|
HC REMOVAL SALIVARY STONE COMPLICATED
|
Facility
|
OP
|
$8,058.00
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$252.40 |
| 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 |
$325.31
|
| Rate for Payer: BCN Commercial |
$325.31
|
| 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) |
$277.64
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$252.40
|
| 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 SALIVARY STONE COMPLICATED
|
Facility
|
IP
|
$8,058.00
|
|
|
Service Code
|
CPT 42335
|
| Hospital Charge Code |
76100470
|
|
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 SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,244.00 |
| Max. Negotiated Rate |
$4,590.00 |
| Rate for Payer: Aetna American Axle |
$3,315.00
|
| Rate for Payer: Aetna Commercial |
$4,335.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,315.00
|
| Rate for Payer: Cash Price |
$4,080.00
|
| Rate for Payer: Cofinity Commercial |
$3,570.00
|
| Rate for Payer: Cofinity Commercial |
$4,386.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,570.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,080.00
|
| Rate for Payer: Healthscope Commercial |
$4,590.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,570.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,825.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,335.00
|
| Rate for Payer: PHP Commercial |
$4,335.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,315.00
|
| Rate for Payer: Priority Health SBD |
$3,213.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,244.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,825.00
|
|
|
HC REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
76100446
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.40 |
| Max. Negotiated Rate |
$5,632.99 |
| Rate for Payer: Aetna American Axle |
$3,315.00
|
| Rate for Payer: Aetna Commercial |
$4,335.00
|
| Rate for Payer: Aetna Medicare |
$1,863.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,315.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,240.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,240.30
|
| Rate for Payer: BCBS Complete |
$1,008.67
|
| Rate for Payer: BCBS MAPPO |
$1,792.24
|
| Rate for Payer: BCBS Trust/PPO |
$87.84
|
| Rate for Payer: BCN Commercial |
$87.84
|
| Rate for Payer: BCN Medicare Advantage |
$1,792.24
|
| Rate for Payer: Cash Price |
$4,080.00
|
| Rate for Payer: Cash Price |
$4,080.00
|
| Rate for Payer: Cash Price |
$4,080.00
|
| Rate for Payer: Cofinity Commercial |
$4,386.00
|
| Rate for Payer: Cofinity Commercial |
$3,570.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,570.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,080.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,792.24
|
| Rate for Payer: Healthscope Commercial |
$4,590.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,570.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,825.00
|
| Rate for Payer: Mclaren Medicaid |
$960.64
|
| Rate for Payer: Mclaren Medicare |
$1,792.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,881.85
|
| Rate for Payer: Meridian Medicaid |
$1,008.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,061.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,335.00
|
| Rate for Payer: Nomi Health Commercial |
$3,763.70
|
| Rate for Payer: PACE Medicare |
$1,702.63
|
| Rate for Payer: PACE SWMI |
$1,792.24
|
| Rate for Payer: PHP Commercial |
$4,335.00
|
| Rate for Payer: PHP Medicare Advantage |
$1,792.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$960.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,315.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,632.99
|
| Rate for Payer: Priority Health Medicare |
$1,792.24
|
| Rate for Payer: Priority Health Narrow Network |
$4,506.39
|
| Rate for Payer: Priority Health SBD |
$3,213.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,792.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.64
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,792.24
|
| Rate for Payer: UHC Exchange |
$62.40
|
| Rate for Payer: UHC Medicare Advantage |
$1,792.24
|
| Rate for Payer: UHCCP Medicaid |
$960.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,887.00
|
| Rate for Payer: VA VA |
$1,792.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,825.00
|
|
|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
IP
|
$1,125.01
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$495.00 |
| Max. Negotiated Rate |
$1,012.51 |
| Rate for Payer: Aetna American Axle |
$731.26
|
| Rate for Payer: Aetna Commercial |
$956.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.26
|
| Rate for Payer: Cash Price |
$900.01
|
| Rate for Payer: Cofinity Commercial |
$787.51
|
| Rate for Payer: Cofinity Commercial |
$967.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$787.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.01
|
| Rate for Payer: Healthscope Commercial |
$1,012.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$787.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$843.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.26
|
| Rate for Payer: PHP Commercial |
$956.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.26
|
| Rate for Payer: Priority Health SBD |
$708.76
|
| Rate for Payer: UMR Bronson Commercial |
$495.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$843.76
|
|
|
HC REMOVAL TUNNELED CVC WO PORT OR PUMP
|
Facility
|
OP
|
$1,125.01
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36100140
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$129.78 |
| Max. Negotiated Rate |
$1,903.90 |
| Rate for Payer: Aetna American Axle |
$731.26
|
| Rate for Payer: Aetna Commercial |
$956.26
|
| Rate for Payer: Aetna Medicare |
$629.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$757.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$757.20
|
| Rate for Payer: BCBS Complete |
$340.92
|
| Rate for Payer: BCBS MAPPO |
$605.76
|
| Rate for Payer: BCBS Trust/PPO |
$852.26
|
| Rate for Payer: BCN Commercial |
$852.26
|
| Rate for Payer: BCN Medicare Advantage |
$605.76
|
| Rate for Payer: Cash Price |
$900.01
|
| Rate for Payer: Cash Price |
$900.01
|
| Rate for Payer: Cash Price |
$900.01
|
| Rate for Payer: Cofinity Commercial |
$787.51
|
| Rate for Payer: Cofinity Commercial |
$967.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$787.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.76
|
| Rate for Payer: Healthscope Commercial |
$1,012.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$787.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$843.76
|
| Rate for Payer: Mclaren Medicaid |
$324.69
|
| Rate for Payer: Mclaren Medicare |
$605.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.05
|
| Rate for Payer: Meridian Medicaid |
$340.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$696.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.26
|
| Rate for Payer: Nomi Health Commercial |
$1,817.28
|
| Rate for Payer: PACE Medicare |
$575.47
|
| Rate for Payer: PACE SWMI |
$605.76
|
| Rate for Payer: PHP Commercial |
$956.26
|
| Rate for Payer: PHP Medicare Advantage |
$605.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,903.90
|
| Rate for Payer: Priority Health Medicare |
$605.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,523.12
|
| Rate for Payer: Priority Health SBD |
$708.76
|
| Rate for Payer: Railroad Medicare Medicare |
$605.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.76
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$605.76
|
| Rate for Payer: UHC Exchange |
$129.78
|
| Rate for Payer: UHC Medicare Advantage |
$605.76
|
| Rate for Payer: UHCCP Medicaid |
$324.69
|
| Rate for Payer: UMR Bronson Commercial |
$416.25
|
| Rate for Payer: VA VA |
$605.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$843.76
|
|
|
HC REMOVAL TUNNELED INTRAPERI CATHETER
|
Facility
|
IP
|
$3,292.84
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
36100221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,448.85 |
| Max. Negotiated Rate |
$2,963.56 |
| Rate for Payer: Aetna American Axle |
$2,140.35
|
| Rate for Payer: Aetna Commercial |
$2,798.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,140.35
|
| Rate for Payer: Cash Price |
$2,634.27
|
| Rate for Payer: Cofinity Commercial |
$2,304.99
|
| Rate for Payer: Cofinity Commercial |
$2,831.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,304.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,634.27
|
| Rate for Payer: Healthscope Commercial |
$2,963.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,304.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,469.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,798.91
|
| Rate for Payer: PHP Commercial |
$2,798.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,140.35
|
| Rate for Payer: Priority Health SBD |
$2,074.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,448.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,469.63
|
|
|
HC REMOVAL TUNNELED INTRAPERI CATHETER
|
Facility
|
OP
|
$3,292.84
|
|
|
Service Code
|
CPT 49422
|
| Hospital Charge Code |
36100221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$216.09 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$2,140.35
|
| Rate for Payer: Aetna Commercial |
$2,798.91
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,140.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,459.21
|
| Rate for Payer: BCN Commercial |
$2,459.21
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$2,634.27
|
| Rate for Payer: Cash Price |
$2,634.27
|
| Rate for Payer: Cash Price |
$2,634.27
|
| Rate for Payer: Cofinity Commercial |
$2,304.99
|
| Rate for Payer: Cofinity Commercial |
$2,831.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,304.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,634.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$2,963.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,304.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,469.63
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,798.91
|
| Rate for Payer: Nomi Health Commercial |
$9,251.58
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$2,798.91
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,140.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$2,074.49
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.70
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$216.09
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,218.35
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,469.63
|
|
|
HC REMOVAL TUNNELED PLEURAL CATHETER
|
Facility
|
IP
|
$983.98
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
36100054
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$432.95 |
| Max. Negotiated Rate |
$885.58 |
| Rate for Payer: Aetna American Axle |
$639.59
|
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.59
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$688.79
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$688.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$688.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health SBD |
$619.91
|
| Rate for Payer: UMR Bronson Commercial |
$432.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.98
|
|
|
HC REMOVAL TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$983.98
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
36100054
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$149.55 |
| Max. Negotiated Rate |
$1,903.90 |
| Rate for Payer: Aetna American Axle |
$639.59
|
| Rate for Payer: Aetna Commercial |
$836.38
|
| Rate for Payer: Aetna Medicare |
$629.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$639.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$757.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$757.20
|
| Rate for Payer: BCBS Complete |
$340.92
|
| Rate for Payer: BCBS MAPPO |
$605.76
|
| Rate for Payer: BCBS Trust/PPO |
$835.41
|
| Rate for Payer: BCN Commercial |
$835.41
|
| Rate for Payer: BCN Medicare Advantage |
$605.76
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cash Price |
$787.18
|
| Rate for Payer: Cofinity Commercial |
$688.79
|
| Rate for Payer: Cofinity Commercial |
$846.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$688.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$787.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.76
|
| Rate for Payer: Healthscope Commercial |
$885.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$688.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$737.98
|
| Rate for Payer: Mclaren Medicaid |
$324.69
|
| Rate for Payer: Mclaren Medicare |
$605.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$636.05
|
| Rate for Payer: Meridian Medicaid |
$340.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$696.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$836.38
|
| Rate for Payer: Nomi Health Commercial |
$1,817.28
|
| Rate for Payer: PACE Medicare |
$575.47
|
| Rate for Payer: PACE SWMI |
$605.76
|
| Rate for Payer: PHP Commercial |
$836.38
|
| Rate for Payer: PHP Medicare Advantage |
$605.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$324.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,903.90
|
| Rate for Payer: Priority Health Medicare |
$605.76
|
| Rate for Payer: Priority Health Narrow Network |
$1,523.12
|
| Rate for Payer: Priority Health SBD |
$619.91
|
| Rate for Payer: Railroad Medicare Medicare |
$605.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.50
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$605.76
|
| Rate for Payer: UHC Exchange |
$149.55
|
| Rate for Payer: UHC Medicare Advantage |
$605.76
|
| Rate for Payer: UHCCP Medicaid |
$324.69
|
| Rate for Payer: UMR Bronson Commercial |
$364.07
|
| Rate for Payer: VA VA |
$605.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$737.98
|
|
|
HC REMOVAL W/ REINSERT DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$543.33
|
|
|
Service Code
|
CPT 11983
|
| Hospital Charge Code |
76100180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$100.36 |
| Max. Negotiated Rate |
$1,228.82 |
| Rate for Payer: Aetna American Axle |
$353.16
|
| Rate for Payer: Aetna Commercial |
$461.83
|
| Rate for Payer: Aetna Medicare |
$406.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.16
|
| 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 |
$423.48
|
| Rate for Payer: BCN Commercial |
$423.48
|
| Rate for Payer: BCN Medicare Advantage |
$390.97
|
| Rate for Payer: Cash Price |
$434.66
|
| Rate for Payer: Cash Price |
$434.66
|
| Rate for Payer: Cash Price |
$434.66
|
| Rate for Payer: Cofinity Commercial |
$380.33
|
| Rate for Payer: Cofinity Commercial |
$467.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$380.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.97
|
| Rate for Payer: Healthscope Commercial |
$489.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$380.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$407.50
|
| Rate for Payer: Mclaren Medicaid |
$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 |
$461.83
|
| 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 |
$461.83
|
| 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 |
$353.16
|
| 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 |
$342.30
|
| Rate for Payer: Railroad Medicare Medicare |
$390.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.40
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$390.97
|
| Rate for Payer: UHC Exchange |
$100.36
|
| Rate for Payer: UHC Medicare Advantage |
$390.97
|
| Rate for Payer: UHCCP Medicaid |
$209.56
|
| Rate for Payer: UMR Bronson Commercial |
$201.03
|
| Rate for Payer: VA VA |
$390.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$407.50
|
|
|
HC REMOVAL W/ REINSERT DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$543.33
|
|
|
Service Code
|
CPT 11983
|
| Hospital Charge Code |
76100180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$239.07 |
| Max. Negotiated Rate |
$489.00 |
| Rate for Payer: Aetna American Axle |
$353.16
|
| Rate for Payer: Aetna Commercial |
$461.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$353.16
|
| Rate for Payer: Cash Price |
$434.66
|
| Rate for Payer: Cofinity Commercial |
$380.33
|
| Rate for Payer: Cofinity Commercial |
$467.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$380.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.66
|
| Rate for Payer: Healthscope Commercial |
$489.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$380.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$407.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.83
|
| Rate for Payer: PHP Commercial |
$461.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.16
|
| Rate for Payer: Priority Health SBD |
$342.30
|
| Rate for Payer: UMR Bronson Commercial |
$239.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$407.50
|
|
|
HC REMOVE ADDITIONAL NAIL PLATE
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
76100329
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$16.28 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$169.06
|
| Rate for Payer: Aetna Commercial |
$221.08
|
| Rate for Payer: Aetna Medicare |
$130.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.06
|
| Rate for Payer: BCBS Complete |
$104.04
|
| Rate for Payer: BCBS Trust/PPO |
$113.71
|
| Rate for Payer: BCN Commercial |
$113.71
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Cofinity Commercial |
$182.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$182.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.08
|
| Rate for Payer: PHP Commercial |
$221.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health SBD |
$163.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.91
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$16.28
|
| Rate for Payer: UMR Bronson Commercial |
$96.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.08
|
|
|
HC REMOVE ADDITIONAL NAIL PLATE
|
Facility
|
IP
|
$260.10
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
76100329
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$114.44 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna American Axle |
$169.06
|
| Rate for Payer: Aetna Commercial |
$221.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.06
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$182.07
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$182.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.08
|
| Rate for Payer: PHP Commercial |
$221.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health SBD |
$163.86
|
| Rate for Payer: UMR Bronson Commercial |
$114.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.08
|
|
|
HC REMOVE AND REPLACE INT URETERAL STENT
|
Facility
|
IP
|
$2,777.30
|
|
|
Service Code
|
CPT 50382
|
| Hospital Charge Code |
36100236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,222.01 |
| Max. Negotiated Rate |
$2,499.57 |
| Rate for Payer: Aetna American Axle |
$1,805.24
|
| Rate for Payer: Aetna Commercial |
$2,360.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,805.24
|
| Rate for Payer: Cash Price |
$2,221.84
|
| Rate for Payer: Cofinity Commercial |
$1,944.11
|
| Rate for Payer: Cofinity Commercial |
$2,388.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,944.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,221.84
|
| Rate for Payer: Healthscope Commercial |
$2,499.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,944.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,082.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,360.70
|
| Rate for Payer: PHP Commercial |
$2,360.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,805.24
|
| Rate for Payer: Priority Health SBD |
$1,749.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,222.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,082.98
|
|
|
HC REMOVE AND REPLACE INT URETERAL STENT
|
Facility
|
OP
|
$2,777.30
|
|
|
Service Code
|
CPT 50382
|
| Hospital Charge Code |
36100236
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$238.46 |
| Max. Negotiated Rate |
$6,308.24 |
| Rate for Payer: Aetna American Axle |
$1,805.24
|
| Rate for Payer: Aetna Commercial |
$2,360.70
|
| Rate for Payer: Aetna Medicare |
$2,087.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,805.24
|
| 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 |
$1,491.19
|
| Rate for Payer: BCN Commercial |
$1,491.19
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$2,221.84
|
| Rate for Payer: Cash Price |
$2,221.84
|
| Rate for Payer: Cash Price |
$2,221.84
|
| Rate for Payer: Cofinity Commercial |
$2,388.48
|
| Rate for Payer: Cofinity Commercial |
$1,944.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,944.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,221.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$2,499.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,944.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,082.98
|
| 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 |
$2,360.70
|
| 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 |
$2,360.70
|
| 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 |
$1,805.24
|
| 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 |
$1,749.70
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.31
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$238.46
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,027.60
|
| Rate for Payer: VA VA |
$2,007.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,082.98
|
|
|
HC REMOVE BILIARY DRAIN CATH
|
Facility
|
OP
|
$861.15
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
36100494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$90.81 |
| Max. Negotiated Rate |
$2,887.15 |
| Rate for Payer: Aetna American Axle |
$559.75
|
| Rate for Payer: Aetna Commercial |
$731.98
|
| Rate for Payer: Aetna Medicare |
$955.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$559.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$674.57
|
| Rate for Payer: BCN Commercial |
$674.57
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$688.92
|
| Rate for Payer: Cash Price |
$688.92
|
| Rate for Payer: Cash Price |
$688.92
|
| Rate for Payer: Cofinity Commercial |
$602.80
|
| Rate for Payer: Cofinity Commercial |
$740.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$602.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$688.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.60
|
| Rate for Payer: Healthscope Commercial |
$775.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$602.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$645.86
|
| Rate for Payer: Mclaren Medicaid |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$731.98
|
| Rate for Payer: Nomi Health Commercial |
$2,755.80
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$731.98
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$559.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,887.15
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,309.72
|
| Rate for Payer: Priority Health SBD |
$542.52
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.89
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Exchange |
$90.81
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$492.37
|
| Rate for Payer: UMR Bronson Commercial |
$318.63
|
| Rate for Payer: VA VA |
$918.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$645.86
|
|
|
HC REMOVE BILIARY DRAIN CATH
|
Facility
|
IP
|
$861.15
|
|
|
Service Code
|
CPT 47537
|
| Hospital Charge Code |
36100494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$378.91 |
| Max. Negotiated Rate |
$775.04 |
| Rate for Payer: Aetna American Axle |
$559.75
|
| Rate for Payer: Aetna Commercial |
$731.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$559.75
|
| Rate for Payer: Cash Price |
$688.92
|
| Rate for Payer: Cofinity Commercial |
$602.80
|
| Rate for Payer: Cofinity Commercial |
$740.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$602.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$688.92
|
| Rate for Payer: Healthscope Commercial |
$775.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$602.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$645.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$731.98
|
| Rate for Payer: PHP Commercial |
$731.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$559.75
|
| Rate for Payer: Priority Health SBD |
$542.52
|
| Rate for Payer: UMR Bronson Commercial |
$378.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$645.86
|
|
|
HC REMOVE/BIVALVE ARM/LEG
|
Facility
|
IP
|
$173.78
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
70000015
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$76.46 |
| Max. Negotiated Rate |
$156.40 |
| Rate for Payer: Aetna American Axle |
$112.96
|
| Rate for Payer: Aetna Commercial |
$147.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.96
|
| Rate for Payer: Cash Price |
$139.02
|
| Rate for Payer: Cofinity Commercial |
$121.65
|
| Rate for Payer: Cofinity Commercial |
$149.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$121.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.02
|
| Rate for Payer: Healthscope Commercial |
$156.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.71
|
| Rate for Payer: PHP Commercial |
$147.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.96
|
| Rate for Payer: Priority Health SBD |
$109.48
|
| Rate for Payer: UMR Bronson Commercial |
$76.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.34
|
|
|
HC REMOVE/BIVALVE ARM/LEG
|
Facility
|
OP
|
$173.78
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
70000015
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$42.92 |
| Max. Negotiated Rate |
$817.84 |
| Rate for Payer: Aetna American Axle |
$112.96
|
| Rate for Payer: Aetna Commercial |
$147.71
|
| Rate for Payer: Aetna Medicare |
$270.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$269.08
|
| Rate for Payer: BCN Commercial |
$269.08
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$139.02
|
| Rate for Payer: Cash Price |
$139.02
|
| Rate for Payer: Cash Price |
$139.02
|
| Rate for Payer: Cofinity Commercial |
$149.45
|
| Rate for Payer: Cofinity Commercial |
$121.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$121.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$156.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.34
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.71
|
| Rate for Payer: Nomi Health Commercial |
$546.44
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$147.71
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$817.84
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$654.27
|
| Rate for Payer: Priority Health SBD |
$109.48
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.21
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Exchange |
$42.92
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$139.47
|
| Rate for Payer: UMR Bronson Commercial |
$64.30
|
| Rate for Payer: VA VA |
$260.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.34
|
|
|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
OP
|
$193.91
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$32.05 |
| Max. Negotiated Rate |
$817.84 |
| Rate for Payer: Aetna American Axle |
$126.04
|
| Rate for Payer: Aetna Commercial |
$164.82
|
| Rate for Payer: Aetna Medicare |
$270.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$54.14
|
| Rate for Payer: BCN Commercial |
$54.14
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$155.13
|
| Rate for Payer: Cash Price |
$155.13
|
| Rate for Payer: Cash Price |
$155.13
|
| Rate for Payer: Cofinity Commercial |
$166.76
|
| Rate for Payer: Cofinity Commercial |
$135.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$135.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$174.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.43
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.82
|
| Rate for Payer: Nomi Health Commercial |
$546.44
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$164.82
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$817.84
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$654.27
|
| Rate for Payer: Priority Health SBD |
$122.16
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.26
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Exchange |
$32.05
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$139.47
|
| Rate for Payer: UMR Bronson Commercial |
$71.75
|
| Rate for Payer: VA VA |
$260.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.43
|
|
|
HC REMOVE/BIVALVE BODY CAST
|
Facility
|
IP
|
$193.91
|
|
|
Service Code
|
CPT 29700
|
| Hospital Charge Code |
70000014
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$85.32 |
| Max. Negotiated Rate |
$174.52 |
| Rate for Payer: Aetna American Axle |
$126.04
|
| Rate for Payer: Aetna Commercial |
$164.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.04
|
| Rate for Payer: Cash Price |
$155.13
|
| Rate for Payer: Cofinity Commercial |
$135.74
|
| Rate for Payer: Cofinity Commercial |
$166.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$135.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.13
|
| Rate for Payer: Healthscope Commercial |
$174.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.82
|
| Rate for Payer: PHP Commercial |
$164.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.04
|
| Rate for Payer: Priority Health SBD |
$122.16
|
| Rate for Payer: UMR Bronson Commercial |
$85.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.43
|
|
|
HC REMOVE/BIVALVE SPICA
|
Facility
|
IP
|
$352.09
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$154.92 |
| Max. Negotiated Rate |
$316.88 |
| Rate for Payer: Aetna American Axle |
$228.86
|
| Rate for Payer: Aetna Commercial |
$299.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.86
|
| Rate for Payer: Cash Price |
$281.67
|
| Rate for Payer: Cofinity Commercial |
$246.46
|
| Rate for Payer: Cofinity Commercial |
$302.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$246.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.67
|
| Rate for Payer: Healthscope Commercial |
$316.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.28
|
| Rate for Payer: PHP Commercial |
$299.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.86
|
| Rate for Payer: Priority Health SBD |
$221.82
|
| Rate for Payer: UMR Bronson Commercial |
$154.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.07
|
|
|
HC REMOVE/BIVALVE SPICA
|
Facility
|
OP
|
$352.09
|
|
|
Service Code
|
CPT 29710
|
| Hospital Charge Code |
70000016
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$79.60 |
| Max. Negotiated Rate |
$817.84 |
| Rate for Payer: Aetna American Axle |
$228.86
|
| Rate for Payer: Aetna Commercial |
$299.28
|
| Rate for Payer: Aetna Medicare |
$270.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$325.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$325.26
|
| Rate for Payer: BCBS Complete |
$146.45
|
| Rate for Payer: BCBS MAPPO |
$260.21
|
| Rate for Payer: BCBS Trust/PPO |
$88.81
|
| Rate for Payer: BCN Commercial |
$88.81
|
| Rate for Payer: BCN Medicare Advantage |
$260.21
|
| Rate for Payer: Cash Price |
$281.67
|
| Rate for Payer: Cash Price |
$281.67
|
| Rate for Payer: Cash Price |
$281.67
|
| Rate for Payer: Cofinity Commercial |
$302.80
|
| Rate for Payer: Cofinity Commercial |
$246.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$246.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$260.21
|
| Rate for Payer: Healthscope Commercial |
$316.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$264.07
|
| Rate for Payer: Mclaren Medicaid |
$139.47
|
| Rate for Payer: Mclaren Medicare |
$260.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$273.22
|
| Rate for Payer: Meridian Medicaid |
$146.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$299.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.28
|
| Rate for Payer: Nomi Health Commercial |
$546.44
|
| Rate for Payer: PACE Medicare |
$247.20
|
| Rate for Payer: PACE SWMI |
$260.21
|
| Rate for Payer: PHP Commercial |
$299.28
|
| Rate for Payer: PHP Medicare Advantage |
$260.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$817.84
|
| Rate for Payer: Priority Health Medicare |
$260.21
|
| Rate for Payer: Priority Health Narrow Network |
$654.27
|
| Rate for Payer: Priority Health SBD |
$221.82
|
| Rate for Payer: Railroad Medicare Medicare |
$260.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.56
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$260.21
|
| Rate for Payer: UHC Exchange |
$79.60
|
| Rate for Payer: UHC Medicare Advantage |
$260.21
|
| Rate for Payer: UHCCP Medicaid |
$139.47
|
| Rate for Payer: UMR Bronson Commercial |
$130.27
|
| Rate for Payer: VA VA |
$260.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$264.07
|
|
|
HC REMOVE CERUMEN INSTR BILAT
|
Facility
|
IP
|
$213.35
|
|
|
Service Code
|
CPT 69210
|
| Hospital Charge Code |
45000099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$93.87 |
| Max. Negotiated Rate |
$192.02 |
| Rate for Payer: Aetna American Axle |
$138.68
|
| Rate for Payer: Aetna Commercial |
$181.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.68
|
| Rate for Payer: Cash Price |
$170.68
|
| Rate for Payer: Cofinity Commercial |
$149.34
|
| Rate for Payer: Cofinity Commercial |
$183.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.68
|
| Rate for Payer: Healthscope Commercial |
$192.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.35
|
| Rate for Payer: PHP Commercial |
$181.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.68
|
| Rate for Payer: Priority Health SBD |
$134.41
|
| Rate for Payer: UMR Bronson Commercial |
$93.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.01
|
|
