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.00
|
| Rate for Payer: PHP Commercial |
$109.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.36
|
| Rate for Payer: Priority Health SBD |
$80.79
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$47.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.18
|
|
|
HC PULSE OX OVERNIGHT
|
Facility
|
OP
|
$205.42
|
|
|
Service Code
|
CPT 94762
|
| Hospital Charge Code |
46000027
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$76.01 |
| Max. Negotiated Rate |
$429.53 |
| Rate for Payer: Aetna American Axle |
$133.52
|
| Rate for Payer: Aetna Commercial |
$174.61
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$164.34
|
| Rate for Payer: Cash Price |
$164.34
|
| Rate for Payer: Cash Price |
$164.34
|
| Rate for Payer: Cofinity Commercial |
$143.79
|
| Rate for Payer: Cofinity Commercial |
$176.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$143.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$184.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$143.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.06
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.61
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$174.61
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.52
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$129.41
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$291.61
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: UMR Bronson Commercial |
$76.01
|
| Rate for Payer: VA VA |
$152.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.06
|
|
|
HC PULSE OX OVERNIGHT
|
Facility
|
IP
|
$205.42
|
|
|
Service Code
|
CPT 94762
|
| Hospital Charge Code |
46000027
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$90.38 |
| Max. Negotiated Rate |
$184.88 |
| Rate for Payer: Aetna American Axle |
$133.52
|
| Rate for Payer: Aetna Commercial |
$174.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.52
|
| Rate for Payer: Cash Price |
$164.34
|
| Rate for Payer: Cofinity Commercial |
$143.79
|
| Rate for Payer: Cofinity Commercial |
$176.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$143.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.34
|
| Rate for Payer: Healthscope Commercial |
$184.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$143.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.61
|
| Rate for Payer: PHP Commercial |
$174.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.52
|
| Rate for Payer: Priority Health SBD |
$129.41
|
| Rate for Payer: UMR Bronson Commercial |
$90.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.06
|
|
|
HC PULSE OX SINGLE
|
Facility
|
OP
|
$86.43
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
46000026
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$31.98 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$56.18
|
| Rate for Payer: Aetna Commercial |
$73.47
|
| Rate for Payer: Aetna Medicare |
$43.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.18
|
| Rate for Payer: BCBS Complete |
$34.57
|
| Rate for Payer: Cash Price |
$69.14
|
| Rate for Payer: Cash Price |
$69.14
|
| Rate for Payer: Cofinity Commercial |
$74.33
|
| Rate for Payer: Cofinity Commercial |
$60.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.14
|
| Rate for Payer: Healthscope Commercial |
$77.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.47
|
| Rate for Payer: PHP Commercial |
$73.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.18
|
| Rate for Payer: Priority Health SBD |
$54.45
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$31.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.82
|
|
|
HC PULSE OX SINGLE
|
Facility
|
IP
|
$86.43
|
|
|
Service Code
|
CPT 94760
|
| Hospital Charge Code |
46000026
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$38.03 |
| Max. Negotiated Rate |
$77.79 |
| Rate for Payer: Aetna American Axle |
$56.18
|
| Rate for Payer: Aetna Commercial |
$73.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.18
|
| Rate for Payer: Cash Price |
$69.14
|
| Rate for Payer: Cofinity Commercial |
$60.50
|
| Rate for Payer: Cofinity Commercial |
$74.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.14
|
| Rate for Payer: Healthscope Commercial |
$77.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.47
|
| Rate for Payer: PHP Commercial |
$73.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.18
|
| Rate for Payer: Priority Health SBD |
$54.45
|
| Rate for Payer: UMR Bronson Commercial |
$38.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.82
|
|
|
HC PULSERIDER
|
Facility
|
OP
|
$17,069.07
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800119
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,315.56 |
| Max. Negotiated Rate |
$15,362.16 |
| Rate for Payer: Aetna American Axle |
$11,094.90
|
| Rate for Payer: Aetna Commercial |
$14,508.71
|
| Rate for Payer: Aetna Medicare |
$8,534.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,094.90
|
| Rate for Payer: BCBS Complete |
$6,827.63
|
| Rate for Payer: Cash Price |
$13,655.26
|
| Rate for Payer: Cofinity Commercial |
$11,948.35
|
| Rate for Payer: Cofinity Commercial |
$14,679.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,948.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,655.26
|
| Rate for Payer: Healthscope Commercial |
$15,362.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,948.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,801.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,508.71
|
| Rate for Payer: PHP Commercial |
$14,508.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,094.90
|
| Rate for Payer: Priority Health SBD |
$10,753.51
|
| Rate for Payer: UMR Bronson Commercial |
$6,315.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,801.80
|
|
|
HC PULSERIDER
|
Facility
|
IP
|
$17,069.07
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800119
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,510.39 |
| Max. Negotiated Rate |
$15,362.16 |
| Rate for Payer: Aetna American Axle |
$11,094.90
|
| Rate for Payer: Aetna Commercial |
$14,508.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,094.90
|
| Rate for Payer: Cash Price |
$13,655.26
|
| Rate for Payer: Cofinity Commercial |
$11,948.35
|
| Rate for Payer: Cofinity Commercial |
$14,679.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,948.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,655.26
|
| Rate for Payer: Healthscope Commercial |
$15,362.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,948.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,801.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,508.71
|
| Rate for Payer: PHP Commercial |
$14,508.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,094.90
|
| Rate for Payer: Priority Health SBD |
$10,753.51
|
| Rate for Payer: UMR Bronson Commercial |
$7,510.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,801.80
|
|
|
HC PUMP CENTRFUGAL
|
Facility
|
IP
|
$457.25
|
|
| Hospital Charge Code |
27000382
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$201.19 |
| Max. Negotiated Rate |
$411.52 |
| Rate for Payer: Aetna American Axle |
$297.21
|
| Rate for Payer: Aetna Commercial |
$388.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$297.21
|
| Rate for Payer: Cash Price |
$365.80
|
| Rate for Payer: Cofinity Commercial |
$320.07
|
| Rate for Payer: Cofinity Commercial |
$393.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$320.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.80
|
| Rate for Payer: Healthscope Commercial |
$411.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$320.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$342.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.66
|
| Rate for Payer: PHP Commercial |
$388.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.21
|
| Rate for Payer: Priority Health SBD |
$288.07
|
| Rate for Payer: UMR Bronson Commercial |
$201.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$342.94
|
|
|
HC PUMP CENTRFUGAL
|
Facility
|
OP
|
$457.25
|
|
| Hospital Charge Code |
27000382
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$169.18 |
| Max. Negotiated Rate |
$411.52 |
| Rate for Payer: Aetna American Axle |
$297.21
|
| Rate for Payer: Aetna Commercial |
$388.66
|
| Rate for Payer: Aetna Medicare |
$228.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$297.21
|
| Rate for Payer: BCBS Complete |
$182.90
|
| Rate for Payer: Cash Price |
$365.80
|
| Rate for Payer: Cofinity Commercial |
$320.07
|
| Rate for Payer: Cofinity Commercial |
$393.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$320.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.80
|
| Rate for Payer: Healthscope Commercial |
$411.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$320.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$342.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.66
|
| Rate for Payer: PHP Commercial |
$388.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.21
|
| Rate for Payer: Priority Health SBD |
$288.07
|
| Rate for Payer: UMR Bronson Commercial |
$169.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$342.94
|
|
|
HC PUNCH BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$83.55
|
|
|
Service Code
|
CPT 11105
|
| Hospital Charge Code |
76100151
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$36.76 |
| Max. Negotiated Rate |
$75.19 |
| Rate for Payer: Aetna American Axle |
$54.31
|
| Rate for Payer: Aetna Commercial |
$71.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.31
|
| Rate for Payer: Cash Price |
$66.84
|
| Rate for Payer: Cofinity Commercial |
$58.48
|
| Rate for Payer: Cofinity Commercial |
$71.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$58.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.84
|
| Rate for Payer: Healthscope Commercial |
$75.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.02
|
| Rate for Payer: PHP Commercial |
$71.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.31
|
| Rate for Payer: Priority Health SBD |
$52.64
|
| Rate for Payer: UMR Bronson Commercial |
$36.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.66
|
|
|
HC PUNCH BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$83.55
|
|
|
Service Code
|
CPT 11105
|
| Hospital Charge Code |
76100151
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.91 |
| Max. Negotiated Rate |
$75.19 |
| Rate for Payer: Aetna American Axle |
$54.31
|
| Rate for Payer: Aetna Commercial |
$71.02
|
| Rate for Payer: Aetna Medicare |
$41.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.31
|
| Rate for Payer: BCBS Complete |
$33.42
|
| Rate for Payer: Cash Price |
$66.84
|
| Rate for Payer: Cofinity Commercial |
$58.48
|
| Rate for Payer: Cofinity Commercial |
$71.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$58.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.84
|
| Rate for Payer: Healthscope Commercial |
$75.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.02
|
| Rate for Payer: PHP Commercial |
$71.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.31
|
| Rate for Payer: Priority Health SBD |
$52.64
|
| Rate for Payer: UMR Bronson Commercial |
$30.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.66
|
|
|
HC PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$319.12
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
76100150
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$140.41 |
| Max. Negotiated Rate |
$287.21 |
| Rate for Payer: Aetna American Axle |
$207.43
|
| Rate for Payer: Aetna Commercial |
$271.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.43
|
| Rate for Payer: Cash Price |
$255.30
|
| Rate for Payer: Cofinity Commercial |
$223.38
|
| Rate for Payer: Cofinity Commercial |
$274.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$223.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.30
|
| Rate for Payer: Healthscope Commercial |
$287.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$223.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$239.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.25
|
| Rate for Payer: PHP Commercial |
$271.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.43
|
| Rate for Payer: Priority Health SBD |
$201.05
|
| Rate for Payer: UMR Bronson Commercial |
$140.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$239.34
|
|
|
HC PUNCH BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$319.12
|
|
|
Service Code
|
CPT 11104
|
| Hospital Charge Code |
76100150
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.07 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna American Axle |
$207.43
|
| Rate for Payer: Aetna Commercial |
$271.25
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$207.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$255.30
|
| Rate for Payer: Cash Price |
$255.30
|
| Rate for Payer: Cofinity Commercial |
$274.44
|
| Rate for Payer: Cofinity Commercial |
$223.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$223.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$255.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$287.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$223.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$239.34
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$271.25
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$271.25
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.43
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$201.05
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$744.66
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: UMR Bronson Commercial |
$118.07
|
| Rate for Payer: VA VA |
$389.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$239.34
|
|
|
HC PUNCTURE ASPIRATION, HYDROCELE
|
Facility
|
IP
|
$951.99
|
|
|
Service Code
|
CPT 55000
|
| Hospital Charge Code |
76100259
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$418.88 |
| Max. Negotiated Rate |
$856.79 |
| Rate for Payer: Aetna American Axle |
$618.79
|
| Rate for Payer: Aetna Commercial |
$809.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$618.79
|
| Rate for Payer: Cash Price |
$761.59
|
| Rate for Payer: Cofinity Commercial |
$666.39
|
| Rate for Payer: Cofinity Commercial |
$818.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$666.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.59
|
| Rate for Payer: Healthscope Commercial |
$856.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$666.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.19
|
| Rate for Payer: PHP Commercial |
$809.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.79
|
| Rate for Payer: Priority Health SBD |
$599.75
|
| Rate for Payer: UMR Bronson Commercial |
$418.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.99
|
|
|
HC PUNCTURE ASPIRATION, HYDROCELE
|
Facility
|
OP
|
$951.99
|
|
|
Service Code
|
CPT 55000
|
| Hospital Charge Code |
76100259
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$352.24 |
| Max. Negotiated Rate |
$1,931.58 |
| Rate for Payer: Aetna American Axle |
$618.79
|
| Rate for Payer: Aetna Commercial |
$809.19
|
| Rate for Payer: Aetna Medicare |
$713.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$618.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$857.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$857.75
|
| Rate for Payer: BCBS Complete |
$386.19
|
| Rate for Payer: BCBS MAPPO |
$686.20
|
| Rate for Payer: BCN Medicare Advantage |
$686.20
|
| Rate for Payer: Cash Price |
$761.59
|
| Rate for Payer: Cash Price |
$761.59
|
| Rate for Payer: Cofinity Commercial |
$818.71
|
| Rate for Payer: Cofinity Commercial |
$666.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$666.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$686.20
|
| Rate for Payer: Healthscope Commercial |
$856.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$666.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.99
|
| Rate for Payer: Mclaren Medicaid |
$367.80
|
| Rate for Payer: Mclaren Medicare |
$686.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$720.51
|
| Rate for Payer: Meridian Medicaid |
$386.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$789.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.19
|
| Rate for Payer: PACE Medicare |
$651.89
|
| Rate for Payer: PACE SWMI |
$686.20
|
| Rate for Payer: PHP Commercial |
$809.19
|
| Rate for Payer: PHP Medicare Advantage |
$686.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$618.79
|
| Rate for Payer: Priority Health Medicare |
$686.20
|
| Rate for Payer: Priority Health SBD |
$599.75
|
| Rate for Payer: Railroad Medicare Medicare |
$686.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,931.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$686.20
|
| Rate for Payer: UHC Exchange |
$1,311.40
|
| Rate for Payer: UHC Medicare Advantage |
$686.20
|
| Rate for Payer: UHCCP Medicaid |
$367.80
|
| Rate for Payer: UMR Bronson Commercial |
$352.24
|
| Rate for Payer: VA VA |
$686.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.99
|
|
|
HC PUNCTURE ASPIRATION OF ABSCESS
|
Facility
|
OP
|
$275.29
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
36100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$101.86 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna American Axle |
$178.94
|
| Rate for Payer: Aetna Commercial |
$234.00
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$220.23
|
| Rate for Payer: Cash Price |
$220.23
|
| Rate for Payer: Cofinity Commercial |
$236.75
|
| Rate for Payer: Cofinity Commercial |
$192.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$192.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$247.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$192.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.47
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.00
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$234.00
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.94
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$173.43
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$744.66
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: UMR Bronson Commercial |
$101.86
|
| Rate for Payer: VA VA |
$389.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.47
|
|
|
HC PUNCTURE ASPIRATION OF ABSCESS
|
Facility
|
IP
|
$275.29
|
|
|
Service Code
|
CPT 10160
|
| Hospital Charge Code |
36100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.13 |
| Max. Negotiated Rate |
$247.76 |
| Rate for Payer: Aetna American Axle |
$178.94
|
| Rate for Payer: Aetna Commercial |
$234.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.94
|
| Rate for Payer: Cash Price |
$220.23
|
| Rate for Payer: Cofinity Commercial |
$192.70
|
| Rate for Payer: Cofinity Commercial |
$236.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$192.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.23
|
| Rate for Payer: Healthscope Commercial |
$247.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$192.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.00
|
| Rate for Payer: PHP Commercial |
$234.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.94
|
| Rate for Payer: Priority Health SBD |
$173.43
|
| Rate for Payer: UMR Bronson Commercial |
$121.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.47
|
|
|
HC PUNCTURE CERVICAL
|
Facility
|
OP
|
$777.71
|
|
|
Service Code
|
CPT 61050
|
| Hospital Charge Code |
36100268
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$154.31 |
| Max. Negotiated Rate |
$810.38 |
| Rate for Payer: Aetna American Axle |
$505.51
|
| Rate for Payer: Aetna Commercial |
$661.05
|
| Rate for Payer: Aetna Medicare |
$299.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$359.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$359.86
|
| Rate for Payer: BCBS Complete |
$162.02
|
| Rate for Payer: BCBS MAPPO |
$287.89
|
| Rate for Payer: BCN Medicare Advantage |
$287.89
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cofinity Commercial |
$668.83
|
| Rate for Payer: Cofinity Commercial |
$544.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$544.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.89
|
| Rate for Payer: Healthscope Commercial |
$699.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$544.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.28
|
| Rate for Payer: Mclaren Medicaid |
$154.31
|
| Rate for Payer: Mclaren Medicare |
$287.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.28
|
| Rate for Payer: Meridian Medicaid |
$162.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.05
|
| Rate for Payer: PACE Medicare |
$273.50
|
| Rate for Payer: PACE SWMI |
$287.89
|
| Rate for Payer: PHP Commercial |
$661.05
|
| Rate for Payer: PHP Medicare Advantage |
$287.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.51
|
| Rate for Payer: Priority Health Medicare |
$287.89
|
| Rate for Payer: Priority Health SBD |
$489.96
|
| Rate for Payer: Railroad Medicare Medicare |
$287.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$810.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.89
|
| Rate for Payer: UHC Exchange |
$550.19
|
| Rate for Payer: UHC Medicare Advantage |
$287.89
|
| Rate for Payer: UHCCP Medicaid |
$154.31
|
| Rate for Payer: UMR Bronson Commercial |
$287.75
|
| Rate for Payer: VA VA |
$287.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.28
|
|
|
HC PUNCTURE CERVICAL
|
Facility
|
IP
|
$777.71
|
|
|
Service Code
|
CPT 61050
|
| Hospital Charge Code |
36100268
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$342.19 |
| Max. Negotiated Rate |
$699.94 |
| Rate for Payer: Aetna American Axle |
$505.51
|
| Rate for Payer: Aetna Commercial |
$661.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.51
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cofinity Commercial |
$544.40
|
| Rate for Payer: Cofinity Commercial |
$668.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$544.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.17
|
| Rate for Payer: Healthscope Commercial |
$699.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$544.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.05
|
| Rate for Payer: PHP Commercial |
$661.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.51
|
| Rate for Payer: Priority Health SBD |
$489.96
|
| Rate for Payer: UMR Bronson Commercial |
$342.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.28
|
|
|
HC PUNCTURE WITH INJECTION CERVICAL
|
Facility
|
IP
|
$777.71
|
|
|
Service Code
|
CPT 61055
|
| Hospital Charge Code |
36100269
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$342.19 |
| Max. Negotiated Rate |
$699.94 |
| Rate for Payer: Aetna American Axle |
$505.51
|
| Rate for Payer: Aetna Commercial |
$661.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.51
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cofinity Commercial |
$544.40
|
| Rate for Payer: Cofinity Commercial |
$668.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$544.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.17
|
| Rate for Payer: Healthscope Commercial |
$699.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$544.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.05
|
| Rate for Payer: PHP Commercial |
$661.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.51
|
| Rate for Payer: Priority Health SBD |
$489.96
|
| Rate for Payer: UMR Bronson Commercial |
$342.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.28
|
|
|
HC PUNCTURE WITH INJECTION CERVICAL
|
Facility
|
OP
|
$777.71
|
|
|
Service Code
|
CPT 61055
|
| Hospital Charge Code |
36100269
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$154.31 |
| Max. Negotiated Rate |
$810.38 |
| Rate for Payer: Aetna American Axle |
$505.51
|
| Rate for Payer: Aetna Commercial |
$661.05
|
| Rate for Payer: Aetna Medicare |
$299.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$359.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$359.86
|
| Rate for Payer: BCBS Complete |
$162.02
|
| Rate for Payer: BCBS MAPPO |
$287.89
|
| Rate for Payer: BCN Medicare Advantage |
$287.89
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cofinity Commercial |
$668.83
|
| Rate for Payer: Cofinity Commercial |
$544.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$544.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$287.89
|
| Rate for Payer: Healthscope Commercial |
$699.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$544.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.28
|
| Rate for Payer: Mclaren Medicaid |
$154.31
|
| Rate for Payer: Mclaren Medicare |
$287.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.28
|
| Rate for Payer: Meridian Medicaid |
$162.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.05
|
| Rate for Payer: PACE Medicare |
$273.50
|
| Rate for Payer: PACE SWMI |
$287.89
|
| Rate for Payer: PHP Commercial |
$661.05
|
| Rate for Payer: PHP Medicare Advantage |
$287.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$154.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.51
|
| Rate for Payer: Priority Health Medicare |
$287.89
|
| Rate for Payer: Priority Health SBD |
$489.96
|
| Rate for Payer: Railroad Medicare Medicare |
$287.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$810.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$287.89
|
| Rate for Payer: UHC Exchange |
$550.19
|
| Rate for Payer: UHC Medicare Advantage |
$287.89
|
| Rate for Payer: UHCCP Medicaid |
$154.31
|
| Rate for Payer: UMR Bronson Commercial |
$287.75
|
| Rate for Payer: VA VA |
$287.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.28
|
|
|
HC PURAPLY AM (1.6 SQ CM DISC) PER SQ CM
|
Facility
|
OP
|
$737.39
|
|
|
Service Code
|
HCPCS Q4196
|
| Hospital Charge Code |
63600128
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$272.83 |
| Max. Negotiated Rate |
$663.65 |
| Rate for Payer: Aetna American Axle |
$479.30
|
| Rate for Payer: Aetna Commercial |
$626.78
|
| Rate for Payer: Aetna Medicare |
$368.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$479.30
|
| Rate for Payer: BCBS Complete |
$294.96
|
| Rate for Payer: Cash Price |
$589.91
|
| Rate for Payer: Cofinity Commercial |
$516.17
|
| Rate for Payer: Cofinity Commercial |
$634.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$516.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$589.91
|
| Rate for Payer: Healthscope Commercial |
$663.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$516.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$553.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.78
|
| Rate for Payer: PHP Commercial |
$626.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$479.30
|
| Rate for Payer: Priority Health SBD |
$464.56
|
| Rate for Payer: UMR Bronson Commercial |
$272.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$553.04
|
|
|
HC PURAPLY AM (1.6 SQ CM DISC) PER SQ CM
|
Facility
|
IP
|
$737.39
|
|
|
Service Code
|
HCPCS Q4196
|
| Hospital Charge Code |
63600128
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$324.45 |
| Max. Negotiated Rate |
$663.65 |
| Rate for Payer: Aetna American Axle |
$479.30
|
| Rate for Payer: Aetna Commercial |
$626.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$479.30
|
| Rate for Payer: Cash Price |
$589.91
|
| Rate for Payer: Cofinity Commercial |
$516.17
|
| Rate for Payer: Cofinity Commercial |
$634.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$516.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$589.91
|
| Rate for Payer: Healthscope Commercial |
$663.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$516.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$553.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.78
|
| Rate for Payer: PHP Commercial |
$626.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$479.30
|
| Rate for Payer: Priority Health SBD |
$464.56
|
| Rate for Payer: UMR Bronson Commercial |
$324.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$553.04
|
|
