|
HC REMOVE NEPHROSTOMY TUBE
|
Facility
|
IP
|
$924.66
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
36100241
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$406.85 |
| Max. Negotiated Rate |
$832.19 |
| Rate for Payer: Aetna American Axle |
$601.03
|
| Rate for Payer: Aetna Commercial |
$785.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$601.03
|
| Rate for Payer: Cash Price |
$739.73
|
| Rate for Payer: Cofinity Commercial |
$647.26
|
| Rate for Payer: Cofinity Commercial |
$795.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$647.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.73
|
| Rate for Payer: Healthscope Commercial |
$832.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$647.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$693.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.96
|
| Rate for Payer: PHP Commercial |
$785.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$601.03
|
| Rate for Payer: Priority Health SBD |
$582.54
|
| Rate for Payer: UMR Bronson Commercial |
$406.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$693.50
|
|
|
HC REMOVE NEPHROSTOMY TUBE
|
Facility
|
OP
|
$924.66
|
|
|
Service Code
|
CPT 50389
|
| Hospital Charge Code |
36100241
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$342.12 |
| Max. Negotiated Rate |
$1,832.42 |
| Rate for Payer: Aetna American Axle |
$601.03
|
| Rate for Payer: Aetna Commercial |
$785.96
|
| Rate for Payer: Aetna Medicare |
$677.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$601.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$813.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$813.71
|
| Rate for Payer: BCBS Complete |
$366.37
|
| Rate for Payer: BCBS MAPPO |
$650.97
|
| Rate for Payer: BCN Medicare Advantage |
$650.97
|
| Rate for Payer: Cash Price |
$739.73
|
| Rate for Payer: Cash Price |
$739.73
|
| Rate for Payer: Cofinity Commercial |
$795.21
|
| Rate for Payer: Cofinity Commercial |
$647.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$647.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$650.97
|
| Rate for Payer: Healthscope Commercial |
$832.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$647.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$693.50
|
| Rate for Payer: Mclaren Medicaid |
$348.92
|
| Rate for Payer: Mclaren Medicare |
$650.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$683.52
|
| Rate for Payer: Meridian Medicaid |
$366.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$748.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.96
|
| Rate for Payer: PACE Medicare |
$618.42
|
| Rate for Payer: PACE SWMI |
$650.97
|
| Rate for Payer: PHP Commercial |
$785.96
|
| Rate for Payer: PHP Medicare Advantage |
$650.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$348.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$601.03
|
| Rate for Payer: Priority Health Medicare |
$650.97
|
| Rate for Payer: Priority Health SBD |
$582.54
|
| Rate for Payer: Railroad Medicare Medicare |
$650.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,832.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$650.97
|
| Rate for Payer: UHC Exchange |
$1,244.07
|
| Rate for Payer: UHC Medicare Advantage |
$650.97
|
| Rate for Payer: UHCCP Medicaid |
$348.92
|
| Rate for Payer: UMR Bronson Commercial |
$342.12
|
| Rate for Payer: VA VA |
$650.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$693.50
|
|
|
HC REMOVE REPLACE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
OP
|
$2,909.30
|
|
|
Service Code
|
CPT 50385
|
| Hospital Charge Code |
36100238
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,070.86 |
| Max. Negotiated Rate |
$5,623.80 |
| Rate for Payer: Aetna American Axle |
$1,891.05
|
| Rate for Payer: Aetna Commercial |
$2,472.91
|
| Rate for Payer: Aetna Medicare |
$2,077.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,891.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$2,327.44
|
| Rate for Payer: Cash Price |
$2,327.44
|
| Rate for Payer: Cofinity Commercial |
$2,502.00
|
| Rate for Payer: Cofinity Commercial |
$2,036.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,036.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,327.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$2,618.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,036.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,181.97
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,472.91
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$2,472.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,891.05
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health SBD |
$1,832.86
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,623.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Exchange |
$3,818.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,070.86
|
| Rate for Payer: UMR Bronson Commercial |
$1,076.44
|
| Rate for Payer: VA VA |
$1,997.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,181.97
|
|
|
HC REMOVE REPLACE INT URETRAL STENT TRANSURETHRAL
|
Facility
|
IP
|
$2,909.30
|
|
|
Service Code
|
CPT 50385
|
| Hospital Charge Code |
36100238
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,280.09 |
| Max. Negotiated Rate |
$2,618.37 |
| Rate for Payer: Aetna American Axle |
$1,891.05
|
| Rate for Payer: Aetna Commercial |
$2,472.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,891.05
|
| Rate for Payer: Cash Price |
$2,327.44
|
| Rate for Payer: Cofinity Commercial |
$2,036.51
|
| Rate for Payer: Cofinity Commercial |
$2,502.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,036.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,327.44
|
| Rate for Payer: Healthscope Commercial |
$2,618.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,036.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,181.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,472.91
|
| Rate for Payer: PHP Commercial |
$2,472.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,891.05
|
| Rate for Payer: Priority Health SBD |
$1,832.86
|
| Rate for Payer: UMR Bronson Commercial |
$1,280.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,181.97
|
|
|
HC REMOVE SESAMOID BONE 1ST TOE
|
Facility
|
OP
|
$8,364.00
|
|
|
Service Code
|
CPT 28315
|
| Hospital Charge Code |
76100368
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,696.12 |
| Max. Negotiated Rate |
$8,907.47 |
| Rate for Payer: Aetna American Axle |
$5,436.60
|
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: Aetna Medicare |
$3,290.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,436.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,955.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,955.50
|
| Rate for Payer: BCBS Complete |
$1,780.92
|
| Rate for Payer: BCBS MAPPO |
$3,164.40
|
| Rate for Payer: BCN Medicare Advantage |
$3,164.40
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Cofinity Commercial |
$5,854.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,854.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,164.40
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,854.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,273.00
|
| Rate for Payer: Mclaren Medicaid |
$1,696.12
|
| Rate for Payer: Mclaren Medicare |
$3,164.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,322.62
|
| Rate for Payer: Meridian Medicaid |
$1,780.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,639.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: PACE Medicare |
$3,006.18
|
| Rate for Payer: PACE SWMI |
$3,164.40
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,164.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,696.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health Medicare |
$3,164.40
|
| Rate for Payer: Priority Health SBD |
$5,269.32
|
| Rate for Payer: Railroad Medicare Medicare |
$3,164.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,907.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,164.40
|
| Rate for Payer: UHC Exchange |
$6,047.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,164.40
|
| Rate for Payer: UHCCP Medicaid |
$1,696.12
|
| Rate for Payer: UMR Bronson Commercial |
$3,094.68
|
| Rate for Payer: VA VA |
$3,164.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,273.00
|
|
|
HC REMOVE SESAMOID BONE 1ST TOE
|
Facility
|
IP
|
$8,364.00
|
|
|
Service Code
|
CPT 28315
|
| Hospital Charge Code |
76100368
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,680.16 |
| Max. Negotiated Rate |
$7,527.60 |
| Rate for Payer: Aetna American Axle |
$5,436.60
|
| Rate for Payer: Aetna Commercial |
$7,109.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,436.60
|
| Rate for Payer: Cash Price |
$6,691.20
|
| Rate for Payer: Cofinity Commercial |
$5,854.80
|
| Rate for Payer: Cofinity Commercial |
$7,193.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,854.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,691.20
|
| Rate for Payer: Healthscope Commercial |
$7,527.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,854.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,273.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,109.40
|
| Rate for Payer: PHP Commercial |
$7,109.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,436.60
|
| Rate for Payer: Priority Health SBD |
$5,269.32
|
| Rate for Payer: UMR Bronson Commercial |
$3,680.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,273.00
|
|
|
HC REMOVE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
IP
|
$4,563.19
|
|
|
Service Code
|
CPT 63661
|
| Hospital Charge Code |
36100611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,007.80 |
| Max. Negotiated Rate |
$4,106.87 |
| Rate for Payer: Aetna American Axle |
$2,966.07
|
| Rate for Payer: Aetna Commercial |
$3,878.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,966.07
|
| Rate for Payer: Cash Price |
$3,650.55
|
| Rate for Payer: Cofinity Commercial |
$3,194.23
|
| Rate for Payer: Cofinity Commercial |
$3,924.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,194.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,650.55
|
| Rate for Payer: Healthscope Commercial |
$4,106.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,194.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,422.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,878.71
|
| Rate for Payer: PHP Commercial |
$3,878.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,966.07
|
| Rate for Payer: Priority Health SBD |
$2,874.81
|
| Rate for Payer: UMR Bronson Commercial |
$2,007.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,422.39
|
|
|
HC REMOVE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
OP
|
$4,563.19
|
|
|
Service Code
|
CPT 63661
|
| Hospital Charge Code |
36100611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,020.81 |
| Max. Negotiated Rate |
$5,360.98 |
| Rate for Payer: Aetna American Axle |
$2,966.07
|
| Rate for Payer: Aetna Commercial |
$3,878.71
|
| Rate for Payer: Aetna Medicare |
$1,980.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,966.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,380.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,380.62
|
| Rate for Payer: BCBS Complete |
$1,071.85
|
| Rate for Payer: BCBS MAPPO |
$1,904.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,904.50
|
| Rate for Payer: Cash Price |
$3,650.55
|
| Rate for Payer: Cash Price |
$3,650.55
|
| Rate for Payer: Cofinity Commercial |
$3,924.34
|
| Rate for Payer: Cofinity Commercial |
$3,194.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,194.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,650.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,904.50
|
| Rate for Payer: Healthscope Commercial |
$4,106.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,194.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,422.39
|
| Rate for Payer: Mclaren Medicaid |
$1,020.81
|
| Rate for Payer: Mclaren Medicare |
$1,904.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,999.72
|
| Rate for Payer: Meridian Medicaid |
$1,071.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,190.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,878.71
|
| Rate for Payer: PACE Medicare |
$1,809.28
|
| Rate for Payer: PACE SWMI |
$1,904.50
|
| Rate for Payer: PHP Commercial |
$3,878.71
|
| Rate for Payer: PHP Medicare Advantage |
$1,904.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,020.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,966.07
|
| Rate for Payer: Priority Health Medicare |
$1,904.50
|
| Rate for Payer: Priority Health SBD |
$2,874.81
|
| Rate for Payer: Railroad Medicare Medicare |
$1,904.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,360.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,904.50
|
| Rate for Payer: UHC Exchange |
$3,639.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,904.50
|
| Rate for Payer: UHCCP Medicaid |
$1,020.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,688.38
|
| Rate for Payer: VA VA |
$1,904.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,422.39
|
|
|
HC REMOVE SUTURES AND STAPLES NO ANES
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 15854
|
| Hospital Charge Code |
76100371
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna American Axle |
$29.17
|
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: Aetna Medicare |
$22.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.17
|
| Rate for Payer: BCBS Complete |
$17.95
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$31.42
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.15
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.17
|
| Rate for Payer: Priority Health SBD |
$28.27
|
| Rate for Payer: UMR Bronson Commercial |
$16.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC REMOVE SUTURES AND STAPLES NO ANES
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 15854
|
| Hospital Charge Code |
76100371
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$19.75 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna American Axle |
$29.17
|
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.17
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$31.42
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.15
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.17
|
| Rate for Payer: Priority Health SBD |
$28.27
|
| Rate for Payer: UMR Bronson Commercial |
$19.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC REMOVE SUTURES OR STAPLES NO ANES
|
Facility
|
IP
|
$31.62
|
|
|
Service Code
|
CPT 15853
|
| Hospital Charge Code |
76100370
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$13.91 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna American Axle |
$20.55
|
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.55
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$22.13
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.88
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.55
|
| Rate for Payer: Priority Health SBD |
$19.92
|
| Rate for Payer: UMR Bronson Commercial |
$13.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.71
|
|
|
HC REMOVE SUTURES OR STAPLES NO ANES
|
Facility
|
OP
|
$31.62
|
|
|
Service Code
|
CPT 15853
|
| Hospital Charge Code |
76100370
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$11.70 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna American Axle |
$20.55
|
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: Aetna Medicare |
$15.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.55
|
| Rate for Payer: BCBS Complete |
$12.65
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$22.13
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.88
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.55
|
| Rate for Payer: Priority Health SBD |
$19.92
|
| Rate for Payer: UMR Bronson Commercial |
$11.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.71
|
|
|
HC REMOVE SUTURES OR STAPLES REQ ANES
|
Facility
|
OP
|
$5,105.09
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$956.23 |
| Max. Negotiated Rate |
$5,021.81 |
| Rate for Payer: Aetna American Axle |
$3,318.31
|
| Rate for Payer: Aetna Commercial |
$4,339.33
|
| Rate for Payer: Aetna Medicare |
$1,855.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,318.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,230.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,230.01
|
| Rate for Payer: BCBS Complete |
$1,004.04
|
| Rate for Payer: BCBS MAPPO |
$1,784.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,784.01
|
| Rate for Payer: Cash Price |
$4,084.07
|
| Rate for Payer: Cash Price |
$4,084.07
|
| Rate for Payer: Cofinity Commercial |
$4,390.38
|
| Rate for Payer: Cofinity Commercial |
$3,573.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,573.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,084.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,784.01
|
| Rate for Payer: Healthscope Commercial |
$4,594.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,573.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,828.82
|
| Rate for Payer: Mclaren Medicaid |
$956.23
|
| Rate for Payer: Mclaren Medicare |
$1,784.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,873.21
|
| Rate for Payer: Meridian Medicaid |
$1,004.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,051.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,339.33
|
| Rate for Payer: PACE Medicare |
$1,694.81
|
| Rate for Payer: PACE SWMI |
$1,784.01
|
| Rate for Payer: PHP Commercial |
$4,339.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,784.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$956.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,318.31
|
| Rate for Payer: Priority Health Medicare |
$1,784.01
|
| Rate for Payer: Priority Health SBD |
$3,216.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,784.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,021.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,784.01
|
| Rate for Payer: UHC Exchange |
$3,409.42
|
| Rate for Payer: UHC Medicare Advantage |
$1,784.01
|
| Rate for Payer: UHCCP Medicaid |
$956.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,888.88
|
| Rate for Payer: VA VA |
$1,784.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,828.82
|
|
|
HC REMOVE SUTURES OR STAPLES REQ ANES
|
Facility
|
IP
|
$5,105.09
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,246.24 |
| Max. Negotiated Rate |
$4,594.58 |
| Rate for Payer: Aetna American Axle |
$3,318.31
|
| Rate for Payer: Aetna Commercial |
$4,339.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,318.31
|
| Rate for Payer: Cash Price |
$4,084.07
|
| Rate for Payer: Cofinity Commercial |
$3,573.56
|
| Rate for Payer: Cofinity Commercial |
$4,390.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,573.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,084.07
|
| Rate for Payer: Healthscope Commercial |
$4,594.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,573.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,828.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,339.33
|
| Rate for Payer: PHP Commercial |
$4,339.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,318.31
|
| Rate for Payer: Priority Health SBD |
$3,216.21
|
| Rate for Payer: UMR Bronson Commercial |
$2,246.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,828.82
|
|
|
HC RENAL FUNCTION PANEL
|
Facility
|
OP
|
$35.37
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
30100016
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna American Axle |
$22.99
|
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: Aetna Medicare |
$9.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.85
|
| Rate for Payer: BCBS Complete |
$4.89
|
| Rate for Payer: BCBS MAPPO |
$8.68
|
| Rate for Payer: BCN Medicare Advantage |
$8.68
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Cofinity Commercial |
$24.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.68
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Mclaren Medicaid |
$4.65
|
| Rate for Payer: Mclaren Medicare |
$8.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.11
|
| Rate for Payer: Meridian Medicaid |
$4.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: PACE Medicare |
$8.25
|
| Rate for Payer: PACE SWMI |
$8.68
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: PHP Medicare Advantage |
$8.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health Medicare |
$8.68
|
| Rate for Payer: Priority Health SBD |
$22.28
|
| Rate for Payer: Railroad Medicare Medicare |
$8.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.68
|
| Rate for Payer: UHC Exchange |
$16.59
|
| Rate for Payer: UHC Medicare Advantage |
$8.68
|
| Rate for Payer: UHCCP Medicaid |
$4.65
|
| Rate for Payer: UMR Bronson Commercial |
$13.09
|
| Rate for Payer: VA VA |
$8.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC RENAL FUNCTION PANEL
|
Facility
|
IP
|
$35.37
|
|
|
Service Code
|
CPT 80069
|
| Hospital Charge Code |
30100016
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.56 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna American Axle |
$22.99
|
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.99
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$24.76
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health SBD |
$22.28
|
| Rate for Payer: UMR Bronson Commercial |
$15.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC RENIN
|
Facility
|
OP
|
$41.51
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
30100419
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.79 |
| Max. Negotiated Rate |
$61.90 |
| Rate for Payer: Aetna American Axle |
$26.98
|
| Rate for Payer: Aetna Commercial |
$35.28
|
| Rate for Payer: Aetna Medicare |
$22.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.49
|
| Rate for Payer: BCBS Complete |
$12.38
|
| Rate for Payer: BCBS MAPPO |
$21.99
|
| Rate for Payer: BCN Medicare Advantage |
$21.99
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$29.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.99
|
| Rate for Payer: Healthscope Commercial |
$37.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.13
|
| Rate for Payer: Mclaren Medicaid |
$11.79
|
| Rate for Payer: Mclaren Medicare |
$21.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.09
|
| Rate for Payer: Meridian Medicaid |
$12.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.28
|
| Rate for Payer: PACE Medicare |
$20.89
|
| Rate for Payer: PACE SWMI |
$21.99
|
| Rate for Payer: PHP Commercial |
$35.28
|
| Rate for Payer: PHP Medicare Advantage |
$21.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.98
|
| Rate for Payer: Priority Health Medicare |
$21.99
|
| Rate for Payer: Priority Health SBD |
$26.15
|
| Rate for Payer: Railroad Medicare Medicare |
$21.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.99
|
| Rate for Payer: UHC Exchange |
$42.03
|
| Rate for Payer: UHC Medicare Advantage |
$21.99
|
| Rate for Payer: UHCCP Medicaid |
$11.79
|
| Rate for Payer: UMR Bronson Commercial |
$15.36
|
| Rate for Payer: VA VA |
$21.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.13
|
|
|
HC RENIN
|
Facility
|
IP
|
$41.51
|
|
|
Service Code
|
CPT 84244
|
| Hospital Charge Code |
30100419
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.26 |
| Max. Negotiated Rate |
$37.36 |
| Rate for Payer: Aetna American Axle |
$26.98
|
| Rate for Payer: Aetna Commercial |
$35.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.98
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cofinity Commercial |
$29.06
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.21
|
| Rate for Payer: Healthscope Commercial |
$37.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.28
|
| Rate for Payer: PHP Commercial |
$35.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.98
|
| Rate for Payer: Priority Health SBD |
$26.15
|
| Rate for Payer: UMR Bronson Commercial |
$18.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.13
|
|
|
HC RENO 60 PER ML
|
Facility
|
IP
|
$0.40
|
|
|
Service Code
|
HCPCS Q9961
|
| Hospital Charge Code |
63600018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$0.36 |
| Rate for Payer: Aetna American Axle |
$0.26
|
| Rate for Payer: Aetna Commercial |
$0.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.26
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cofinity Commercial |
$0.28
|
| Rate for Payer: Cofinity Commercial |
$0.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.32
|
| Rate for Payer: Healthscope Commercial |
$0.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.34
|
| Rate for Payer: PHP Commercial |
$0.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.26
|
| Rate for Payer: Priority Health SBD |
$0.25
|
| Rate for Payer: UMR Bronson Commercial |
$0.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.30
|
|
|
HC RENO 60 PER ML
|
Facility
|
OP
|
$0.40
|
|
|
Service Code
|
HCPCS Q9961
|
| Hospital Charge Code |
63600018
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$0.36 |
| Rate for Payer: Aetna American Axle |
$0.26
|
| Rate for Payer: Aetna Commercial |
$0.34
|
| Rate for Payer: Aetna Medicare |
$0.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.26
|
| Rate for Payer: BCBS Complete |
$0.16
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cofinity Commercial |
$0.28
|
| Rate for Payer: Cofinity Commercial |
$0.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.32
|
| Rate for Payer: Healthscope Commercial |
$0.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.34
|
| Rate for Payer: PHP Commercial |
$0.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.26
|
| Rate for Payer: Priority Health SBD |
$0.25
|
| Rate for Payer: UMR Bronson Commercial |
$0.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.30
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM
|
Facility
|
OP
|
$1,581.00
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
76100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$319.99 |
| Max. Negotiated Rate |
$1,680.50 |
| Rate for Payer: Aetna American Axle |
$1,027.65
|
| Rate for Payer: Aetna Commercial |
$1,343.85
|
| Rate for Payer: Aetna Medicare |
$620.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,027.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$746.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$746.25
|
| Rate for Payer: BCBS Complete |
$335.99
|
| Rate for Payer: BCBS MAPPO |
$597.00
|
| Rate for Payer: BCN Medicare Advantage |
$597.00
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cofinity Commercial |
$1,359.66
|
| Rate for Payer: Cofinity Commercial |
$1,106.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,106.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,264.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.00
|
| Rate for Payer: Healthscope Commercial |
$1,422.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,106.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,185.75
|
| Rate for Payer: Mclaren Medicaid |
$319.99
|
| Rate for Payer: Mclaren Medicare |
$597.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$626.85
|
| Rate for Payer: Meridian Medicaid |
$335.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$686.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,343.85
|
| Rate for Payer: PACE Medicare |
$567.15
|
| Rate for Payer: PACE SWMI |
$597.00
|
| Rate for Payer: PHP Commercial |
$1,343.85
|
| Rate for Payer: PHP Medicare Advantage |
$597.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.65
|
| Rate for Payer: Priority Health Medicare |
$597.00
|
| Rate for Payer: Priority Health SBD |
$996.03
|
| Rate for Payer: Railroad Medicare Medicare |
$597.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,680.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$597.00
|
| Rate for Payer: UHC Exchange |
$1,140.93
|
| Rate for Payer: UHC Medicare Advantage |
$597.00
|
| Rate for Payer: UHCCP Medicaid |
$319.99
|
| Rate for Payer: UMR Bronson Commercial |
$584.97
|
| Rate for Payer: VA VA |
$597.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,185.75
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM
|
Facility
|
IP
|
$1,581.00
|
|
|
Service Code
|
CPT 13151
|
| Hospital Charge Code |
76100443
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$695.64 |
| Max. Negotiated Rate |
$1,422.90 |
| Rate for Payer: Aetna American Axle |
$1,027.65
|
| Rate for Payer: Aetna Commercial |
$1,343.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,027.65
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cofinity Commercial |
$1,106.70
|
| Rate for Payer: Cofinity Commercial |
$1,359.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,106.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,264.80
|
| Rate for Payer: Healthscope Commercial |
$1,422.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,106.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,185.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,343.85
|
| Rate for Payer: PHP Commercial |
$1,343.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.65
|
| Rate for Payer: Priority Health SBD |
$996.03
|
| Rate for Payer: UMR Bronson Commercial |
$695.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,185.75
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM
|
Facility
|
IP
|
$1,581.00
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
76100444
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$695.64 |
| Max. Negotiated Rate |
$1,422.90 |
| Rate for Payer: Aetna American Axle |
$1,027.65
|
| Rate for Payer: Aetna Commercial |
$1,343.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,027.65
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cofinity Commercial |
$1,106.70
|
| Rate for Payer: Cofinity Commercial |
$1,359.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,106.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,264.80
|
| Rate for Payer: Healthscope Commercial |
$1,422.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,106.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,185.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,343.85
|
| Rate for Payer: PHP Commercial |
$1,343.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.65
|
| Rate for Payer: Priority Health SBD |
$996.03
|
| Rate for Payer: UMR Bronson Commercial |
$695.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,185.75
|
|
|
HC REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM
|
Facility
|
OP
|
$1,581.00
|
|
|
Service Code
|
CPT 13152
|
| Hospital Charge Code |
76100444
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$319.99 |
| Max. Negotiated Rate |
$1,680.50 |
| Rate for Payer: Aetna American Axle |
$1,027.65
|
| Rate for Payer: Aetna Commercial |
$1,343.85
|
| Rate for Payer: Aetna Medicare |
$620.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,027.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$746.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$746.25
|
| Rate for Payer: BCBS Complete |
$335.99
|
| Rate for Payer: BCBS MAPPO |
$597.00
|
| Rate for Payer: BCN Medicare Advantage |
$597.00
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cash Price |
$1,264.80
|
| Rate for Payer: Cofinity Commercial |
$1,359.66
|
| Rate for Payer: Cofinity Commercial |
$1,106.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,106.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,264.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.00
|
| Rate for Payer: Healthscope Commercial |
$1,422.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,106.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,185.75
|
| Rate for Payer: Mclaren Medicaid |
$319.99
|
| Rate for Payer: Mclaren Medicare |
$597.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$626.85
|
| Rate for Payer: Meridian Medicaid |
$335.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$686.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,343.85
|
| Rate for Payer: PACE Medicare |
$567.15
|
| Rate for Payer: PACE SWMI |
$597.00
|
| Rate for Payer: PHP Commercial |
$1,343.85
|
| Rate for Payer: PHP Medicare Advantage |
$597.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.65
|
| Rate for Payer: Priority Health Medicare |
$597.00
|
| Rate for Payer: Priority Health SBD |
$996.03
|
| Rate for Payer: Railroad Medicare Medicare |
$597.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,680.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$597.00
|
| Rate for Payer: UHC Exchange |
$1,140.93
|
| Rate for Payer: UHC Medicare Advantage |
$597.00
|
| Rate for Payer: UHCCP Medicaid |
$319.99
|
| Rate for Payer: UMR Bronson Commercial |
$584.97
|
| Rate for Payer: VA VA |
$597.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,185.75
|
|
|
HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM
|
Facility
|
OP
|
$1,662.60
|
|
|
Service Code
|
CPT 13132
|
| Hospital Charge Code |
76100379
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$319.99 |
| Max. Negotiated Rate |
$1,680.50 |
| Rate for Payer: Aetna American Axle |
$1,080.69
|
| Rate for Payer: Aetna Commercial |
$1,413.21
|
| Rate for Payer: Aetna Medicare |
$620.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,080.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$746.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$746.25
|
| Rate for Payer: BCBS Complete |
$335.99
|
| Rate for Payer: BCBS MAPPO |
$597.00
|
| Rate for Payer: BCN Medicare Advantage |
$597.00
|
| Rate for Payer: Cash Price |
$1,330.08
|
| Rate for Payer: Cash Price |
$1,330.08
|
| Rate for Payer: Cofinity Commercial |
$1,429.84
|
| Rate for Payer: Cofinity Commercial |
$1,163.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,163.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,330.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.00
|
| Rate for Payer: Healthscope Commercial |
$1,496.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,163.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,246.95
|
| Rate for Payer: Mclaren Medicaid |
$319.99
|
| Rate for Payer: Mclaren Medicare |
$597.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$626.85
|
| Rate for Payer: Meridian Medicaid |
$335.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$686.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,413.21
|
| Rate for Payer: PACE Medicare |
$567.15
|
| Rate for Payer: PACE SWMI |
$597.00
|
| Rate for Payer: PHP Commercial |
$1,413.21
|
| Rate for Payer: PHP Medicare Advantage |
$597.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,080.69
|
| Rate for Payer: Priority Health Medicare |
$597.00
|
| Rate for Payer: Priority Health SBD |
$1,047.44
|
| Rate for Payer: Railroad Medicare Medicare |
$597.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,680.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$597.00
|
| Rate for Payer: UHC Exchange |
$1,140.93
|
| Rate for Payer: UHC Medicare Advantage |
$597.00
|
| Rate for Payer: UHCCP Medicaid |
$319.99
|
| Rate for Payer: UMR Bronson Commercial |
$615.16
|
| Rate for Payer: VA VA |
$597.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,246.95
|
|
