|
HC SIMULATION - S
|
Facility
|
OP
|
$742.85
|
|
|
Service Code
|
CPT 77280
|
| Hospital Charge Code |
33300002
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$70.05 |
| Max. Negotiated Rate |
$668.57 |
| Rate for Payer: Aetna American Axle |
$482.85
|
| Rate for Payer: Aetna Commercial |
$631.42
|
| Rate for Payer: Aetna Medicare |
$139.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$482.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$167.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$167.41
|
| Rate for Payer: BCBS Complete |
$73.55
|
| Rate for Payer: BCBS MAPPO |
$133.93
|
| Rate for Payer: BCBS Trust/PPO |
$567.24
|
| Rate for Payer: BCN Commercial |
$567.24
|
| Rate for Payer: BCN Medicare Advantage |
$133.93
|
| Rate for Payer: Cash Price |
$594.28
|
| Rate for Payer: Cash Price |
$594.28
|
| Rate for Payer: Cofinity Advantage |
$520.00
|
| Rate for Payer: Cofinity Commercial |
$638.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$594.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.93
|
| Rate for Payer: Healthscope Commercial |
$668.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$520.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$557.14
|
| Rate for Payer: Mclaren Medicaid |
$133.93
|
| Rate for Payer: Mclaren Medicare |
$133.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.63
|
| Rate for Payer: Meridian Medicaid |
$140.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$154.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$631.42
|
| Rate for Payer: Nomi Health Commercial |
$401.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$557.14
|
| Rate for Payer: PACE Medicare |
$127.23
|
| Rate for Payer: PACE SWMI |
$133.93
|
| Rate for Payer: PHP Commercial |
$631.42
|
| Rate for Payer: PHP Medicare Advantage |
$133.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$433.11
|
| Rate for Payer: Priority Health Medicare |
$133.93
|
| Rate for Payer: Priority Health SBD |
$468.00
|
| Rate for Payer: Priority Health Tiered Network |
$346.49
|
| Rate for Payer: Railroad Medicare Medicare |
$133.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$482.85
|
| Rate for Payer: UHC Core |
$387.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$133.93
|
| Rate for Payer: UHC Exchange |
$291.94
|
| Rate for Payer: UHC Medicaid |
$70.05
|
| Rate for Payer: UHCCP Medicaid |
$70.05
|
| Rate for Payer: UMR Bronson Commercial |
$274.85
|
| Rate for Payer: VA VA |
$133.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$557.14
|
|
|
HC SINGLE LEAD INSERTION
|
Facility
|
OP
|
$4,427.69
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
36100065
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,638.25 |
| Max. Negotiated Rate |
$26,665.62 |
| Rate for Payer: Aetna American Axle |
$2,878.00
|
| Rate for Payer: Aetna Commercial |
$3,763.54
|
| Rate for Payer: Aetna Medicare |
$8,575.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,878.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,307.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,307.04
|
| Rate for Payer: BCBS Complete |
$4,528.50
|
| Rate for Payer: BCBS MAPPO |
$8,245.63
|
| Rate for Payer: BCBS Trust/PPO |
$9,069.08
|
| Rate for Payer: BCN Commercial |
$9,069.08
|
| Rate for Payer: BCN Medicare Advantage |
$8,245.63
|
| Rate for Payer: Cash Price |
$3,542.15
|
| Rate for Payer: Cash Price |
$3,542.15
|
| Rate for Payer: Cash Price |
$3,542.15
|
| Rate for Payer: Cofinity Advantage |
$3,099.38
|
| Rate for Payer: Cofinity Commercial |
$3,807.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,542.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,245.63
|
| Rate for Payer: Healthscope Commercial |
$3,984.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,099.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,320.77
|
| Rate for Payer: Mclaren Medicaid |
$8,245.63
|
| Rate for Payer: Mclaren Medicare |
$8,245.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,657.91
|
| Rate for Payer: Meridian Medicaid |
$8,657.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,482.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,070.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,763.54
|
| Rate for Payer: Nomi Health Commercial |
$24,736.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,320.77
|
| Rate for Payer: PACE Medicare |
$7,833.35
|
| Rate for Payer: PACE SWMI |
$8,245.63
|
| Rate for Payer: PHP Commercial |
$3,763.54
|
| Rate for Payer: PHP Medicare Advantage |
$8,245.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,312.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26,665.62
|
| Rate for Payer: Priority Health Medicare |
$8,245.63
|
| Rate for Payer: Priority Health SBD |
$2,789.44
|
| Rate for Payer: Priority Health Tiered Network |
$21,332.50
|
| Rate for Payer: Railroad Medicare Medicare |
$8,245.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,245.63
|
| Rate for Payer: UHC Medicaid |
$4,312.46
|
| Rate for Payer: UHCCP Medicaid |
$4,312.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,638.25
|
| Rate for Payer: VA VA |
$8,245.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,320.77
|
|
|
HC SINGLE LEAD INSERTION
|
Facility
|
IP
|
$4,427.69
|
|
|
Service Code
|
CPT 33216
|
| Hospital Charge Code |
36100065
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,948.18 |
| Max. Negotiated Rate |
$3,984.92 |
| Rate for Payer: Aetna American Axle |
$2,878.00
|
| Rate for Payer: Aetna Commercial |
$3,763.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,878.00
|
| Rate for Payer: Cash Price |
$3,542.15
|
| Rate for Payer: Cofinity Advantage |
$3,099.38
|
| Rate for Payer: Cofinity Commercial |
$3,807.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,542.15
|
| Rate for Payer: Healthscope Commercial |
$3,984.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,099.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,320.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,763.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,320.77
|
| Rate for Payer: PHP Commercial |
$3,763.54
|
| Rate for Payer: Priority Health SBD |
$2,789.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,948.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,320.77
|
|
|
HC SINOGRAM INJECTION
|
Facility
|
OP
|
$461.05
|
|
|
Service Code
|
CPT 20501
|
| Hospital Charge Code |
36100021
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$170.59 |
| Max. Negotiated Rate |
$511.34 |
| Rate for Payer: Aetna American Axle |
$299.68
|
| Rate for Payer: Aetna Commercial |
$391.89
|
| Rate for Payer: Aetna Medicare |
$230.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.68
|
| Rate for Payer: BCBS Complete |
$184.42
|
| Rate for Payer: BCBS Trust/PPO |
$511.34
|
| Rate for Payer: BCN Commercial |
$511.34
|
| Rate for Payer: Cash Price |
$368.84
|
| Rate for Payer: Cash Price |
$368.84
|
| Rate for Payer: Cash Price |
$368.84
|
| Rate for Payer: Cofinity Advantage |
$322.74
|
| Rate for Payer: Cofinity Commercial |
$396.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.84
|
| Rate for Payer: Healthscope Commercial |
$414.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$322.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$368.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.79
|
| Rate for Payer: PHP Commercial |
$391.89
|
| Rate for Payer: Priority Health SBD |
$290.46
|
| Rate for Payer: UMR Bronson Commercial |
$170.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.79
|
|
|
HC SINOGRAM INJECTION
|
Facility
|
IP
|
$461.05
|
|
|
Service Code
|
CPT 20501
|
| Hospital Charge Code |
36100021
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$202.86 |
| Max. Negotiated Rate |
$414.94 |
| Rate for Payer: Aetna American Axle |
$299.68
|
| Rate for Payer: Aetna Commercial |
$391.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.68
|
| Rate for Payer: Cash Price |
$368.84
|
| Rate for Payer: Cofinity Advantage |
$322.74
|
| Rate for Payer: Cofinity Commercial |
$396.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.84
|
| Rate for Payer: Healthscope Commercial |
$414.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$322.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.79
|
| Rate for Payer: PHP Commercial |
$391.89
|
| Rate for Payer: Priority Health SBD |
$290.46
|
| Rate for Payer: UMR Bronson Commercial |
$202.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.79
|
|
|
HC SIROLIMUS
|
Facility
|
OP
|
$77.47
|
|
|
Service Code
|
CPT 80195
|
| Hospital Charge Code |
30100045
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.18 |
| Max. Negotiated Rate |
$69.72 |
| Rate for Payer: Aetna American Axle |
$50.36
|
| Rate for Payer: Aetna Commercial |
$65.85
|
| Rate for Payer: Aetna Medicare |
$14.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.16
|
| Rate for Payer: BCBS Complete |
$7.54
|
| Rate for Payer: BCBS MAPPO |
$13.73
|
| Rate for Payer: BCBS Trust/PPO |
$15.88
|
| Rate for Payer: BCN Commercial |
$15.88
|
| Rate for Payer: BCN Medicare Advantage |
$13.73
|
| Rate for Payer: Cash Price |
$61.98
|
| Rate for Payer: Cash Price |
$61.98
|
| Rate for Payer: Cofinity Advantage |
$54.23
|
| Rate for Payer: Cofinity Commercial |
$66.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.73
|
| Rate for Payer: Healthscope Commercial |
$69.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.10
|
| Rate for Payer: Mclaren Medicaid |
$13.73
|
| Rate for Payer: Mclaren Medicare |
$13.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.42
|
| Rate for Payer: Meridian Medicaid |
$14.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.85
|
| Rate for Payer: Nomi Health Commercial |
$20.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.10
|
| Rate for Payer: PACE Medicare |
$13.04
|
| Rate for Payer: PACE SWMI |
$13.73
|
| Rate for Payer: PHP Commercial |
$65.85
|
| Rate for Payer: PHP Medicare Advantage |
$13.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.73
|
| Rate for Payer: Priority Health Medicare |
$13.73
|
| Rate for Payer: Priority Health SBD |
$48.81
|
| Rate for Payer: Priority Health Tiered Network |
$10.98
|
| Rate for Payer: Railroad Medicare Medicare |
$13.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.60
|
| Rate for Payer: UHC Core |
$20.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.73
|
| Rate for Payer: UHC Exchange |
$20.60
|
| Rate for Payer: UHC Medicaid |
$7.18
|
| Rate for Payer: UHCCP Medicaid |
$7.18
|
| Rate for Payer: UMR Bronson Commercial |
$28.66
|
| Rate for Payer: VA VA |
$13.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.10
|
|
|
HC SIROLIMUS
|
Facility
|
IP
|
$77.47
|
|
|
Service Code
|
CPT 80195
|
| Hospital Charge Code |
30100045
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.09 |
| Max. Negotiated Rate |
$69.72 |
| Rate for Payer: Aetna American Axle |
$50.36
|
| Rate for Payer: Aetna Commercial |
$65.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.36
|
| Rate for Payer: Cash Price |
$61.98
|
| Rate for Payer: Cofinity Advantage |
$54.23
|
| Rate for Payer: Cofinity Commercial |
$66.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.98
|
| Rate for Payer: Healthscope Commercial |
$69.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.10
|
| Rate for Payer: PHP Commercial |
$65.85
|
| Rate for Payer: Priority Health SBD |
$48.81
|
| Rate for Payer: UMR Bronson Commercial |
$34.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.10
|
|
|
HC SITZ MARKER
|
Facility
|
IP
|
$87.39
|
|
|
Service Code
|
CPT A9698
|
| Hospital Charge Code |
25500004
|
|
Hospital Revenue Code
|
255
|
| Min. Negotiated Rate |
$38.45 |
| Max. Negotiated Rate |
$78.65 |
| Rate for Payer: Aetna American Axle |
$56.80
|
| Rate for Payer: Aetna Commercial |
$74.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.80
|
| Rate for Payer: Cash Price |
$69.91
|
| Rate for Payer: Cofinity Advantage |
$61.17
|
| Rate for Payer: Cofinity Commercial |
$75.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.91
|
| Rate for Payer: Healthscope Commercial |
$78.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.54
|
| Rate for Payer: PHP Commercial |
$74.28
|
| Rate for Payer: Priority Health SBD |
$55.06
|
| Rate for Payer: UMR Bronson Commercial |
$38.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.54
|
|
|
HC SITZ MARKER
|
Facility
|
OP
|
$87.39
|
|
|
Service Code
|
CPT A9698
|
| Hospital Charge Code |
25500004
|
|
Hospital Revenue Code
|
255
|
| Min. Negotiated Rate |
$32.33 |
| Max. Negotiated Rate |
$78.65 |
| Rate for Payer: Aetna American Axle |
$56.80
|
| Rate for Payer: Aetna Commercial |
$74.28
|
| Rate for Payer: Aetna Medicare |
$43.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.80
|
| Rate for Payer: BCBS Complete |
$34.96
|
| Rate for Payer: Cash Price |
$69.91
|
| Rate for Payer: Cofinity Advantage |
$61.17
|
| Rate for Payer: Cofinity Commercial |
$75.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.91
|
| Rate for Payer: Healthscope Commercial |
$78.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.54
|
| Rate for Payer: PHP Commercial |
$74.28
|
| Rate for Payer: Priority Health SBD |
$55.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.80
|
| Rate for Payer: UHC Core |
$45.53
|
| Rate for Payer: UHC Exchange |
$34.34
|
| Rate for Payer: UMR Bronson Commercial |
$32.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.54
|
|
|
HC SKIN FULL GRFT FACE/GENIT/HF 20 SQ CM OR <
|
Facility
|
IP
|
$5,604.91
|
|
|
Service Code
|
CPT 15240
|
| Hospital Charge Code |
76100445
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,466.16 |
| Max. Negotiated Rate |
$5,044.42 |
| Rate for Payer: Aetna American Axle |
$3,643.19
|
| Rate for Payer: Aetna Commercial |
$4,764.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,643.19
|
| Rate for Payer: Cash Price |
$4,483.93
|
| Rate for Payer: Cofinity Advantage |
$3,923.44
|
| Rate for Payer: Cofinity Commercial |
$4,820.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,483.93
|
| Rate for Payer: Healthscope Commercial |
$5,044.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,923.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,203.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,764.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,203.68
|
| Rate for Payer: PHP Commercial |
$4,764.17
|
| Rate for Payer: Priority Health SBD |
$3,531.09
|
| Rate for Payer: UMR Bronson Commercial |
$2,466.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,203.68
|
|
|
HC SKIN FULL GRFT FACE/GENIT/HF 20 SQ CM OR <
|
Facility
|
OP
|
$5,604.91
|
|
|
Service Code
|
CPT 15240
|
| Hospital Charge Code |
76100445
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,075.21 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna American Axle |
$3,643.19
|
| Rate for Payer: Aetna Commercial |
$4,764.17
|
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,643.19
|
| 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 |
$3,603.07
|
| Rate for Payer: BCN Commercial |
$3,603.07
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Cash Price |
$4,483.93
|
| Rate for Payer: Cash Price |
$4,483.93
|
| Rate for Payer: Cash Price |
$4,483.93
|
| Rate for Payer: Cofinity Advantage |
$3,923.44
|
| Rate for Payer: Cofinity Commercial |
$4,820.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,483.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Healthscope Commercial |
$5,044.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,923.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,203.68
|
| 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 |
$4,764.17
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,203.68
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Commercial |
$4,764.17
|
| 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 |
$3,531.09
|
| 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) |
$3,643.19
|
| Rate for Payer: UHC Core |
$2,920.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Exchange |
$2,202.73
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: UMR Bronson Commercial |
$2,073.82
|
| Rate for Payer: VA VA |
$2,055.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,203.68
|
|
|
HC SKIN TAG REMOVAL UP TO 15
|
Facility
|
IP
|
$278.14
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
45000078
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$122.38 |
| Max. Negotiated Rate |
$250.33 |
| Rate for Payer: Aetna American Axle |
$180.79
|
| Rate for Payer: Aetna Commercial |
$236.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.79
|
| Rate for Payer: Cash Price |
$222.51
|
| Rate for Payer: Cofinity Advantage |
$194.70
|
| Rate for Payer: Cofinity Commercial |
$239.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.51
|
| Rate for Payer: Healthscope Commercial |
$250.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$194.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.60
|
| Rate for Payer: PHP Commercial |
$236.42
|
| Rate for Payer: Priority Health SBD |
$175.23
|
| Rate for Payer: UMR Bronson Commercial |
$122.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.60
|
|
|
HC SKIN TAG REMOVAL UP TO 15
|
Facility
|
OP
|
$278.14
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
45000078
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$102.91 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna American Axle |
$180.79
|
| Rate for Payer: Aetna Commercial |
$236.42
|
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$176.33
|
| Rate for Payer: BCN Commercial |
$176.33
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$222.51
|
| Rate for Payer: Cash Price |
$222.51
|
| Rate for Payer: Cash Price |
$222.51
|
| Rate for Payer: Cofinity Advantage |
$194.70
|
| Rate for Payer: Cofinity Commercial |
$239.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$250.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$194.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.60
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$209.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.42
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.60
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$236.42
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.50
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health SBD |
$175.23
|
| Rate for Payer: Priority Health Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.79
|
| Rate for Payer: UHC Core |
$144.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$109.31
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: UMR Bronson Commercial |
$102.91
|
| Rate for Payer: VA VA |
$199.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.60
|
|
|
HC SKIN TAGS REMOVAL EA ADDL 10 LESIONS
|
Facility
|
OP
|
$19.10
|
|
|
Service Code
|
CPT 11201
|
| Hospital Charge Code |
76100079
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$82.42 |
| Rate for Payer: Aetna American Axle |
$12.41
|
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: Aetna Medicare |
$9.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.41
|
| Rate for Payer: BCBS Complete |
$7.64
|
| Rate for Payer: BCBS Trust/PPO |
$82.42
|
| Rate for Payer: BCN Commercial |
$82.42
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cofinity Advantage |
$13.37
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: PHP Commercial |
$16.23
|
| Rate for Payer: Priority Health SBD |
$12.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.41
|
| Rate for Payer: UHC Core |
$9.95
|
| Rate for Payer: UHC Exchange |
$7.51
|
| Rate for Payer: UMR Bronson Commercial |
$7.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.32
|
|
|
HC SKIN TAGS REMOVAL EA ADDL 10 LESIONS
|
Facility
|
IP
|
$19.10
|
|
|
Service Code
|
CPT 11201
|
| Hospital Charge Code |
76100079
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$17.19 |
| Rate for Payer: Aetna American Axle |
$12.41
|
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.41
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cofinity Advantage |
$13.37
|
| Rate for Payer: Cofinity Commercial |
$16.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.28
|
| Rate for Payer: Healthscope Commercial |
$17.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.32
|
| Rate for Payer: PHP Commercial |
$16.23
|
| Rate for Payer: Priority Health SBD |
$12.03
|
| Rate for Payer: UMR Bronson Commercial |
$8.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.32
|
|
|
HC SLITTING OF PREPUCE, DORSAL/LAT, EXCEPT NEWBORN
|
Facility
|
IP
|
$2,819.98
|
|
|
Service Code
|
CPT 54001
|
| Hospital Charge Code |
76100250
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,240.79 |
| Max. Negotiated Rate |
$2,537.98 |
| Rate for Payer: Aetna American Axle |
$1,832.99
|
| Rate for Payer: Aetna Commercial |
$2,396.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,832.99
|
| Rate for Payer: Cash Price |
$2,255.98
|
| Rate for Payer: Cofinity Advantage |
$1,973.99
|
| Rate for Payer: Cofinity Commercial |
$2,425.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,255.98
|
| Rate for Payer: Healthscope Commercial |
$2,537.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,973.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,114.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,396.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,114.99
|
| Rate for Payer: PHP Commercial |
$2,396.98
|
| Rate for Payer: Priority Health SBD |
$1,776.59
|
| Rate for Payer: UMR Bronson Commercial |
$1,240.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,114.99
|
|
|
HC SLITTING OF PREPUCE, DORSAL/LAT, EXCEPT NEWBORN
|
Facility
|
OP
|
$2,819.98
|
|
|
Service Code
|
CPT 54001
|
| Hospital Charge Code |
76100250
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,043.39 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna American Axle |
$1,832.99
|
| Rate for Payer: Aetna Commercial |
$2,396.98
|
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,832.99
|
| 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 |
$2,255.98
|
| Rate for Payer: Cash Price |
$2,255.98
|
| Rate for Payer: Cash Price |
$2,255.98
|
| Rate for Payer: Cofinity Advantage |
$1,973.99
|
| Rate for Payer: Cofinity Commercial |
$2,425.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,255.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$2,537.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,973.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,114.99
|
| 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 |
$2,396.98
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,114.99
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$2,396.98
|
| 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 |
$1,776.59
|
| Rate for Payer: Priority Health Tiered Network |
$5,388.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,832.99
|
| Rate for Payer: UHC Core |
$1,469.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Exchange |
$1,108.25
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,043.39
|
| Rate for Payer: VA VA |
$2,082.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,114.99
|
|
|
HC SMALLPOX 0.3ML PERQ
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT 90622
|
| Hospital Charge Code |
63600213
|
|
Hospital Revenue Code
|
636
|
| Max. Negotiated Rate |
$0.03 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.01
|
| Rate for Payer: BCBS Complete |
$0.01
|
| Rate for Payer: BCBS MAPPO |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Advantage |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Mclaren Medicaid |
$0.01
|
| Rate for Payer: Mclaren Medicare |
$0.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.01
|
| Rate for Payer: Meridian Medicaid |
$0.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PACE Medicare |
$0.01
|
| Rate for Payer: PACE SWMI |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.03
|
| Rate for Payer: Priority Health Medicare |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: Priority Health Tiered Network |
$0.02
|
| Rate for Payer: Railroad Medicare Medicare |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Medicaid |
$0.01
|
| Rate for Payer: UHCCP Medicaid |
$0.01
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: VA VA |
$0.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC SMALLPOX 0.3ML PERQ
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT 90622
|
| Hospital Charge Code |
63600213
|
|
Hospital Revenue Code
|
636
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Advantage |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC SMALLPOX & MONKEYPOX 0.5ML SUBQ
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT 90611
|
| Hospital Charge Code |
63600212
|
|
Hospital Revenue Code
|
636
|
| Max. Negotiated Rate |
$859.30 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.01
|
| Rate for Payer: BCBS Complete |
$0.01
|
| Rate for Payer: BCBS MAPPO |
$0.01
|
| Rate for Payer: BCBS Trust/PPO |
$859.30
|
| Rate for Payer: BCN Commercial |
$859.30
|
| Rate for Payer: BCN Medicare Advantage |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Advantage |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Mclaren Medicaid |
$0.01
|
| Rate for Payer: Mclaren Medicare |
$0.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.01
|
| Rate for Payer: Meridian Medicaid |
$0.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PACE Medicare |
$0.01
|
| Rate for Payer: PACE SWMI |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.03
|
| Rate for Payer: Priority Health Medicare |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: Priority Health Tiered Network |
$0.02
|
| Rate for Payer: Railroad Medicare Medicare |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.02
|
| Rate for Payer: UHC Core |
$0.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.02
|
| Rate for Payer: UHC Medicaid |
$0.01
|
| Rate for Payer: UHCCP Medicaid |
$0.01
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: VA VA |
$0.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC SMALLPOX & MONKEYPOX 0.5ML SUBQ
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT 90611
|
| Hospital Charge Code |
63600212
|
|
Hospital Revenue Code
|
636
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Advantage |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC SMART NEEDLE
|
Facility
|
OP
|
$510.33
|
|
| Hospital Charge Code |
62200011
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$188.82 |
| Max. Negotiated Rate |
$459.30 |
| Rate for Payer: Aetna American Axle |
$331.71
|
| Rate for Payer: Aetna Commercial |
$433.78
|
| Rate for Payer: Aetna Medicare |
$255.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.71
|
| Rate for Payer: BCBS Complete |
$204.13
|
| Rate for Payer: Cash Price |
$408.26
|
| Rate for Payer: Cofinity Advantage |
$357.23
|
| Rate for Payer: Cofinity Commercial |
$438.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.26
|
| Rate for Payer: Healthscope Commercial |
$459.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$357.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$408.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.75
|
| Rate for Payer: PHP Commercial |
$433.78
|
| Rate for Payer: Priority Health SBD |
$321.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$331.71
|
| Rate for Payer: UHC Core |
$265.88
|
| Rate for Payer: UHC Exchange |
$200.56
|
| Rate for Payer: UMR Bronson Commercial |
$188.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.75
|
|
|
HC SMART NEEDLE
|
Facility
|
IP
|
$510.33
|
|
| Hospital Charge Code |
62200011
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$224.55 |
| Max. Negotiated Rate |
$459.30 |
| Rate for Payer: Aetna American Axle |
$331.71
|
| Rate for Payer: Aetna Commercial |
$433.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.71
|
| Rate for Payer: Cash Price |
$408.26
|
| Rate for Payer: Cofinity Advantage |
$357.23
|
| Rate for Payer: Cofinity Commercial |
$438.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.26
|
| Rate for Payer: Healthscope Commercial |
$459.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$357.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$382.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$433.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$382.75
|
| Rate for Payer: PHP Commercial |
$433.78
|
| Rate for Payer: Priority Health SBD |
$321.51
|
| Rate for Payer: UMR Bronson Commercial |
$224.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$382.75
|
|
|
HC SMITH SM ANTIBODY
|
Facility
|
IP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200165
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.78 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna American Axle |
$23.32
|
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.32
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Advantage |
$25.11
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: Priority Health SBD |
$22.60
|
| Rate for Payer: UMR Bronson Commercial |
$15.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
|
HC SMITH SM ANTIBODY
|
Facility
|
OP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200165
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna American Axle |
$23.32
|
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$20.73
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Advantage |
$25.11
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Mclaren Medicaid |
$17.93
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$26.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health SBD |
$22.60
|
| Rate for Payer: Priority Health Tiered Network |
$14.34
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.90
|
| Rate for Payer: UHC Core |
$26.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.93
|
| Rate for Payer: UHC Exchange |
$26.90
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: UMR Bronson Commercial |
$13.27
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
