|
HC SPLINT FINGER STATIC
|
Facility
|
OP
|
$143.04
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
43000004
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$52.92 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna American Axle |
$92.98
|
| Rate for Payer: Aetna Commercial |
$121.58
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$91.00
|
| Rate for Payer: BCN Commercial |
$91.00
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$114.43
|
| Rate for Payer: Cash Price |
$114.43
|
| Rate for Payer: Cash Price |
$114.43
|
| Rate for Payer: Cash Price |
$114.43
|
| Rate for Payer: Cofinity Advantage |
$100.13
|
| Rate for Payer: Cofinity Commercial |
$123.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$128.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$100.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.28
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.58
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.28
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$121.58
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$90.12
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.98
|
| Rate for Payer: UHC Core |
$74.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$56.21
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$52.92
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.28
|
|
|
HC SPLINT FINGER STATIC
|
Facility
|
IP
|
$143.04
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
43000004
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$62.94 |
| Max. Negotiated Rate |
$128.74 |
| Rate for Payer: Aetna American Axle |
$92.98
|
| Rate for Payer: Aetna Commercial |
$121.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.98
|
| Rate for Payer: Cash Price |
$114.43
|
| Rate for Payer: Cofinity Advantage |
$100.13
|
| Rate for Payer: Cofinity Commercial |
$123.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.43
|
| Rate for Payer: Healthscope Commercial |
$128.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$100.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$107.28
|
| Rate for Payer: PHP Commercial |
$121.58
|
| Rate for Payer: Priority Health SBD |
$90.12
|
| Rate for Payer: UMR Bronson Commercial |
$62.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.28
|
|
|
HC SPLINT LONG ARM
|
Facility
|
OP
|
$404.91
|
|
|
Service Code
|
CPT 29105
|
| Hospital Charge Code |
70000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$84.68 |
| Max. Negotiated Rate |
$523.62 |
| Rate for Payer: Aetna American Axle |
$263.19
|
| Rate for Payer: Aetna Commercial |
$344.17
|
| Rate for Payer: Aetna Medicare |
$168.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$202.40
|
| Rate for Payer: BCBS Complete |
$88.93
|
| Rate for Payer: BCBS MAPPO |
$161.92
|
| Rate for Payer: BCBS Trust/PPO |
$149.66
|
| Rate for Payer: BCN Commercial |
$149.66
|
| Rate for Payer: BCN Medicare Advantage |
$161.92
|
| Rate for Payer: Cash Price |
$323.93
|
| Rate for Payer: Cash Price |
$323.93
|
| Rate for Payer: Cash Price |
$323.93
|
| Rate for Payer: Cofinity Advantage |
$283.44
|
| Rate for Payer: Cofinity Commercial |
$348.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.92
|
| Rate for Payer: Healthscope Commercial |
$364.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$283.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.68
|
| Rate for Payer: Mclaren Medicaid |
$161.92
|
| Rate for Payer: Mclaren Medicare |
$161.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.02
|
| Rate for Payer: Meridian Medicaid |
$170.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$344.17
|
| Rate for Payer: Nomi Health Commercial |
$485.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.68
|
| Rate for Payer: PACE Medicare |
$153.82
|
| Rate for Payer: PACE SWMI |
$161.92
|
| Rate for Payer: PHP Commercial |
$344.17
|
| Rate for Payer: PHP Medicare Advantage |
$161.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$523.62
|
| Rate for Payer: Priority Health Medicare |
$161.92
|
| Rate for Payer: Priority Health SBD |
$255.09
|
| Rate for Payer: Priority Health Tiered Network |
$418.90
|
| Rate for Payer: Railroad Medicare Medicare |
$161.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.19
|
| Rate for Payer: UHC Core |
$210.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$161.92
|
| Rate for Payer: UHC Exchange |
$159.13
|
| Rate for Payer: UHC Medicaid |
$84.68
|
| Rate for Payer: UHCCP Medicaid |
$84.68
|
| Rate for Payer: UMR Bronson Commercial |
$149.82
|
| Rate for Payer: VA VA |
$161.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.68
|
|
|
HC SPLINT LONG ARM
|
Facility
|
IP
|
$404.91
|
|
|
Service Code
|
CPT 29105
|
| Hospital Charge Code |
70000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$178.16 |
| Max. Negotiated Rate |
$364.42 |
| Rate for Payer: Aetna American Axle |
$263.19
|
| Rate for Payer: Aetna Commercial |
$344.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.19
|
| Rate for Payer: Cash Price |
$323.93
|
| Rate for Payer: Cofinity Advantage |
$283.44
|
| Rate for Payer: Cofinity Commercial |
$348.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.93
|
| Rate for Payer: Healthscope Commercial |
$364.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$283.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$344.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.68
|
| Rate for Payer: PHP Commercial |
$344.17
|
| Rate for Payer: Priority Health SBD |
$255.09
|
| Rate for Payer: UMR Bronson Commercial |
$178.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.68
|
|
|
HC SPLINT LONG LEG
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 29505
|
| Hospital Charge Code |
70000012
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$84.68 |
| Max. Negotiated Rate |
$523.62 |
| Rate for Payer: Aetna American Axle |
$236.94
|
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna Medicare |
$168.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$202.40
|
| Rate for Payer: BCBS Complete |
$88.93
|
| Rate for Payer: BCBS MAPPO |
$161.92
|
| Rate for Payer: BCBS Trust/PPO |
$159.10
|
| Rate for Payer: BCN Commercial |
$159.10
|
| Rate for Payer: BCN Medicare Advantage |
$161.92
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Advantage |
$255.17
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.92
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$255.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Mclaren Medicaid |
$161.92
|
| Rate for Payer: Mclaren Medicare |
$161.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.02
|
| Rate for Payer: Meridian Medicaid |
$170.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$485.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PACE Medicare |
$153.82
|
| Rate for Payer: PACE SWMI |
$161.92
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: PHP Medicare Advantage |
$161.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$523.62
|
| Rate for Payer: Priority Health Medicare |
$161.92
|
| Rate for Payer: Priority Health SBD |
$229.65
|
| Rate for Payer: Priority Health Tiered Network |
$418.90
|
| Rate for Payer: Railroad Medicare Medicare |
$161.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.94
|
| Rate for Payer: UHC Core |
$189.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$161.92
|
| Rate for Payer: UHC Exchange |
$143.26
|
| Rate for Payer: UHC Medicaid |
$84.68
|
| Rate for Payer: UHCCP Medicaid |
$84.68
|
| Rate for Payer: UMR Bronson Commercial |
$134.88
|
| Rate for Payer: VA VA |
$161.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC SPLINT LONG LEG
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 29505
|
| Hospital Charge Code |
70000012
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$160.39 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna American Axle |
$236.94
|
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.94
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Advantage |
$255.17
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$255.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: Priority Health SBD |
$229.65
|
| Rate for Payer: UMR Bronson Commercial |
$160.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC SPLINT SHORT ARM DYNAMIC
|
Facility
|
OP
|
$563.37
|
|
|
Service Code
|
CPT 29126
|
| Hospital Charge Code |
43000003
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$507.03 |
| Rate for Payer: Aetna American Axle |
$366.19
|
| Rate for Payer: Aetna Commercial |
$478.86
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$112.86
|
| Rate for Payer: BCN Commercial |
$112.86
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$450.70
|
| Rate for Payer: Cash Price |
$450.70
|
| Rate for Payer: Cash Price |
$450.70
|
| Rate for Payer: Cash Price |
$450.70
|
| Rate for Payer: Cofinity Advantage |
$394.36
|
| Rate for Payer: Cofinity Commercial |
$484.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$450.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$507.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$394.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.53
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.86
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$422.53
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$478.86
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$354.92
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.19
|
| Rate for Payer: UHC Core |
$293.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$221.40
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$208.45
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.53
|
|
|
HC SPLINT SHORT ARM DYNAMIC
|
Facility
|
IP
|
$563.37
|
|
|
Service Code
|
CPT 29126
|
| Hospital Charge Code |
43000003
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$247.88 |
| Max. Negotiated Rate |
$507.03 |
| Rate for Payer: Aetna American Axle |
$366.19
|
| Rate for Payer: Aetna Commercial |
$478.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.19
|
| Rate for Payer: Cash Price |
$450.70
|
| Rate for Payer: Cofinity Advantage |
$394.36
|
| Rate for Payer: Cofinity Commercial |
$484.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$450.70
|
| Rate for Payer: Healthscope Commercial |
$507.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$394.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$422.53
|
| Rate for Payer: PHP Commercial |
$478.86
|
| Rate for Payer: Priority Health SBD |
$354.92
|
| Rate for Payer: UMR Bronson Commercial |
$247.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.53
|
|
|
HC SPLINT SHORT ARM STATIC
|
Facility
|
IP
|
$244.08
|
|
|
Service Code
|
CPT 29125
|
| Hospital Charge Code |
43000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$107.40 |
| Max. Negotiated Rate |
$219.67 |
| Rate for Payer: Aetna American Axle |
$158.65
|
| Rate for Payer: Aetna Commercial |
$207.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.65
|
| Rate for Payer: Cash Price |
$195.26
|
| Rate for Payer: Cofinity Advantage |
$170.86
|
| Rate for Payer: Cofinity Commercial |
$209.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.26
|
| Rate for Payer: Healthscope Commercial |
$219.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.06
|
| Rate for Payer: PHP Commercial |
$207.47
|
| Rate for Payer: Priority Health SBD |
$153.77
|
| Rate for Payer: UMR Bronson Commercial |
$107.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.06
|
|
|
HC SPLINT SHORT ARM STATIC
|
Facility
|
OP
|
$244.08
|
|
|
Service Code
|
CPT 29125
|
| Hospital Charge Code |
43000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna American Axle |
$158.65
|
| Rate for Payer: Aetna Commercial |
$207.47
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$120.88
|
| Rate for Payer: BCN Commercial |
$120.88
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$195.26
|
| Rate for Payer: Cash Price |
$195.26
|
| Rate for Payer: Cash Price |
$195.26
|
| Rate for Payer: Cofinity Advantage |
$170.86
|
| Rate for Payer: Cofinity Commercial |
$209.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$219.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.06
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.47
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.06
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$207.47
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$153.77
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.65
|
| Rate for Payer: UHC Core |
$127.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$95.92
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$90.31
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.06
|
|
|
HC SPLINT SHORT LEG
|
Facility
|
IP
|
$385.31
|
|
|
Service Code
|
CPT 29515
|
| Hospital Charge Code |
70000013
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$169.54 |
| Max. Negotiated Rate |
$346.78 |
| Rate for Payer: Aetna American Axle |
$250.45
|
| Rate for Payer: Aetna Commercial |
$327.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.45
|
| Rate for Payer: Cash Price |
$308.25
|
| Rate for Payer: Cofinity Advantage |
$269.72
|
| Rate for Payer: Cofinity Commercial |
$331.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.25
|
| Rate for Payer: Healthscope Commercial |
$346.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$288.98
|
| Rate for Payer: PHP Commercial |
$327.51
|
| Rate for Payer: Priority Health SBD |
$242.75
|
| Rate for Payer: UMR Bronson Commercial |
$169.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.98
|
|
|
HC SPLINT SHORT LEG
|
Facility
|
OP
|
$385.31
|
|
|
Service Code
|
CPT 29515
|
| Hospital Charge Code |
70000013
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$84.68 |
| Max. Negotiated Rate |
$523.62 |
| Rate for Payer: Aetna American Axle |
$250.45
|
| Rate for Payer: Aetna Commercial |
$327.51
|
| Rate for Payer: Aetna Medicare |
$168.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$202.40
|
| Rate for Payer: BCBS Complete |
$88.93
|
| Rate for Payer: BCBS MAPPO |
$161.92
|
| Rate for Payer: BCBS Trust/PPO |
$133.36
|
| Rate for Payer: BCN Commercial |
$133.36
|
| Rate for Payer: BCN Medicare Advantage |
$161.92
|
| Rate for Payer: Cash Price |
$308.25
|
| Rate for Payer: Cash Price |
$308.25
|
| Rate for Payer: Cash Price |
$308.25
|
| Rate for Payer: Cofinity Advantage |
$269.72
|
| Rate for Payer: Cofinity Commercial |
$331.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.92
|
| Rate for Payer: Healthscope Commercial |
$346.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.98
|
| Rate for Payer: Mclaren Medicaid |
$161.92
|
| Rate for Payer: Mclaren Medicare |
$161.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.02
|
| Rate for Payer: Meridian Medicaid |
$170.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.51
|
| Rate for Payer: Nomi Health Commercial |
$485.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$288.98
|
| Rate for Payer: PACE Medicare |
$153.82
|
| Rate for Payer: PACE SWMI |
$161.92
|
| Rate for Payer: PHP Commercial |
$327.51
|
| Rate for Payer: PHP Medicare Advantage |
$161.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$84.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$523.62
|
| Rate for Payer: Priority Health Medicare |
$161.92
|
| Rate for Payer: Priority Health SBD |
$242.75
|
| Rate for Payer: Priority Health Tiered Network |
$418.90
|
| Rate for Payer: Railroad Medicare Medicare |
$161.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.45
|
| Rate for Payer: UHC Core |
$200.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$161.92
|
| Rate for Payer: UHC Exchange |
$151.43
|
| Rate for Payer: UHC Medicaid |
$84.68
|
| Rate for Payer: UHCCP Medicaid |
$84.68
|
| Rate for Payer: UMR Bronson Commercial |
$142.56
|
| Rate for Payer: VA VA |
$161.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.98
|
|
|
HC SPLINT SUPPLIES MISC
|
Facility
|
OP
|
$76.50
|
|
| Hospital Charge Code |
27200394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.30 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna American Axle |
$49.73
|
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: Aetna Medicare |
$38.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.73
|
| Rate for Payer: BCBS Complete |
$30.60
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Advantage |
$53.55
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.38
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: Priority Health SBD |
$48.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.73
|
| Rate for Payer: UHC Core |
$39.86
|
| Rate for Payer: UHC Exchange |
$30.06
|
| Rate for Payer: UMR Bronson Commercial |
$28.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC SPLINT SUPPLIES MISC
|
Facility
|
IP
|
$76.50
|
|
| Hospital Charge Code |
27200394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.66 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna American Axle |
$49.73
|
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.73
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Advantage |
$53.55
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.38
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: Priority Health SBD |
$48.20
|
| Rate for Payer: UMR Bronson Commercial |
$33.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC SPLITTING BLOOD/BLOOD PROD EA UNIT
|
Facility
|
OP
|
$99.04
|
|
|
Service Code
|
CPT 86985
|
| Hospital Charge Code |
39000029
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$14.16 |
| Max. Negotiated Rate |
$548.99 |
| Rate for Payer: Aetna American Axle |
$64.38
|
| Rate for Payer: Aetna Commercial |
$84.18
|
| Rate for Payer: Aetna Medicare |
$176.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.20
|
| Rate for Payer: BCBS Complete |
$93.23
|
| Rate for Payer: BCBS MAPPO |
$169.76
|
| Rate for Payer: BCBS Trust/PPO |
$14.16
|
| Rate for Payer: BCN Commercial |
$14.16
|
| Rate for Payer: BCN Medicare Advantage |
$169.76
|
| Rate for Payer: Cash Price |
$79.23
|
| Rate for Payer: Cash Price |
$79.23
|
| Rate for Payer: Cofinity Advantage |
$69.33
|
| Rate for Payer: Cofinity Commercial |
$85.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.76
|
| Rate for Payer: Healthscope Commercial |
$89.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.28
|
| Rate for Payer: Mclaren Medicaid |
$169.76
|
| Rate for Payer: Mclaren Medicare |
$169.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.25
|
| Rate for Payer: Meridian Medicaid |
$178.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$186.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.18
|
| Rate for Payer: Nomi Health Commercial |
$509.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.28
|
| Rate for Payer: PACE Medicare |
$161.27
|
| Rate for Payer: PACE SWMI |
$169.76
|
| Rate for Payer: PHP Commercial |
$84.18
|
| Rate for Payer: PHP Medicare Advantage |
$169.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$548.99
|
| Rate for Payer: Priority Health Medicare |
$169.76
|
| Rate for Payer: Priority Health SBD |
$62.40
|
| Rate for Payer: Priority Health Tiered Network |
$439.19
|
| Rate for Payer: Railroad Medicare Medicare |
$169.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.38
|
| Rate for Payer: UHC Core |
$51.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$169.76
|
| Rate for Payer: UHC Exchange |
$38.92
|
| Rate for Payer: UHC Medicaid |
$88.78
|
| Rate for Payer: UHCCP Medicaid |
$88.78
|
| Rate for Payer: UMR Bronson Commercial |
$36.64
|
| Rate for Payer: VA VA |
$169.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.28
|
|
|
HC SPLITTING BLOOD/BLOOD PROD EA UNIT
|
Facility
|
IP
|
$99.04
|
|
|
Service Code
|
CPT 86985
|
| Hospital Charge Code |
39000029
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$43.58 |
| Max. Negotiated Rate |
$89.14 |
| Rate for Payer: Aetna American Axle |
$64.38
|
| Rate for Payer: Aetna Commercial |
$84.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.38
|
| Rate for Payer: Cash Price |
$79.23
|
| Rate for Payer: Cofinity Advantage |
$69.33
|
| Rate for Payer: Cofinity Commercial |
$85.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.23
|
| Rate for Payer: Healthscope Commercial |
$89.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.28
|
| Rate for Payer: PHP Commercial |
$84.18
|
| Rate for Payer: Priority Health SBD |
$62.40
|
| Rate for Payer: UMR Bronson Commercial |
$43.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.28
|
|
|
HC SPORE CHECK
|
Facility
|
OP
|
$23.73
|
|
| Hospital Charge Code |
30600180
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.78 |
| Max. Negotiated Rate |
$21.36 |
| Rate for Payer: Aetna American Axle |
$15.42
|
| Rate for Payer: Aetna Commercial |
$20.17
|
| Rate for Payer: Aetna Medicare |
$11.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.42
|
| Rate for Payer: BCBS Complete |
$9.49
|
| Rate for Payer: Cash Price |
$18.98
|
| Rate for Payer: Cofinity Advantage |
$16.61
|
| Rate for Payer: Cofinity Commercial |
$20.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.98
|
| Rate for Payer: Healthscope Commercial |
$21.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.80
|
| Rate for Payer: PHP Commercial |
$20.17
|
| Rate for Payer: Priority Health SBD |
$14.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.87
|
| Rate for Payer: UHC Core |
$11.87
|
| Rate for Payer: UHC Exchange |
$11.87
|
| Rate for Payer: UMR Bronson Commercial |
$8.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.80
|
|
|
HC SPORE CHECK
|
Facility
|
IP
|
$23.73
|
|
| Hospital Charge Code |
30600180
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.44 |
| Max. Negotiated Rate |
$21.36 |
| Rate for Payer: Aetna American Axle |
$15.42
|
| Rate for Payer: Aetna Commercial |
$20.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.42
|
| Rate for Payer: Cash Price |
$18.98
|
| Rate for Payer: Cofinity Advantage |
$16.61
|
| Rate for Payer: Cofinity Commercial |
$20.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.98
|
| Rate for Payer: Healthscope Commercial |
$21.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.80
|
| Rate for Payer: PHP Commercial |
$20.17
|
| Rate for Payer: Priority Health SBD |
$14.95
|
| Rate for Payer: UMR Bronson Commercial |
$10.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.80
|
|
|
HC SP REMOVAL IVC FILTER
|
Facility
|
OP
|
$4,942.72
|
|
|
Service Code
|
CPT 37193
|
| Hospital Charge Code |
36100353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$3,212.77
|
| Rate for Payer: Aetna Commercial |
$4,201.31
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,212.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,556.75
|
| Rate for Payer: BCN Commercial |
$3,556.75
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,954.18
|
| Rate for Payer: Cash Price |
$3,954.18
|
| Rate for Payer: Cash Price |
$3,954.18
|
| Rate for Payer: Cofinity Advantage |
$3,459.90
|
| Rate for Payer: Cofinity Commercial |
$4,250.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,954.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$4,448.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,459.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,707.04
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,201.31
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,707.04
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$4,201.31
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$3,113.91
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,828.81
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,707.04
|
|
|
HC SP REMOVAL IVC FILTER
|
Facility
|
IP
|
$4,942.72
|
|
|
Service Code
|
CPT 37193
|
| Hospital Charge Code |
36100353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,174.80 |
| Max. Negotiated Rate |
$4,448.45 |
| Rate for Payer: Aetna American Axle |
$3,212.77
|
| Rate for Payer: Aetna Commercial |
$4,201.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,212.77
|
| Rate for Payer: Cash Price |
$3,954.18
|
| Rate for Payer: Cofinity Advantage |
$3,459.90
|
| Rate for Payer: Cofinity Commercial |
$4,250.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,954.18
|
| Rate for Payer: Healthscope Commercial |
$4,448.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,459.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,707.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,201.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,707.04
|
| Rate for Payer: PHP Commercial |
$4,201.31
|
| Rate for Payer: Priority Health SBD |
$3,113.91
|
| Rate for Payer: UMR Bronson Commercial |
$2,174.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,707.04
|
|
|
HC SP REPAIR ANAL FISTULA W FIBRN GL
|
Facility
|
OP
|
$3,842.80
|
|
|
Service Code
|
CPT 46706
|
| Hospital Charge Code |
36100316
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,421.84 |
| Max. Negotiated Rate |
$8,943.95 |
| Rate for Payer: Aetna American Axle |
$2,497.82
|
| Rate for Payer: Aetna Commercial |
$3,266.38
|
| Rate for Payer: Aetna Medicare |
$2,876.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,497.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,457.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,457.10
|
| Rate for Payer: BCBS Complete |
$1,518.91
|
| Rate for Payer: BCBS MAPPO |
$2,765.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,096.27
|
| Rate for Payer: BCN Commercial |
$2,096.27
|
| Rate for Payer: BCN Medicare Advantage |
$2,765.68
|
| Rate for Payer: Cash Price |
$3,074.24
|
| Rate for Payer: Cash Price |
$3,074.24
|
| Rate for Payer: Cash Price |
$3,074.24
|
| Rate for Payer: Cofinity Advantage |
$2,689.96
|
| Rate for Payer: Cofinity Commercial |
$3,304.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,074.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,765.68
|
| Rate for Payer: Healthscope Commercial |
$3,458.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,689.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,882.10
|
| Rate for Payer: Mclaren Medicaid |
$2,765.68
|
| Rate for Payer: Mclaren Medicare |
$2,765.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,903.96
|
| Rate for Payer: Meridian Medicaid |
$2,903.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,180.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,042.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,266.38
|
| Rate for Payer: Nomi Health Commercial |
$8,297.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,882.10
|
| Rate for Payer: PACE Medicare |
$2,627.40
|
| Rate for Payer: PACE SWMI |
$2,765.68
|
| Rate for Payer: PHP Commercial |
$3,266.38
|
| Rate for Payer: PHP Medicare Advantage |
$2,765.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,446.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8,943.95
|
| Rate for Payer: Priority Health Medicare |
$2,765.68
|
| Rate for Payer: Priority Health SBD |
$2,420.96
|
| Rate for Payer: Priority Health Tiered Network |
$7,155.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2,765.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,765.68
|
| Rate for Payer: UHC Medicaid |
$1,446.45
|
| Rate for Payer: UHCCP Medicaid |
$1,446.45
|
| Rate for Payer: UMR Bronson Commercial |
$1,421.84
|
| Rate for Payer: VA VA |
$2,765.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,882.10
|
|
|
HC SP REPAIR ANAL FISTULA W FIBRN GL
|
Facility
|
IP
|
$3,842.80
|
|
|
Service Code
|
CPT 46706
|
| Hospital Charge Code |
36100316
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,690.83 |
| Max. Negotiated Rate |
$3,458.52 |
| Rate for Payer: Aetna American Axle |
$2,497.82
|
| Rate for Payer: Aetna Commercial |
$3,266.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,497.82
|
| Rate for Payer: Cash Price |
$3,074.24
|
| Rate for Payer: Cofinity Advantage |
$2,689.96
|
| Rate for Payer: Cofinity Commercial |
$3,304.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,074.24
|
| Rate for Payer: Healthscope Commercial |
$3,458.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,689.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,882.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,266.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,882.10
|
| Rate for Payer: PHP Commercial |
$3,266.38
|
| Rate for Payer: Priority Health SBD |
$2,420.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,690.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,882.10
|
|
|
HC SP REPOSITION IVC FILTER
|
Facility
|
IP
|
$4,365.00
|
|
|
Service Code
|
CPT 37192
|
| Hospital Charge Code |
36100352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,920.60 |
| Max. Negotiated Rate |
$3,928.50 |
| Rate for Payer: Aetna American Axle |
$2,837.25
|
| Rate for Payer: Aetna Commercial |
$3,710.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,837.25
|
| Rate for Payer: Cash Price |
$3,492.00
|
| Rate for Payer: Cofinity Advantage |
$3,055.50
|
| Rate for Payer: Cofinity Commercial |
$3,753.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,492.00
|
| Rate for Payer: Healthscope Commercial |
$3,928.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,055.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,273.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,710.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,273.75
|
| Rate for Payer: PHP Commercial |
$3,710.25
|
| Rate for Payer: Priority Health SBD |
$2,749.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,920.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,273.75
|
|
|
HC SP REPOSITION IVC FILTER
|
Facility
|
OP
|
$4,365.00
|
|
|
Service Code
|
CPT 37192
|
| Hospital Charge Code |
36100352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,615.05 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$2,837.25
|
| Rate for Payer: Aetna Commercial |
$3,710.25
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,837.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,663.55
|
| Rate for Payer: BCN Commercial |
$2,663.55
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,492.00
|
| Rate for Payer: Cash Price |
$3,492.00
|
| Rate for Payer: Cash Price |
$3,492.00
|
| Rate for Payer: Cofinity Advantage |
$3,055.50
|
| Rate for Payer: Cofinity Commercial |
$3,753.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,492.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,928.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,055.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,273.75
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,710.25
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,273.75
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,710.25
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$2,749.95
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,615.05
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,273.75
|
|
|
HC SP UNLISTED PROC SKIN SUBCUT TISS
|
Facility
|
IP
|
$710.23
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
36100314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$312.50 |
| Max. Negotiated Rate |
$639.21 |
| Rate for Payer: Aetna American Axle |
$461.65
|
| Rate for Payer: Aetna Commercial |
$603.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$461.65
|
| Rate for Payer: Cash Price |
$568.18
|
| Rate for Payer: Cofinity Advantage |
$497.16
|
| Rate for Payer: Cofinity Commercial |
$610.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$568.18
|
| Rate for Payer: Healthscope Commercial |
$639.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$497.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$532.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$603.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$532.67
|
| Rate for Payer: PHP Commercial |
$603.70
|
| Rate for Payer: Priority Health SBD |
$447.44
|
| Rate for Payer: UMR Bronson Commercial |
$312.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$532.67
|
|
