|
HC TEG COAGULATION TIME ACTIVATED
|
Facility
|
IP
|
$29.71
|
|
|
Service Code
|
CPT 85347
|
| Hospital Charge Code |
30500100
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.07 |
| Max. Negotiated Rate |
$26.74 |
| Rate for Payer: Aetna American Axle |
$19.31
|
| Rate for Payer: Aetna Commercial |
$25.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.31
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Advantage |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$25.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Healthscope Commercial |
$26.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: PHP Commercial |
$25.25
|
| Rate for Payer: Priority Health SBD |
$18.72
|
| Rate for Payer: UMR Bronson Commercial |
$13.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.28
|
|
|
HC TEG FIBRINOGEN ACTIVITY
|
Facility
|
OP
|
$66.59
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500101
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna American Axle |
$43.28
|
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare |
$10.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.15
|
| Rate for Payer: BCBS Complete |
$5.34
|
| Rate for Payer: BCBS MAPPO |
$9.72
|
| Rate for Payer: BCBS Trust/PPO |
$11.24
|
| Rate for Payer: BCN Commercial |
$11.24
|
| Rate for Payer: BCN Medicare Advantage |
$9.72
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Advantage |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.72
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.94
|
| Rate for Payer: Mclaren Medicaid |
$9.72
|
| Rate for Payer: Mclaren Medicare |
$9.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.21
|
| Rate for Payer: Meridian Medicaid |
$10.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$14.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.94
|
| Rate for Payer: PACE Medicare |
$9.23
|
| Rate for Payer: PACE SWMI |
$9.72
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: PHP Medicare Advantage |
$9.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.72
|
| Rate for Payer: Priority Health Medicare |
$9.72
|
| Rate for Payer: Priority Health SBD |
$41.95
|
| Rate for Payer: Priority Health Tiered Network |
$7.78
|
| Rate for Payer: Railroad Medicare Medicare |
$9.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.58
|
| Rate for Payer: UHC Core |
$14.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.72
|
| Rate for Payer: UHC Exchange |
$14.58
|
| Rate for Payer: UHC Medicaid |
$5.08
|
| Rate for Payer: UHCCP Medicaid |
$5.08
|
| Rate for Payer: UMR Bronson Commercial |
$24.64
|
| Rate for Payer: VA VA |
$9.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.94
|
|
|
HC TEG FIBRINOGEN ACTIVITY
|
Facility
|
IP
|
$66.59
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500101
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$29.30 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna American Axle |
$43.28
|
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.28
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Advantage |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.94
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: Priority Health SBD |
$41.95
|
| Rate for Payer: UMR Bronson Commercial |
$29.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.94
|
|
|
HC TEG PLATELET AGGREGATION IN VITRO EACH
|
Facility
|
IP
|
$127.35
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500102
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$56.03 |
| Max. Negotiated Rate |
$114.61 |
| Rate for Payer: Aetna American Axle |
$82.78
|
| Rate for Payer: Aetna Commercial |
$108.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.78
|
| Rate for Payer: Cash Price |
$101.88
|
| Rate for Payer: Cofinity Advantage |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$109.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.88
|
| Rate for Payer: Healthscope Commercial |
$114.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.51
|
| Rate for Payer: PHP Commercial |
$108.25
|
| Rate for Payer: Priority Health SBD |
$80.23
|
| Rate for Payer: UMR Bronson Commercial |
$56.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.51
|
|
|
HC TEG PLATELET AGGREGATION IN VITRO EACH
|
Facility
|
OP
|
$127.35
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500102
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.03 |
| Max. Negotiated Rate |
$114.61 |
| Rate for Payer: Aetna American Axle |
$82.78
|
| Rate for Payer: Aetna Commercial |
$108.25
|
| Rate for Payer: Aetna Medicare |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: BCBS Complete |
$13.68
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCBS Trust/PPO |
$21.59
|
| Rate for Payer: BCN Commercial |
$21.59
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$101.88
|
| Rate for Payer: Cash Price |
$101.88
|
| Rate for Payer: Cofinity Advantage |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$109.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$114.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.51
|
| Rate for Payer: Mclaren Medicaid |
$24.91
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: Meridian Medicaid |
$26.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.25
|
| Rate for Payer: Nomi Health Commercial |
$37.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.51
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$108.25
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24.91
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health SBD |
$80.23
|
| Rate for Payer: Priority Health Tiered Network |
$19.93
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.37
|
| Rate for Payer: UHC Core |
$37.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.91
|
| Rate for Payer: UHC Exchange |
$37.37
|
| Rate for Payer: UHC Medicaid |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$13.03
|
| Rate for Payer: UMR Bronson Commercial |
$47.12
|
| Rate for Payer: VA VA |
$24.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.51
|
|
|
HC TEGRETOL CARBAMAZEPINE LVL
|
Facility
|
IP
|
$109.66
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
30100585
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.25 |
| Max. Negotiated Rate |
$98.69 |
| Rate for Payer: Aetna American Axle |
$71.28
|
| Rate for Payer: Aetna Commercial |
$93.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.28
|
| Rate for Payer: Cash Price |
$87.73
|
| Rate for Payer: Cofinity Advantage |
$76.76
|
| Rate for Payer: Cofinity Commercial |
$94.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.73
|
| Rate for Payer: Healthscope Commercial |
$98.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.25
|
| Rate for Payer: PHP Commercial |
$93.21
|
| Rate for Payer: Priority Health SBD |
$69.09
|
| Rate for Payer: UMR Bronson Commercial |
$48.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.25
|
|
|
HC TEGRETOL CARBAMAZEPINE LVL
|
Facility
|
OP
|
$109.66
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
30100585
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.62 |
| Max. Negotiated Rate |
$98.69 |
| Rate for Payer: Aetna American Axle |
$71.28
|
| Rate for Payer: Aetna Commercial |
$93.21
|
| Rate for Payer: Aetna Medicare |
$15.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.21
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS MAPPO |
$14.57
|
| Rate for Payer: BCBS Trust/PPO |
$16.85
|
| Rate for Payer: BCN Commercial |
$16.85
|
| Rate for Payer: BCN Medicare Advantage |
$14.57
|
| Rate for Payer: Cash Price |
$87.73
|
| Rate for Payer: Cash Price |
$87.73
|
| Rate for Payer: Cofinity Advantage |
$76.76
|
| Rate for Payer: Cofinity Commercial |
$94.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.57
|
| Rate for Payer: Healthscope Commercial |
$98.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.25
|
| Rate for Payer: Mclaren Medicaid |
$14.57
|
| Rate for Payer: Mclaren Medicare |
$14.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.30
|
| Rate for Payer: Meridian Medicaid |
$15.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.21
|
| Rate for Payer: Nomi Health Commercial |
$21.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.25
|
| Rate for Payer: PACE Medicare |
$13.84
|
| Rate for Payer: PACE SWMI |
$14.57
|
| Rate for Payer: PHP Commercial |
$93.21
|
| Rate for Payer: PHP Medicare Advantage |
$14.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14.57
|
| Rate for Payer: Priority Health Medicare |
$14.57
|
| Rate for Payer: Priority Health SBD |
$69.09
|
| Rate for Payer: Priority Health Tiered Network |
$11.66
|
| Rate for Payer: Railroad Medicare Medicare |
$14.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.86
|
| Rate for Payer: UHC Core |
$21.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.57
|
| Rate for Payer: UHC Exchange |
$21.86
|
| Rate for Payer: UHC Medicaid |
$7.62
|
| Rate for Payer: UHCCP Medicaid |
$7.62
|
| Rate for Payer: UMR Bronson Commercial |
$40.57
|
| Rate for Payer: VA VA |
$14.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.25
|
|
|
HC TEGRETOL FREE AND TOTAL CMPT
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
30100023
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.62 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna American Axle |
$31.04
|
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna Medicare |
$15.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.21
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS MAPPO |
$14.57
|
| Rate for Payer: BCBS Trust/PPO |
$16.85
|
| Rate for Payer: BCN Commercial |
$16.85
|
| Rate for Payer: BCN Medicare Advantage |
$14.57
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Advantage |
$33.43
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.57
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Mclaren Medicaid |
$14.57
|
| Rate for Payer: Mclaren Medicare |
$14.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.30
|
| Rate for Payer: Meridian Medicaid |
$15.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$21.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Medicare |
$13.84
|
| Rate for Payer: PACE SWMI |
$14.57
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: PHP Medicare Advantage |
$14.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14.57
|
| Rate for Payer: Priority Health Medicare |
$14.57
|
| Rate for Payer: Priority Health SBD |
$30.09
|
| Rate for Payer: Priority Health Tiered Network |
$11.66
|
| Rate for Payer: Railroad Medicare Medicare |
$14.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.86
|
| Rate for Payer: UHC Core |
$21.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.57
|
| Rate for Payer: UHC Exchange |
$21.86
|
| Rate for Payer: UHC Medicaid |
$7.62
|
| Rate for Payer: UHCCP Medicaid |
$7.62
|
| Rate for Payer: UMR Bronson Commercial |
$17.67
|
| Rate for Payer: VA VA |
$14.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC TEGRETOL FREE AND TOTAL CMPT
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
30100023
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.01 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna American Axle |
$31.04
|
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.04
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Advantage |
$33.43
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: Priority Health SBD |
$30.09
|
| Rate for Payer: UMR Bronson Commercial |
$21.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC TEGRETOL FREE AND TOTAL LEVEL
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 80157
|
| Hospital Charge Code |
30100024
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna American Axle |
$27.59
|
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$13.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.56
|
| Rate for Payer: BCBS Complete |
$7.28
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCBS Trust/PPO |
$15.32
|
| Rate for Payer: BCN Commercial |
$15.32
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$13.25
|
| Rate for Payer: Mclaren Medicare |
$13.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: Meridian Medicaid |
$13.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$19.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$12.59
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.25
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: Priority Health Tiered Network |
$10.60
|
| Rate for Payer: Railroad Medicare Medicare |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.88
|
| Rate for Payer: UHC Core |
$19.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.25
|
| Rate for Payer: UHC Exchange |
$19.88
|
| Rate for Payer: UHC Medicaid |
$6.93
|
| Rate for Payer: UHCCP Medicaid |
$6.93
|
| Rate for Payer: UMR Bronson Commercial |
$15.71
|
| Rate for Payer: VA VA |
$13.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC TEGRETOL FREE AND TOTAL LEVEL
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 80157
|
| Hospital Charge Code |
30100024
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna American Axle |
$27.59
|
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: UMR Bronson Commercial |
$18.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC TELEHEALTH ORG SITE FACILITY
|
Facility
|
OP
|
$91.58
|
|
|
Service Code
|
HCPCS Q3014
|
| Hospital Charge Code |
78000001
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$33.88 |
| Max. Negotiated Rate |
$82.42 |
| Rate for Payer: Aetna American Axle |
$59.53
|
| Rate for Payer: Aetna Commercial |
$77.84
|
| Rate for Payer: Aetna Medicare |
$45.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.53
|
| Rate for Payer: BCBS Complete |
$36.63
|
| Rate for Payer: BCBS Trust/PPO |
$55.31
|
| Rate for Payer: BCN Commercial |
$55.31
|
| Rate for Payer: Cash Price |
$73.26
|
| Rate for Payer: Cash Price |
$73.26
|
| Rate for Payer: Cofinity Advantage |
$64.11
|
| Rate for Payer: Cofinity Commercial |
$78.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.26
|
| Rate for Payer: Healthscope Commercial |
$82.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.69
|
| Rate for Payer: PHP Commercial |
$77.84
|
| Rate for Payer: Priority Health SBD |
$57.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.53
|
| Rate for Payer: UHC Core |
$47.71
|
| Rate for Payer: UHC Exchange |
$35.99
|
| Rate for Payer: UMR Bronson Commercial |
$33.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.69
|
|
|
HC TELEHEALTH ORG SITE FACILITY
|
Facility
|
IP
|
$91.58
|
|
|
Service Code
|
HCPCS Q3014
|
| Hospital Charge Code |
78000001
|
|
Hospital Revenue Code
|
780
|
| Min. Negotiated Rate |
$40.30 |
| Max. Negotiated Rate |
$82.42 |
| Rate for Payer: Aetna American Axle |
$59.53
|
| Rate for Payer: Aetna Commercial |
$77.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.53
|
| Rate for Payer: Cash Price |
$73.26
|
| Rate for Payer: Cofinity Advantage |
$64.11
|
| Rate for Payer: Cofinity Commercial |
$78.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.26
|
| Rate for Payer: Healthscope Commercial |
$82.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.69
|
| Rate for Payer: PHP Commercial |
$77.84
|
| Rate for Payer: Priority Health SBD |
$57.70
|
| Rate for Payer: UMR Bronson Commercial |
$40.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.69
|
|
|
HC TE MANUAL TX EACH 15 MIN
|
Facility
|
IP
|
$116.73
|
|
|
Service Code
|
CPT 97140
|
| Hospital Charge Code |
42000026
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$51.36 |
| Max. Negotiated Rate |
$105.06 |
| Rate for Payer: Aetna American Axle |
$75.87
|
| Rate for Payer: Aetna Commercial |
$99.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.87
|
| Rate for Payer: Cash Price |
$93.38
|
| Rate for Payer: Cofinity Advantage |
$81.71
|
| Rate for Payer: Cofinity Commercial |
$100.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.38
|
| Rate for Payer: Healthscope Commercial |
$105.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.55
|
| Rate for Payer: PHP Commercial |
$99.22
|
| Rate for Payer: Priority Health SBD |
$73.54
|
| Rate for Payer: UMR Bronson Commercial |
$51.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.55
|
|
|
HC TE MANUAL TX EACH 15 MIN
|
Facility
|
OP
|
$116.73
|
|
|
Service Code
|
CPT 97140
|
| Hospital Charge Code |
42000026
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$75.87
|
| Rate for Payer: Aetna Commercial |
$99.22
|
| Rate for Payer: Aetna Medicare |
$58.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.87
|
| Rate for Payer: BCBS Complete |
$46.69
|
| Rate for Payer: BCBS Trust/PPO |
$25.40
|
| Rate for Payer: BCN Commercial |
$25.40
|
| Rate for Payer: Cash Price |
$93.38
|
| Rate for Payer: Cash Price |
$93.38
|
| Rate for Payer: Cash Price |
$93.38
|
| Rate for Payer: Cofinity Advantage |
$81.71
|
| Rate for Payer: Cofinity Commercial |
$100.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.38
|
| Rate for Payer: Healthscope Commercial |
$105.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.22
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.55
|
| Rate for Payer: PHP Commercial |
$99.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26.00
|
| Rate for Payer: Priority Health SBD |
$73.54
|
| Rate for Payer: Priority Health Tiered Network |
$20.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.87
|
| Rate for Payer: UHC Core |
$60.82
|
| Rate for Payer: UHC Exchange |
$45.87
|
| Rate for Payer: UMR Bronson Commercial |
$43.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.55
|
|
|
HC TEMPORARY PACEMAKER
|
Facility
|
IP
|
$2,859.96
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
36100060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,258.38 |
| Max. Negotiated Rate |
$2,573.96 |
| Rate for Payer: Aetna American Axle |
$1,858.97
|
| Rate for Payer: Aetna Commercial |
$2,430.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,858.97
|
| Rate for Payer: Cash Price |
$2,287.97
|
| Rate for Payer: Cofinity Advantage |
$2,001.97
|
| Rate for Payer: Cofinity Commercial |
$2,459.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,287.97
|
| Rate for Payer: Healthscope Commercial |
$2,573.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,001.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,144.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,430.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,144.97
|
| Rate for Payer: PHP Commercial |
$2,430.97
|
| Rate for Payer: Priority Health SBD |
$1,801.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,258.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,144.97
|
|
|
HC TEMPORARY PACEMAKER
|
Facility
|
OP
|
$2,859.96
|
|
|
Service Code
|
CPT 33210
|
| Hospital Charge Code |
36100060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,058.19 |
| Max. Negotiated Rate |
$26,665.62 |
| Rate for Payer: Aetna American Axle |
$1,858.97
|
| Rate for Payer: Aetna Commercial |
$2,430.97
|
| Rate for Payer: Aetna Medicare |
$8,575.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,858.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,307.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,307.04
|
| Rate for Payer: BCBS Complete |
$4,528.50
|
| Rate for Payer: BCBS MAPPO |
$8,245.63
|
| Rate for Payer: BCBS Trust/PPO |
$9,069.08
|
| Rate for Payer: BCN Commercial |
$9,069.08
|
| Rate for Payer: BCN Medicare Advantage |
$8,245.63
|
| Rate for Payer: Cash Price |
$2,287.97
|
| Rate for Payer: Cash Price |
$2,287.97
|
| Rate for Payer: Cash Price |
$2,287.97
|
| Rate for Payer: Cofinity Advantage |
$2,001.97
|
| Rate for Payer: Cofinity Commercial |
$2,459.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,287.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,245.63
|
| Rate for Payer: Healthscope Commercial |
$2,573.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,001.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,144.97
|
| Rate for Payer: Mclaren Medicaid |
$8,245.63
|
| Rate for Payer: Mclaren Medicare |
$8,245.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,657.91
|
| Rate for Payer: Meridian Medicaid |
$8,657.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,482.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,070.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,430.97
|
| Rate for Payer: Nomi Health Commercial |
$24,736.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,144.97
|
| Rate for Payer: PACE Medicare |
$7,833.35
|
| Rate for Payer: PACE SWMI |
$8,245.63
|
| Rate for Payer: PHP Commercial |
$2,430.97
|
| Rate for Payer: PHP Medicare Advantage |
$8,245.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,312.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26,665.62
|
| Rate for Payer: Priority Health Medicare |
$8,245.63
|
| Rate for Payer: Priority Health SBD |
$1,801.77
|
| Rate for Payer: Priority Health Tiered Network |
$21,332.50
|
| Rate for Payer: Railroad Medicare Medicare |
$8,245.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,858.97
|
| Rate for Payer: UHC Core |
$1,490.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,245.63
|
| Rate for Payer: UHC Exchange |
$1,123.96
|
| Rate for Payer: UHC Medicaid |
$4,312.46
|
| Rate for Payer: UHCCP Medicaid |
$4,312.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,058.19
|
| Rate for Payer: VA VA |
$8,245.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,144.97
|
|
|
HC TEMPORARY PACING WIRE
|
Facility
|
OP
|
$702.06
|
|
|
Service Code
|
HCPCS C1756
|
| Hospital Charge Code |
27200074
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$259.76 |
| Max. Negotiated Rate |
$631.85 |
| Rate for Payer: Aetna American Axle |
$456.34
|
| Rate for Payer: Aetna Commercial |
$596.75
|
| Rate for Payer: Aetna Medicare |
$351.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$456.34
|
| Rate for Payer: BCBS Complete |
$280.82
|
| Rate for Payer: Cash Price |
$561.65
|
| Rate for Payer: Cofinity Advantage |
$491.44
|
| Rate for Payer: Cofinity Commercial |
$603.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$561.65
|
| Rate for Payer: Healthscope Commercial |
$631.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$491.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$526.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$561.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$596.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$526.54
|
| Rate for Payer: PHP Commercial |
$596.75
|
| Rate for Payer: Priority Health SBD |
$442.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$456.34
|
| Rate for Payer: UHC Core |
$365.77
|
| Rate for Payer: UHC Exchange |
$275.91
|
| Rate for Payer: UMR Bronson Commercial |
$259.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$526.54
|
|
|
HC TEMPORARY PACING WIRE
|
Facility
|
IP
|
$702.06
|
|
|
Service Code
|
HCPCS C1756
|
| Hospital Charge Code |
27200074
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$308.91 |
| Max. Negotiated Rate |
$631.85 |
| Rate for Payer: Aetna American Axle |
$456.34
|
| Rate for Payer: Aetna Commercial |
$596.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$456.34
|
| Rate for Payer: Cash Price |
$561.65
|
| Rate for Payer: Cofinity Advantage |
$491.44
|
| Rate for Payer: Cofinity Commercial |
$603.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$561.65
|
| Rate for Payer: Healthscope Commercial |
$631.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$491.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$526.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$596.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$526.54
|
| Rate for Payer: PHP Commercial |
$596.75
|
| Rate for Payer: Priority Health SBD |
$442.30
|
| Rate for Payer: UMR Bronson Commercial |
$308.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$526.54
|
|
|
HC TE NEURO EA 15 MIN
|
Facility
|
OP
|
$108.24
|
|
|
Service Code
|
CPT 97112
|
| Hospital Charge Code |
42000021
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$70.36
|
| Rate for Payer: Aetna Commercial |
$92.00
|
| Rate for Payer: Aetna Medicare |
$54.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.36
|
| Rate for Payer: BCBS Complete |
$43.30
|
| Rate for Payer: BCBS Trust/PPO |
$29.93
|
| Rate for Payer: BCN Commercial |
$29.93
|
| Rate for Payer: Cash Price |
$86.59
|
| Rate for Payer: Cash Price |
$86.59
|
| Rate for Payer: Cash Price |
$86.59
|
| Rate for Payer: Cofinity Advantage |
$75.77
|
| Rate for Payer: Cofinity Commercial |
$93.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.59
|
| Rate for Payer: Healthscope Commercial |
$97.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.00
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.18
|
| Rate for Payer: PHP Commercial |
$92.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29.00
|
| Rate for Payer: Priority Health SBD |
$68.19
|
| Rate for Payer: Priority Health Tiered Network |
$23.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.36
|
| Rate for Payer: UHC Core |
$56.39
|
| Rate for Payer: UHC Exchange |
$42.54
|
| Rate for Payer: UMR Bronson Commercial |
$40.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.18
|
|
|
HC TE NEURO EA 15 MIN
|
Facility
|
IP
|
$108.24
|
|
|
Service Code
|
CPT 97112
|
| Hospital Charge Code |
42000021
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$47.63 |
| Max. Negotiated Rate |
$97.42 |
| Rate for Payer: Aetna American Axle |
$70.36
|
| Rate for Payer: Aetna Commercial |
$92.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.36
|
| Rate for Payer: Cash Price |
$86.59
|
| Rate for Payer: Cofinity Advantage |
$75.77
|
| Rate for Payer: Cofinity Commercial |
$93.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.59
|
| Rate for Payer: Healthscope Commercial |
$97.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.18
|
| Rate for Payer: PHP Commercial |
$92.00
|
| Rate for Payer: Priority Health SBD |
$68.19
|
| Rate for Payer: UMR Bronson Commercial |
$47.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.18
|
|
|
HC TENOTOMY
|
Facility
|
IP
|
$2,950.53
|
|
|
Service Code
|
CPT 27605
|
| Hospital Charge Code |
36100046
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,298.23 |
| Max. Negotiated Rate |
$2,655.48 |
| Rate for Payer: Aetna American Axle |
$1,917.84
|
| Rate for Payer: Aetna Commercial |
$2,507.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,917.84
|
| Rate for Payer: Cash Price |
$2,360.42
|
| Rate for Payer: Cofinity Advantage |
$2,065.37
|
| Rate for Payer: Cofinity Commercial |
$2,537.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,360.42
|
| Rate for Payer: Healthscope Commercial |
$2,655.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,065.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,212.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,507.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,212.90
|
| Rate for Payer: PHP Commercial |
$2,507.95
|
| Rate for Payer: Priority Health SBD |
$1,858.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,298.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,212.90
|
|
|
HC TENOTOMY
|
Facility
|
OP
|
$2,950.53
|
|
|
Service Code
|
CPT 27605
|
| Hospital Charge Code |
36100046
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$837.96 |
| Max. Negotiated Rate |
$5,181.40 |
| Rate for Payer: Aetna American Axle |
$1,917.84
|
| Rate for Payer: Aetna Commercial |
$2,507.95
|
| Rate for Payer: Aetna Medicare |
$1,666.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,917.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,002.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,002.76
|
| Rate for Payer: BCBS Complete |
$879.93
|
| Rate for Payer: BCBS MAPPO |
$1,602.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,429.28
|
| Rate for Payer: BCN Commercial |
$1,429.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Cash Price |
$2,360.42
|
| Rate for Payer: Cash Price |
$2,360.42
|
| Rate for Payer: Cash Price |
$2,360.42
|
| Rate for Payer: Cofinity Advantage |
$2,065.37
|
| Rate for Payer: Cofinity Commercial |
$2,537.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,360.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Healthscope Commercial |
$2,655.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,065.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,212.90
|
| Rate for Payer: Mclaren Medicaid |
$1,602.21
|
| Rate for Payer: Mclaren Medicare |
$1,602.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,682.32
|
| Rate for Payer: Meridian Medicaid |
$1,682.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,762.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,507.95
|
| Rate for Payer: Nomi Health Commercial |
$4,806.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,212.90
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Commercial |
$2,507.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,602.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$837.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,181.40
|
| Rate for Payer: Priority Health Medicare |
$1,602.21
|
| Rate for Payer: Priority Health SBD |
$1,858.83
|
| Rate for Payer: Priority Health Tiered Network |
$4,145.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,602.21
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,091.70
|
| Rate for Payer: VA VA |
$1,602.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,212.90
|
|
|
HC TENOTOMY ADDUCTOR OF HIP PERCUTANEOUS
|
Facility
|
OP
|
$4,363.48
|
|
| Hospital Charge Code |
36000096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,614.49 |
| Max. Negotiated Rate |
$3,927.13 |
| Rate for Payer: Aetna American Axle |
$2,836.26
|
| Rate for Payer: Aetna Commercial |
$3,708.96
|
| Rate for Payer: Aetna Medicare |
$2,181.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,836.26
|
| Rate for Payer: BCBS Complete |
$1,745.39
|
| Rate for Payer: Cash Price |
$3,490.78
|
| Rate for Payer: Cofinity Advantage |
$3,054.44
|
| Rate for Payer: Cofinity Commercial |
$3,752.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,490.78
|
| Rate for Payer: Healthscope Commercial |
$3,927.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,054.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,272.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,490.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,708.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,272.61
|
| Rate for Payer: PHP Commercial |
$3,708.96
|
| Rate for Payer: Priority Health SBD |
$2,748.99
|
| Rate for Payer: UMR Bronson Commercial |
$1,614.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,272.61
|
|
|
HC TENOTOMY ADDUCTOR OF HIP PERCUTANEOUS
|
Facility
|
IP
|
$4,363.48
|
|
| Hospital Charge Code |
36000096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,919.93 |
| Max. Negotiated Rate |
$3,927.13 |
| Rate for Payer: Aetna American Axle |
$2,836.26
|
| Rate for Payer: Aetna Commercial |
$3,708.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,836.26
|
| Rate for Payer: Cash Price |
$3,490.78
|
| Rate for Payer: Cofinity Advantage |
$3,054.44
|
| Rate for Payer: Cofinity Commercial |
$3,752.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,490.78
|
| Rate for Payer: Healthscope Commercial |
$3,927.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,054.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,272.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,708.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,272.61
|
| Rate for Payer: PHP Commercial |
$3,708.96
|
| Rate for Payer: Priority Health SBD |
$2,748.99
|
| Rate for Payer: UMR Bronson Commercial |
$1,919.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,272.61
|
|
