|
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 |
$264.27 |
| Max. Negotiated Rate |
$1,885.01 |
| Rate for Payer: Aetna American Axle |
$1,027.65
|
| Rate for Payer: Aetna Commercial |
$1,343.85
|
| Rate for Payer: Aetna Medicare |
$623.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,027.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$749.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$749.69
|
| Rate for Payer: BCBS Complete |
$337.54
|
| Rate for Payer: BCBS MAPPO |
$599.75
|
| Rate for Payer: BCBS Trust/PPO |
$651.59
|
| Rate for Payer: BCN Commercial |
$651.59
|
| Rate for Payer: BCN Medicare Advantage |
$599.75
|
| Rate for Payer: Cash Price |
$1,264.80
|
| 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 |
$599.75
|
| 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 |
$321.47
|
| Rate for Payer: Mclaren Medicare |
$599.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.74
|
| Rate for Payer: Meridian Medicaid |
$337.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$689.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,343.85
|
| Rate for Payer: Nomi Health Commercial |
$1,259.48
|
| Rate for Payer: PACE Medicare |
$569.76
|
| Rate for Payer: PACE SWMI |
$599.75
|
| Rate for Payer: PHP Commercial |
$1,343.85
|
| Rate for Payer: PHP Medicare Advantage |
$599.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,885.01
|
| Rate for Payer: Priority Health Medicare |
$599.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,508.01
|
| Rate for Payer: Priority Health SBD |
$996.03
|
| Rate for Payer: Railroad Medicare Medicare |
$599.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.70
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.75
|
| Rate for Payer: UHC Exchange |
$264.27
|
| Rate for Payer: UHC Medicare Advantage |
$599.75
|
| Rate for Payer: UHCCP Medicaid |
$321.47
|
| Rate for Payer: UMR Bronson Commercial |
$584.97
|
| Rate for Payer: VA VA |
$599.75
|
| 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 |
$318.93 |
| Max. Negotiated Rate |
$1,885.01 |
| Rate for Payer: Aetna American Axle |
$1,027.65
|
| Rate for Payer: Aetna Commercial |
$1,343.85
|
| Rate for Payer: Aetna Medicare |
$623.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,027.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$749.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$749.69
|
| Rate for Payer: BCBS Complete |
$337.54
|
| Rate for Payer: BCBS MAPPO |
$599.75
|
| Rate for Payer: BCBS Trust/PPO |
$1,354.66
|
| Rate for Payer: BCN Commercial |
$1,354.66
|
| Rate for Payer: BCN Medicare Advantage |
$599.75
|
| Rate for Payer: Cash Price |
$1,264.80
|
| 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 |
$599.75
|
| 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 |
$321.47
|
| Rate for Payer: Mclaren Medicare |
$599.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.74
|
| Rate for Payer: Meridian Medicaid |
$337.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$689.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,343.85
|
| Rate for Payer: Nomi Health Commercial |
$1,259.48
|
| Rate for Payer: PACE Medicare |
$569.76
|
| Rate for Payer: PACE SWMI |
$599.75
|
| Rate for Payer: PHP Commercial |
$1,343.85
|
| Rate for Payer: PHP Medicare Advantage |
$599.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,027.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,885.01
|
| Rate for Payer: Priority Health Medicare |
$599.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,508.01
|
| Rate for Payer: Priority Health SBD |
$996.03
|
| Rate for Payer: Railroad Medicare Medicare |
$599.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.82
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.75
|
| Rate for Payer: UHC Exchange |
$318.93
|
| Rate for Payer: UHC Medicare Advantage |
$599.75
|
| Rate for Payer: UHCCP Medicaid |
$321.47
|
| Rate for Payer: UMR Bronson Commercial |
$584.97
|
| Rate for Payer: VA VA |
$599.75
|
| 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 |
$287.12 |
| Max. Negotiated Rate |
$1,885.01 |
| Rate for Payer: Aetna American Axle |
$1,080.69
|
| Rate for Payer: Aetna Commercial |
$1,413.21
|
| Rate for Payer: Aetna Medicare |
$623.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,080.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$749.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$749.69
|
| Rate for Payer: BCBS Complete |
$337.54
|
| Rate for Payer: BCBS MAPPO |
$599.75
|
| Rate for Payer: BCBS Trust/PPO |
$946.39
|
| Rate for Payer: BCN Commercial |
$946.39
|
| Rate for Payer: BCN Medicare Advantage |
$599.75
|
| Rate for Payer: Cash Price |
$1,330.08
|
| 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 |
$599.75
|
| 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 |
$321.47
|
| Rate for Payer: Mclaren Medicare |
$599.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.74
|
| Rate for Payer: Meridian Medicaid |
$337.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$689.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,413.21
|
| Rate for Payer: Nomi Health Commercial |
$1,259.48
|
| Rate for Payer: PACE Medicare |
$569.76
|
| Rate for Payer: PACE SWMI |
$599.75
|
| Rate for Payer: PHP Commercial |
$1,413.21
|
| Rate for Payer: PHP Medicare Advantage |
$599.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,080.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,885.01
|
| Rate for Payer: Priority Health Medicare |
$599.75
|
| Rate for Payer: Priority Health Narrow Network |
$1,508.01
|
| Rate for Payer: Priority Health SBD |
$1,047.44
|
| Rate for Payer: Railroad Medicare Medicare |
$599.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.83
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.75
|
| Rate for Payer: UHC Exchange |
$287.12
|
| Rate for Payer: UHC Medicare Advantage |
$599.75
|
| Rate for Payer: UHCCP Medicaid |
$321.47
|
| Rate for Payer: UMR Bronson Commercial |
$615.16
|
| Rate for Payer: VA VA |
$599.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,246.95
|
|
|
HC REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM
|
Facility
|
IP
|
$1,662.60
|
|
|
Service Code
|
CPT 13132
|
| Hospital Charge Code |
76100379
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$731.54 |
| Max. Negotiated Rate |
$1,496.34 |
| Rate for Payer: Aetna American Axle |
$1,080.69
|
| Rate for Payer: Aetna Commercial |
$1,413.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,080.69
|
| Rate for Payer: Cash Price |
$1,330.08
|
| Rate for Payer: Cofinity Commercial |
$1,163.82
|
| Rate for Payer: Cofinity Commercial |
$1,429.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,163.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,330.08
|
| 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: Multiplan/Beech St/PHCS Commercial |
$1,413.21
|
| Rate for Payer: PHP Commercial |
$1,413.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,080.69
|
| Rate for Payer: Priority Health SBD |
$1,047.44
|
| Rate for Payer: UMR Bronson Commercial |
$731.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,246.95
|
|
|
HC REPAIR CVAC WO PORT OR PUMP
|
Facility
|
OP
|
$1,069.35
|
|
|
Service Code
|
CPT 36575
|
| Hospital Charge Code |
36100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$31.79 |
| Max. Negotiated Rate |
$1,903.90 |
| Rate for Payer: Aetna American Axle |
$695.08
|
| Rate for Payer: Aetna Commercial |
$908.95
|
| Rate for Payer: Aetna Medicare |
$629.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$695.08
|
| 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 |
$575.80
|
| Rate for Payer: BCN Commercial |
$575.80
|
| Rate for Payer: BCN Medicare Advantage |
$605.76
|
| Rate for Payer: Cash Price |
$855.48
|
| Rate for Payer: Cash Price |
$855.48
|
| Rate for Payer: Cash Price |
$855.48
|
| Rate for Payer: Cofinity Commercial |
$919.64
|
| Rate for Payer: Cofinity Commercial |
$748.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$748.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$605.76
|
| Rate for Payer: Healthscope Commercial |
$962.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$748.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$802.01
|
| 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 |
$908.95
|
| Rate for Payer: Nomi Health Commercial |
$1,272.10
|
| Rate for Payer: PACE Medicare |
$575.47
|
| Rate for Payer: PACE SWMI |
$605.76
|
| Rate for Payer: PHP Commercial |
$908.95
|
| 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 |
$695.08
|
| 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 |
$673.69
|
| Rate for Payer: Railroad Medicare Medicare |
$605.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.97
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$605.76
|
| Rate for Payer: UHC Exchange |
$31.79
|
| Rate for Payer: UHC Medicare Advantage |
$605.76
|
| Rate for Payer: UHCCP Medicaid |
$324.69
|
| Rate for Payer: UMR Bronson Commercial |
$395.66
|
| Rate for Payer: VA VA |
$605.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$802.01
|
|
|
HC REPAIR CVAC WO PORT OR PUMP
|
Facility
|
IP
|
$1,069.35
|
|
|
Service Code
|
CPT 36575
|
| Hospital Charge Code |
36100131
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$470.51 |
| Max. Negotiated Rate |
$962.42 |
| Rate for Payer: Aetna American Axle |
$695.08
|
| Rate for Payer: Aetna Commercial |
$908.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$695.08
|
| Rate for Payer: Cash Price |
$855.48
|
| Rate for Payer: Cofinity Commercial |
$748.54
|
| Rate for Payer: Cofinity Commercial |
$919.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$748.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.48
|
| Rate for Payer: Healthscope Commercial |
$962.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$748.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$802.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.95
|
| Rate for Payer: PHP Commercial |
$908.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.08
|
| Rate for Payer: Priority Health SBD |
$673.69
|
| Rate for Payer: UMR Bronson Commercial |
$470.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$802.01
|
|
|
HC REPAIR EXT TENDON FINGER WO GRAFT EA
|
Facility
|
OP
|
$4,637.18
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
45000093
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$588.37 |
| Max. Negotiated Rate |
$4,928.37 |
| Rate for Payer: Aetna American Axle |
$3,014.17
|
| Rate for Payer: Aetna Commercial |
$3,941.60
|
| Rate for Payer: Aetna Medicare |
$1,630.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,014.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,516.85
|
| Rate for Payer: BCN Commercial |
$2,516.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$3,709.74
|
| Rate for Payer: Cash Price |
$3,709.74
|
| Rate for Payer: Cash Price |
$3,709.74
|
| Rate for Payer: Cofinity Commercial |
$3,987.97
|
| Rate for Payer: Cofinity Commercial |
$3,246.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,246.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,709.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$4,173.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,246.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,477.88
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,941.60
|
| Rate for Payer: Nomi Health Commercial |
$3,292.90
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$3,941.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,014.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,928.37
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$3,942.70
|
| Rate for Payer: Priority Health SBD |
$2,921.42
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.21
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Exchange |
$588.37
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$840.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,715.76
|
| Rate for Payer: VA VA |
$1,568.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,477.88
|
|
|
HC REPAIR EXT TENDON FINGER WO GRAFT EA
|
Facility
|
IP
|
$4,637.18
|
|
|
Service Code
|
CPT 26418
|
| Hospital Charge Code |
45000093
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,040.36 |
| Max. Negotiated Rate |
$4,173.46 |
| Rate for Payer: Aetna American Axle |
$3,014.17
|
| Rate for Payer: Aetna Commercial |
$3,941.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,014.17
|
| Rate for Payer: Cash Price |
$3,709.74
|
| Rate for Payer: Cofinity Commercial |
$3,246.03
|
| Rate for Payer: Cofinity Commercial |
$3,987.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,246.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,709.74
|
| Rate for Payer: Healthscope Commercial |
$4,173.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,246.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,477.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,941.60
|
| Rate for Payer: PHP Commercial |
$3,941.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,014.17
|
| Rate for Payer: Priority Health SBD |
$2,921.42
|
| Rate for Payer: UMR Bronson Commercial |
$2,040.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,477.88
|
|
|
HC REPAIR FINGER TENDON
|
Facility
|
OP
|
$4,291.95
|
|
|
Service Code
|
CPT 26432
|
| Hospital Charge Code |
76100358
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$840.47 |
| Max. Negotiated Rate |
$4,928.37 |
| Rate for Payer: Aetna American Axle |
$2,789.77
|
| Rate for Payer: Aetna Commercial |
$3,648.16
|
| Rate for Payer: Aetna Medicare |
$1,630.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,789.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,444.32
|
| Rate for Payer: BCN Commercial |
$1,444.32
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$3,433.56
|
| Rate for Payer: Cash Price |
$3,433.56
|
| Rate for Payer: Cash Price |
$3,433.56
|
| Rate for Payer: Cofinity Commercial |
$3,691.08
|
| Rate for Payer: Cofinity Commercial |
$3,004.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,004.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,433.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$3,862.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,004.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,218.96
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,648.16
|
| Rate for Payer: Nomi Health Commercial |
$3,292.90
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$3,648.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,789.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,928.37
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$3,942.70
|
| Rate for Payer: Priority Health SBD |
$2,703.93
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,413.90
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Exchange |
$2,996.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$840.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,588.02
|
| Rate for Payer: VA VA |
$1,568.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,218.96
|
|
|
HC REPAIR FINGER TENDON
|
Facility
|
IP
|
$4,291.95
|
|
|
Service Code
|
CPT 26432
|
| Hospital Charge Code |
76100358
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,888.46 |
| Max. Negotiated Rate |
$3,862.76 |
| Rate for Payer: Aetna American Axle |
$2,789.77
|
| Rate for Payer: Aetna Commercial |
$3,648.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,789.77
|
| Rate for Payer: Cash Price |
$3,433.56
|
| Rate for Payer: Cofinity Commercial |
$3,004.36
|
| Rate for Payer: Cofinity Commercial |
$3,691.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,004.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,433.56
|
| Rate for Payer: Healthscope Commercial |
$3,862.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,004.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,218.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,648.16
|
| Rate for Payer: PHP Commercial |
$3,648.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,789.77
|
| Rate for Payer: Priority Health SBD |
$2,703.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,888.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,218.96
|
|
|
HC REPAIR OF CIRCUMCISION
|
Facility
|
OP
|
$5,814.00
|
|
|
Service Code
|
CPT 54163
|
| Hospital Charge Code |
76100416
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$210.28 |
| Max. Negotiated Rate |
$6,308.24 |
| Rate for Payer: Aetna American Axle |
$3,779.10
|
| Rate for Payer: Aetna Commercial |
$4,941.90
|
| Rate for Payer: Aetna Medicare |
$2,087.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,779.10
|
| 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 |
$2,581.31
|
| Rate for Payer: BCN Commercial |
$2,581.31
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$4,651.20
|
| Rate for Payer: Cash Price |
$4,651.20
|
| Rate for Payer: Cash Price |
$4,651.20
|
| Rate for Payer: Cofinity Commercial |
$5,000.04
|
| Rate for Payer: Cofinity Commercial |
$4,069.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,069.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,651.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$5,232.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,069.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,360.50
|
| 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 |
$4,941.90
|
| 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 |
$4,941.90
|
| 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 |
$3,779.10
|
| 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 |
$3,662.82
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.31
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$210.28
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: UMR Bronson Commercial |
$2,151.18
|
| Rate for Payer: VA VA |
$2,007.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,360.50
|
|
|
HC REPAIR OF CIRCUMCISION
|
Facility
|
IP
|
$5,814.00
|
|
|
Service Code
|
CPT 54163
|
| Hospital Charge Code |
76100416
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,558.16 |
| Max. Negotiated Rate |
$5,232.60 |
| Rate for Payer: Aetna American Axle |
$3,779.10
|
| Rate for Payer: Aetna Commercial |
$4,941.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,779.10
|
| Rate for Payer: Cash Price |
$4,651.20
|
| Rate for Payer: Cofinity Commercial |
$4,069.80
|
| Rate for Payer: Cofinity Commercial |
$5,000.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,069.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,651.20
|
| Rate for Payer: Healthscope Commercial |
$5,232.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,069.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,360.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,941.90
|
| Rate for Payer: PHP Commercial |
$4,941.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,779.10
|
| Rate for Payer: Priority Health SBD |
$3,662.82
|
| Rate for Payer: UMR Bronson Commercial |
$2,558.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,360.50
|
|
|
HC REPAIR SINGLE ELECTRODE PACEMAKER OR ICD
|
Facility
|
OP
|
$4,885.51
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
36100569
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$371.93 |
| Max. Negotiated Rate |
$11,206.98 |
| Rate for Payer: Aetna American Axle |
$3,175.58
|
| Rate for Payer: Aetna Commercial |
$4,152.68
|
| Rate for Payer: Aetna Medicare |
$3,708.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,175.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,457.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,457.14
|
| Rate for Payer: BCBS Complete |
$2,006.78
|
| Rate for Payer: BCBS MAPPO |
$3,565.71
|
| Rate for Payer: BCBS Trust/PPO |
$2,154.30
|
| Rate for Payer: BCN Commercial |
$2,154.30
|
| Rate for Payer: BCN Medicare Advantage |
$3,565.71
|
| Rate for Payer: Cash Price |
$3,908.41
|
| Rate for Payer: Cash Price |
$3,908.41
|
| Rate for Payer: Cash Price |
$3,908.41
|
| Rate for Payer: Cofinity Commercial |
$4,201.54
|
| Rate for Payer: Cofinity Commercial |
$3,419.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,419.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,908.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,565.71
|
| Rate for Payer: Healthscope Commercial |
$4,396.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,419.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,664.13
|
| Rate for Payer: Mclaren Medicaid |
$1,911.22
|
| Rate for Payer: Mclaren Medicare |
$3,565.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,744.00
|
| Rate for Payer: Meridian Medicaid |
$2,006.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,100.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,152.68
|
| Rate for Payer: Nomi Health Commercial |
$7,487.99
|
| Rate for Payer: PACE Medicare |
$3,387.42
|
| Rate for Payer: PACE SWMI |
$3,565.71
|
| Rate for Payer: PHP Commercial |
$4,152.68
|
| Rate for Payer: PHP Medicare Advantage |
$3,565.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,911.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,175.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,206.98
|
| Rate for Payer: Priority Health Medicare |
$3,565.71
|
| Rate for Payer: Priority Health Narrow Network |
$8,965.58
|
| Rate for Payer: Priority Health SBD |
$3,077.87
|
| Rate for Payer: Railroad Medicare Medicare |
$3,565.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$409.12
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,565.71
|
| Rate for Payer: UHC Exchange |
$371.93
|
| Rate for Payer: UHC Medicare Advantage |
$3,565.71
|
| Rate for Payer: UHCCP Medicaid |
$1,911.22
|
| Rate for Payer: UMR Bronson Commercial |
$1,807.64
|
| Rate for Payer: VA VA |
$3,565.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,664.13
|
|
|
HC REPAIR SINGLE ELECTRODE PACEMAKER OR ICD
|
Facility
|
IP
|
$4,885.51
|
|
|
Service Code
|
CPT 33218
|
| Hospital Charge Code |
36100569
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,149.62 |
| Max. Negotiated Rate |
$4,396.96 |
| Rate for Payer: Aetna American Axle |
$3,175.58
|
| Rate for Payer: Aetna Commercial |
$4,152.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,175.58
|
| Rate for Payer: Cash Price |
$3,908.41
|
| Rate for Payer: Cofinity Commercial |
$3,419.86
|
| Rate for Payer: Cofinity Commercial |
$4,201.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,419.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,908.41
|
| Rate for Payer: Healthscope Commercial |
$4,396.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,419.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,664.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,152.68
|
| Rate for Payer: PHP Commercial |
$4,152.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,175.58
|
| Rate for Payer: Priority Health SBD |
$3,077.87
|
| Rate for Payer: UMR Bronson Commercial |
$2,149.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,664.13
|
|
|
HC REPAIR SPICA/BODY CAST
|
Facility
|
IP
|
$193.91
|
|
|
Service Code
|
CPT 29720
|
| Hospital Charge Code |
70000017
|
|
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 REPAIR SPICA/BODY CAST
|
Facility
|
OP
|
$193.91
|
|
|
Service Code
|
CPT 29720
|
| Hospital Charge Code |
70000017
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$42.26 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$126.04
|
| Rate for Payer: Aetna Commercial |
$164.82
|
| Rate for Payer: Aetna Medicare |
$160.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.25
|
| Rate for Payer: BCBS Complete |
$87.01
|
| Rate for Payer: BCBS MAPPO |
$154.60
|
| Rate for Payer: BCBS Trust/PPO |
$76.48
|
| Rate for Payer: BCN Commercial |
$76.48
|
| Rate for Payer: BCN Medicare Advantage |
$154.60
|
| 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 |
$154.60
|
| 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 |
$82.87
|
| Rate for Payer: Mclaren Medicare |
$154.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.33
|
| Rate for Payer: Meridian Medicaid |
$87.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.82
|
| Rate for Payer: Nomi Health Commercial |
$324.66
|
| Rate for Payer: PACE Medicare |
$146.87
|
| Rate for Payer: PACE SWMI |
$154.60
|
| Rate for Payer: PHP Commercial |
$164.82
|
| Rate for Payer: PHP Medicare Advantage |
$154.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$485.91
|
| Rate for Payer: Priority Health Medicare |
$154.60
|
| Rate for Payer: Priority Health Narrow Network |
$388.73
|
| Rate for Payer: Priority Health SBD |
$122.16
|
| Rate for Payer: Railroad Medicare Medicare |
$154.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.49
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.60
|
| Rate for Payer: UHC Exchange |
$42.26
|
| Rate for Payer: UHC Medicare Advantage |
$154.60
|
| Rate for Payer: UHCCP Medicaid |
$82.87
|
| Rate for Payer: UMR Bronson Commercial |
$71.75
|
| Rate for Payer: VA VA |
$154.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.43
|
|
|
HC REPAIR TENDON HAND/FINGER
|
Facility
|
IP
|
$4,214.96
|
|
| Hospital Charge Code |
45000096
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,854.58 |
| Max. Negotiated Rate |
$3,793.46 |
| Rate for Payer: Aetna American Axle |
$2,739.72
|
| Rate for Payer: Aetna Commercial |
$3,582.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,739.72
|
| Rate for Payer: Cash Price |
$3,371.97
|
| Rate for Payer: Cofinity Commercial |
$2,950.47
|
| Rate for Payer: Cofinity Commercial |
$3,624.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,950.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,371.97
|
| Rate for Payer: Healthscope Commercial |
$3,793.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,950.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,161.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,582.72
|
| Rate for Payer: PHP Commercial |
$3,582.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,739.72
|
| Rate for Payer: Priority Health SBD |
$2,655.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,854.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,161.22
|
|
|
HC REPAIR TENDON HAND/FINGER
|
Facility
|
OP
|
$4,214.96
|
|
| Hospital Charge Code |
45000096
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,559.54 |
| Max. Negotiated Rate |
$3,793.46 |
| Rate for Payer: Aetna American Axle |
$2,739.72
|
| Rate for Payer: Aetna Commercial |
$3,582.72
|
| Rate for Payer: Aetna Medicare |
$2,107.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,739.72
|
| Rate for Payer: BCBS Complete |
$1,685.98
|
| Rate for Payer: Cash Price |
$3,371.97
|
| Rate for Payer: Cofinity Commercial |
$2,950.47
|
| Rate for Payer: Cofinity Commercial |
$3,624.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,950.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,371.97
|
| Rate for Payer: Healthscope Commercial |
$3,793.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,950.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,161.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,582.72
|
| Rate for Payer: PHP Commercial |
$3,582.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,739.72
|
| Rate for Payer: Priority Health SBD |
$2,655.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,559.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,161.22
|
|
|
HC REPAZ CVAD WITH PORT OR PUMP
|
Facility
|
IP
|
$1,642.24
|
|
|
Service Code
|
CPT 36576
|
| Hospital Charge Code |
36100132
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$722.59 |
| Max. Negotiated Rate |
$1,478.02 |
| Rate for Payer: Aetna American Axle |
$1,067.46
|
| Rate for Payer: Aetna Commercial |
$1,395.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,067.46
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cofinity Commercial |
$1,149.57
|
| Rate for Payer: Cofinity Commercial |
$1,412.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,149.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,313.79
|
| Rate for Payer: Healthscope Commercial |
$1,478.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,149.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,231.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,395.90
|
| Rate for Payer: PHP Commercial |
$1,395.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,067.46
|
| Rate for Payer: Priority Health SBD |
$1,034.61
|
| Rate for Payer: UMR Bronson Commercial |
$722.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,231.68
|
|
|
HC REPAZ CVAD WITH PORT OR PUMP
|
Facility
|
OP
|
$1,642.24
|
|
|
Service Code
|
CPT 36576
|
| Hospital Charge Code |
36100132
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$175.58 |
| Max. Negotiated Rate |
$4,783.71 |
| Rate for Payer: Aetna American Axle |
$1,067.46
|
| Rate for Payer: Aetna Commercial |
$1,395.90
|
| Rate for Payer: Aetna Medicare |
$1,582.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,067.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,902.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,902.54
|
| Rate for Payer: BCBS Complete |
$856.60
|
| Rate for Payer: BCBS MAPPO |
$1,522.03
|
| Rate for Payer: BCBS Trust/PPO |
$671.78
|
| Rate for Payer: BCN Commercial |
$671.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,522.03
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cash Price |
$1,313.79
|
| Rate for Payer: Cofinity Commercial |
$1,412.33
|
| Rate for Payer: Cofinity Commercial |
$1,149.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,149.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,313.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,522.03
|
| Rate for Payer: Healthscope Commercial |
$1,478.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,149.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,231.68
|
| Rate for Payer: Mclaren Medicaid |
$815.81
|
| Rate for Payer: Mclaren Medicare |
$1,522.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,598.13
|
| Rate for Payer: Meridian Medicaid |
$856.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,750.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,395.90
|
| Rate for Payer: Nomi Health Commercial |
$3,196.26
|
| Rate for Payer: PACE Medicare |
$1,445.93
|
| Rate for Payer: PACE SWMI |
$1,522.03
|
| Rate for Payer: PHP Commercial |
$1,395.90
|
| Rate for Payer: PHP Medicare Advantage |
$1,522.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$815.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,067.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,783.71
|
| Rate for Payer: Priority Health Medicare |
$1,522.03
|
| Rate for Payer: Priority Health Narrow Network |
$3,826.97
|
| Rate for Payer: Priority Health SBD |
$1,034.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,522.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.14
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,522.03
|
| Rate for Payer: UHC Exchange |
$175.58
|
| Rate for Payer: UHC Medicare Advantage |
$1,522.03
|
| Rate for Payer: UHCCP Medicaid |
$815.81
|
| Rate for Payer: UMR Bronson Commercial |
$607.63
|
| Rate for Payer: VA VA |
$1,522.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,231.68
|
|
|
HC REPLACE AORTIC VALVE OPEN AXILLRY ARTERY APPR
|
Facility
|
OP
|
$66,762.47
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
48100119
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,320.60 |
| Max. Negotiated Rate |
$60,086.22 |
| Rate for Payer: Aetna American Axle |
$43,395.61
|
| Rate for Payer: Aetna Commercial |
$56,748.10
|
| Rate for Payer: Aetna Medicare |
$33,381.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43,395.61
|
| Rate for Payer: BCBS Complete |
$26,704.99
|
| Rate for Payer: BCBS Trust/PPO |
$5,746.27
|
| Rate for Payer: BCN Commercial |
$5,746.27
|
| Rate for Payer: Cash Price |
$53,409.98
|
| Rate for Payer: Cash Price |
$53,409.98
|
| Rate for Payer: Cash Price |
$53,409.98
|
| Rate for Payer: Cofinity Commercial |
$57,415.72
|
| Rate for Payer: Cofinity Commercial |
$46,733.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$46,733.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53,409.98
|
| Rate for Payer: Healthscope Commercial |
$60,086.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46,733.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50,071.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56,748.10
|
| Rate for Payer: PHP Commercial |
$56,748.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43,395.61
|
| Rate for Payer: Priority Health SBD |
$42,060.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,452.66
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UHC Exchange |
$1,320.60
|
| Rate for Payer: UMR Bronson Commercial |
$24,702.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50,071.85
|
|
|
HC REPLACE AORTIC VALVE OPEN AXILLRY ARTERY APPR
|
Facility
|
IP
|
$66,762.47
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
48100119
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$29,375.49 |
| Max. Negotiated Rate |
$60,086.22 |
| Rate for Payer: Aetna American Axle |
$43,395.61
|
| Rate for Payer: Aetna Commercial |
$56,748.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43,395.61
|
| Rate for Payer: Cash Price |
$53,409.98
|
| Rate for Payer: Cofinity Commercial |
$46,733.73
|
| Rate for Payer: Cofinity Commercial |
$57,415.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$46,733.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53,409.98
|
| Rate for Payer: Healthscope Commercial |
$60,086.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46,733.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50,071.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56,748.10
|
| Rate for Payer: PHP Commercial |
$56,748.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43,395.61
|
| Rate for Payer: Priority Health SBD |
$42,060.36
|
| Rate for Payer: UMR Bronson Commercial |
$29,375.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50,071.85
|
|
|
HC REPLACE AORTIC VALVE OPEN FEMORAL ARTERY APPR
|
Facility
|
IP
|
$63,641.27
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
48100118
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$28,002.16 |
| Max. Negotiated Rate |
$57,277.14 |
| Rate for Payer: Aetna American Axle |
$41,366.83
|
| Rate for Payer: Aetna Commercial |
$54,095.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41,366.83
|
| Rate for Payer: Cash Price |
$50,913.02
|
| Rate for Payer: Cofinity Commercial |
$44,548.89
|
| Rate for Payer: Cofinity Commercial |
$54,731.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$44,548.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50,913.02
|
| Rate for Payer: Healthscope Commercial |
$57,277.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44,548.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47,730.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54,095.08
|
| Rate for Payer: PHP Commercial |
$54,095.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41,366.83
|
| Rate for Payer: Priority Health SBD |
$40,094.00
|
| Rate for Payer: UMR Bronson Commercial |
$28,002.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47,730.95
|
|
|
HC REPLACE AORTIC VALVE OPEN FEMORAL ARTERY APPR
|
Facility
|
OP
|
$63,641.27
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
48100118
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,272.20 |
| Max. Negotiated Rate |
$57,277.14 |
| Rate for Payer: Aetna American Axle |
$41,366.83
|
| Rate for Payer: Aetna Commercial |
$54,095.08
|
| Rate for Payer: Aetna Medicare |
$31,820.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41,366.83
|
| Rate for Payer: BCBS Complete |
$25,456.51
|
| Rate for Payer: BCBS Trust/PPO |
$5,458.21
|
| Rate for Payer: BCN Commercial |
$5,458.21
|
| Rate for Payer: Cash Price |
$50,913.02
|
| Rate for Payer: Cash Price |
$50,913.02
|
| Rate for Payer: Cash Price |
$50,913.02
|
| Rate for Payer: Cofinity Commercial |
$54,731.49
|
| Rate for Payer: Cofinity Commercial |
$44,548.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$44,548.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50,913.02
|
| Rate for Payer: Healthscope Commercial |
$57,277.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44,548.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47,730.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54,095.08
|
| Rate for Payer: PHP Commercial |
$54,095.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41,366.83
|
| Rate for Payer: Priority Health SBD |
$40,094.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,399.42
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UHC Exchange |
$1,272.20
|
| Rate for Payer: UMR Bronson Commercial |
$23,547.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47,730.95
|
|
