|
HC THIN PREP PAP SCREENING
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
HCPCS G0123
|
| Hospital Charge Code |
31100028
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$10.60 |
| 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 |
$21.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.32
|
| Rate for Payer: BCBS Complete |
$11.13
|
| Rate for Payer: BCBS MAPPO |
$20.26
|
| Rate for Payer: BCBS Trust/PPO |
$23.43
|
| Rate for Payer: BCCCP Commercial |
$20.26
|
| Rate for Payer: BCN Commercial |
$23.43
|
| Rate for Payer: BCN Medicare Advantage |
$20.26
|
| 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 |
$20.26
|
| 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 |
$20.26
|
| Rate for Payer: Mclaren Medicare |
$20.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.27
|
| Rate for Payer: Meridian Medicaid |
$21.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$60.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Medicare |
$19.25
|
| Rate for Payer: PACE SWMI |
$20.26
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: PHP Medicare Advantage |
$20.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20.26
|
| Rate for Payer: Priority Health Medicare |
$20.26
|
| Rate for Payer: Priority Health SBD |
$50.14
|
| Rate for Payer: Priority Health Tiered Network |
$16.21
|
| Rate for Payer: Railroad Medicare Medicare |
$20.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.39
|
| Rate for Payer: UHC Core |
$30.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.26
|
| Rate for Payer: UHC Exchange |
$30.39
|
| Rate for Payer: UHC Medicaid |
$10.60
|
| Rate for Payer: UHCCP Medicaid |
$10.60
|
| Rate for Payer: UMR Bronson Commercial |
$29.45
|
| Rate for Payer: VA VA |
$20.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC THIN PREP PAP SCREENING AUTO
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
HCPCS G0145
|
| Hospital Charge Code |
31100032
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$13.85 |
| Max. Negotiated Rate |
$79.47 |
| Rate for Payer: Aetna American Axle |
$51.73
|
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: Aetna Medicare |
$27.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.11
|
| Rate for Payer: BCBS Complete |
$14.55
|
| Rate for Payer: BCBS MAPPO |
$26.49
|
| Rate for Payer: BCBS Trust/PPO |
$30.63
|
| Rate for Payer: BCCCP Commercial |
$26.61
|
| Rate for Payer: BCN Commercial |
$30.63
|
| Rate for Payer: BCN Medicare Advantage |
$26.49
|
| 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 |
$26.49
|
| 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 |
$26.49
|
| Rate for Payer: Mclaren Medicare |
$26.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.81
|
| Rate for Payer: Meridian Medicaid |
$27.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$79.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Medicare |
$25.17
|
| Rate for Payer: PACE SWMI |
$26.49
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: PHP Medicare Advantage |
$26.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26.49
|
| Rate for Payer: Priority Health Medicare |
$26.49
|
| Rate for Payer: Priority Health SBD |
$50.14
|
| Rate for Payer: Priority Health Tiered Network |
$21.19
|
| Rate for Payer: Railroad Medicare Medicare |
$26.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.74
|
| Rate for Payer: UHC Core |
$39.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.49
|
| Rate for Payer: UHC Exchange |
$39.74
|
| Rate for Payer: UHC Medicaid |
$13.85
|
| Rate for Payer: UHCCP Medicaid |
$13.85
|
| Rate for Payer: UMR Bronson Commercial |
$29.45
|
| Rate for Payer: VA VA |
$26.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC THIN PREP PAP SCREENING AUTO
|
Facility
|
IP
|
$79.59
|
|
|
Service Code
|
HCPCS G0145
|
| Hospital Charge Code |
31100032
|
|
Hospital Revenue Code
|
311
|
| 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 THIOPURINE METABOLITES
|
Facility
|
IP
|
$301.72
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100719
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$132.76 |
| Max. Negotiated Rate |
$271.55 |
| Rate for Payer: Aetna American Axle |
$196.12
|
| Rate for Payer: Aetna Commercial |
$256.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.12
|
| Rate for Payer: Cash Price |
$241.38
|
| Rate for Payer: Cofinity Advantage |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$259.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$241.38
|
| Rate for Payer: Healthscope Commercial |
$271.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$211.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$226.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$256.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$226.29
|
| Rate for Payer: PHP Commercial |
$256.46
|
| Rate for Payer: Priority Health SBD |
$190.08
|
| Rate for Payer: UMR Bronson Commercial |
$132.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$226.29
|
|
|
HC THIOPURINE METABOLITES
|
Facility
|
OP
|
$301.72
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100719
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$271.55 |
| Rate for Payer: Aetna American Axle |
$196.12
|
| Rate for Payer: Aetna Commercial |
$256.46
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.24
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$21.55
|
| Rate for Payer: BCN Commercial |
$21.55
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$241.38
|
| Rate for Payer: Cash Price |
$241.38
|
| Rate for Payer: Cofinity Advantage |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$259.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$241.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$271.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$211.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$226.29
|
| Rate for Payer: Mclaren Medicaid |
$18.64
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$19.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$256.46
|
| Rate for Payer: Nomi Health Commercial |
$27.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$226.29
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$256.46
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.75
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health SBD |
$190.08
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.96
|
| Rate for Payer: UHC Core |
$27.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.64
|
| Rate for Payer: UHC Exchange |
$27.96
|
| Rate for Payer: UHC Medicaid |
$9.75
|
| Rate for Payer: UHCCP Medicaid |
$9.75
|
| Rate for Payer: UMR Bronson Commercial |
$111.64
|
| Rate for Payer: VA VA |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$226.29
|
|
|
HC THIOPURINE METHYLTRANSFERASE RBC
|
Facility
|
OP
|
$337.09
|
|
|
Service Code
|
CPT 82657
|
| Hospital Charge Code |
30100621
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.59 |
| Max. Negotiated Rate |
$303.38 |
| Rate for Payer: Aetna American Axle |
$219.11
|
| Rate for Payer: Aetna Commercial |
$286.53
|
| Rate for Payer: Aetna Medicare |
$23.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.71
|
| Rate for Payer: BCBS Complete |
$12.18
|
| Rate for Payer: BCBS MAPPO |
$22.17
|
| Rate for Payer: BCBS Trust/PPO |
$25.63
|
| Rate for Payer: BCN Commercial |
$25.63
|
| Rate for Payer: BCN Medicare Advantage |
$22.17
|
| Rate for Payer: Cash Price |
$269.67
|
| Rate for Payer: Cash Price |
$269.67
|
| Rate for Payer: Cofinity Advantage |
$235.96
|
| Rate for Payer: Cofinity Commercial |
$289.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.17
|
| Rate for Payer: Healthscope Commercial |
$303.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$235.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$252.82
|
| Rate for Payer: Mclaren Medicaid |
$22.17
|
| Rate for Payer: Mclaren Medicare |
$22.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.28
|
| Rate for Payer: Meridian Medicaid |
$23.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.53
|
| Rate for Payer: Nomi Health Commercial |
$33.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.82
|
| Rate for Payer: PACE Medicare |
$21.06
|
| Rate for Payer: PACE SWMI |
$22.17
|
| Rate for Payer: PHP Commercial |
$286.53
|
| Rate for Payer: PHP Medicare Advantage |
$22.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$22.17
|
| Rate for Payer: Priority Health Medicare |
$22.17
|
| Rate for Payer: Priority Health SBD |
$212.37
|
| Rate for Payer: Priority Health Tiered Network |
$17.74
|
| Rate for Payer: Railroad Medicare Medicare |
$22.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.26
|
| Rate for Payer: UHC Core |
$33.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.17
|
| Rate for Payer: UHC Exchange |
$33.26
|
| Rate for Payer: UHC Medicaid |
$11.59
|
| Rate for Payer: UHCCP Medicaid |
$11.59
|
| Rate for Payer: UMR Bronson Commercial |
$124.72
|
| Rate for Payer: VA VA |
$22.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$252.82
|
|
|
HC THIOPURINE METHYLTRANSFERASE RBC
|
Facility
|
IP
|
$337.09
|
|
|
Service Code
|
CPT 82657
|
| Hospital Charge Code |
30100621
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$148.32 |
| Max. Negotiated Rate |
$303.38 |
| Rate for Payer: Aetna American Axle |
$219.11
|
| Rate for Payer: Aetna Commercial |
$286.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.11
|
| Rate for Payer: Cash Price |
$269.67
|
| Rate for Payer: Cofinity Advantage |
$235.96
|
| Rate for Payer: Cofinity Commercial |
$289.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.67
|
| Rate for Payer: Healthscope Commercial |
$303.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$235.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$252.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$252.82
|
| Rate for Payer: PHP Commercial |
$286.53
|
| Rate for Payer: Priority Health SBD |
$212.37
|
| Rate for Payer: UMR Bronson Commercial |
$148.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$252.82
|
|
|
HC THIOPURINE METHYLTRANSFERASE T
|
Facility
|
OP
|
$145.66
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100290
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$131.09 |
| Rate for Payer: Aetna American Axle |
$94.68
|
| Rate for Payer: Aetna Commercial |
$123.81
|
| Rate for Payer: Aetna Medicare |
$25.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.11
|
| Rate for Payer: BCBS Complete |
$13.23
|
| Rate for Payer: BCBS MAPPO |
$24.09
|
| Rate for Payer: BCBS Trust/PPO |
$27.85
|
| Rate for Payer: BCN Commercial |
$27.85
|
| Rate for Payer: BCN Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$116.53
|
| Rate for Payer: Cash Price |
$116.53
|
| Rate for Payer: Cofinity Advantage |
$101.96
|
| Rate for Payer: Cofinity Commercial |
$125.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$131.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.25
|
| Rate for Payer: Mclaren Medicaid |
$24.09
|
| Rate for Payer: Mclaren Medicare |
$24.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.29
|
| Rate for Payer: Meridian Medicaid |
$25.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.81
|
| Rate for Payer: Nomi Health Commercial |
$36.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.25
|
| Rate for Payer: PACE Medicare |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.09
|
| Rate for Payer: PHP Commercial |
$123.81
|
| Rate for Payer: PHP Medicare Advantage |
$24.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24.09
|
| Rate for Payer: Priority Health Medicare |
$24.09
|
| Rate for Payer: Priority Health SBD |
$91.77
|
| Rate for Payer: Priority Health Tiered Network |
$19.27
|
| Rate for Payer: Railroad Medicare Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.14
|
| Rate for Payer: UHC Core |
$36.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.09
|
| Rate for Payer: UHC Exchange |
$36.14
|
| Rate for Payer: UHC Medicaid |
$12.60
|
| Rate for Payer: UHCCP Medicaid |
$12.60
|
| Rate for Payer: UMR Bronson Commercial |
$53.89
|
| Rate for Payer: VA VA |
$24.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.25
|
|
|
HC THIOPURINE METHYLTRANSFERASE T
|
Facility
|
IP
|
$145.66
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100290
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.09 |
| Max. Negotiated Rate |
$131.09 |
| Rate for Payer: Aetna American Axle |
$94.68
|
| Rate for Payer: Aetna Commercial |
$123.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.68
|
| Rate for Payer: Cash Price |
$116.53
|
| Rate for Payer: Cofinity Advantage |
$101.96
|
| Rate for Payer: Cofinity Commercial |
$125.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.53
|
| Rate for Payer: Healthscope Commercial |
$131.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.25
|
| Rate for Payer: PHP Commercial |
$123.81
|
| Rate for Payer: Priority Health SBD |
$91.77
|
| Rate for Payer: UMR Bronson Commercial |
$64.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.25
|
|
|
HC THIRD STEP GEL 8 OZ
|
Facility
|
OP
|
$71.19
|
|
| Hospital Charge Code |
27100018
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$26.34 |
| Max. Negotiated Rate |
$64.07 |
| Rate for Payer: Aetna American Axle |
$46.27
|
| Rate for Payer: Aetna Commercial |
$60.51
|
| Rate for Payer: Aetna Medicare |
$35.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.27
|
| Rate for Payer: BCBS Complete |
$28.48
|
| Rate for Payer: Cash Price |
$56.95
|
| Rate for Payer: Cofinity Advantage |
$49.83
|
| Rate for Payer: Cofinity Commercial |
$61.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.95
|
| Rate for Payer: Healthscope Commercial |
$64.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.39
|
| Rate for Payer: PHP Commercial |
$60.51
|
| Rate for Payer: Priority Health SBD |
$44.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.27
|
| Rate for Payer: UHC Core |
$37.09
|
| Rate for Payer: UHC Exchange |
$27.98
|
| Rate for Payer: UMR Bronson Commercial |
$26.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.39
|
|
|
HC THIRD STEP GEL 8 OZ
|
Facility
|
IP
|
$71.19
|
|
| Hospital Charge Code |
27100018
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$31.32 |
| Max. Negotiated Rate |
$64.07 |
| Rate for Payer: Aetna American Axle |
$46.27
|
| Rate for Payer: Aetna Commercial |
$60.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.27
|
| Rate for Payer: Cash Price |
$56.95
|
| Rate for Payer: Cofinity Advantage |
$49.83
|
| Rate for Payer: Cofinity Commercial |
$61.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.95
|
| Rate for Payer: Healthscope Commercial |
$64.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.39
|
| Rate for Payer: PHP Commercial |
$60.51
|
| Rate for Payer: Priority Health SBD |
$44.85
|
| Rate for Payer: UMR Bronson Commercial |
$31.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.39
|
|
|
HC THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Facility
|
IP
|
$1,910.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
76100543
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$840.40 |
| Max. Negotiated Rate |
$1,719.00 |
| Rate for Payer: Aetna American Axle |
$1,241.50
|
| Rate for Payer: Aetna Commercial |
$1,623.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,241.50
|
| Rate for Payer: Cash Price |
$1,528.00
|
| Rate for Payer: Cofinity Advantage |
$1,337.00
|
| Rate for Payer: Cofinity Commercial |
$1,642.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,528.00
|
| Rate for Payer: Healthscope Commercial |
$1,719.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,337.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,432.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,623.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,432.50
|
| Rate for Payer: PHP Commercial |
$1,623.50
|
| Rate for Payer: Priority Health SBD |
$1,203.30
|
| Rate for Payer: UMR Bronson Commercial |
$840.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,432.50
|
|
|
HC THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Facility
|
OP
|
$1,910.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
76100543
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$326.90 |
| Max. Negotiated Rate |
$2,021.35 |
| Rate for Payer: Aetna American Axle |
$1,241.50
|
| Rate for Payer: Aetna Commercial |
$1,623.50
|
| Rate for Payer: Aetna Medicare |
$650.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,241.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.31
|
| Rate for Payer: BCBS Complete |
$343.28
|
| Rate for Payer: BCBS MAPPO |
$625.05
|
| Rate for Payer: BCBS Trust/PPO |
$550.04
|
| Rate for Payer: BCN Commercial |
$550.04
|
| Rate for Payer: BCN Medicare Advantage |
$625.05
|
| Rate for Payer: Cash Price |
$1,528.00
|
| Rate for Payer: Cash Price |
$1,528.00
|
| Rate for Payer: Cash Price |
$1,528.00
|
| Rate for Payer: Cofinity Advantage |
$1,337.00
|
| Rate for Payer: Cofinity Commercial |
$1,642.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,528.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.05
|
| Rate for Payer: Healthscope Commercial |
$1,719.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,337.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,432.50
|
| Rate for Payer: Mclaren Medicaid |
$625.05
|
| Rate for Payer: Mclaren Medicare |
$625.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.30
|
| Rate for Payer: Meridian Medicaid |
$656.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$718.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$687.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,623.50
|
| Rate for Payer: Nomi Health Commercial |
$1,875.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,432.50
|
| Rate for Payer: PACE Medicare |
$593.80
|
| Rate for Payer: PACE SWMI |
$625.05
|
| Rate for Payer: PHP Commercial |
$1,623.50
|
| Rate for Payer: PHP Medicare Advantage |
$625.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,021.35
|
| Rate for Payer: Priority Health Medicare |
$625.05
|
| Rate for Payer: Priority Health SBD |
$1,203.30
|
| Rate for Payer: Priority Health Tiered Network |
$1,617.08
|
| Rate for Payer: Railroad Medicare Medicare |
$625.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,241.50
|
| Rate for Payer: UHC Core |
$995.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.05
|
| Rate for Payer: UHC Exchange |
$750.63
|
| Rate for Payer: UHC Medicaid |
$326.90
|
| Rate for Payer: UHCCP Medicaid |
$326.90
|
| Rate for Payer: UMR Bronson Commercial |
$706.70
|
| Rate for Payer: VA VA |
$625.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,432.50
|
|
|
HC THORACENTESIS/PARACENTESIS
|
Facility
|
IP
|
$864.86
|
|
| Hospital Charge Code |
45000054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$380.54 |
| Max. Negotiated Rate |
$778.37 |
| Rate for Payer: Aetna American Axle |
$562.16
|
| Rate for Payer: Aetna Commercial |
$735.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$562.16
|
| Rate for Payer: Cash Price |
$691.89
|
| Rate for Payer: Cofinity Advantage |
$605.40
|
| Rate for Payer: Cofinity Commercial |
$743.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.89
|
| Rate for Payer: Healthscope Commercial |
$778.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$605.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$648.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$735.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$648.64
|
| Rate for Payer: PHP Commercial |
$735.13
|
| Rate for Payer: Priority Health SBD |
$544.86
|
| Rate for Payer: UMR Bronson Commercial |
$380.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$648.64
|
|
|
HC THORACENTESIS/PARACENTESIS
|
Facility
|
OP
|
$864.86
|
|
| Hospital Charge Code |
45000054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$778.37 |
| Rate for Payer: Aetna American Axle |
$562.16
|
| Rate for Payer: Aetna Commercial |
$735.13
|
| Rate for Payer: Aetna Medicare |
$432.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$562.16
|
| Rate for Payer: BCBS Complete |
$345.94
|
| Rate for Payer: Cash Price |
$691.89
|
| Rate for Payer: Cash Price |
$691.89
|
| Rate for Payer: Cofinity Advantage |
$605.40
|
| Rate for Payer: Cofinity Commercial |
$743.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$691.89
|
| Rate for Payer: Healthscope Commercial |
$778.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$605.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$648.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$691.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$735.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$648.64
|
| Rate for Payer: PHP Commercial |
$735.13
|
| Rate for Payer: Priority Health SBD |
$544.86
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: UMR Bronson Commercial |
$320.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$648.64
|
|
|
HC THORACENT WO TUBE
|
Facility
|
OP
|
$1,331.95
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
36100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$326.90 |
| Max. Negotiated Rate |
$2,021.35 |
| Rate for Payer: Aetna American Axle |
$865.77
|
| Rate for Payer: Aetna Commercial |
$1,132.16
|
| Rate for Payer: Aetna Medicare |
$650.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$865.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.31
|
| Rate for Payer: BCBS Complete |
$343.28
|
| Rate for Payer: BCBS MAPPO |
$625.05
|
| Rate for Payer: BCBS Trust/PPO |
$881.29
|
| Rate for Payer: BCN Commercial |
$881.29
|
| Rate for Payer: BCN Medicare Advantage |
$625.05
|
| Rate for Payer: Cash Price |
$1,065.56
|
| Rate for Payer: Cash Price |
$1,065.56
|
| Rate for Payer: Cash Price |
$1,065.56
|
| Rate for Payer: Cofinity Advantage |
$932.37
|
| Rate for Payer: Cofinity Commercial |
$1,145.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,065.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.05
|
| Rate for Payer: Healthscope Commercial |
$1,198.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$932.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$998.96
|
| Rate for Payer: Mclaren Medicaid |
$625.05
|
| Rate for Payer: Mclaren Medicare |
$625.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.30
|
| Rate for Payer: Meridian Medicaid |
$656.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$718.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$687.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,132.16
|
| Rate for Payer: Nomi Health Commercial |
$1,875.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$998.96
|
| Rate for Payer: PACE Medicare |
$593.80
|
| Rate for Payer: PACE SWMI |
$625.05
|
| Rate for Payer: PHP Commercial |
$1,132.16
|
| Rate for Payer: PHP Medicare Advantage |
$625.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,021.35
|
| Rate for Payer: Priority Health Medicare |
$625.05
|
| Rate for Payer: Priority Health SBD |
$839.13
|
| Rate for Payer: Priority Health Tiered Network |
$1,617.08
|
| Rate for Payer: Railroad Medicare Medicare |
$625.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$865.77
|
| Rate for Payer: UHC Core |
$693.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.05
|
| Rate for Payer: UHC Exchange |
$523.46
|
| Rate for Payer: UHC Medicaid |
$326.90
|
| Rate for Payer: UHCCP Medicaid |
$326.90
|
| Rate for Payer: UMR Bronson Commercial |
$492.82
|
| Rate for Payer: VA VA |
$625.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$998.96
|
|
|
HC THORACENT WO TUBE
|
Facility
|
IP
|
$1,331.95
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
36100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$586.06 |
| Max. Negotiated Rate |
$1,198.76 |
| Rate for Payer: Aetna American Axle |
$865.77
|
| Rate for Payer: Aetna Commercial |
$1,132.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$865.77
|
| Rate for Payer: Cash Price |
$1,065.56
|
| Rate for Payer: Cofinity Advantage |
$932.37
|
| Rate for Payer: Cofinity Commercial |
$1,145.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,065.56
|
| Rate for Payer: Healthscope Commercial |
$1,198.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$932.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$998.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,132.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$998.96
|
| Rate for Payer: PHP Commercial |
$1,132.16
|
| Rate for Payer: Priority Health SBD |
$839.13
|
| Rate for Payer: UMR Bronson Commercial |
$586.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$998.96
|
|
|
HC THORACENT W TUBE
|
Facility
|
OP
|
$1,442.76
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
36100384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$533.82 |
| Max. Negotiated Rate |
$5,072.36 |
| Rate for Payer: Aetna American Axle |
$937.79
|
| Rate for Payer: Aetna Commercial |
$1,226.35
|
| Rate for Payer: Aetna Medicare |
$1,631.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$550.04
|
| Rate for Payer: BCN Commercial |
$550.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$1,154.21
|
| Rate for Payer: Cash Price |
$1,154.21
|
| Rate for Payer: Cash Price |
$1,154.21
|
| Rate for Payer: Cofinity Advantage |
$1,009.93
|
| Rate for Payer: Cofinity Commercial |
$1,240.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,154.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$1,298.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,009.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,082.07
|
| Rate for Payer: Mclaren Medicaid |
$1,568.49
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$1,646.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,226.35
|
| Rate for Payer: Nomi Health Commercial |
$4,705.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,082.07
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$1,226.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,072.36
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health SBD |
$908.94
|
| Rate for Payer: Priority Health Tiered Network |
$4,057.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: UMR Bronson Commercial |
$533.82
|
| Rate for Payer: VA VA |
$1,568.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,082.07
|
|
|
HC THORACENT W TUBE
|
Facility
|
IP
|
$1,442.76
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
36100384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$634.81 |
| Max. Negotiated Rate |
$1,298.48 |
| Rate for Payer: Aetna American Axle |
$937.79
|
| Rate for Payer: Aetna Commercial |
$1,226.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$937.79
|
| Rate for Payer: Cash Price |
$1,154.21
|
| Rate for Payer: Cofinity Advantage |
$1,009.93
|
| Rate for Payer: Cofinity Commercial |
$1,240.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,154.21
|
| Rate for Payer: Healthscope Commercial |
$1,298.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,009.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,082.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,226.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,082.07
|
| Rate for Payer: PHP Commercial |
$1,226.35
|
| Rate for Payer: Priority Health SBD |
$908.94
|
| Rate for Payer: UMR Bronson Commercial |
$634.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,082.07
|
|
|
HC THORACIC FASCIAL PLANE BLOCK BILAT CONT
|
Facility
|
IP
|
$1,125.00
|
|
|
Service Code
|
CPT 64469
|
| Hospital Charge Code |
37000028
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$495.00 |
| Max. Negotiated Rate |
$1,012.50 |
| Rate for Payer: Aetna American Axle |
$731.25
|
| Rate for Payer: Aetna Commercial |
$956.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.25
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Advantage |
$787.50
|
| Rate for Payer: Cofinity Commercial |
$967.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.00
|
| Rate for Payer: Healthscope Commercial |
$1,012.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$787.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$843.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$843.75
|
| Rate for Payer: PHP Commercial |
$956.25
|
| Rate for Payer: Priority Health SBD |
$708.75
|
| Rate for Payer: UMR Bronson Commercial |
$495.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$843.75
|
|
|
HC THORACIC FASCIAL PLANE BLOCK BILAT CONT
|
Facility
|
OP
|
$1,125.00
|
|
|
Service Code
|
CPT 64469
|
| Hospital Charge Code |
37000028
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$416.25 |
| Max. Negotiated Rate |
$1,012.50 |
| Rate for Payer: Aetna American Axle |
$731.25
|
| Rate for Payer: Aetna Commercial |
$956.25
|
| Rate for Payer: Aetna Medicare |
$562.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.25
|
| Rate for Payer: BCBS Complete |
$450.00
|
| Rate for Payer: Cash Price |
$900.00
|
| Rate for Payer: Cofinity Advantage |
$787.50
|
| Rate for Payer: Cofinity Commercial |
$967.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.00
|
| Rate for Payer: Healthscope Commercial |
$1,012.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$787.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$843.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$900.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$843.75
|
| Rate for Payer: PHP Commercial |
$956.25
|
| Rate for Payer: Priority Health SBD |
$708.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$731.25
|
| Rate for Payer: UHC Core |
$586.12
|
| Rate for Payer: UHC Exchange |
$442.12
|
| Rate for Payer: UMR Bronson Commercial |
$416.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$843.75
|
|
|
HC THORACIC FASCIAL PLANE BLOCK BILAT INJ
|
Facility
|
IP
|
$1,111.79
|
|
|
Service Code
|
CPT 64468
|
| Hospital Charge Code |
37000022
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$489.19 |
| Max. Negotiated Rate |
$1,000.61 |
| Rate for Payer: Aetna American Axle |
$722.66
|
| Rate for Payer: Aetna Commercial |
$945.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$722.66
|
| Rate for Payer: Cash Price |
$889.43
|
| Rate for Payer: Cofinity Advantage |
$778.25
|
| Rate for Payer: Cofinity Commercial |
$956.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$889.43
|
| Rate for Payer: Healthscope Commercial |
$1,000.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$778.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$833.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$945.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$833.84
|
| Rate for Payer: PHP Commercial |
$945.02
|
| Rate for Payer: Priority Health SBD |
$700.43
|
| Rate for Payer: UMR Bronson Commercial |
$489.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$833.84
|
|
|
HC THORACIC FASCIAL PLANE BLOCK BILAT INJ
|
Facility
|
OP
|
$1,111.79
|
|
|
Service Code
|
CPT 64468
|
| Hospital Charge Code |
37000022
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$411.36 |
| Max. Negotiated Rate |
$1,000.61 |
| Rate for Payer: Aetna American Axle |
$722.66
|
| Rate for Payer: Aetna Commercial |
$945.02
|
| Rate for Payer: Aetna Medicare |
$555.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$722.66
|
| Rate for Payer: BCBS Complete |
$444.72
|
| Rate for Payer: Cash Price |
$889.43
|
| Rate for Payer: Cofinity Advantage |
$778.25
|
| Rate for Payer: Cofinity Commercial |
$956.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$889.43
|
| Rate for Payer: Healthscope Commercial |
$1,000.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$778.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$833.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$889.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$945.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$833.84
|
| Rate for Payer: PHP Commercial |
$945.02
|
| Rate for Payer: Priority Health SBD |
$700.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$722.66
|
| Rate for Payer: UHC Core |
$579.24
|
| Rate for Payer: UHC Exchange |
$436.93
|
| Rate for Payer: UMR Bronson Commercial |
$411.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$833.84
|
|
|
HC THORACIC FASCIAL PLANE BLOCK UNILAT CONT
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
CPT 64467
|
| Hospital Charge Code |
37000027
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$330.00 |
| Max. Negotiated Rate |
$675.00 |
| Rate for Payer: Aetna American Axle |
$487.50
|
| Rate for Payer: Aetna Commercial |
$637.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.50
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cofinity Advantage |
$525.00
|
| Rate for Payer: Cofinity Commercial |
$645.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.00
|
| Rate for Payer: Healthscope Commercial |
$675.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$525.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$562.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$637.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$562.50
|
| Rate for Payer: PHP Commercial |
$637.50
|
| Rate for Payer: Priority Health SBD |
$472.50
|
| Rate for Payer: UMR Bronson Commercial |
$330.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$562.50
|
|
|
HC THORACIC FASCIAL PLANE BLOCK UNILAT CONT
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
CPT 64467
|
| Hospital Charge Code |
37000027
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$277.50 |
| Max. Negotiated Rate |
$675.00 |
| Rate for Payer: Aetna American Axle |
$487.50
|
| Rate for Payer: Aetna Commercial |
$637.50
|
| Rate for Payer: Aetna Medicare |
$375.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$487.50
|
| Rate for Payer: BCBS Complete |
$300.00
|
| Rate for Payer: Cash Price |
$600.00
|
| Rate for Payer: Cofinity Advantage |
$525.00
|
| Rate for Payer: Cofinity Commercial |
$645.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$600.00
|
| Rate for Payer: Healthscope Commercial |
$675.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$525.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$562.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$600.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$637.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$562.50
|
| Rate for Payer: PHP Commercial |
$637.50
|
| Rate for Payer: Priority Health SBD |
$472.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$487.50
|
| Rate for Payer: UHC Core |
$390.75
|
| Rate for Payer: UHC Exchange |
$294.75
|
| Rate for Payer: UMR Bronson Commercial |
$277.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$562.50
|
|
