|
HC TENOTOMY ELBOW LATERAL/MEDIAL PERC
|
Facility
|
OP
|
$4,584.09
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
76100408
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,696.11 |
| Max. Negotiated Rate |
$10,543.31 |
| Rate for Payer: Aetna American Axle |
$2,979.66
|
| Rate for Payer: Aetna Commercial |
$3,896.48
|
| Rate for Payer: Aetna Medicare |
$3,390.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,979.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,075.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,075.29
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,213.22
|
| Rate for Payer: BCN Commercial |
$2,213.22
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Cash Price |
$3,667.27
|
| Rate for Payer: Cash Price |
$3,667.27
|
| Rate for Payer: Cash Price |
$3,667.27
|
| Rate for Payer: Cofinity Advantage |
$3,208.86
|
| Rate for Payer: Cofinity Commercial |
$3,942.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,667.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Healthscope Commercial |
$4,125.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,208.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,438.07
|
| Rate for Payer: Mclaren Medicaid |
$3,260.23
|
| Rate for Payer: Mclaren Medicare |
$3,260.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,423.24
|
| Rate for Payer: Meridian Medicaid |
$3,423.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,749.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,586.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,896.48
|
| Rate for Payer: Nomi Health Commercial |
$9,780.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,438.07
|
| Rate for Payer: PACE Medicare |
$3,097.22
|
| Rate for Payer: PACE SWMI |
$3,260.23
|
| Rate for Payer: PHP Commercial |
$3,896.48
|
| Rate for Payer: PHP Medicare Advantage |
$3,260.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,705.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,543.31
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health SBD |
$2,887.98
|
| Rate for Payer: Priority Health Tiered Network |
$8,434.65
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,979.66
|
| Rate for Payer: UHC Core |
$2,388.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,260.23
|
| Rate for Payer: UHC Exchange |
$1,801.55
|
| Rate for Payer: UHC Medicaid |
$1,705.10
|
| Rate for Payer: UHCCP Medicaid |
$1,705.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,696.11
|
| Rate for Payer: VA VA |
$3,260.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,438.07
|
|
|
HC TENOTOMY ELBOW LATERAL/MEDIAL PERC
|
Facility
|
IP
|
$4,584.09
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
76100408
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,017.00 |
| Max. Negotiated Rate |
$4,125.68 |
| Rate for Payer: Aetna American Axle |
$2,979.66
|
| Rate for Payer: Aetna Commercial |
$3,896.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,979.66
|
| Rate for Payer: Cash Price |
$3,667.27
|
| Rate for Payer: Cofinity Advantage |
$3,208.86
|
| Rate for Payer: Cofinity Commercial |
$3,942.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,667.27
|
| Rate for Payer: Healthscope Commercial |
$4,125.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,208.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,438.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,896.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,438.07
|
| Rate for Payer: PHP Commercial |
$3,896.48
|
| Rate for Payer: Priority Health SBD |
$2,887.98
|
| Rate for Payer: UMR Bronson Commercial |
$2,017.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,438.07
|
|
|
HC TENOTOMY ELBOW LATERAL OR MEDIAL
|
Facility
|
OP
|
$4,584.09
|
|
| Hospital Charge Code |
36000093
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,696.11 |
| Max. Negotiated Rate |
$4,125.68 |
| Rate for Payer: Aetna American Axle |
$2,979.66
|
| Rate for Payer: Aetna Commercial |
$3,896.48
|
| Rate for Payer: Aetna Medicare |
$2,292.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,979.66
|
| Rate for Payer: BCBS Complete |
$1,833.64
|
| Rate for Payer: Cash Price |
$3,667.27
|
| Rate for Payer: Cofinity Advantage |
$3,208.86
|
| Rate for Payer: Cofinity Commercial |
$3,942.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,667.27
|
| Rate for Payer: Healthscope Commercial |
$4,125.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,208.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,438.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,667.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,896.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,438.07
|
| Rate for Payer: PHP Commercial |
$3,896.48
|
| Rate for Payer: Priority Health SBD |
$2,887.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,696.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,438.07
|
|
|
HC TENOTOMY ELBOW LATERAL OR MEDIAL
|
Facility
|
IP
|
$4,584.09
|
|
| Hospital Charge Code |
36000093
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,017.00 |
| Max. Negotiated Rate |
$4,125.68 |
| Rate for Payer: Aetna American Axle |
$2,979.66
|
| Rate for Payer: Aetna Commercial |
$3,896.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,979.66
|
| Rate for Payer: Cash Price |
$3,667.27
|
| Rate for Payer: Cofinity Advantage |
$3,208.86
|
| Rate for Payer: Cofinity Commercial |
$3,942.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,667.27
|
| Rate for Payer: Healthscope Commercial |
$4,125.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,208.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,438.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,896.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,438.07
|
| Rate for Payer: PHP Commercial |
$3,896.48
|
| Rate for Payer: Priority Health SBD |
$2,887.98
|
| Rate for Payer: UMR Bronson Commercial |
$2,017.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,438.07
|
|
|
HC TENOTOMY MULTIPLE TENDONS
|
Facility
|
OP
|
$5,340.69
|
|
| Hospital Charge Code |
36000095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,976.06 |
| Max. Negotiated Rate |
$4,806.62 |
| Rate for Payer: Aetna American Axle |
$3,471.45
|
| Rate for Payer: Aetna Commercial |
$4,539.59
|
| Rate for Payer: Aetna Medicare |
$2,670.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,471.45
|
| Rate for Payer: BCBS Complete |
$2,136.28
|
| Rate for Payer: Cash Price |
$4,272.55
|
| Rate for Payer: Cofinity Advantage |
$3,738.48
|
| Rate for Payer: Cofinity Commercial |
$4,592.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,272.55
|
| Rate for Payer: Healthscope Commercial |
$4,806.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,738.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,005.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,272.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,539.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,005.52
|
| Rate for Payer: PHP Commercial |
$4,539.59
|
| Rate for Payer: Priority Health SBD |
$3,364.63
|
| Rate for Payer: UMR Bronson Commercial |
$1,976.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,005.52
|
|
|
HC TENOTOMY MULTIPLE TENDONS
|
Facility
|
IP
|
$5,340.69
|
|
| Hospital Charge Code |
36000095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,349.90 |
| Max. Negotiated Rate |
$4,806.62 |
| Rate for Payer: Aetna American Axle |
$3,471.45
|
| Rate for Payer: Aetna Commercial |
$4,539.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,471.45
|
| Rate for Payer: Cash Price |
$4,272.55
|
| Rate for Payer: Cofinity Advantage |
$3,738.48
|
| Rate for Payer: Cofinity Commercial |
$4,592.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,272.55
|
| Rate for Payer: Healthscope Commercial |
$4,806.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,738.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,005.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,539.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,005.52
|
| Rate for Payer: PHP Commercial |
$4,539.59
|
| Rate for Payer: Priority Health SBD |
$3,364.63
|
| Rate for Payer: UMR Bronson Commercial |
$2,349.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,005.52
|
|
|
HC TENOTOMY PERCUTANEOUS ACHILLES TENDON
|
Facility
|
OP
|
$3,812.64
|
|
| Hospital Charge Code |
36000097
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,410.68 |
| Max. Negotiated Rate |
$3,431.38 |
| Rate for Payer: Aetna American Axle |
$2,478.22
|
| Rate for Payer: Aetna Commercial |
$3,240.74
|
| Rate for Payer: Aetna Medicare |
$1,906.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,478.22
|
| Rate for Payer: BCBS Complete |
$1,525.06
|
| Rate for Payer: Cash Price |
$3,050.11
|
| Rate for Payer: Cofinity Advantage |
$2,668.85
|
| Rate for Payer: Cofinity Commercial |
$3,278.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,050.11
|
| Rate for Payer: Healthscope Commercial |
$3,431.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,668.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,859.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,050.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,240.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,859.48
|
| Rate for Payer: PHP Commercial |
$3,240.74
|
| Rate for Payer: Priority Health SBD |
$2,401.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,410.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,859.48
|
|
|
HC TENOTOMY PERCUTANEOUS ACHILLES TENDON
|
Facility
|
IP
|
$3,812.64
|
|
| Hospital Charge Code |
36000097
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,677.56 |
| Max. Negotiated Rate |
$3,431.38 |
| Rate for Payer: Aetna American Axle |
$2,478.22
|
| Rate for Payer: Aetna Commercial |
$3,240.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,478.22
|
| Rate for Payer: Cash Price |
$3,050.11
|
| Rate for Payer: Cofinity Advantage |
$2,668.85
|
| Rate for Payer: Cofinity Commercial |
$3,278.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,050.11
|
| Rate for Payer: Healthscope Commercial |
$3,431.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,668.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,859.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,240.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,859.48
|
| Rate for Payer: PHP Commercial |
$3,240.74
|
| Rate for Payer: Priority Health SBD |
$2,401.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,677.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,859.48
|
|
|
HC TENOTOMY PERCUTANEOUS ADDUCTOR OR HAMSTRING
|
Facility
|
OP
|
$3,641.43
|
|
| Hospital Charge Code |
36000094
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,347.33 |
| Max. Negotiated Rate |
$3,277.29 |
| Rate for Payer: Aetna American Axle |
$2,366.93
|
| Rate for Payer: Aetna Commercial |
$3,095.22
|
| Rate for Payer: Aetna Medicare |
$1,820.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,366.93
|
| Rate for Payer: BCBS Complete |
$1,456.57
|
| Rate for Payer: Cash Price |
$2,913.14
|
| Rate for Payer: Cofinity Advantage |
$2,549.00
|
| Rate for Payer: Cofinity Commercial |
$3,131.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.14
|
| Rate for Payer: Healthscope Commercial |
$3,277.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,549.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,731.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,913.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,731.07
|
| Rate for Payer: PHP Commercial |
$3,095.22
|
| Rate for Payer: Priority Health SBD |
$2,294.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,347.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,731.07
|
|
|
HC TENOTOMY PERCUTANEOUS ADDUCTOR OR HAMSTRING
|
Facility
|
IP
|
$3,641.43
|
|
| Hospital Charge Code |
36000094
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,602.23 |
| Max. Negotiated Rate |
$3,277.29 |
| Rate for Payer: Aetna American Axle |
$2,366.93
|
| Rate for Payer: Aetna Commercial |
$3,095.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,366.93
|
| Rate for Payer: Cash Price |
$2,913.14
|
| Rate for Payer: Cofinity Advantage |
$2,549.00
|
| Rate for Payer: Cofinity Commercial |
$3,131.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.14
|
| Rate for Payer: Healthscope Commercial |
$3,277.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,549.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,731.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,731.07
|
| Rate for Payer: PHP Commercial |
$3,095.22
|
| Rate for Payer: Priority Health SBD |
$2,294.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,602.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,731.07
|
|
|
HC TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT
|
Facility
|
OP
|
$4,681.80
|
|
|
Service Code
|
CPT 26060
|
| Hospital Charge Code |
76100424
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$837.96 |
| Max. Negotiated Rate |
$5,181.40 |
| Rate for Payer: Aetna American Axle |
$3,043.17
|
| Rate for Payer: Aetna Commercial |
$3,979.53
|
| Rate for Payer: Aetna Medicare |
$1,666.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,043.17
|
| 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 |
$1,526.76
|
| Rate for Payer: BCN Commercial |
$1,526.76
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Cash Price |
$3,745.44
|
| Rate for Payer: Cash Price |
$3,745.44
|
| Rate for Payer: Cash Price |
$3,745.44
|
| Rate for Payer: Cofinity Advantage |
$3,277.26
|
| Rate for Payer: Cofinity Commercial |
$4,026.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,745.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Healthscope Commercial |
$4,213.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,277.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,511.35
|
| 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 |
$3,979.53
|
| Rate for Payer: Nomi Health Commercial |
$4,806.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,511.35
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Commercial |
$3,979.53
|
| 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 |
$2,949.53
|
| Rate for Payer: Priority Health Tiered Network |
$4,145.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,043.17
|
| Rate for Payer: UHC Core |
$2,439.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,602.21
|
| Rate for Payer: UHC Exchange |
$1,839.95
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,732.27
|
| Rate for Payer: VA VA |
$1,602.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,511.35
|
|
|
HC TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT
|
Facility
|
IP
|
$4,681.80
|
|
|
Service Code
|
CPT 26060
|
| Hospital Charge Code |
76100424
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,059.99 |
| Max. Negotiated Rate |
$4,213.62 |
| Rate for Payer: Aetna American Axle |
$3,043.17
|
| Rate for Payer: Aetna Commercial |
$3,979.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,043.17
|
| Rate for Payer: Cash Price |
$3,745.44
|
| Rate for Payer: Cofinity Advantage |
$3,277.26
|
| Rate for Payer: Cofinity Commercial |
$4,026.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,745.44
|
| Rate for Payer: Healthscope Commercial |
$4,213.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,277.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,511.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,979.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,511.35
|
| Rate for Payer: PHP Commercial |
$3,979.53
|
| Rate for Payer: Priority Health SBD |
$2,949.53
|
| Rate for Payer: UMR Bronson Commercial |
$2,059.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,511.35
|
|
|
HC TENOTOMY SHOULDER AREA SINGLE TENDON
|
Facility
|
OP
|
$4,922.84
|
|
| Hospital Charge Code |
36000098
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,821.45 |
| Max. Negotiated Rate |
$4,430.56 |
| Rate for Payer: Aetna American Axle |
$3,199.85
|
| Rate for Payer: Aetna Commercial |
$4,184.41
|
| Rate for Payer: Aetna Medicare |
$2,461.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,199.85
|
| Rate for Payer: BCBS Complete |
$1,969.14
|
| Rate for Payer: Cash Price |
$3,938.27
|
| Rate for Payer: Cofinity Advantage |
$3,445.99
|
| Rate for Payer: Cofinity Commercial |
$4,233.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,938.27
|
| Rate for Payer: Healthscope Commercial |
$4,430.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,445.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,692.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,938.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,184.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,692.13
|
| Rate for Payer: PHP Commercial |
$4,184.41
|
| Rate for Payer: Priority Health SBD |
$3,101.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,821.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,692.13
|
|
|
HC TENOTOMY SHOULDER AREA SINGLE TENDON
|
Facility
|
IP
|
$4,922.84
|
|
| Hospital Charge Code |
36000098
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,166.05 |
| Max. Negotiated Rate |
$4,430.56 |
| Rate for Payer: Aetna American Axle |
$3,199.85
|
| Rate for Payer: Aetna Commercial |
$4,184.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,199.85
|
| Rate for Payer: Cash Price |
$3,938.27
|
| Rate for Payer: Cofinity Advantage |
$3,445.99
|
| Rate for Payer: Cofinity Commercial |
$4,233.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,938.27
|
| Rate for Payer: Healthscope Commercial |
$4,430.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,445.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,692.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,184.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,692.13
|
| Rate for Payer: PHP Commercial |
$4,184.41
|
| Rate for Payer: Priority Health SBD |
$3,101.39
|
| Rate for Payer: UMR Bronson Commercial |
$2,166.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,692.13
|
|
|
HC TENOTOMY TOE SINGLE TENDON
|
Facility
|
OP
|
$2,263.53
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
45000092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$197.92 |
| Max. Negotiated Rate |
$5,181.40 |
| Rate for Payer: Aetna American Axle |
$1,471.29
|
| Rate for Payer: Aetna Commercial |
$1,924.00
|
| Rate for Payer: Aetna Medicare |
$1,666.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,471.29
|
| 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 |
$197.92
|
| Rate for Payer: BCN Commercial |
$197.92
|
| Rate for Payer: BCN Medicare Advantage |
$1,602.21
|
| Rate for Payer: Cash Price |
$1,810.82
|
| Rate for Payer: Cash Price |
$1,810.82
|
| Rate for Payer: Cash Price |
$1,810.82
|
| Rate for Payer: Cofinity Advantage |
$1,584.47
|
| Rate for Payer: Cofinity Commercial |
$1,946.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,810.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,602.21
|
| Rate for Payer: Healthscope Commercial |
$2,037.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,584.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,697.65
|
| 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 |
$1,924.00
|
| Rate for Payer: Nomi Health Commercial |
$4,806.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,697.65
|
| Rate for Payer: PACE Medicare |
$1,522.10
|
| Rate for Payer: PACE SWMI |
$1,602.21
|
| Rate for Payer: PHP Commercial |
$1,924.00
|
| 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 |
$1,426.02
|
| Rate for Payer: Priority Health Tiered Network |
$4,145.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,602.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,471.29
|
| Rate for Payer: UHC Core |
$1,179.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,602.21
|
| Rate for Payer: UHC Exchange |
$889.57
|
| Rate for Payer: UHC Medicaid |
$837.96
|
| Rate for Payer: UHCCP Medicaid |
$837.96
|
| Rate for Payer: UMR Bronson Commercial |
$837.51
|
| Rate for Payer: VA VA |
$1,602.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,697.65
|
|
|
HC TENOTOMY TOE SINGLE TENDON
|
Facility
|
IP
|
$2,263.53
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
45000092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$995.95 |
| Max. Negotiated Rate |
$2,037.18 |
| Rate for Payer: Aetna American Axle |
$1,471.29
|
| Rate for Payer: Aetna Commercial |
$1,924.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,471.29
|
| Rate for Payer: Cash Price |
$1,810.82
|
| Rate for Payer: Cofinity Advantage |
$1,584.47
|
| Rate for Payer: Cofinity Commercial |
$1,946.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,810.82
|
| Rate for Payer: Healthscope Commercial |
$2,037.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,584.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,697.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,924.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,697.65
|
| Rate for Payer: PHP Commercial |
$1,924.00
|
| Rate for Payer: Priority Health SBD |
$1,426.02
|
| Rate for Payer: UMR Bronson Commercial |
$995.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,697.65
|
|
|
HC TESTOSTERONE BIOAVAILABLE
|
Facility
|
IP
|
$79.59
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100429
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.02 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna American Axle |
$51.73
|
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.73
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Advantage |
$55.71
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: Priority Health SBD |
$50.14
|
| Rate for Payer: UMR Bronson Commercial |
$35.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC TESTOSTERONE BIOAVAILABLE
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100429
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.32 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna American Axle |
$51.73
|
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: Aetna Medicare |
$26.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.84
|
| Rate for Payer: BCBS Complete |
$13.99
|
| Rate for Payer: BCBS MAPPO |
$25.47
|
| Rate for Payer: BCBS Trust/PPO |
$29.44
|
| Rate for Payer: BCN Commercial |
$29.44
|
| Rate for Payer: BCN Medicare Advantage |
$25.47
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Advantage |
$55.71
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.47
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Mclaren Medicaid |
$25.47
|
| Rate for Payer: Mclaren Medicare |
$25.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.74
|
| Rate for Payer: Meridian Medicaid |
$26.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$38.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Medicare |
$24.20
|
| Rate for Payer: PACE SWMI |
$25.47
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: PHP Medicare Advantage |
$25.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25.47
|
| Rate for Payer: Priority Health Medicare |
$25.47
|
| Rate for Payer: Priority Health SBD |
$50.14
|
| Rate for Payer: Priority Health Tiered Network |
$20.38
|
| Rate for Payer: Railroad Medicare Medicare |
$25.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.21
|
| Rate for Payer: UHC Core |
$38.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.47
|
| Rate for Payer: UHC Exchange |
$38.21
|
| Rate for Payer: UHC Medicaid |
$13.32
|
| Rate for Payer: UHCCP Medicaid |
$13.32
|
| Rate for Payer: UMR Bronson Commercial |
$29.45
|
| Rate for Payer: VA VA |
$25.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC TESTOSTERONE FREE
|
Facility
|
OP
|
$45.59
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100428
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.32 |
| Max. Negotiated Rate |
$41.03 |
| Rate for Payer: Aetna American Axle |
$29.63
|
| Rate for Payer: Aetna Commercial |
$38.75
|
| Rate for Payer: Aetna Medicare |
$26.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.84
|
| Rate for Payer: BCBS Complete |
$13.99
|
| Rate for Payer: BCBS MAPPO |
$25.47
|
| Rate for Payer: BCBS Trust/PPO |
$29.44
|
| Rate for Payer: BCN Commercial |
$29.44
|
| Rate for Payer: BCN Medicare Advantage |
$25.47
|
| Rate for Payer: Cash Price |
$36.47
|
| Rate for Payer: Cash Price |
$36.47
|
| Rate for Payer: Cofinity Advantage |
$31.91
|
| Rate for Payer: Cofinity Commercial |
$39.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.47
|
| Rate for Payer: Healthscope Commercial |
$41.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.19
|
| Rate for Payer: Mclaren Medicaid |
$25.47
|
| Rate for Payer: Mclaren Medicare |
$25.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.74
|
| Rate for Payer: Meridian Medicaid |
$26.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.75
|
| Rate for Payer: Nomi Health Commercial |
$38.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.19
|
| Rate for Payer: PACE Medicare |
$24.20
|
| Rate for Payer: PACE SWMI |
$25.47
|
| Rate for Payer: PHP Commercial |
$38.75
|
| Rate for Payer: PHP Medicare Advantage |
$25.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25.47
|
| Rate for Payer: Priority Health Medicare |
$25.47
|
| Rate for Payer: Priority Health SBD |
$28.72
|
| Rate for Payer: Priority Health Tiered Network |
$20.38
|
| Rate for Payer: Railroad Medicare Medicare |
$25.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.21
|
| Rate for Payer: UHC Core |
$38.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.47
|
| Rate for Payer: UHC Exchange |
$38.21
|
| Rate for Payer: UHC Medicaid |
$13.32
|
| Rate for Payer: UHCCP Medicaid |
$13.32
|
| Rate for Payer: UMR Bronson Commercial |
$16.87
|
| Rate for Payer: VA VA |
$25.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.19
|
|
|
HC TESTOSTERONE FREE
|
Facility
|
IP
|
$45.59
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100428
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.06 |
| Max. Negotiated Rate |
$41.03 |
| Rate for Payer: Aetna American Axle |
$29.63
|
| Rate for Payer: Aetna Commercial |
$38.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.63
|
| Rate for Payer: Cash Price |
$36.47
|
| Rate for Payer: Cofinity Advantage |
$31.91
|
| Rate for Payer: Cofinity Commercial |
$39.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.47
|
| Rate for Payer: Healthscope Commercial |
$41.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.19
|
| Rate for Payer: PHP Commercial |
$38.75
|
| Rate for Payer: Priority Health SBD |
$28.72
|
| Rate for Payer: UMR Bronson Commercial |
$20.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.19
|
|
|
HC TESTOSTERONE, FREE & WKLY BOUND
|
Facility
|
IP
|
$83.23
|
|
|
Service Code
|
CPT 84410
|
| Hospital Charge Code |
30100736
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.62 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna American Axle |
$54.10
|
| Rate for Payer: Aetna Commercial |
$70.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.10
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cofinity Advantage |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.58
|
| Rate for Payer: Healthscope Commercial |
$74.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.42
|
| Rate for Payer: PHP Commercial |
$70.75
|
| Rate for Payer: Priority Health SBD |
$52.43
|
| Rate for Payer: UMR Bronson Commercial |
$36.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.42
|
|
|
HC TESTOSTERONE, FREE & WKLY BOUND
|
Facility
|
OP
|
$83.23
|
|
|
Service Code
|
CPT 84410
|
| Hospital Charge Code |
30100736
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.82 |
| Max. Negotiated Rate |
$76.92 |
| Rate for Payer: Aetna American Axle |
$54.10
|
| Rate for Payer: Aetna Commercial |
$70.75
|
| Rate for Payer: Aetna Medicare |
$53.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.10
|
| Rate for Payer: BCBS Complete |
$28.16
|
| Rate for Payer: BCBS MAPPO |
$51.28
|
| Rate for Payer: BCBS Trust/PPO |
$59.28
|
| Rate for Payer: BCN Commercial |
$59.28
|
| Rate for Payer: BCN Medicare Advantage |
$51.28
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cofinity Advantage |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.28
|
| Rate for Payer: Healthscope Commercial |
$74.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.42
|
| Rate for Payer: Mclaren Medicaid |
$51.28
|
| Rate for Payer: Mclaren Medicare |
$51.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.84
|
| Rate for Payer: Meridian Medicaid |
$53.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.75
|
| Rate for Payer: Nomi Health Commercial |
$76.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.42
|
| Rate for Payer: PACE Medicare |
$48.72
|
| Rate for Payer: PACE SWMI |
$51.28
|
| Rate for Payer: PHP Commercial |
$70.75
|
| Rate for Payer: PHP Medicare Advantage |
$51.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.28
|
| Rate for Payer: Priority Health Medicare |
$51.28
|
| Rate for Payer: Priority Health SBD |
$52.43
|
| Rate for Payer: Priority Health Tiered Network |
$41.02
|
| Rate for Payer: Railroad Medicare Medicare |
$51.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.92
|
| Rate for Payer: UHC Core |
$76.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.28
|
| Rate for Payer: UHC Exchange |
$76.92
|
| Rate for Payer: UHC Medicaid |
$26.82
|
| Rate for Payer: UHCCP Medicaid |
$26.82
|
| Rate for Payer: UMR Bronson Commercial |
$30.80
|
| Rate for Payer: VA VA |
$51.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.42
|
|
|
HC TESTOSTERONE LEVEL
|
Facility
|
IP
|
$88.57
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
30100430
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.97 |
| Max. Negotiated Rate |
$79.71 |
| Rate for Payer: Aetna American Axle |
$57.57
|
| Rate for Payer: Aetna Commercial |
$75.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.57
|
| Rate for Payer: Cash Price |
$70.86
|
| Rate for Payer: Cofinity Advantage |
$62.00
|
| Rate for Payer: Cofinity Commercial |
$76.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.86
|
| Rate for Payer: Healthscope Commercial |
$79.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.43
|
| Rate for Payer: PHP Commercial |
$75.28
|
| Rate for Payer: Priority Health SBD |
$55.80
|
| Rate for Payer: UMR Bronson Commercial |
$38.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.43
|
|
|
HC TESTOSTERONE LEVEL
|
Facility
|
OP
|
$88.57
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
30100430
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$79.71 |
| Rate for Payer: Aetna American Axle |
$57.57
|
| Rate for Payer: Aetna Commercial |
$75.28
|
| Rate for Payer: Aetna Medicare |
$26.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.26
|
| Rate for Payer: BCBS Complete |
$14.17
|
| Rate for Payer: BCBS MAPPO |
$25.81
|
| Rate for Payer: BCBS Trust/PPO |
$29.84
|
| Rate for Payer: BCN Commercial |
$29.84
|
| Rate for Payer: BCN Medicare Advantage |
$25.81
|
| Rate for Payer: Cash Price |
$70.86
|
| Rate for Payer: Cash Price |
$70.86
|
| Rate for Payer: Cofinity Advantage |
$62.00
|
| Rate for Payer: Cofinity Commercial |
$76.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.81
|
| Rate for Payer: Healthscope Commercial |
$79.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.43
|
| Rate for Payer: Mclaren Medicaid |
$25.81
|
| Rate for Payer: Mclaren Medicare |
$25.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.10
|
| Rate for Payer: Meridian Medicaid |
$27.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.28
|
| Rate for Payer: Nomi Health Commercial |
$38.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.43
|
| Rate for Payer: PACE Medicare |
$24.52
|
| Rate for Payer: PACE SWMI |
$25.81
|
| Rate for Payer: PHP Commercial |
$75.28
|
| Rate for Payer: PHP Medicare Advantage |
$25.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25.81
|
| Rate for Payer: Priority Health Medicare |
$25.81
|
| Rate for Payer: Priority Health SBD |
$55.80
|
| Rate for Payer: Priority Health Tiered Network |
$20.65
|
| Rate for Payer: Railroad Medicare Medicare |
$25.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.72
|
| Rate for Payer: UHC Core |
$38.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.81
|
| Rate for Payer: UHC Exchange |
$38.72
|
| Rate for Payer: UHC Medicaid |
$13.50
|
| Rate for Payer: UHCCP Medicaid |
$13.50
|
| Rate for Payer: UMR Bronson Commercial |
$32.77
|
| Rate for Payer: VA VA |
$25.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.43
|
|
|
HC TESTOSTERONE LEVEL TOTAL
|
Facility
|
IP
|
$95.51
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
30100431
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.02 |
| Max. Negotiated Rate |
$85.96 |
| Rate for Payer: Aetna American Axle |
$62.08
|
| Rate for Payer: Aetna Commercial |
$81.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.08
|
| Rate for Payer: Cash Price |
$76.41
|
| Rate for Payer: Cofinity Advantage |
$66.86
|
| Rate for Payer: Cofinity Commercial |
$82.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.41
|
| Rate for Payer: Healthscope Commercial |
$85.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.63
|
| Rate for Payer: PHP Commercial |
$81.18
|
| Rate for Payer: Priority Health SBD |
$60.17
|
| Rate for Payer: UMR Bronson Commercial |
$42.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.63
|
|
