|
HC REMOTE THER MON DEVICE SUPPLY MS EA 30 DAY
|
Facility
|
IP
|
$114.75
|
|
|
Service Code
|
CPT 98977
|
| Hospital Charge Code |
42000063
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$50.49 |
| Max. Negotiated Rate |
$103.28 |
| Rate for Payer: Aetna American Axle |
$74.59
|
| Rate for Payer: Aetna Commercial |
$97.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.59
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Cofinity Commercial |
$80.32
|
| Rate for Payer: Cofinity Commercial |
$98.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.80
|
| Rate for Payer: Healthscope Commercial |
$103.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.54
|
| Rate for Payer: PHP Commercial |
$97.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.59
|
| Rate for Payer: Priority Health SBD |
$72.29
|
| Rate for Payer: UMR Bronson Commercial |
$50.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.06
|
|
|
HC REMOTE THER MON SETUP & EDU
|
Facility
|
IP
|
$366.14
|
|
|
Service Code
|
CPT 98975
|
| Hospital Charge Code |
42000062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$161.10 |
| Max. Negotiated Rate |
$329.53 |
| Rate for Payer: Aetna American Axle |
$237.99
|
| Rate for Payer: Aetna Commercial |
$311.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.99
|
| Rate for Payer: Cash Price |
$292.91
|
| Rate for Payer: Cofinity Commercial |
$256.30
|
| Rate for Payer: Cofinity Commercial |
$314.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$256.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.91
|
| Rate for Payer: Healthscope Commercial |
$329.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$256.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.22
|
| Rate for Payer: PHP Commercial |
$311.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.99
|
| Rate for Payer: Priority Health SBD |
$230.67
|
| Rate for Payer: UMR Bronson Commercial |
$161.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.60
|
|
|
HC REMOTE THER MON SETUP & EDU
|
Facility
|
OP
|
$366.14
|
|
|
Service Code
|
CPT 98975
|
| Hospital Charge Code |
42000062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.07 |
| Max. Negotiated Rate |
$396.84 |
| Rate for Payer: Aetna American Axle |
$237.99
|
| Rate for Payer: Aetna Commercial |
$311.22
|
| Rate for Payer: Aetna Medicare |
$131.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.82
|
| Rate for Payer: BCBS Complete |
$71.06
|
| Rate for Payer: BCBS MAPPO |
$126.26
|
| Rate for Payer: BCBS Trust/PPO |
$81.75
|
| Rate for Payer: BCN Commercial |
$81.75
|
| Rate for Payer: BCN Medicare Advantage |
$126.26
|
| Rate for Payer: Cash Price |
$292.91
|
| Rate for Payer: Cash Price |
$292.91
|
| Rate for Payer: Cash Price |
$292.91
|
| Rate for Payer: Cofinity Commercial |
$314.88
|
| Rate for Payer: Cofinity Commercial |
$256.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$256.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.26
|
| Rate for Payer: Healthscope Commercial |
$329.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$256.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.60
|
| Rate for Payer: Mclaren Medicaid |
$67.68
|
| Rate for Payer: Mclaren Medicare |
$126.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.57
|
| Rate for Payer: Meridian Medicaid |
$71.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.22
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PACE Medicare |
$119.95
|
| Rate for Payer: PACE SWMI |
$126.26
|
| Rate for Payer: PHP Commercial |
$311.22
|
| Rate for Payer: PHP Medicare Advantage |
$126.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.84
|
| Rate for Payer: Priority Health Medicare |
$126.26
|
| Rate for Payer: Priority Health Narrow Network |
$317.47
|
| Rate for Payer: Priority Health SBD |
$230.67
|
| Rate for Payer: Railroad Medicare Medicare |
$126.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.88
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.26
|
| Rate for Payer: UHC Exchange |
$18.07
|
| Rate for Payer: UHC Medicare Advantage |
$126.26
|
| Rate for Payer: UHCCP Medicaid |
$67.68
|
| Rate for Payer: UMR Bronson Commercial |
$135.47
|
| Rate for Payer: VA VA |
$126.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.60
|
|
|
HC REMOVAL BILIARY STONE
|
Facility
|
IP
|
$662.41
|
|
|
Service Code
|
CPT 47544
|
| Hospital Charge Code |
36100516
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$291.46 |
| Max. Negotiated Rate |
$596.17 |
| Rate for Payer: Aetna American Axle |
$430.57
|
| Rate for Payer: Aetna Commercial |
$563.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.57
|
| Rate for Payer: Cash Price |
$529.93
|
| Rate for Payer: Cofinity Commercial |
$463.69
|
| Rate for Payer: Cofinity Commercial |
$569.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$463.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$529.93
|
| Rate for Payer: Healthscope Commercial |
$596.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$463.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$496.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.05
|
| Rate for Payer: PHP Commercial |
$563.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.57
|
| Rate for Payer: Priority Health SBD |
$417.32
|
| Rate for Payer: UMR Bronson Commercial |
$291.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$496.81
|
|
|
HC REMOVAL BILIARY STONE
|
Facility
|
OP
|
$662.41
|
|
|
Service Code
|
CPT 47544
|
| Hospital Charge Code |
36100516
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$147.69 |
| Max. Negotiated Rate |
$4,465.72 |
| Rate for Payer: Aetna American Axle |
$430.57
|
| Rate for Payer: Aetna Commercial |
$563.05
|
| Rate for Payer: Aetna Medicare |
$331.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.57
|
| Rate for Payer: BCBS Complete |
$264.96
|
| Rate for Payer: BCBS Trust/PPO |
$4,465.72
|
| Rate for Payer: BCN Commercial |
$4,465.72
|
| Rate for Payer: Cash Price |
$529.93
|
| Rate for Payer: Cash Price |
$529.93
|
| Rate for Payer: Cash Price |
$529.93
|
| Rate for Payer: Cofinity Commercial |
$569.67
|
| Rate for Payer: Cofinity Commercial |
$463.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$463.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$529.93
|
| Rate for Payer: Healthscope Commercial |
$596.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$463.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$496.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.05
|
| Rate for Payer: PHP Commercial |
$563.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.57
|
| Rate for Payer: Priority Health SBD |
$417.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.46
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$147.69
|
| Rate for Payer: UMR Bronson Commercial |
$245.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$496.81
|
|
|
HC REMOVAL CHEST PORT OR PUMP
|
Facility
|
OP
|
$2,180.57
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36100141
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$181.31 |
| Max. Negotiated Rate |
$4,783.71 |
| Rate for Payer: Aetna American Axle |
$1,417.37
|
| Rate for Payer: Aetna Commercial |
$1,853.48
|
| Rate for Payer: Aetna Medicare |
$1,582.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,417.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,902.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,902.54
|
| Rate for Payer: BCBS Complete |
$856.60
|
| Rate for Payer: BCBS MAPPO |
$1,522.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.51
|
| Rate for Payer: BCN Commercial |
$1,183.51
|
| Rate for Payer: BCN Medicare Advantage |
$1,522.03
|
| Rate for Payer: Cash Price |
$1,744.46
|
| Rate for Payer: Cash Price |
$1,744.46
|
| Rate for Payer: Cash Price |
$1,744.46
|
| Rate for Payer: Cofinity Commercial |
$1,526.40
|
| Rate for Payer: Cofinity Commercial |
$1,875.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,526.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,744.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,522.03
|
| Rate for Payer: Healthscope Commercial |
$1,962.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,526.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,635.43
|
| Rate for Payer: Mclaren Medicaid |
$815.81
|
| Rate for Payer: Mclaren Medicare |
$1,522.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,598.13
|
| Rate for Payer: Meridian Medicaid |
$856.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,750.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,853.48
|
| Rate for Payer: Nomi Health Commercial |
$4,566.09
|
| Rate for Payer: PACE Medicare |
$1,445.93
|
| Rate for Payer: PACE SWMI |
$1,522.03
|
| Rate for Payer: PHP Commercial |
$1,853.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,522.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$815.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,783.71
|
| Rate for Payer: Priority Health Medicare |
$1,522.03
|
| Rate for Payer: Priority Health Narrow Network |
$3,826.97
|
| Rate for Payer: Priority Health SBD |
$1,373.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,522.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.44
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,522.03
|
| Rate for Payer: UHC Exchange |
$181.31
|
| Rate for Payer: UHC Medicare Advantage |
$1,522.03
|
| Rate for Payer: UHCCP Medicaid |
$815.81
|
| Rate for Payer: UMR Bronson Commercial |
$806.81
|
| Rate for Payer: VA VA |
$1,522.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,635.43
|
|
|
HC REMOVAL CHEST PORT OR PUMP
|
Facility
|
IP
|
$2,180.57
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36100141
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$959.45 |
| Max. Negotiated Rate |
$1,962.51 |
| Rate for Payer: Aetna American Axle |
$1,417.37
|
| Rate for Payer: Aetna Commercial |
$1,853.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,417.37
|
| Rate for Payer: Cash Price |
$1,744.46
|
| Rate for Payer: Cofinity Commercial |
$1,526.40
|
| Rate for Payer: Cofinity Commercial |
$1,875.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,526.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,744.46
|
| Rate for Payer: Healthscope Commercial |
$1,962.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,526.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,635.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,853.48
|
| Rate for Payer: PHP Commercial |
$1,853.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.37
|
| Rate for Payer: Priority Health SBD |
$1,373.76
|
| Rate for Payer: UMR Bronson Commercial |
$959.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,635.43
|
|
|
HC REMOVAL DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$343.33
|
|
|
Service Code
|
CPT 11982
|
| Hospital Charge Code |
76100143
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$151.07 |
| Max. Negotiated Rate |
$309.00 |
| Rate for Payer: Aetna American Axle |
$223.16
|
| Rate for Payer: Aetna Commercial |
$291.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.16
|
| Rate for Payer: Cash Price |
$274.66
|
| Rate for Payer: Cofinity Commercial |
$240.33
|
| Rate for Payer: Cofinity Commercial |
$295.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$240.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.66
|
| Rate for Payer: Healthscope Commercial |
$309.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$240.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.83
|
| Rate for Payer: PHP Commercial |
$291.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.16
|
| Rate for Payer: Priority Health SBD |
$216.30
|
| Rate for Payer: UMR Bronson Commercial |
$151.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.50
|
|
|
HC REMOVAL DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$343.33
|
|
|
Service Code
|
CPT 11982
|
| Hospital Charge Code |
76100143
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$70.99 |
| Max. Negotiated Rate |
$1,228.82 |
| Rate for Payer: Aetna American Axle |
$223.16
|
| Rate for Payer: Aetna Commercial |
$291.83
|
| Rate for Payer: Aetna Medicare |
$406.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$488.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$488.71
|
| Rate for Payer: BCBS Complete |
$220.04
|
| Rate for Payer: BCBS MAPPO |
$390.97
|
| Rate for Payer: BCBS Trust/PPO |
$521.71
|
| Rate for Payer: BCN Commercial |
$521.71
|
| Rate for Payer: BCN Medicare Advantage |
$390.97
|
| Rate for Payer: Cash Price |
$274.66
|
| Rate for Payer: Cash Price |
$274.66
|
| Rate for Payer: Cash Price |
$274.66
|
| Rate for Payer: Cofinity Commercial |
$240.33
|
| Rate for Payer: Cofinity Commercial |
$295.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$240.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.97
|
| Rate for Payer: Healthscope Commercial |
$309.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$240.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.50
|
| Rate for Payer: Mclaren Medicaid |
$209.56
|
| Rate for Payer: Mclaren Medicare |
$390.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$410.52
|
| Rate for Payer: Meridian Medicaid |
$220.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$449.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.83
|
| Rate for Payer: Nomi Health Commercial |
$1,172.91
|
| Rate for Payer: PACE Medicare |
$371.42
|
| Rate for Payer: PACE SWMI |
$390.97
|
| Rate for Payer: PHP Commercial |
$291.83
|
| Rate for Payer: PHP Medicare Advantage |
$390.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,228.82
|
| Rate for Payer: Priority Health Medicare |
$390.97
|
| Rate for Payer: Priority Health Narrow Network |
$983.06
|
| Rate for Payer: Priority Health SBD |
$216.30
|
| Rate for Payer: Railroad Medicare Medicare |
$390.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.09
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$390.97
|
| Rate for Payer: UHC Exchange |
$70.99
|
| Rate for Payer: UHC Medicare Advantage |
$390.97
|
| Rate for Payer: UHCCP Medicaid |
$209.56
|
| Rate for Payer: UMR Bronson Commercial |
$127.03
|
| Rate for Payer: VA VA |
$390.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.50
|
|
|
HC REMOVAL FB EXTERNAL EYE CORNEAL WO SLIT LAMP
|
Facility
|
IP
|
$1,122.00
|
|
|
Service Code
|
CPT 65220
|
| Hospital Charge Code |
76100401
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$493.68 |
| Max. Negotiated Rate |
$1,009.80 |
| Rate for Payer: Aetna American Axle |
$729.30
|
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.30
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$785.40
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$785.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$785.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.70
|
| Rate for Payer: PHP Commercial |
$953.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.30
|
| Rate for Payer: Priority Health SBD |
$706.86
|
| Rate for Payer: UMR Bronson Commercial |
$493.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.50
|
|
|
HC REMOVAL FB EXTERNAL EYE CORNEAL WO SLIT LAMP
|
Facility
|
OP
|
$1,122.00
|
|
|
Service Code
|
CPT 65220
|
| Hospital Charge Code |
76100401
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$39.53 |
| Max. Negotiated Rate |
$1,228.82 |
| Rate for Payer: Aetna American Axle |
$729.30
|
| Rate for Payer: Aetna Commercial |
$953.70
|
| Rate for Payer: Aetna Medicare |
$406.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$488.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$488.71
|
| Rate for Payer: BCBS Complete |
$220.04
|
| Rate for Payer: BCBS MAPPO |
$390.97
|
| Rate for Payer: BCBS Trust/PPO |
$178.68
|
| Rate for Payer: BCN Commercial |
$178.68
|
| Rate for Payer: BCN Medicare Advantage |
$390.97
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cash Price |
$897.60
|
| Rate for Payer: Cofinity Commercial |
$785.40
|
| Rate for Payer: Cofinity Commercial |
$964.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$785.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$897.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.97
|
| Rate for Payer: Healthscope Commercial |
$1,009.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$785.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$841.50
|
| Rate for Payer: Mclaren Medicaid |
$209.56
|
| Rate for Payer: Mclaren Medicare |
$390.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$410.52
|
| Rate for Payer: Meridian Medicaid |
$220.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$449.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$953.70
|
| Rate for Payer: Nomi Health Commercial |
$1,172.91
|
| Rate for Payer: PACE Medicare |
$371.42
|
| Rate for Payer: PACE SWMI |
$390.97
|
| Rate for Payer: PHP Commercial |
$953.70
|
| Rate for Payer: PHP Medicare Advantage |
$390.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,228.82
|
| Rate for Payer: Priority Health Medicare |
$390.97
|
| Rate for Payer: Priority Health Narrow Network |
$983.06
|
| Rate for Payer: Priority Health SBD |
$706.86
|
| Rate for Payer: Railroad Medicare Medicare |
$390.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.48
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$390.97
|
| Rate for Payer: UHC Exchange |
$39.53
|
| Rate for Payer: UHC Medicare Advantage |
$390.97
|
| Rate for Payer: UHCCP Medicaid |
$209.56
|
| Rate for Payer: UMR Bronson Commercial |
$415.14
|
| Rate for Payer: VA VA |
$390.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$841.50
|
|
|
HC REMOVAL FOREIGN BODY INTRANASAL
|
Facility
|
OP
|
$357.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$232.05
|
| Rate for Payer: Aetna Commercial |
$303.45
|
| Rate for Payer: Aetna Medicare |
$131.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$75.48
|
| Rate for Payer: BCN Commercial |
$75.48
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$249.90
|
| Rate for Payer: Cofinity Commercial |
$307.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$249.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$321.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$249.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.75
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.45
|
| Rate for Payer: Nomi Health Commercial |
$378.87
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$303.45
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.95
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$317.56
|
| Rate for Payer: Priority Health SBD |
$224.91
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.07
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$115.52
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: UMR Bronson Commercial |
$132.09
|
| Rate for Payer: VA VA |
$126.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.75
|
|
|
HC REMOVAL FOREIGN BODY INTRANASAL
|
Facility
|
IP
|
$357.00
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
76100451
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$157.08 |
| Max. Negotiated Rate |
$321.30 |
| Rate for Payer: Aetna American Axle |
$232.05
|
| Rate for Payer: Aetna Commercial |
$303.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.05
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$249.90
|
| Rate for Payer: Cofinity Commercial |
$307.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$249.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.60
|
| Rate for Payer: Healthscope Commercial |
$321.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$249.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.45
|
| Rate for Payer: PHP Commercial |
$303.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.05
|
| Rate for Payer: Priority Health SBD |
$224.91
|
| Rate for Payer: UMR Bronson Commercial |
$157.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.75
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
OP
|
$2,142.08
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$138.19 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$1,392.35
|
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,392.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,616.89
|
| Rate for Payer: BCN Commercial |
$1,616.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,499.46
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,499.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,499.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.56
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: Nomi Health Commercial |
$4,762.44
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$1,349.51
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.01
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$138.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$792.57
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.56
|
|
|
HC REMOVAL IMPLANT, SUPERFICIAL
|
Facility
|
IP
|
$2,142.08
|
|
|
Service Code
|
CPT 20670
|
| Hospital Charge Code |
76100257
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$942.52 |
| Max. Negotiated Rate |
$1,927.87 |
| Rate for Payer: Aetna American Axle |
$1,392.35
|
| Rate for Payer: Aetna Commercial |
$1,820.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,392.35
|
| Rate for Payer: Cash Price |
$1,713.66
|
| Rate for Payer: Cofinity Commercial |
$1,499.46
|
| Rate for Payer: Cofinity Commercial |
$1,842.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,499.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,713.66
|
| Rate for Payer: Healthscope Commercial |
$1,927.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,499.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,606.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,820.77
|
| Rate for Payer: PHP Commercial |
$1,820.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,392.35
|
| Rate for Payer: Priority Health SBD |
$1,349.51
|
| Rate for Payer: UMR Bronson Commercial |
$942.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,606.56
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
IP
|
$5,084.21
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,237.05 |
| Max. Negotiated Rate |
$4,575.79 |
| Rate for Payer: Aetna American Axle |
$3,304.74
|
| Rate for Payer: Aetna Commercial |
$4,321.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,304.74
|
| Rate for Payer: Cash Price |
$4,067.37
|
| Rate for Payer: Cofinity Commercial |
$3,558.95
|
| Rate for Payer: Cofinity Commercial |
$4,372.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,558.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,067.37
|
| Rate for Payer: Healthscope Commercial |
$4,575.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,558.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,813.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,321.58
|
| Rate for Payer: PHP Commercial |
$4,321.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,304.74
|
| Rate for Payer: Priority Health SBD |
$3,203.05
|
| Rate for Payer: UMR Bronson Commercial |
$2,237.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,813.16
|
|
|
HC REMOVAL OF ANAL TAGS
|
Facility
|
OP
|
$5,084.21
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
76100316
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$167.98 |
| Max. Negotiated Rate |
$8,445.02 |
| Rate for Payer: Aetna American Axle |
$3,304.74
|
| Rate for Payer: Aetna Commercial |
$4,321.58
|
| Rate for Payer: Aetna Medicare |
$2,794.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,304.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,094.59
|
| Rate for Payer: BCN Commercial |
$2,094.59
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Cash Price |
$4,067.37
|
| Rate for Payer: Cash Price |
$4,067.37
|
| Rate for Payer: Cash Price |
$4,067.37
|
| Rate for Payer: Cofinity Commercial |
$4,372.42
|
| Rate for Payer: Cofinity Commercial |
$3,558.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,558.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,067.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,686.94
|
| Rate for Payer: Healthscope Commercial |
$4,575.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,558.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,813.16
|
| Rate for Payer: Mclaren Medicaid |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,321.58
|
| Rate for Payer: Nomi Health Commercial |
$5,642.57
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Commercial |
$4,321.58
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,304.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,445.02
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$6,756.02
|
| Rate for Payer: Priority Health SBD |
$3,203.05
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.78
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$167.98
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,881.16
|
| Rate for Payer: VA VA |
$2,686.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,813.16
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
OP
|
$3,062.03
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$204.88 |
| Max. Negotiated Rate |
$11,206.98 |
| Rate for Payer: Aetna American Axle |
$1,990.32
|
| Rate for Payer: Aetna Commercial |
$2,602.73
|
| Rate for Payer: Aetna Medicare |
$3,708.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,990.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,457.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,457.14
|
| Rate for Payer: BCBS Complete |
$2,006.78
|
| Rate for Payer: BCBS MAPPO |
$3,565.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,513.36
|
| Rate for Payer: BCN Commercial |
$2,513.36
|
| Rate for Payer: BCN Medicare Advantage |
$3,565.71
|
| Rate for Payer: Cash Price |
$2,449.62
|
| Rate for Payer: Cash Price |
$2,449.62
|
| Rate for Payer: Cash Price |
$2,449.62
|
| Rate for Payer: Cofinity Commercial |
$2,143.42
|
| Rate for Payer: Cofinity Commercial |
$2,633.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,143.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,449.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,565.71
|
| Rate for Payer: Healthscope Commercial |
$2,755.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,143.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,296.52
|
| Rate for Payer: Mclaren Medicaid |
$1,911.22
|
| Rate for Payer: Mclaren Medicare |
$3,565.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,744.00
|
| Rate for Payer: Meridian Medicaid |
$2,006.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,100.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,602.73
|
| Rate for Payer: Nomi Health Commercial |
$10,697.13
|
| Rate for Payer: PACE Medicare |
$3,387.42
|
| Rate for Payer: PACE SWMI |
$3,565.71
|
| Rate for Payer: PHP Commercial |
$2,602.73
|
| Rate for Payer: PHP Medicare Advantage |
$3,565.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,911.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,990.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,206.98
|
| Rate for Payer: Priority Health Medicare |
$3,565.71
|
| Rate for Payer: Priority Health Narrow Network |
$8,965.58
|
| Rate for Payer: Priority Health SBD |
$1,929.08
|
| Rate for Payer: Railroad Medicare Medicare |
$3,565.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.37
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,565.71
|
| Rate for Payer: UHC Exchange |
$204.88
|
| Rate for Payer: UHC Medicare Advantage |
$3,565.71
|
| Rate for Payer: UHCCP Medicaid |
$1,911.22
|
| Rate for Payer: UMR Bronson Commercial |
$1,132.95
|
| Rate for Payer: VA VA |
$3,565.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,296.52
|
|
|
HC REMOVAL OF DEFIBRILLATOR
|
Facility
|
IP
|
$3,062.03
|
|
|
Service Code
|
CPT 33241
|
| Hospital Charge Code |
36100077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,347.29 |
| Max. Negotiated Rate |
$2,755.83 |
| Rate for Payer: Aetna American Axle |
$1,990.32
|
| Rate for Payer: Aetna Commercial |
$2,602.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,990.32
|
| Rate for Payer: Cash Price |
$2,449.62
|
| Rate for Payer: Cofinity Commercial |
$2,143.42
|
| Rate for Payer: Cofinity Commercial |
$2,633.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,143.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,449.62
|
| Rate for Payer: Healthscope Commercial |
$2,755.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,143.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,296.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,602.73
|
| Rate for Payer: PHP Commercial |
$2,602.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,990.32
|
| Rate for Payer: Priority Health SBD |
$1,929.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,347.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,296.52
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
IP
|
$3,368.23
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,482.02 |
| Max. Negotiated Rate |
$3,031.41 |
| Rate for Payer: Aetna American Axle |
$2,189.35
|
| Rate for Payer: Aetna Commercial |
$2,863.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,189.35
|
| Rate for Payer: Cash Price |
$2,694.58
|
| Rate for Payer: Cofinity Commercial |
$2,357.76
|
| Rate for Payer: Cofinity Commercial |
$2,896.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,357.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,694.58
|
| Rate for Payer: Healthscope Commercial |
$3,031.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,357.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,526.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,863.00
|
| Rate for Payer: PHP Commercial |
$2,863.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,189.35
|
| Rate for Payer: Priority Health SBD |
$2,121.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,482.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,526.17
|
|
|
HC REMOVAL OF PERM GENERATOR
|
Facility
|
OP
|
$3,368.23
|
|
|
Service Code
|
CPT 33233
|
| Hospital Charge Code |
36100072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$221.75 |
| Max. Negotiated Rate |
$25,485.33 |
| Rate for Payer: Aetna American Axle |
$2,189.35
|
| Rate for Payer: Aetna Commercial |
$2,863.00
|
| Rate for Payer: Aetna Medicare |
$8,432.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,189.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,135.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,135.80
|
| Rate for Payer: BCBS Complete |
$4,563.54
|
| Rate for Payer: BCBS MAPPO |
$8,108.64
|
| Rate for Payer: BCBS Trust/PPO |
$7,385.16
|
| Rate for Payer: BCN Commercial |
$7,385.16
|
| Rate for Payer: BCN Medicare Advantage |
$8,108.64
|
| Rate for Payer: Cash Price |
$2,694.58
|
| Rate for Payer: Cash Price |
$2,694.58
|
| Rate for Payer: Cash Price |
$2,694.58
|
| Rate for Payer: Cofinity Commercial |
$2,357.76
|
| Rate for Payer: Cofinity Commercial |
$2,896.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,357.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,694.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,108.64
|
| Rate for Payer: Healthscope Commercial |
$3,031.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,357.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,526.17
|
| Rate for Payer: Mclaren Medicaid |
$4,346.23
|
| Rate for Payer: Mclaren Medicare |
$8,108.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,514.07
|
| Rate for Payer: Meridian Medicaid |
$4,563.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,324.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,863.00
|
| Rate for Payer: Nomi Health Commercial |
$24,325.92
|
| Rate for Payer: PACE Medicare |
$7,703.21
|
| Rate for Payer: PACE SWMI |
$8,108.64
|
| Rate for Payer: PHP Commercial |
$2,863.00
|
| Rate for Payer: PHP Medicare Advantage |
$8,108.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,346.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,189.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,485.33
|
| Rate for Payer: Priority Health Medicare |
$8,108.64
|
| Rate for Payer: Priority Health Narrow Network |
$20,388.26
|
| Rate for Payer: Priority Health SBD |
$2,121.98
|
| Rate for Payer: Railroad Medicare Medicare |
$8,108.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.92
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,108.64
|
| Rate for Payer: UHC Exchange |
$221.75
|
| Rate for Payer: UHC Medicare Advantage |
$8,108.64
|
| Rate for Payer: UHCCP Medicaid |
$4,346.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,246.25
|
| Rate for Payer: VA VA |
$8,108.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,526.17
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$194.21 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna American Axle |
$5,237.70
|
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,237.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$194.21
|
| Rate for Payer: BCN Commercial |
$194.21
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Cofinity Commercial |
$5,640.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,640.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,640.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,043.50
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: Nomi Health Commercial |
$6,672.75
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,986.81
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$7,989.45
|
| Rate for Payer: Priority Health SBD |
$5,076.54
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,944.34
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$6,072.52
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,703.14
|
| Rate for Payer: UMR Bronson Commercial |
$2,981.46
|
| Rate for Payer: VA VA |
$3,177.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
|
HC REMOVAL OF SALIVARY STONE UNCOMPLICATED
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 42330
|
| Hospital Charge Code |
76100469
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,545.52 |
| Max. Negotiated Rate |
$7,252.20 |
| Rate for Payer: Aetna American Axle |
$5,237.70
|
| Rate for Payer: Aetna Commercial |
$6,849.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,237.70
|
| Rate for Payer: Cash Price |
$6,446.40
|
| Rate for Payer: Cofinity Commercial |
$5,640.60
|
| Rate for Payer: Cofinity Commercial |
$6,929.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,640.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,446.40
|
| Rate for Payer: Healthscope Commercial |
$7,252.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,640.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,043.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,849.30
|
| Rate for Payer: PHP Commercial |
$6,849.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,237.70
|
| Rate for Payer: Priority Health SBD |
$5,076.54
|
| Rate for Payer: UMR Bronson Commercial |
$3,545.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,043.50
|
|
|
HC REMOVAL OF SPERM DUCT(S)
|
Facility
|
IP
|
$2,715.06
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
76100200
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,194.63 |
| Max. Negotiated Rate |
$2,443.55 |
| Rate for Payer: Aetna American Axle |
$1,764.79
|
| Rate for Payer: Aetna Commercial |
$2,307.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,764.79
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cofinity Commercial |
$1,900.54
|
| Rate for Payer: Cofinity Commercial |
$2,334.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,900.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,172.05
|
| Rate for Payer: Healthscope Commercial |
$2,443.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,900.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,036.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,307.80
|
| Rate for Payer: PHP Commercial |
$2,307.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.79
|
| Rate for Payer: Priority Health SBD |
$1,710.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,194.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,036.30
|
|
|
HC REMOVAL OF SPERM DUCT(S)
|
Facility
|
OP
|
$2,715.06
|
|
|
Service Code
|
CPT 55250
|
| Hospital Charge Code |
76100200
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,004.57 |
| Max. Negotiated Rate |
$6,308.24 |
| Rate for Payer: Aetna American Axle |
$1,764.79
|
| Rate for Payer: Aetna Commercial |
$2,307.80
|
| Rate for Payer: Aetna Medicare |
$2,087.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,764.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,369.87
|
| Rate for Payer: BCN Commercial |
$1,369.87
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cash Price |
$2,172.05
|
| Rate for Payer: Cofinity Commercial |
$2,334.95
|
| Rate for Payer: Cofinity Commercial |
$1,900.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,900.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,172.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$2,443.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,900.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,036.30
|
| Rate for Payer: Mclaren Medicaid |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,307.80
|
| Rate for Payer: Nomi Health Commercial |
$4,214.89
|
| Rate for Payer: PACE Medicare |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Commercial |
$2,307.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,764.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,308.24
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$5,046.59
|
| Rate for Payer: Priority Health SBD |
$1,710.49
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,649.76
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$3,835.75
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,004.57
|
| Rate for Payer: VA VA |
$2,007.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,036.30
|
|
