|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
IP
|
$1,125.01
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$495.00 |
| Max. Negotiated Rate |
$1,012.51 |
| Rate for Payer: Aetna American Axle |
$731.26
|
| Rate for Payer: Aetna Commercial |
$956.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.26
|
| Rate for Payer: Cash Price |
$900.01
|
| Rate for Payer: Cofinity Commercial |
$787.51
|
| Rate for Payer: Cofinity Commercial |
$967.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$787.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.01
|
| Rate for Payer: Healthscope Commercial |
$1,012.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$787.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$843.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.26
|
| Rate for Payer: PHP Commercial |
$956.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.26
|
| Rate for Payer: Priority Health SBD |
$708.76
|
| Rate for Payer: UMR Bronson Commercial |
$495.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$843.76
|
|
|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
OP
|
$1,125.01
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$323.20 |
| Max. Negotiated Rate |
$1,697.33 |
| Rate for Payer: Aetna American Axle |
$731.26
|
| Rate for Payer: Aetna Commercial |
$956.26
|
| Rate for Payer: Aetna Medicare |
$627.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$753.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$753.73
|
| Rate for Payer: BCBS Complete |
$339.36
|
| Rate for Payer: BCBS MAPPO |
$602.98
|
| Rate for Payer: BCN Medicare Advantage |
$602.98
|
| Rate for Payer: Cash Price |
$900.01
|
| Rate for Payer: Cash Price |
$900.01
|
| Rate for Payer: Cofinity Commercial |
$967.51
|
| Rate for Payer: Cofinity Commercial |
$787.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$787.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.98
|
| Rate for Payer: Healthscope Commercial |
$1,012.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$787.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$843.76
|
| Rate for Payer: Mclaren Medicaid |
$323.20
|
| Rate for Payer: Mclaren Medicare |
$602.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.13
|
| Rate for Payer: Meridian Medicaid |
$339.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$693.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.26
|
| Rate for Payer: PACE Medicare |
$572.83
|
| Rate for Payer: PACE SWMI |
$602.98
|
| Rate for Payer: PHP Commercial |
$956.26
|
| Rate for Payer: PHP Medicare Advantage |
$602.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.26
|
| Rate for Payer: Priority Health Medicare |
$602.98
|
| Rate for Payer: Priority Health SBD |
$708.76
|
| Rate for Payer: Railroad Medicare Medicare |
$602.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,697.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$602.98
|
| Rate for Payer: UHC Exchange |
$1,152.36
|
| Rate for Payer: UHC Medicare Advantage |
$602.98
|
| Rate for Payer: UHCCP Medicaid |
$323.20
|
| Rate for Payer: UMR Bronson Commercial |
$416.25
|
| Rate for Payer: VA VA |
$602.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$843.76
|
|
|
HC REMOVAL TUNNELED INTRAPERI CATHETER
|
Facility
|
OP
|
$3,292.84
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
36100221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,218.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$2,140.35
|
| Rate for Payer: Aetna Commercial |
$2,798.91
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,140.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,634.27
|
| Rate for Payer: Cash Price |
$2,634.27
|
| Rate for Payer: Cofinity Commercial |
$2,831.84
|
| Rate for Payer: Cofinity Commercial |
$2,304.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,304.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,634.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$2,963.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,304.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,469.63
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,798.91
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$2,798.91
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,140.35
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,074.49
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$5,866.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,218.35
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,469.63
|
|
|
HC REMOVAL TUNNELED INTRAPERI CATHETER
|
Facility
|
IP
|
$3,292.84
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
36100221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,448.85 |
| Max. Negotiated Rate |
$2,963.56 |
| Rate for Payer: Aetna American Axle |
$2,140.35
|
| Rate for Payer: Aetna Commercial |
$2,798.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,140.35
|
| Rate for Payer: Cash Price |
$2,634.27
|
| Rate for Payer: Cofinity Commercial |
$2,304.99
|
| Rate for Payer: Cofinity Commercial |
$2,831.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,304.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,634.27
|
| Rate for Payer: Healthscope Commercial |
$2,963.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,304.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,469.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,798.91
|
| Rate for Payer: PHP Commercial |
$2,798.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,140.35
|
| Rate for Payer: Priority Health SBD |
$2,074.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,448.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,469.63
|
|
|
HC REMOVAL TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$983.98
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
36100054
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$323.20 |
| Max. Negotiated Rate |
$1,697.33 |
| Rate for Payer: Aetna American Axle |
$639.59
|
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: Aetna Medicare |
$627.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$753.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$753.73
|
| Rate for Payer: BCBS Complete |
$339.36
|
| Rate for Payer: BCBS MAPPO |
$602.98
|
| Rate for Payer: BCN Medicare Advantage |
$602.98
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Cofinity Commercial |
$688.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$688.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.98
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$688.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.99
|
| Rate for Payer: Mclaren Medicaid |
$323.20
|
| Rate for Payer: Mclaren Medicare |
$602.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.13
|
| Rate for Payer: Meridian Medicaid |
$339.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$693.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: PACE Medicare |
$572.83
|
| Rate for Payer: PACE SWMI |
$602.98
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: PHP Medicare Advantage |
$602.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health Medicare |
$602.98
|
| Rate for Payer: Priority Health SBD |
$619.91
|
| Rate for Payer: Railroad Medicare Medicare |
$602.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,697.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$602.98
|
| Rate for Payer: UHC Exchange |
$1,152.36
|
| Rate for Payer: UHC Medicare Advantage |
$602.98
|
| Rate for Payer: UHCCP Medicaid |
$323.20
|
| Rate for Payer: UMR Bronson Commercial |
$364.07
|
| Rate for Payer: VA VA |
$602.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.99
|
|
|
HC REMOVAL TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$983.98
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
36100054
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$432.95 |
| Max. Negotiated Rate |
$885.58 |
| Rate for Payer: Aetna American Axle |
$639.59
|
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.59
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$688.79
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$688.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$688.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health SBD |
$619.91
|
| Rate for Payer: UMR Bronson Commercial |
$432.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.99
|
|
|
HC REMOVAL W/ REINSERT DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$543.33
|
|
|
Service Code
|
CPT 11983
|
| Hospital Charge Code |
76100180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$239.07 |
| Max. Negotiated Rate |
$489.00 |
| Rate for Payer: Aetna American Axle |
$353.16
|
| Rate for Payer: Aetna Commercial |
$461.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.16
|
| Rate for Payer: Cash Price |
$434.66
|
| Rate for Payer: Cofinity Commercial |
$380.33
|
| Rate for Payer: Cofinity Commercial |
$467.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$380.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.66
|
| Rate for Payer: Healthscope Commercial |
$489.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$380.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$407.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.83
|
| Rate for Payer: PHP Commercial |
$461.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.16
|
| Rate for Payer: Priority Health SBD |
$342.30
|
| Rate for Payer: UMR Bronson Commercial |
$239.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$407.50
|
|
|
HC REMOVAL W/ REINSERT DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$543.33
|
|
|
Service Code
|
CPT 11983
|
| Hospital Charge Code |
76100180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$201.03 |
| Max. Negotiated Rate |
$1,095.50 |
| Rate for Payer: Aetna American Axle |
$353.16
|
| Rate for Payer: Aetna Commercial |
$461.83
|
| Rate for Payer: Aetna Medicare |
$404.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$486.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$486.48
|
| Rate for Payer: BCBS Complete |
$219.03
|
| Rate for Payer: BCBS MAPPO |
$389.18
|
| Rate for Payer: BCN Medicare Advantage |
$389.18
|
| Rate for Payer: Cash Price |
$434.66
|
| Rate for Payer: Cash Price |
$434.66
|
| Rate for Payer: Cofinity Commercial |
$467.26
|
| Rate for Payer: Cofinity Commercial |
$380.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$380.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.18
|
| Rate for Payer: Healthscope Commercial |
$489.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$380.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$407.50
|
| Rate for Payer: Mclaren Medicaid |
$208.60
|
| Rate for Payer: Mclaren Medicare |
$389.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$408.64
|
| Rate for Payer: Meridian Medicaid |
$219.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$447.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.83
|
| Rate for Payer: PACE Medicare |
$369.72
|
| Rate for Payer: PACE SWMI |
$389.18
|
| Rate for Payer: PHP Commercial |
$461.83
|
| Rate for Payer: PHP Medicare Advantage |
$389.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.16
|
| Rate for Payer: Priority Health Medicare |
$389.18
|
| Rate for Payer: Priority Health SBD |
$342.30
|
| Rate for Payer: Railroad Medicare Medicare |
$389.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,095.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.18
|
| Rate for Payer: UHC Exchange |
$743.76
|
| Rate for Payer: UHC Medicare Advantage |
$389.18
|
| Rate for Payer: UHCCP Medicaid |
$208.60
|
| Rate for Payer: UMR Bronson Commercial |
$201.03
|
| Rate for Payer: VA VA |
$389.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$407.50
|
|
|
HC REMOVE ADDITIONAL NAIL PLATE
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
76100329
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.24 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna American Axle |
$169.06
|
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: Aetna Medicare |
$130.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.06
|
| Rate for Payer: BCBS Complete |
$104.04
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$182.07
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$182.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health SBD |
$163.86
|
| Rate for Payer: UMR Bronson Commercial |
$96.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC REMOVE ADDITIONAL NAIL PLATE
|
Facility
|
IP
|
$260.10
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
76100329
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.44 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna American Axle |
$169.06
|
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.06
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$182.07
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$182.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health SBD |
$163.86
|
| Rate for Payer: UMR Bronson Commercial |
$114.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC REMOVE AND REPLACE INT URETERAL STENT
|
Facility
|
IP
|
$2,777.30
|
|
|
Service Code
|
CPT 50382
|
| Hospital Charge Code |
36100236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,222.01 |
| Max. Negotiated Rate |
$2,499.57 |
| Rate for Payer: Aetna American Axle |
$1,805.24
|
| Rate for Payer: Aetna Commercial |
$2,360.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,805.24
|
| Rate for Payer: Cash Price |
$2,221.84
|
| Rate for Payer: Cofinity Commercial |
$1,944.11
|
| Rate for Payer: Cofinity Commercial |
$2,388.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,944.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,221.84
|
| Rate for Payer: Healthscope Commercial |
$2,499.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,944.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,082.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,360.70
|
| Rate for Payer: PHP Commercial |
$2,360.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,805.24
|
| Rate for Payer: Priority Health SBD |
$1,749.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,222.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,082.97
|
|
|
HC REMOVE AND REPLACE INT URETERAL STENT
|
Facility
|
OP
|
$2,777.30
|
|
|
Service Code
|
CPT 50382
|
| Hospital Charge Code |
36100236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,027.60 |
| Max. Negotiated Rate |
$5,623.80 |
| Rate for Payer: Aetna American Axle |
$1,805.24
|
| Rate for Payer: Aetna Commercial |
$2,360.70
|
| Rate for Payer: Aetna Medicare |
$2,077.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,805.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$2,221.84
|
| Rate for Payer: Cash Price |
$2,221.84
|
| Rate for Payer: Cofinity Commercial |
$2,388.48
|
| Rate for Payer: Cofinity Commercial |
$1,944.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,944.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,221.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$2,499.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,944.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,082.97
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,360.70
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$2,360.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,805.24
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health SBD |
$1,749.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,623.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Exchange |
$3,818.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,070.86
|
| Rate for Payer: UMR Bronson Commercial |
$1,027.60
|
| Rate for Payer: VA VA |
$1,997.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,082.97
|
|
|
HC REMOVE BILIARY DRAIN CATH
|
Facility
|
IP
|
$861.15
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
36100494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$378.91 |
| Max. Negotiated Rate |
$775.03 |
| Rate for Payer: Aetna American Axle |
$559.75
|
| Rate for Payer: Aetna Commercial |
$731.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$559.75
|
| Rate for Payer: Cash Price |
$688.92
|
| Rate for Payer: Cofinity Commercial |
$602.80
|
| Rate for Payer: Cofinity Commercial |
$740.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$602.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$688.92
|
| Rate for Payer: Healthscope Commercial |
$775.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$602.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$645.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$731.98
|
| Rate for Payer: PHP Commercial |
$731.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$559.75
|
| Rate for Payer: Priority Health SBD |
$542.52
|
| Rate for Payer: UMR Bronson Commercial |
$378.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$645.86
|
|
|
HC REMOVE BILIARY DRAIN CATH
|
Facility
|
OP
|
$861.15
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
36100494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$318.63 |
| Max. Negotiated Rate |
$2,573.89 |
| Rate for Payer: Aetna American Axle |
$559.75
|
| Rate for Payer: Aetna Commercial |
$731.98
|
| Rate for Payer: Aetna Medicare |
$950.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$559.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,142.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,142.97
|
| Rate for Payer: BCBS Complete |
$514.61
|
| Rate for Payer: BCBS MAPPO |
$914.38
|
| Rate for Payer: BCN Medicare Advantage |
$914.38
|
| Rate for Payer: Cash Price |
$688.92
|
| Rate for Payer: Cash Price |
$688.92
|
| Rate for Payer: Cofinity Commercial |
$740.59
|
| Rate for Payer: Cofinity Commercial |
$602.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$602.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$688.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$914.38
|
| Rate for Payer: Healthscope Commercial |
$775.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$602.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$645.86
|
| Rate for Payer: Mclaren Medicaid |
$490.11
|
| Rate for Payer: Mclaren Medicare |
$914.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.10
|
| Rate for Payer: Meridian Medicaid |
$514.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,051.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$731.98
|
| Rate for Payer: PACE Medicare |
$868.66
|
| Rate for Payer: PACE SWMI |
$914.38
|
| Rate for Payer: PHP Commercial |
$731.98
|
| Rate for Payer: PHP Medicare Advantage |
$914.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$490.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$559.75
|
| Rate for Payer: Priority Health Medicare |
$914.38
|
| Rate for Payer: Priority Health SBD |
$542.52
|
| Rate for Payer: Railroad Medicare Medicare |
$914.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,573.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$914.38
|
| Rate for Payer: UHC Exchange |
$1,747.47
|
| Rate for Payer: UHC Medicare Advantage |
$914.38
|
| Rate for Payer: UHCCP Medicaid |
$490.11
|
| Rate for Payer: UMR Bronson Commercial |
$318.63
|
| Rate for Payer: VA VA |
$914.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$645.86
|
|
|
HC REMOVE/BIVALVE ARM/LEG
|
Facility
|
OP
|
$173.78
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
70000015
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$64.30 |
| Max. Negotiated Rate |
$729.09 |
| Rate for Payer: Aetna American Axle |
$112.96
|
| Rate for Payer: Aetna Commercial |
$147.71
|
| Rate for Payer: Aetna Medicare |
$269.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.76
|
| Rate for Payer: BCBS Complete |
$145.77
|
| Rate for Payer: BCBS MAPPO |
$259.01
|
| Rate for Payer: BCN Medicare Advantage |
$259.01
|
| Rate for Payer: Cash Price |
$139.02
|
| Rate for Payer: Cash Price |
$139.02
|
| Rate for Payer: Cofinity Commercial |
$149.45
|
| Rate for Payer: Cofinity Commercial |
$121.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$121.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$259.01
|
| Rate for Payer: Healthscope Commercial |
$156.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.34
|
| Rate for Payer: Mclaren Medicaid |
$138.83
|
| Rate for Payer: Mclaren Medicare |
$259.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.96
|
| Rate for Payer: Meridian Medicaid |
$145.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.71
|
| Rate for Payer: PACE Medicare |
$246.06
|
| Rate for Payer: PACE SWMI |
$259.01
|
| Rate for Payer: PHP Commercial |
$147.71
|
| Rate for Payer: PHP Medicare Advantage |
$259.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.96
|
| Rate for Payer: Priority Health Medicare |
$259.01
|
| Rate for Payer: Priority Health SBD |
$109.48
|
| Rate for Payer: Railroad Medicare Medicare |
$259.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$729.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.01
|
| Rate for Payer: UHC Exchange |
$494.99
|
| Rate for Payer: UHC Medicare Advantage |
$259.01
|
| Rate for Payer: UHCCP Medicaid |
$138.83
|
| Rate for Payer: UMR Bronson Commercial |
$64.30
|
| Rate for Payer: VA VA |
$259.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.34
|
|
|
HC REMOVE/BIVALVE ARM/LEG
|
Facility
|
IP
|
$173.78
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
70000015
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$76.46 |
| Max. Negotiated Rate |
$156.40 |
| Rate for Payer: Aetna American Axle |
$112.96
|
| Rate for Payer: Aetna Commercial |
$147.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.96
|
| Rate for Payer: Cash Price |
$139.02
|
| Rate for Payer: Cofinity Commercial |
$121.65
|
| Rate for Payer: Cofinity Commercial |
$149.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$121.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.02
|
| Rate for Payer: Healthscope Commercial |
$156.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.71
|
| Rate for Payer: PHP Commercial |
$147.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.96
|
| Rate for Payer: Priority Health SBD |
$109.48
|
| Rate for Payer: UMR Bronson Commercial |
$76.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.34
|
|
|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
OP
|
$193.91
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$71.75 |
| Max. Negotiated Rate |
$729.09 |
| Rate for Payer: Aetna American Axle |
$126.04
|
| Rate for Payer: Aetna Commercial |
$164.82
|
| Rate for Payer: Aetna Medicare |
$269.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.76
|
| Rate for Payer: BCBS Complete |
$145.77
|
| Rate for Payer: BCBS MAPPO |
$259.01
|
| Rate for Payer: BCN Medicare Advantage |
$259.01
|
| Rate for Payer: Cash Price |
$155.13
|
| Rate for Payer: Cash Price |
$155.13
|
| Rate for Payer: Cofinity Commercial |
$166.76
|
| Rate for Payer: Cofinity Commercial |
$135.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$135.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$259.01
|
| Rate for Payer: Healthscope Commercial |
$174.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.43
|
| Rate for Payer: Mclaren Medicaid |
$138.83
|
| Rate for Payer: Mclaren Medicare |
$259.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.96
|
| Rate for Payer: Meridian Medicaid |
$145.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.82
|
| Rate for Payer: PACE Medicare |
$246.06
|
| Rate for Payer: PACE SWMI |
$259.01
|
| Rate for Payer: PHP Commercial |
$164.82
|
| Rate for Payer: PHP Medicare Advantage |
$259.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.04
|
| Rate for Payer: Priority Health Medicare |
$259.01
|
| Rate for Payer: Priority Health SBD |
$122.16
|
| Rate for Payer: Railroad Medicare Medicare |
$259.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$729.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.01
|
| Rate for Payer: UHC Exchange |
$494.99
|
| Rate for Payer: UHC Medicare Advantage |
$259.01
|
| Rate for Payer: UHCCP Medicaid |
$138.83
|
| Rate for Payer: UMR Bronson Commercial |
$71.75
|
| Rate for Payer: VA VA |
$259.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.43
|
|
|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
IP
|
$193.91
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$85.32 |
| Max. Negotiated Rate |
$174.52 |
| Rate for Payer: Aetna American Axle |
$126.04
|
| Rate for Payer: Aetna Commercial |
$164.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.04
|
| Rate for Payer: Cash Price |
$155.13
|
| Rate for Payer: Cofinity Commercial |
$135.74
|
| Rate for Payer: Cofinity Commercial |
$166.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$135.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.13
|
| Rate for Payer: Healthscope Commercial |
$174.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.82
|
| Rate for Payer: PHP Commercial |
$164.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.04
|
| Rate for Payer: Priority Health SBD |
$122.16
|
| Rate for Payer: UMR Bronson Commercial |
$85.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.43
|
|
|
HC REMOVE/BIVALVE SPICA
|
Facility
|
OP
|
$352.09
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$130.27 |
| Max. Negotiated Rate |
$729.09 |
| Rate for Payer: Aetna American Axle |
$228.86
|
| Rate for Payer: Aetna Commercial |
$299.28
|
| Rate for Payer: Aetna Medicare |
$269.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$323.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$323.76
|
| Rate for Payer: BCBS Complete |
$145.77
|
| Rate for Payer: BCBS MAPPO |
$259.01
|
| Rate for Payer: BCN Medicare Advantage |
$259.01
|
| Rate for Payer: Cash Price |
$281.67
|
| Rate for Payer: Cash Price |
$281.67
|
| Rate for Payer: Cofinity Commercial |
$302.80
|
| Rate for Payer: Cofinity Commercial |
$246.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$246.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$259.01
|
| Rate for Payer: Healthscope Commercial |
$316.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.07
|
| Rate for Payer: Mclaren Medicaid |
$138.83
|
| Rate for Payer: Mclaren Medicare |
$259.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$271.96
|
| Rate for Payer: Meridian Medicaid |
$145.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$297.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.28
|
| Rate for Payer: PACE Medicare |
$246.06
|
| Rate for Payer: PACE SWMI |
$259.01
|
| Rate for Payer: PHP Commercial |
$299.28
|
| Rate for Payer: PHP Medicare Advantage |
$259.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.86
|
| Rate for Payer: Priority Health Medicare |
$259.01
|
| Rate for Payer: Priority Health SBD |
$221.82
|
| Rate for Payer: Railroad Medicare Medicare |
$259.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$729.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.01
|
| Rate for Payer: UHC Exchange |
$494.99
|
| Rate for Payer: UHC Medicare Advantage |
$259.01
|
| Rate for Payer: UHCCP Medicaid |
$138.83
|
| Rate for Payer: UMR Bronson Commercial |
$130.27
|
| Rate for Payer: VA VA |
$259.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.07
|
|
|
HC REMOVE/BIVALVE SPICA
|
Facility
|
IP
|
$352.09
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$154.92 |
| Max. Negotiated Rate |
$316.88 |
| Rate for Payer: Aetna American Axle |
$228.86
|
| Rate for Payer: Aetna Commercial |
$299.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.86
|
| Rate for Payer: Cash Price |
$281.67
|
| Rate for Payer: Cofinity Commercial |
$246.46
|
| Rate for Payer: Cofinity Commercial |
$302.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$246.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.67
|
| Rate for Payer: Healthscope Commercial |
$316.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.28
|
| Rate for Payer: PHP Commercial |
$299.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.86
|
| Rate for Payer: Priority Health SBD |
$221.82
|
| Rate for Payer: UMR Bronson Commercial |
$154.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.07
|
|
|
HC REMOVE CERUMEN INSTR BILAT
|
Facility
|
OP
|
$213.35
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$192.01 |
| Rate for Payer: Aetna American Axle |
$138.68
|
| Rate for Payer: Aetna Commercial |
$181.35
|
| Rate for Payer: Aetna Medicare |
$60.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$170.68
|
| Rate for Payer: Cash Price |
$170.68
|
| Rate for Payer: Cofinity Commercial |
$183.48
|
| Rate for Payer: Cofinity Commercial |
$149.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$192.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.01
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.35
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$181.35
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.68
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health SBD |
$134.41
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$110.71
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: UMR Bronson Commercial |
$78.94
|
| Rate for Payer: VA VA |
$57.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.01
|
|
|
HC REMOVE CERUMEN INSTR BILAT
|
Facility
|
IP
|
$213.35
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$93.87 |
| Max. Negotiated Rate |
$192.01 |
| Rate for Payer: Aetna American Axle |
$138.68
|
| Rate for Payer: Aetna Commercial |
$181.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.68
|
| Rate for Payer: Cash Price |
$170.68
|
| Rate for Payer: Cofinity Commercial |
$149.34
|
| Rate for Payer: Cofinity Commercial |
$183.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.68
|
| Rate for Payer: Healthscope Commercial |
$192.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.35
|
| Rate for Payer: PHP Commercial |
$181.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.68
|
| Rate for Payer: Priority Health SBD |
$134.41
|
| Rate for Payer: UMR Bronson Commercial |
$93.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.01
|
|
|
HC REMOVE CERUMEN INSTR UNILATERAL
|
Facility
|
OP
|
$142.83
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$163.07 |
| Rate for Payer: Aetna American Axle |
$92.84
|
| Rate for Payer: Aetna Commercial |
$121.41
|
| Rate for Payer: Aetna Medicare |
$60.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$114.26
|
| Rate for Payer: Cash Price |
$114.26
|
| Rate for Payer: Cofinity Commercial |
$99.98
|
| Rate for Payer: Cofinity Commercial |
$122.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$99.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$128.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.12
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.41
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$121.41
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.84
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health SBD |
$89.98
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$110.71
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: UMR Bronson Commercial |
$52.85
|
| Rate for Payer: VA VA |
$57.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.12
|
|
|
HC REMOVE CERUMEN INSTR UNILATERAL
|
Facility
|
IP
|
$142.83
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000017
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.85 |
| Max. Negotiated Rate |
$128.55 |
| Rate for Payer: Aetna American Axle |
$92.84
|
| Rate for Payer: Aetna Commercial |
$121.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.84
|
| Rate for Payer: Cash Price |
$114.26
|
| Rate for Payer: Cofinity Commercial |
$122.83
|
| Rate for Payer: Cofinity Commercial |
$99.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$99.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.26
|
| Rate for Payer: Healthscope Commercial |
$128.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.41
|
| Rate for Payer: PHP Commercial |
$121.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.84
|
| Rate for Payer: Priority Health SBD |
$89.98
|
| Rate for Payer: UMR Bronson Commercial |
$62.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.12
|
|
|
HC REMOVE CERUMEN IRR OR LAVAGE BILAT
|
Facility
|
IP
|
$213.35
|
|
|
Service Code
|
CPT 69209
|
| Hospital Charge Code |
45000098
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$93.87 |
| Max. Negotiated Rate |
$192.01 |
| Rate for Payer: Aetna American Axle |
$138.68
|
| Rate for Payer: Aetna Commercial |
$181.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.68
|
| Rate for Payer: Cash Price |
$170.68
|
| Rate for Payer: Cofinity Commercial |
$149.34
|
| Rate for Payer: Cofinity Commercial |
$183.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.68
|
| Rate for Payer: Healthscope Commercial |
$192.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.35
|
| Rate for Payer: PHP Commercial |
$181.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.68
|
| Rate for Payer: Priority Health SBD |
$134.41
|
| Rate for Payer: UMR Bronson Commercial |
$93.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.01
|
|
