|
HC US PROSTATE TRANSRECTAL
|
Facility
|
OP
|
$1,107.77
|
|
|
Service Code
|
CPT 76872
|
| Hospital Charge Code |
40200036
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$996.99 |
| Rate for Payer: Aetna American Axle |
$720.05
|
| Rate for Payer: Aetna Commercial |
$941.60
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$720.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$404.70
|
| Rate for Payer: BCN Commercial |
$404.70
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$886.22
|
| Rate for Payer: Cash Price |
$886.22
|
| Rate for Payer: Cofinity Advantage |
$775.44
|
| Rate for Payer: Cofinity Commercial |
$952.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$886.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$996.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$775.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$830.83
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$941.60
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$830.83
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$941.60
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$697.90
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$720.05
|
| Rate for Payer: UHC Core |
$577.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$435.35
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$409.87
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$830.83
|
|
|
HC US PROSTATE TRANSRECTAL
|
Facility
|
IP
|
$1,107.77
|
|
|
Service Code
|
CPT 76872
|
| Hospital Charge Code |
40200036
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$487.42 |
| Max. Negotiated Rate |
$996.99 |
| Rate for Payer: Aetna American Axle |
$720.05
|
| Rate for Payer: Aetna Commercial |
$941.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$720.05
|
| Rate for Payer: Cash Price |
$886.22
|
| Rate for Payer: Cofinity Advantage |
$775.44
|
| Rate for Payer: Cofinity Commercial |
$952.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$886.22
|
| Rate for Payer: Healthscope Commercial |
$996.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$775.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$830.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$941.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$830.83
|
| Rate for Payer: PHP Commercial |
$941.60
|
| Rate for Payer: Priority Health SBD |
$697.90
|
| Rate for Payer: UMR Bronson Commercial |
$487.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$830.83
|
|
|
HC US PROSTATE TRANSRECT TX PLAN SEP PROC
|
Facility
|
OP
|
$297.14
|
|
|
Service Code
|
CPT 76873
|
| Hospital Charge Code |
40200081
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$336.87 |
| Rate for Payer: Aetna American Axle |
$193.14
|
| Rate for Payer: Aetna Commercial |
$252.57
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$243.80
|
| Rate for Payer: BCN Commercial |
$243.80
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$237.71
|
| Rate for Payer: Cash Price |
$237.71
|
| Rate for Payer: Cofinity Advantage |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$255.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$267.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.85
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.57
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$222.85
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$252.57
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$187.20
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.14
|
| Rate for Payer: UHC Core |
$154.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$116.78
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$109.94
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.85
|
|
|
HC US PROSTATE TRANSRECT TX PLAN SEP PROC
|
Facility
|
IP
|
$297.14
|
|
|
Service Code
|
CPT 76873
|
| Hospital Charge Code |
40200081
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$130.74 |
| Max. Negotiated Rate |
$267.43 |
| Rate for Payer: Aetna American Axle |
$193.14
|
| Rate for Payer: Aetna Commercial |
$252.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.14
|
| Rate for Payer: Cash Price |
$237.71
|
| Rate for Payer: Cofinity Advantage |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$255.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.71
|
| Rate for Payer: Healthscope Commercial |
$267.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$222.85
|
| Rate for Payer: PHP Commercial |
$252.57
|
| Rate for Payer: Priority Health SBD |
$187.20
|
| Rate for Payer: UMR Bronson Commercial |
$130.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.85
|
|
|
HC US RETROPERITONEAL COMPLETE
|
Facility
|
IP
|
$781.02
|
|
|
Service Code
|
CPT 76770
|
| Hospital Charge Code |
40200011
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$343.65 |
| Max. Negotiated Rate |
$702.92 |
| Rate for Payer: Aetna American Axle |
$507.66
|
| Rate for Payer: Aetna Commercial |
$663.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$507.66
|
| Rate for Payer: Cash Price |
$624.82
|
| Rate for Payer: Cofinity Advantage |
$546.71
|
| Rate for Payer: Cofinity Commercial |
$671.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$624.82
|
| Rate for Payer: Healthscope Commercial |
$702.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$546.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$585.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$663.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$585.76
|
| Rate for Payer: PHP Commercial |
$663.87
|
| Rate for Payer: Priority Health SBD |
$492.04
|
| Rate for Payer: UMR Bronson Commercial |
$343.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$585.76
|
|
|
HC US RETROPERITONEAL COMPLETE
|
Facility
|
OP
|
$781.02
|
|
|
Service Code
|
CPT 76770
|
| Hospital Charge Code |
40200011
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$702.92 |
| Rate for Payer: Aetna American Axle |
$507.66
|
| Rate for Payer: Aetna Commercial |
$663.87
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$507.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$179.78
|
| Rate for Payer: BCN Commercial |
$179.78
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$624.82
|
| Rate for Payer: Cash Price |
$624.82
|
| Rate for Payer: Cofinity Advantage |
$546.71
|
| Rate for Payer: Cofinity Commercial |
$671.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$624.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$702.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$546.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$585.76
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$663.87
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$585.76
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$663.87
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$492.04
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$507.66
|
| Rate for Payer: UHC Core |
$406.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$306.94
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$288.98
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$585.76
|
|
|
HC US RETROPERITONEAL LTD
|
Facility
|
OP
|
$781.02
|
|
|
Service Code
|
CPT 76775
|
| Hospital Charge Code |
40200012
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$702.92 |
| Rate for Payer: Aetna American Axle |
$507.66
|
| Rate for Payer: Aetna Commercial |
$663.87
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$507.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$82.09
|
| Rate for Payer: BCN Commercial |
$82.09
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$624.82
|
| Rate for Payer: Cash Price |
$624.82
|
| Rate for Payer: Cofinity Advantage |
$546.71
|
| Rate for Payer: Cofinity Commercial |
$671.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$624.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$702.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$546.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$585.76
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$663.87
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$585.76
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$663.87
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$492.04
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$507.66
|
| Rate for Payer: UHC Core |
$406.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$306.94
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$288.98
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$585.76
|
|
|
HC US RETROPERITONEAL LTD
|
Facility
|
IP
|
$781.02
|
|
|
Service Code
|
CPT 76775
|
| Hospital Charge Code |
40200012
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$343.65 |
| Max. Negotiated Rate |
$702.92 |
| Rate for Payer: Aetna American Axle |
$507.66
|
| Rate for Payer: Aetna Commercial |
$663.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$507.66
|
| Rate for Payer: Cash Price |
$624.82
|
| Rate for Payer: Cofinity Advantage |
$546.71
|
| Rate for Payer: Cofinity Commercial |
$671.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$624.82
|
| Rate for Payer: Healthscope Commercial |
$702.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$546.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$585.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$663.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$585.76
|
| Rate for Payer: PHP Commercial |
$663.87
|
| Rate for Payer: Priority Health SBD |
$492.04
|
| Rate for Payer: UMR Bronson Commercial |
$343.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$585.76
|
|
|
HC US SCROTUM AND CONTENTS
|
Facility
|
OP
|
$728.91
|
|
|
Service Code
|
CPT 76870
|
| Hospital Charge Code |
40200035
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$656.02 |
| Rate for Payer: Aetna American Axle |
$473.79
|
| Rate for Payer: Aetna Commercial |
$619.57
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$171.56
|
| Rate for Payer: BCN Commercial |
$171.56
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$583.13
|
| Rate for Payer: Cash Price |
$583.13
|
| Rate for Payer: Cofinity Advantage |
$510.24
|
| Rate for Payer: Cofinity Commercial |
$626.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$583.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$656.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$510.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.68
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.57
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.68
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$619.57
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$459.21
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.79
|
| Rate for Payer: UHC Core |
$379.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$286.46
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$269.70
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.68
|
|
|
HC US SCROTUM AND CONTENTS
|
Facility
|
IP
|
$728.91
|
|
|
Service Code
|
CPT 76870
|
| Hospital Charge Code |
40200035
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$320.72 |
| Max. Negotiated Rate |
$656.02 |
| Rate for Payer: Aetna American Axle |
$473.79
|
| Rate for Payer: Aetna Commercial |
$619.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.79
|
| Rate for Payer: Cash Price |
$583.13
|
| Rate for Payer: Cofinity Advantage |
$510.24
|
| Rate for Payer: Cofinity Commercial |
$626.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$583.13
|
| Rate for Payer: Healthscope Commercial |
$656.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$510.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.68
|
| Rate for Payer: PHP Commercial |
$619.57
|
| Rate for Payer: Priority Health SBD |
$459.21
|
| Rate for Payer: UMR Bronson Commercial |
$320.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.68
|
|
|
HC U.S. SKIN PREP PACK
|
Facility
|
OP
|
$17.23
|
|
| Hospital Charge Code |
27000163
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.38 |
| Max. Negotiated Rate |
$15.51 |
| Rate for Payer: Aetna American Axle |
$11.20
|
| Rate for Payer: Aetna Commercial |
$14.65
|
| Rate for Payer: Aetna Medicare |
$8.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.20
|
| Rate for Payer: BCBS Complete |
$6.89
|
| Rate for Payer: Cash Price |
$13.78
|
| Rate for Payer: Cofinity Advantage |
$12.06
|
| Rate for Payer: Cofinity Commercial |
$14.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.78
|
| Rate for Payer: Healthscope Commercial |
$15.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.92
|
| Rate for Payer: PHP Commercial |
$14.65
|
| Rate for Payer: Priority Health SBD |
$10.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.20
|
| Rate for Payer: UHC Core |
$8.98
|
| Rate for Payer: UHC Exchange |
$6.77
|
| Rate for Payer: UMR Bronson Commercial |
$6.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.92
|
|
|
HC U.S. SKIN PREP PACK
|
Facility
|
IP
|
$17.23
|
|
| Hospital Charge Code |
27000163
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$15.51 |
| Rate for Payer: Aetna American Axle |
$11.20
|
| Rate for Payer: Aetna Commercial |
$14.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.20
|
| Rate for Payer: Cash Price |
$13.78
|
| Rate for Payer: Cofinity Advantage |
$12.06
|
| Rate for Payer: Cofinity Commercial |
$14.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.78
|
| Rate for Payer: Healthscope Commercial |
$15.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.92
|
| Rate for Payer: PHP Commercial |
$14.65
|
| Rate for Payer: Priority Health SBD |
$10.85
|
| Rate for Payer: UMR Bronson Commercial |
$7.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.92
|
|
|
HC US SOFT TISSUE HEAD NECK
|
Facility
|
OP
|
$801.68
|
|
|
Service Code
|
CPT 76536
|
| Hospital Charge Code |
40200006
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$721.51 |
| Rate for Payer: Aetna American Axle |
$521.09
|
| Rate for Payer: Aetna Commercial |
$681.43
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$521.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$203.57
|
| Rate for Payer: BCN Commercial |
$203.57
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$641.34
|
| Rate for Payer: Cash Price |
$641.34
|
| Rate for Payer: Cofinity Advantage |
$561.18
|
| Rate for Payer: Cofinity Commercial |
$689.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$721.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$561.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$601.26
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$681.43
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$601.26
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$681.43
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$505.06
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$521.09
|
| Rate for Payer: UHC Core |
$417.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$315.06
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$296.62
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$601.26
|
|
|
HC US SOFT TISSUE HEAD NECK
|
Facility
|
IP
|
$801.68
|
|
|
Service Code
|
CPT 76536
|
| Hospital Charge Code |
40200006
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$352.74 |
| Max. Negotiated Rate |
$721.51 |
| Rate for Payer: Aetna American Axle |
$521.09
|
| Rate for Payer: Aetna Commercial |
$681.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$521.09
|
| Rate for Payer: Cash Price |
$641.34
|
| Rate for Payer: Cofinity Advantage |
$561.18
|
| Rate for Payer: Cofinity Commercial |
$689.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.34
|
| Rate for Payer: Healthscope Commercial |
$721.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$561.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$601.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$681.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$601.26
|
| Rate for Payer: PHP Commercial |
$681.43
|
| Rate for Payer: Priority Health SBD |
$505.06
|
| Rate for Payer: UMR Bronson Commercial |
$352.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$601.26
|
|
|
HC US SPINAL CANAL AND CONTENTS
|
Facility
|
IP
|
$495.72
|
|
|
Service Code
|
CPT 76800
|
| Hospital Charge Code |
40200014
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$218.12 |
| Max. Negotiated Rate |
$446.15 |
| Rate for Payer: Aetna American Axle |
$322.22
|
| Rate for Payer: Aetna Commercial |
$421.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.22
|
| Rate for Payer: Cash Price |
$396.58
|
| Rate for Payer: Cofinity Advantage |
$347.00
|
| Rate for Payer: Cofinity Commercial |
$426.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.58
|
| Rate for Payer: Healthscope Commercial |
$446.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$347.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$421.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$371.79
|
| Rate for Payer: PHP Commercial |
$421.36
|
| Rate for Payer: Priority Health SBD |
$312.30
|
| Rate for Payer: UMR Bronson Commercial |
$218.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.79
|
|
|
HC US SPINAL CANAL AND CONTENTS
|
Facility
|
OP
|
$495.72
|
|
|
Service Code
|
CPT 76800
|
| Hospital Charge Code |
40200014
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$446.15 |
| Rate for Payer: Aetna American Axle |
$322.22
|
| Rate for Payer: Aetna Commercial |
$421.36
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$290.60
|
| Rate for Payer: BCN Commercial |
$290.60
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$396.58
|
| Rate for Payer: Cash Price |
$396.58
|
| Rate for Payer: Cofinity Advantage |
$347.00
|
| Rate for Payer: Cofinity Commercial |
$426.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$396.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$446.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$347.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.79
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$421.36
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$371.79
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$421.36
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$312.30
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$322.22
|
| Rate for Payer: UHC Core |
$258.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$194.82
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$183.42
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.79
|
|
|
HC US SURGERY INTRAOPERATIVE
|
Facility
|
OP
|
$694.03
|
|
|
Service Code
|
CPT 76998
|
| Hospital Charge Code |
40200050
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$228.20 |
| Max. Negotiated Rate |
$624.63 |
| Rate for Payer: Aetna American Axle |
$451.12
|
| Rate for Payer: Aetna Commercial |
$589.93
|
| Rate for Payer: Aetna Medicare |
$347.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.12
|
| Rate for Payer: BCBS Complete |
$277.61
|
| Rate for Payer: BCBS Trust/PPO |
$228.20
|
| Rate for Payer: BCN Commercial |
$228.20
|
| Rate for Payer: Cash Price |
$555.22
|
| Rate for Payer: Cash Price |
$555.22
|
| Rate for Payer: Cofinity Advantage |
$485.82
|
| Rate for Payer: Cofinity Commercial |
$596.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$555.22
|
| Rate for Payer: Healthscope Commercial |
$624.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$485.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$520.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$555.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$589.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$520.52
|
| Rate for Payer: PHP Commercial |
$589.93
|
| Rate for Payer: Priority Health SBD |
$437.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$451.12
|
| Rate for Payer: UHC Core |
$361.59
|
| Rate for Payer: UHC Exchange |
$272.75
|
| Rate for Payer: UMR Bronson Commercial |
$256.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$520.52
|
|
|
HC US SURGERY INTRAOPERATIVE
|
Facility
|
IP
|
$694.03
|
|
|
Service Code
|
CPT 76998
|
| Hospital Charge Code |
40200050
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$305.37 |
| Max. Negotiated Rate |
$624.63 |
| Rate for Payer: Aetna American Axle |
$451.12
|
| Rate for Payer: Aetna Commercial |
$589.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.12
|
| Rate for Payer: Cash Price |
$555.22
|
| Rate for Payer: Cofinity Advantage |
$485.82
|
| Rate for Payer: Cofinity Commercial |
$596.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$555.22
|
| Rate for Payer: Healthscope Commercial |
$624.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$485.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$520.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$589.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$520.52
|
| Rate for Payer: PHP Commercial |
$589.93
|
| Rate for Payer: Priority Health SBD |
$437.24
|
| Rate for Payer: UMR Bronson Commercial |
$305.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$520.52
|
|
|
HC USTEKINUMAB AND AB
|
Facility
|
IP
|
$169.59
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100673
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$74.62 |
| Max. Negotiated Rate |
$152.63 |
| Rate for Payer: Aetna American Axle |
$110.23
|
| Rate for Payer: Aetna Commercial |
$144.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.23
|
| Rate for Payer: Cash Price |
$135.67
|
| Rate for Payer: Cofinity Advantage |
$118.71
|
| Rate for Payer: Cofinity Commercial |
$145.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.67
|
| Rate for Payer: Healthscope Commercial |
$152.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.19
|
| Rate for Payer: PHP Commercial |
$144.15
|
| Rate for Payer: Priority Health SBD |
$106.84
|
| Rate for Payer: UMR Bronson Commercial |
$74.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.19
|
|
|
HC USTEKINUMAB AND AB
|
Facility
|
OP
|
$169.59
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100673
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$152.63 |
| Rate for Payer: Aetna American Axle |
$110.23
|
| Rate for Payer: Aetna Commercial |
$144.15
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$19.96
|
| Rate for Payer: BCN Commercial |
$19.96
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$135.67
|
| Rate for Payer: Cash Price |
$135.67
|
| Rate for Payer: Cofinity Advantage |
$118.71
|
| Rate for Payer: Cofinity Commercial |
$145.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$152.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.19
|
| Rate for Payer: Mclaren Medicaid |
$17.27
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.15
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.19
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$144.15
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$106.84
|
| Rate for Payer: Priority Health Tiered Network |
$13.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.91
|
| Rate for Payer: UHC Core |
$25.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$25.91
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: UMR Bronson Commercial |
$62.75
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.19
|
|
|
HC USTEKINUMAB AND AB CMPT
|
Facility
|
OP
|
$168.54
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100674
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$151.69 |
| Rate for Payer: Aetna American Axle |
$109.55
|
| Rate for Payer: Aetna Commercial |
$143.26
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.55
|
| 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 |
$134.83
|
| Rate for Payer: Cash Price |
$134.83
|
| Rate for Payer: Cofinity Advantage |
$117.98
|
| Rate for Payer: Cofinity Commercial |
$144.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$151.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.41
|
| 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 |
$143.26
|
| Rate for Payer: Nomi Health Commercial |
$27.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.41
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$143.26
|
| 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 |
$106.18
|
| 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 |
$62.36
|
| Rate for Payer: VA VA |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.41
|
|
|
HC USTEKINUMAB AND AB CMPT
|
Facility
|
IP
|
$168.54
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100674
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$74.16 |
| Max. Negotiated Rate |
$151.69 |
| Rate for Payer: Aetna American Axle |
$109.55
|
| Rate for Payer: Aetna Commercial |
$143.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.55
|
| Rate for Payer: Cash Price |
$134.83
|
| Rate for Payer: Cofinity Advantage |
$117.98
|
| Rate for Payer: Cofinity Commercial |
$144.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.83
|
| Rate for Payer: Healthscope Commercial |
$151.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.41
|
| Rate for Payer: PHP Commercial |
$143.26
|
| Rate for Payer: Priority Health SBD |
$106.18
|
| Rate for Payer: UMR Bronson Commercial |
$74.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.41
|
|
|
HC US TRANSPLANTED KIDNEY
|
Facility
|
OP
|
$520.60
|
|
|
Service Code
|
CPT 76776
|
| Hospital Charge Code |
40200013
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$468.54 |
| Rate for Payer: Aetna American Axle |
$338.39
|
| Rate for Payer: Aetna Commercial |
$442.51
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$271.72
|
| Rate for Payer: BCN Commercial |
$271.72
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Advantage |
$364.42
|
| Rate for Payer: Cofinity Commercial |
$447.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$468.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.45
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.51
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$442.51
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$327.98
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.39
|
| Rate for Payer: UHC Core |
$271.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$204.60
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$192.62
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.45
|
|
|
HC US TRANSPLANTED KIDNEY
|
Facility
|
IP
|
$520.60
|
|
|
Service Code
|
CPT 76776
|
| Hospital Charge Code |
40200013
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$229.06 |
| Max. Negotiated Rate |
$468.54 |
| Rate for Payer: Aetna American Axle |
$338.39
|
| Rate for Payer: Aetna Commercial |
$442.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.39
|
| Rate for Payer: Cash Price |
$416.48
|
| Rate for Payer: Cofinity Advantage |
$364.42
|
| Rate for Payer: Cofinity Commercial |
$447.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.48
|
| Rate for Payer: Healthscope Commercial |
$468.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.45
|
| Rate for Payer: PHP Commercial |
$442.51
|
| Rate for Payer: Priority Health SBD |
$327.98
|
| Rate for Payer: UMR Bronson Commercial |
$229.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.45
|
|
|
HC UVULECTOMY EXCISION UVULA
|
Facility
|
OP
|
$8,219.16
|
|
|
Service Code
|
CPT 42140
|
| Hospital Charge Code |
76100468
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,727.75 |
| Max. Negotiated Rate |
$10,683.35 |
| Rate for Payer: Aetna American Axle |
$5,342.45
|
| Rate for Payer: Aetna Commercial |
$6,986.29
|
| Rate for Payer: Aetna Medicare |
$3,435.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,342.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,129.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,129.43
|
| Rate for Payer: BCBS Complete |
$1,814.30
|
| Rate for Payer: BCBS MAPPO |
$3,303.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,064.42
|
| Rate for Payer: BCN Commercial |
$2,064.42
|
| Rate for Payer: BCN Medicare Advantage |
$3,303.54
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cash Price |
$6,575.33
|
| Rate for Payer: Cofinity Advantage |
$5,753.41
|
| Rate for Payer: Cofinity Commercial |
$7,068.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,575.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,303.54
|
| Rate for Payer: Healthscope Commercial |
$7,397.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,753.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,164.37
|
| Rate for Payer: Mclaren Medicaid |
$3,303.54
|
| Rate for Payer: Mclaren Medicare |
$3,303.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,468.72
|
| Rate for Payer: Meridian Medicaid |
$3,468.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,799.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,633.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,986.29
|
| Rate for Payer: Nomi Health Commercial |
$9,910.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,164.37
|
| Rate for Payer: PACE Medicare |
$3,138.36
|
| Rate for Payer: PACE SWMI |
$3,303.54
|
| Rate for Payer: PHP Commercial |
$6,986.29
|
| Rate for Payer: PHP Medicare Advantage |
$3,303.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,727.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,683.35
|
| Rate for Payer: Priority Health Medicare |
$3,303.54
|
| Rate for Payer: Priority Health SBD |
$5,178.07
|
| Rate for Payer: Priority Health Tiered Network |
$8,546.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,303.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,342.45
|
| Rate for Payer: UHC Core |
$4,282.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,303.54
|
| Rate for Payer: UHC Exchange |
$3,230.13
|
| Rate for Payer: UHC Medicaid |
$1,727.75
|
| Rate for Payer: UHCCP Medicaid |
$1,727.75
|
| Rate for Payer: UMR Bronson Commercial |
$3,041.09
|
| Rate for Payer: VA VA |
$3,303.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,164.37
|
|
