|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL BILAT
|
Facility
|
IP
|
$12,163.50
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100378
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,351.94 |
| Max. Negotiated Rate |
$10,947.15 |
| Rate for Payer: Aetna American Axle |
$7,906.27
|
| Rate for Payer: Aetna Commercial |
$10,338.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,906.27
|
| Rate for Payer: Cash Price |
$9,730.80
|
| Rate for Payer: Cofinity Commercial |
$10,460.61
|
| Rate for Payer: Cofinity Commercial |
$8,514.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,514.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,730.80
|
| Rate for Payer: Healthscope Commercial |
$10,947.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,514.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,122.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,338.98
|
| Rate for Payer: PHP Commercial |
$10,338.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,906.27
|
| Rate for Payer: Priority Health SBD |
$7,663.01
|
| Rate for Payer: UMR Bronson Commercial |
$5,351.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,122.62
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL BILAT
|
Facility
|
OP
|
$12,163.50
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100378
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,695.31 |
| Max. Negotiated Rate |
$10,947.15 |
| Rate for Payer: Aetna American Axle |
$7,906.27
|
| Rate for Payer: Aetna Commercial |
$10,338.98
|
| Rate for Payer: Aetna Medicare |
$3,289.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,906.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,953.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,953.62
|
| Rate for Payer: BCBS Complete |
$1,780.08
|
| Rate for Payer: BCBS MAPPO |
$3,162.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.90
|
| Rate for Payer: Cash Price |
$9,730.80
|
| Rate for Payer: Cash Price |
$9,730.80
|
| Rate for Payer: Cofinity Commercial |
$8,514.45
|
| Rate for Payer: Cofinity Commercial |
$10,460.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,514.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,730.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.90
|
| Rate for Payer: Healthscope Commercial |
$10,947.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,514.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,122.62
|
| Rate for Payer: Mclaren Medicaid |
$1,695.31
|
| Rate for Payer: Mclaren Medicare |
$3,162.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,321.05
|
| Rate for Payer: Meridian Medicaid |
$1,780.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,637.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,338.98
|
| Rate for Payer: PACE Medicare |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Commercial |
$10,338.98
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,906.27
|
| Rate for Payer: Priority Health Medicare |
$3,162.90
|
| Rate for Payer: Priority Health SBD |
$7,663.01
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,903.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.90
|
| Rate for Payer: UHC Exchange |
$6,044.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,162.90
|
| Rate for Payer: UHCCP Medicaid |
$1,695.31
|
| Rate for Payer: UMR Bronson Commercial |
$4,500.49
|
| Rate for Payer: VA VA |
$3,162.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,122.62
|
|
|
HC SUCTION A&A LINE
|
Facility
|
OP
|
$32.13
|
|
| Hospital Charge Code |
27000110
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.89 |
| Max. Negotiated Rate |
$28.92 |
| Rate for Payer: Aetna American Axle |
$20.88
|
| Rate for Payer: Aetna Commercial |
$27.31
|
| Rate for Payer: Aetna Medicare |
$16.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.88
|
| Rate for Payer: BCBS Complete |
$12.85
|
| Rate for Payer: Cash Price |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$22.49
|
| Rate for Payer: Cofinity Commercial |
$27.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.70
|
| Rate for Payer: Healthscope Commercial |
$28.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.31
|
| Rate for Payer: PHP Commercial |
$27.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.88
|
| Rate for Payer: Priority Health SBD |
$20.24
|
| Rate for Payer: UMR Bronson Commercial |
$11.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.10
|
|
|
HC SUCTION A&A LINE
|
Facility
|
IP
|
$32.13
|
|
| Hospital Charge Code |
27000110
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.14 |
| Max. Negotiated Rate |
$28.92 |
| Rate for Payer: Aetna American Axle |
$20.88
|
| Rate for Payer: Aetna Commercial |
$27.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.88
|
| Rate for Payer: Cash Price |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$22.49
|
| Rate for Payer: Cofinity Commercial |
$27.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.70
|
| Rate for Payer: Healthscope Commercial |
$28.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.31
|
| Rate for Payer: PHP Commercial |
$27.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.88
|
| Rate for Payer: Priority Health SBD |
$20.24
|
| Rate for Payer: UMR Bronson Commercial |
$14.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.10
|
|
|
HC SUMP VENTRICULAR LIVANOVA
|
Facility
|
IP
|
$44.37
|
|
| Hospital Charge Code |
27000659
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.52 |
| Max. Negotiated Rate |
$39.93 |
| Rate for Payer: Aetna American Axle |
$28.84
|
| Rate for Payer: Aetna Commercial |
$37.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.84
|
| Rate for Payer: Cash Price |
$35.50
|
| Rate for Payer: Cofinity Commercial |
$31.06
|
| Rate for Payer: Cofinity Commercial |
$38.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.50
|
| Rate for Payer: Healthscope Commercial |
$39.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.71
|
| Rate for Payer: PHP Commercial |
$37.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.84
|
| Rate for Payer: Priority Health SBD |
$27.95
|
| Rate for Payer: UMR Bronson Commercial |
$19.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.28
|
|
|
HC SUMP VENTRICULAR LIVANOVA
|
Facility
|
OP
|
$44.37
|
|
| Hospital Charge Code |
27000659
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.42 |
| Max. Negotiated Rate |
$39.93 |
| Rate for Payer: Aetna American Axle |
$28.84
|
| Rate for Payer: Aetna Commercial |
$37.71
|
| Rate for Payer: Aetna Medicare |
$22.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.84
|
| Rate for Payer: BCBS Complete |
$17.75
|
| Rate for Payer: Cash Price |
$35.50
|
| Rate for Payer: Cofinity Commercial |
$31.06
|
| Rate for Payer: Cofinity Commercial |
$38.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.50
|
| Rate for Payer: Healthscope Commercial |
$39.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.71
|
| Rate for Payer: PHP Commercial |
$37.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.84
|
| Rate for Payer: Priority Health SBD |
$27.95
|
| Rate for Payer: UMR Bronson Commercial |
$16.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.28
|
|
|
HC SUMP VENTRICULAR MEDTRONIC
|
Facility
|
OP
|
$42.84
|
|
| Hospital Charge Code |
27000122
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.85 |
| Max. Negotiated Rate |
$38.56 |
| Rate for Payer: Aetna American Axle |
$27.85
|
| Rate for Payer: Aetna Commercial |
$36.41
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.85
|
| Rate for Payer: BCBS Complete |
$17.14
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$29.99
|
| Rate for Payer: Cofinity Commercial |
$36.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Healthscope Commercial |
$38.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.41
|
| Rate for Payer: PHP Commercial |
$36.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.85
|
| Rate for Payer: Priority Health SBD |
$26.99
|
| Rate for Payer: UMR Bronson Commercial |
$15.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.13
|
|
|
HC SUMP VENTRICULAR MEDTRONIC
|
Facility
|
IP
|
$42.84
|
|
| Hospital Charge Code |
27000122
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.85 |
| Max. Negotiated Rate |
$38.56 |
| Rate for Payer: Aetna American Axle |
$27.85
|
| Rate for Payer: Aetna Commercial |
$36.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.85
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$29.99
|
| Rate for Payer: Cofinity Commercial |
$36.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Healthscope Commercial |
$38.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.41
|
| Rate for Payer: PHP Commercial |
$36.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.85
|
| Rate for Payer: Priority Health SBD |
$26.99
|
| Rate for Payer: UMR Bronson Commercial |
$18.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.13
|
|
|
HC SUPERVISION & HANDLING
|
Facility
|
OP
|
$157.10
|
|
|
Service Code
|
CPT 77790
|
| Hospital Charge Code |
33300029
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$58.13 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$102.11
|
| Rate for Payer: Aetna Commercial |
$133.53
|
| Rate for Payer: Aetna Medicare |
$78.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.11
|
| Rate for Payer: BCBS Complete |
$62.84
|
| Rate for Payer: Cash Price |
$125.68
|
| Rate for Payer: Cash Price |
$125.68
|
| Rate for Payer: Cofinity Commercial |
$135.11
|
| Rate for Payer: Cofinity Commercial |
$109.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$109.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.68
|
| Rate for Payer: Healthscope Commercial |
$141.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.53
|
| Rate for Payer: PHP Commercial |
$133.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.11
|
| Rate for Payer: Priority Health SBD |
$98.97
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UMR Bronson Commercial |
$58.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.83
|
|
|
HC SUPERVISION & HANDLING
|
Facility
|
IP
|
$157.10
|
|
|
Service Code
|
CPT 77790
|
| Hospital Charge Code |
33300029
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$69.12 |
| Max. Negotiated Rate |
$141.39 |
| Rate for Payer: Aetna American Axle |
$102.11
|
| Rate for Payer: Aetna Commercial |
$133.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.11
|
| Rate for Payer: Cash Price |
$125.68
|
| Rate for Payer: Cofinity Commercial |
$109.97
|
| Rate for Payer: Cofinity Commercial |
$135.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$109.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.68
|
| Rate for Payer: Healthscope Commercial |
$141.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.53
|
| Rate for Payer: PHP Commercial |
$133.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.11
|
| Rate for Payer: Priority Health SBD |
$98.97
|
| Rate for Payer: UMR Bronson Commercial |
$69.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.83
|
|
|
HC SUPPLEMENTAL NEWBORN SCRN
|
Facility
|
OP
|
$86.70
|
|
|
Service Code
|
CPT 83789
|
| Hospital Charge Code |
30100686
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.92 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna American Axle |
$56.35
|
| Rate for Payer: Aetna Commercial |
$73.69
|
| Rate for Payer: Aetna Medicare |
$25.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.14
|
| Rate for Payer: BCBS Complete |
$13.57
|
| Rate for Payer: BCBS MAPPO |
$24.11
|
| Rate for Payer: BCN Medicare Advantage |
$24.11
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cofinity Commercial |
$74.56
|
| Rate for Payer: Cofinity Commercial |
$60.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.11
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.03
|
| Rate for Payer: Mclaren Medicaid |
$12.92
|
| Rate for Payer: Mclaren Medicare |
$24.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.32
|
| Rate for Payer: Meridian Medicaid |
$13.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.69
|
| Rate for Payer: PACE Medicare |
$22.90
|
| Rate for Payer: PACE SWMI |
$24.11
|
| Rate for Payer: PHP Commercial |
$73.69
|
| Rate for Payer: PHP Medicare Advantage |
$24.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.35
|
| Rate for Payer: Priority Health Medicare |
$24.11
|
| Rate for Payer: Priority Health SBD |
$54.62
|
| Rate for Payer: Railroad Medicare Medicare |
$24.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.11
|
| Rate for Payer: UHC Exchange |
$46.08
|
| Rate for Payer: UHC Medicare Advantage |
$24.11
|
| Rate for Payer: UHCCP Medicaid |
$12.92
|
| Rate for Payer: UMR Bronson Commercial |
$32.08
|
| Rate for Payer: VA VA |
$24.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.03
|
|
|
HC SUPPLEMENTAL NEWBORN SCRN
|
Facility
|
IP
|
$86.70
|
|
|
Service Code
|
CPT 83789
|
| Hospital Charge Code |
30100686
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.15 |
| Max. Negotiated Rate |
$78.03 |
| Rate for Payer: Aetna American Axle |
$56.35
|
| Rate for Payer: Aetna Commercial |
$73.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.35
|
| Rate for Payer: Cash Price |
$69.36
|
| Rate for Payer: Cofinity Commercial |
$60.69
|
| Rate for Payer: Cofinity Commercial |
$74.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.36
|
| Rate for Payer: Healthscope Commercial |
$78.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.69
|
| Rate for Payer: PHP Commercial |
$73.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.35
|
| Rate for Payer: Priority Health SBD |
$54.62
|
| Rate for Payer: UMR Bronson Commercial |
$38.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.03
|
|
|
HC SUPRAPUBIC CATHETER
|
Facility
|
IP
|
$118.97
|
|
|
Service Code
|
HCPCS C2627
|
| Hospital Charge Code |
27200072
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.35 |
| Max. Negotiated Rate |
$107.07 |
| Rate for Payer: Aetna American Axle |
$77.33
|
| Rate for Payer: Aetna Commercial |
$101.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.33
|
| Rate for Payer: Cash Price |
$95.18
|
| Rate for Payer: Cofinity Commercial |
$102.31
|
| Rate for Payer: Cofinity Commercial |
$83.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.18
|
| Rate for Payer: Healthscope Commercial |
$107.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.12
|
| Rate for Payer: PHP Commercial |
$101.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.33
|
| Rate for Payer: Priority Health SBD |
$74.95
|
| Rate for Payer: UMR Bronson Commercial |
$52.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.23
|
|
|
HC SUPRAPUBIC CATHETER
|
Facility
|
OP
|
$118.97
|
|
|
Service Code
|
HCPCS C2627
|
| Hospital Charge Code |
27200072
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.02 |
| Max. Negotiated Rate |
$107.07 |
| Rate for Payer: Aetna American Axle |
$77.33
|
| Rate for Payer: Aetna Commercial |
$101.12
|
| Rate for Payer: Aetna Medicare |
$59.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.33
|
| Rate for Payer: BCBS Complete |
$47.59
|
| Rate for Payer: Cash Price |
$95.18
|
| Rate for Payer: Cofinity Commercial |
$102.31
|
| Rate for Payer: Cofinity Commercial |
$83.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.18
|
| Rate for Payer: Healthscope Commercial |
$107.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.12
|
| Rate for Payer: PHP Commercial |
$101.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.33
|
| Rate for Payer: Priority Health SBD |
$74.95
|
| Rate for Payer: UMR Bronson Commercial |
$44.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.23
|
|
|
HC SURGERY FROZEN EA ADDL
|
Facility
|
IP
|
$74.70
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
31000057
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$32.87 |
| Max. Negotiated Rate |
$67.23 |
| Rate for Payer: Aetna American Axle |
$48.55
|
| Rate for Payer: Aetna Commercial |
$63.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.55
|
| Rate for Payer: Cash Price |
$59.76
|
| Rate for Payer: Cofinity Commercial |
$52.29
|
| Rate for Payer: Cofinity Commercial |
$64.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.76
|
| Rate for Payer: Healthscope Commercial |
$67.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.49
|
| Rate for Payer: PHP Commercial |
$63.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health SBD |
$47.06
|
| Rate for Payer: UMR Bronson Commercial |
$32.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.02
|
|
|
HC SURGERY FROZEN EA ADDL
|
Facility
|
OP
|
$74.70
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
31000057
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.64 |
| Max. Negotiated Rate |
$67.23 |
| Rate for Payer: Aetna American Axle |
$48.55
|
| Rate for Payer: Aetna Commercial |
$63.49
|
| Rate for Payer: Aetna Medicare |
$37.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.55
|
| Rate for Payer: BCBS Complete |
$29.88
|
| Rate for Payer: Cash Price |
$59.76
|
| Rate for Payer: Cofinity Commercial |
$52.29
|
| Rate for Payer: Cofinity Commercial |
$64.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.76
|
| Rate for Payer: Healthscope Commercial |
$67.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.49
|
| Rate for Payer: PHP Commercial |
$63.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health SBD |
$47.06
|
| Rate for Payer: UMR Bronson Commercial |
$27.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.02
|
|
|
HC SURGICAL HAND
|
Facility
|
IP
|
$704.42
|
|
| Hospital Charge Code |
45000053
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$309.94 |
| Max. Negotiated Rate |
$633.98 |
| Rate for Payer: Aetna American Axle |
$457.87
|
| Rate for Payer: Aetna Commercial |
$598.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.87
|
| Rate for Payer: Cash Price |
$563.54
|
| Rate for Payer: Cofinity Commercial |
$493.09
|
| Rate for Payer: Cofinity Commercial |
$605.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.54
|
| Rate for Payer: Healthscope Commercial |
$633.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.76
|
| Rate for Payer: PHP Commercial |
$598.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$457.87
|
| Rate for Payer: Priority Health SBD |
$443.78
|
| Rate for Payer: UMR Bronson Commercial |
$309.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.32
|
|
|
HC SURGICAL HAND
|
Facility
|
OP
|
$704.42
|
|
| Hospital Charge Code |
45000053
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$260.64 |
| Max. Negotiated Rate |
$633.98 |
| Rate for Payer: Aetna American Axle |
$457.87
|
| Rate for Payer: Aetna Commercial |
$598.76
|
| Rate for Payer: Aetna Medicare |
$352.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.87
|
| Rate for Payer: BCBS Complete |
$281.77
|
| Rate for Payer: Cash Price |
$563.54
|
| Rate for Payer: Cofinity Commercial |
$493.09
|
| Rate for Payer: Cofinity Commercial |
$605.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.54
|
| Rate for Payer: Healthscope Commercial |
$633.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$598.76
|
| Rate for Payer: PHP Commercial |
$598.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$457.87
|
| Rate for Payer: Priority Health SBD |
$443.78
|
| Rate for Payer: UMR Bronson Commercial |
$260.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.32
|
|
|
HC SURG SUPPLY MISC
|
Facility
|
OP
|
$86.43
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
62300132
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$31.98 |
| Max. Negotiated Rate |
$77.79 |
| Rate for Payer: Aetna American Axle |
$56.18
|
| Rate for Payer: Aetna Commercial |
$73.47
|
| Rate for Payer: Aetna Medicare |
$43.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.18
|
| Rate for Payer: BCBS Complete |
$34.57
|
| Rate for Payer: Cash Price |
$69.14
|
| Rate for Payer: Cofinity Commercial |
$60.50
|
| Rate for Payer: Cofinity Commercial |
$74.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.14
|
| Rate for Payer: Healthscope Commercial |
$77.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.47
|
| Rate for Payer: PHP Commercial |
$73.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.18
|
| Rate for Payer: Priority Health SBD |
$54.45
|
| Rate for Payer: UMR Bronson Commercial |
$31.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.82
|
|
|
HC SURG SUPPLY MISC
|
Facility
|
IP
|
$86.43
|
|
|
Service Code
|
HCPCS A4649
|
| Hospital Charge Code |
62300132
|
|
Hospital Revenue Code
|
623
|
| Min. Negotiated Rate |
$38.03 |
| Max. Negotiated Rate |
$77.79 |
| Rate for Payer: Aetna American Axle |
$56.18
|
| Rate for Payer: Aetna Commercial |
$73.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.18
|
| Rate for Payer: Cash Price |
$69.14
|
| Rate for Payer: Cofinity Commercial |
$60.50
|
| Rate for Payer: Cofinity Commercial |
$74.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.14
|
| Rate for Payer: Healthscope Commercial |
$77.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.47
|
| Rate for Payer: PHP Commercial |
$73.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.18
|
| Rate for Payer: Priority Health SBD |
$54.45
|
| Rate for Payer: UMR Bronson Commercial |
$38.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.82
|
|
|
HC SUSCEPTIBILITY DISK
|
Facility
|
OP
|
$58.65
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
30600098
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.01 |
| Max. Negotiated Rate |
$52.78 |
| Rate for Payer: Aetna American Axle |
$38.12
|
| Rate for Payer: Aetna Commercial |
$49.85
|
| Rate for Payer: Aetna Medicare |
$7.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.35
|
| Rate for Payer: BCBS Complete |
$4.21
|
| Rate for Payer: BCBS MAPPO |
$7.48
|
| Rate for Payer: BCN Medicare Advantage |
$7.48
|
| Rate for Payer: Cash Price |
$46.92
|
| Rate for Payer: Cash Price |
$46.92
|
| Rate for Payer: Cofinity Commercial |
$50.44
|
| Rate for Payer: Cofinity Commercial |
$41.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.48
|
| Rate for Payer: Healthscope Commercial |
$52.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.99
|
| Rate for Payer: Mclaren Medicaid |
$4.01
|
| Rate for Payer: Mclaren Medicare |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.85
|
| Rate for Payer: Meridian Medicaid |
$4.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.85
|
| Rate for Payer: PACE Medicare |
$7.11
|
| Rate for Payer: PACE SWMI |
$7.48
|
| Rate for Payer: PHP Commercial |
$49.85
|
| Rate for Payer: PHP Medicare Advantage |
$7.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.12
|
| Rate for Payer: Priority Health Medicare |
$7.48
|
| Rate for Payer: Priority Health SBD |
$36.95
|
| Rate for Payer: Railroad Medicare Medicare |
$7.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.48
|
| Rate for Payer: UHC Exchange |
$14.30
|
| Rate for Payer: UHC Medicare Advantage |
$7.48
|
| Rate for Payer: UHCCP Medicaid |
$4.01
|
| Rate for Payer: UMR Bronson Commercial |
$21.70
|
| Rate for Payer: VA VA |
$7.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.99
|
|
|
HC SUSCEPTIBILITY DISK
|
Facility
|
IP
|
$58.65
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
30600098
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.81 |
| Max. Negotiated Rate |
$52.78 |
| Rate for Payer: Aetna American Axle |
$38.12
|
| Rate for Payer: Aetna Commercial |
$49.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.12
|
| Rate for Payer: Cash Price |
$46.92
|
| Rate for Payer: Cofinity Commercial |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$50.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.92
|
| Rate for Payer: Healthscope Commercial |
$52.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.85
|
| Rate for Payer: PHP Commercial |
$49.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.12
|
| Rate for Payer: Priority Health SBD |
$36.95
|
| Rate for Payer: UMR Bronson Commercial |
$25.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.99
|
|
|
HC SUSCEPTIBILITY E TEST
|
Facility
|
IP
|
$32.77
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
30600097
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.42 |
| Max. Negotiated Rate |
$29.49 |
| Rate for Payer: Aetna American Axle |
$21.30
|
| Rate for Payer: Aetna Commercial |
$27.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.30
|
| Rate for Payer: Cash Price |
$26.22
|
| Rate for Payer: Cofinity Commercial |
$22.94
|
| Rate for Payer: Cofinity Commercial |
$28.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.22
|
| Rate for Payer: Healthscope Commercial |
$29.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.85
|
| Rate for Payer: PHP Commercial |
$27.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.30
|
| Rate for Payer: Priority Health SBD |
$20.65
|
| Rate for Payer: UMR Bronson Commercial |
$14.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.58
|
|
|
HC SUSCEPTIBILITY E TEST
|
Facility
|
OP
|
$32.77
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
30600097
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$29.49 |
| Rate for Payer: Aetna American Axle |
$21.30
|
| Rate for Payer: Aetna Commercial |
$27.85
|
| Rate for Payer: Aetna Medicare |
$4.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.94
|
| Rate for Payer: BCBS Complete |
$2.67
|
| Rate for Payer: BCBS MAPPO |
$4.75
|
| Rate for Payer: BCN Medicare Advantage |
$4.75
|
| Rate for Payer: Cash Price |
$26.22
|
| Rate for Payer: Cash Price |
$26.22
|
| Rate for Payer: Cofinity Commercial |
$28.18
|
| Rate for Payer: Cofinity Commercial |
$22.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.75
|
| Rate for Payer: Healthscope Commercial |
$29.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.58
|
| Rate for Payer: Mclaren Medicaid |
$2.55
|
| Rate for Payer: Mclaren Medicare |
$4.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.99
|
| Rate for Payer: Meridian Medicaid |
$2.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.85
|
| Rate for Payer: PACE Medicare |
$4.51
|
| Rate for Payer: PACE SWMI |
$4.75
|
| Rate for Payer: PHP Commercial |
$27.85
|
| Rate for Payer: PHP Medicare Advantage |
$4.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.30
|
| Rate for Payer: Priority Health Medicare |
$4.75
|
| Rate for Payer: Priority Health SBD |
$20.65
|
| Rate for Payer: Railroad Medicare Medicare |
$4.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.75
|
| Rate for Payer: UHC Exchange |
$9.08
|
| Rate for Payer: UHC Medicare Advantage |
$4.75
|
| Rate for Payer: UHCCP Medicaid |
$2.55
|
| Rate for Payer: UMR Bronson Commercial |
$12.12
|
| Rate for Payer: VA VA |
$4.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.58
|
|
|
HC SUSCEPTIBILITY, MIC
|
Facility
|
IP
|
$80.58
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
30600100
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.46 |
| Max. Negotiated Rate |
$72.52 |
| Rate for Payer: Aetna American Axle |
$52.38
|
| Rate for Payer: Aetna Commercial |
$68.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.38
|
| Rate for Payer: Cash Price |
$64.46
|
| Rate for Payer: Cofinity Commercial |
$56.41
|
| Rate for Payer: Cofinity Commercial |
$69.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$56.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.46
|
| Rate for Payer: Healthscope Commercial |
$72.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.49
|
| Rate for Payer: PHP Commercial |
$68.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.38
|
| Rate for Payer: Priority Health SBD |
$50.77
|
| Rate for Payer: UMR Bronson Commercial |
$35.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.44
|
|
