|
HC TEMPORARY PACING WIRE
|
Facility
|
OP
|
$688.29
|
|
|
Service Code
|
HCPCS C1756
|
| Hospital Charge Code |
27200074
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$254.67 |
| Max. Negotiated Rate |
$619.46 |
| Rate for Payer: Aetna American Axle |
$447.39
|
| Rate for Payer: Aetna Commercial |
$585.05
|
| Rate for Payer: Aetna Medicare |
$344.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.39
|
| Rate for Payer: BCBS Complete |
$275.32
|
| Rate for Payer: Cash Price |
$550.63
|
| Rate for Payer: Cofinity Commercial |
$481.80
|
| Rate for Payer: Cofinity Commercial |
$591.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$481.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.63
|
| Rate for Payer: Healthscope Commercial |
$619.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$481.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$516.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.05
|
| Rate for Payer: PHP Commercial |
$585.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.39
|
| Rate for Payer: Priority Health SBD |
$433.62
|
| Rate for Payer: UMR Bronson Commercial |
$254.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$516.22
|
|
|
HC TE NEURO EA 15 MIN
|
Facility
|
IP
|
$106.12
|
|
|
Service Code
|
CPT 97112
|
| Hospital Charge Code |
42000021
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$46.69 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna American Axle |
$68.98
|
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.98
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$74.28
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.98
|
| Rate for Payer: Priority Health SBD |
$66.86
|
| Rate for Payer: UMR Bronson Commercial |
$46.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC TE NEURO EA 15 MIN
|
Facility
|
OP
|
$106.12
|
|
|
Service Code
|
CPT 97112
|
| Hospital Charge Code |
42000021
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$68.98
|
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna Medicare |
$53.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.98
|
| Rate for Payer: BCBS Complete |
$42.45
|
| Rate for Payer: BCBS Trust/PPO |
$27.31
|
| Rate for Payer: BCN Commercial |
$27.31
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$74.28
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.00
|
| Rate for Payer: Priority Health Narrow Network |
$23.20
|
| Rate for Payer: Priority Health SBD |
$66.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.84
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$31.67
|
| Rate for Payer: UMR Bronson Commercial |
$39.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC TENOTOMY
|
Facility
|
IP
|
$2,892.68
|
|
|
Service Code
|
CPT 27605
|
| Hospital Charge Code |
36100046
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,272.78 |
| Max. Negotiated Rate |
$2,603.41 |
| Rate for Payer: Aetna American Axle |
$1,880.24
|
| Rate for Payer: Aetna Commercial |
$2,458.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,880.24
|
| Rate for Payer: Cash Price |
$2,314.14
|
| Rate for Payer: Cofinity Commercial |
$2,024.88
|
| Rate for Payer: Cofinity Commercial |
$2,487.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,024.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,314.14
|
| Rate for Payer: Healthscope Commercial |
$2,603.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,024.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,169.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,458.78
|
| Rate for Payer: PHP Commercial |
$2,458.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,880.24
|
| Rate for Payer: Priority Health SBD |
$1,822.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,272.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,169.51
|
|
|
HC TENOTOMY
|
Facility
|
OP
|
$2,892.68
|
|
|
Service Code
|
CPT 27605
|
| Hospital Charge Code |
36100046
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$175.66 |
| Max. Negotiated Rate |
$4,928.37 |
| Rate for Payer: Aetna American Axle |
$1,880.24
|
| Rate for Payer: Aetna Commercial |
$2,458.78
|
| Rate for Payer: Aetna Medicare |
$1,630.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,880.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,183.09
|
| Rate for Payer: BCN Commercial |
$1,183.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$2,314.14
|
| Rate for Payer: Cash Price |
$2,314.14
|
| Rate for Payer: Cash Price |
$2,314.14
|
| Rate for Payer: Cofinity Commercial |
$2,487.70
|
| Rate for Payer: Cofinity Commercial |
$2,024.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,024.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,314.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$2,603.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,024.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,169.51
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,458.78
|
| Rate for Payer: Nomi Health Commercial |
$3,292.90
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$2,458.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,880.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,928.37
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$3,942.70
|
| Rate for Payer: Priority Health SBD |
$1,822.39
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.23
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Exchange |
$175.66
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$840.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,070.29
|
| Rate for Payer: VA VA |
$1,568.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,169.51
|
|
|
HC TENOTOMY ADDUCTOR OF HIP PERCUTANEOUS
|
Facility
|
IP
|
$4,277.92
|
|
| Hospital Charge Code |
36000096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,882.28 |
| Max. Negotiated Rate |
$3,850.13 |
| Rate for Payer: Aetna American Axle |
$2,780.65
|
| Rate for Payer: Aetna Commercial |
$3,636.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,780.65
|
| Rate for Payer: Cash Price |
$3,422.34
|
| Rate for Payer: Cofinity Commercial |
$2,994.54
|
| Rate for Payer: Cofinity Commercial |
$3,679.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,994.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,422.34
|
| Rate for Payer: Healthscope Commercial |
$3,850.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,994.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,208.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,636.23
|
| Rate for Payer: PHP Commercial |
$3,636.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,780.65
|
| Rate for Payer: Priority Health SBD |
$2,695.09
|
| Rate for Payer: UMR Bronson Commercial |
$1,882.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,208.44
|
|
|
HC TENOTOMY ADDUCTOR OF HIP PERCUTANEOUS
|
Facility
|
OP
|
$4,277.92
|
|
| Hospital Charge Code |
36000096
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,582.83 |
| Max. Negotiated Rate |
$3,850.13 |
| Rate for Payer: Aetna American Axle |
$2,780.65
|
| Rate for Payer: Aetna Commercial |
$3,636.23
|
| Rate for Payer: Aetna Medicare |
$2,138.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,780.65
|
| Rate for Payer: BCBS Complete |
$1,711.17
|
| Rate for Payer: Cash Price |
$3,422.34
|
| Rate for Payer: Cofinity Commercial |
$2,994.54
|
| Rate for Payer: Cofinity Commercial |
$3,679.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,994.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,422.34
|
| Rate for Payer: Healthscope Commercial |
$3,850.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,994.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,208.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,636.23
|
| Rate for Payer: PHP Commercial |
$3,636.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,780.65
|
| Rate for Payer: Priority Health SBD |
$2,695.09
|
| Rate for Payer: UMR Bronson Commercial |
$1,582.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,208.44
|
|
|
HC TENOTOMY ELBOW LATERAL/MEDIAL PERC
|
Facility
|
IP
|
$4,494.21
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
76100408
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,977.45 |
| Max. Negotiated Rate |
$4,044.79 |
| Rate for Payer: Aetna American Axle |
$2,921.24
|
| Rate for Payer: Aetna Commercial |
$3,820.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,921.24
|
| Rate for Payer: Cash Price |
$3,595.37
|
| Rate for Payer: Cofinity Commercial |
$3,145.95
|
| Rate for Payer: Cofinity Commercial |
$3,865.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,145.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,595.37
|
| Rate for Payer: Healthscope Commercial |
$4,044.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,145.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,370.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,820.08
|
| Rate for Payer: PHP Commercial |
$3,820.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,921.24
|
| Rate for Payer: Priority Health SBD |
$2,831.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,977.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,370.66
|
|
|
HC TENOTOMY ELBOW LATERAL/MEDIAL PERC
|
Facility
|
OP
|
$4,494.21
|
|
|
Service Code
|
CPT 24357
|
| Hospital Charge Code |
76100408
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$401.30 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna American Axle |
$2,921.24
|
| Rate for Payer: Aetna Commercial |
$3,820.08
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,921.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$1,831.99
|
| Rate for Payer: BCN Commercial |
$1,831.99
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$3,595.37
|
| Rate for Payer: Cash Price |
$3,595.37
|
| Rate for Payer: Cash Price |
$3,595.37
|
| Rate for Payer: Cofinity Commercial |
$3,865.02
|
| Rate for Payer: Cofinity Commercial |
$3,145.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,145.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,595.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$4,044.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,145.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,370.66
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,820.08
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$3,820.08
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,921.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$2,831.35
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.43
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$401.30
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,662.86
|
| Rate for Payer: VA VA |
$3,179.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,370.66
|
|
|
HC TENOTOMY ELBOW LATERAL OR MEDIAL
|
Facility
|
OP
|
$4,494.21
|
|
| Hospital Charge Code |
36000093
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,662.86 |
| Max. Negotiated Rate |
$4,044.79 |
| Rate for Payer: Aetna American Axle |
$2,921.24
|
| Rate for Payer: Aetna Commercial |
$3,820.08
|
| Rate for Payer: Aetna Medicare |
$2,247.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,921.24
|
| Rate for Payer: BCBS Complete |
$1,797.68
|
| Rate for Payer: Cash Price |
$3,595.37
|
| Rate for Payer: Cofinity Commercial |
$3,145.95
|
| Rate for Payer: Cofinity Commercial |
$3,865.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,145.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,595.37
|
| Rate for Payer: Healthscope Commercial |
$4,044.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,145.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,370.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,820.08
|
| Rate for Payer: PHP Commercial |
$3,820.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,921.24
|
| Rate for Payer: Priority Health SBD |
$2,831.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,662.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,370.66
|
|
|
HC TENOTOMY ELBOW LATERAL OR MEDIAL
|
Facility
|
IP
|
$4,494.21
|
|
| Hospital Charge Code |
36000093
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,977.45 |
| Max. Negotiated Rate |
$4,044.79 |
| Rate for Payer: Aetna American Axle |
$2,921.24
|
| Rate for Payer: Aetna Commercial |
$3,820.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,921.24
|
| Rate for Payer: Cash Price |
$3,595.37
|
| Rate for Payer: Cofinity Commercial |
$3,145.95
|
| Rate for Payer: Cofinity Commercial |
$3,865.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,145.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,595.37
|
| Rate for Payer: Healthscope Commercial |
$4,044.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,145.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,370.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,820.08
|
| Rate for Payer: PHP Commercial |
$3,820.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,921.24
|
| Rate for Payer: Priority Health SBD |
$2,831.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,977.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,370.66
|
|
|
HC TENOTOMY MULTIPLE TENDONS
|
Facility
|
IP
|
$5,235.97
|
|
| Hospital Charge Code |
36000095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,303.83 |
| Max. Negotiated Rate |
$4,712.37 |
| Rate for Payer: Aetna American Axle |
$3,403.38
|
| Rate for Payer: Aetna Commercial |
$4,450.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,403.38
|
| Rate for Payer: Cash Price |
$4,188.78
|
| Rate for Payer: Cofinity Commercial |
$3,665.18
|
| Rate for Payer: Cofinity Commercial |
$4,502.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,665.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,188.78
|
| Rate for Payer: Healthscope Commercial |
$4,712.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,665.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,926.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,450.57
|
| Rate for Payer: PHP Commercial |
$4,450.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,403.38
|
| Rate for Payer: Priority Health SBD |
$3,298.66
|
| Rate for Payer: UMR Bronson Commercial |
$2,303.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,926.98
|
|
|
HC TENOTOMY MULTIPLE TENDONS
|
Facility
|
OP
|
$5,235.97
|
|
| Hospital Charge Code |
36000095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,937.31 |
| Max. Negotiated Rate |
$4,712.37 |
| Rate for Payer: Aetna American Axle |
$3,403.38
|
| Rate for Payer: Aetna Commercial |
$4,450.57
|
| Rate for Payer: Aetna Medicare |
$2,617.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,403.38
|
| Rate for Payer: BCBS Complete |
$2,094.39
|
| Rate for Payer: Cash Price |
$4,188.78
|
| Rate for Payer: Cofinity Commercial |
$3,665.18
|
| Rate for Payer: Cofinity Commercial |
$4,502.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,665.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,188.78
|
| Rate for Payer: Healthscope Commercial |
$4,712.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,665.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,926.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,450.57
|
| Rate for Payer: PHP Commercial |
$4,450.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,403.38
|
| Rate for Payer: Priority Health SBD |
$3,298.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,937.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,926.98
|
|
|
HC TENOTOMY PERCUTANEOUS ACHILLES TENDON
|
Facility
|
OP
|
$3,737.88
|
|
| Hospital Charge Code |
36000097
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,383.02 |
| Max. Negotiated Rate |
$3,364.09 |
| Rate for Payer: Aetna American Axle |
$2,429.62
|
| Rate for Payer: Aetna Commercial |
$3,177.20
|
| Rate for Payer: Aetna Medicare |
$1,868.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,429.62
|
| Rate for Payer: BCBS Complete |
$1,495.15
|
| Rate for Payer: Cash Price |
$2,990.30
|
| Rate for Payer: Cofinity Commercial |
$2,616.52
|
| Rate for Payer: Cofinity Commercial |
$3,214.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,616.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,990.30
|
| Rate for Payer: Healthscope Commercial |
$3,364.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,616.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,803.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,177.20
|
| Rate for Payer: PHP Commercial |
$3,177.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,429.62
|
| Rate for Payer: Priority Health SBD |
$2,354.86
|
| Rate for Payer: UMR Bronson Commercial |
$1,383.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,803.41
|
|
|
HC TENOTOMY PERCUTANEOUS ACHILLES TENDON
|
Facility
|
IP
|
$3,737.88
|
|
| Hospital Charge Code |
36000097
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,644.67 |
| Max. Negotiated Rate |
$3,364.09 |
| Rate for Payer: Aetna American Axle |
$2,429.62
|
| Rate for Payer: Aetna Commercial |
$3,177.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,429.62
|
| Rate for Payer: Cash Price |
$2,990.30
|
| Rate for Payer: Cofinity Commercial |
$2,616.52
|
| Rate for Payer: Cofinity Commercial |
$3,214.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,616.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,990.30
|
| Rate for Payer: Healthscope Commercial |
$3,364.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,616.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,803.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,177.20
|
| Rate for Payer: PHP Commercial |
$3,177.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,429.62
|
| Rate for Payer: Priority Health SBD |
$2,354.86
|
| Rate for Payer: UMR Bronson Commercial |
$1,644.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,803.41
|
|
|
HC TENOTOMY PERCUTANEOUS ADDUCTOR OR HAMSTRING
|
Facility
|
OP
|
$3,570.03
|
|
| Hospital Charge Code |
36000094
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,320.91 |
| Max. Negotiated Rate |
$3,213.03 |
| Rate for Payer: Aetna American Axle |
$2,320.52
|
| Rate for Payer: Aetna Commercial |
$3,034.53
|
| Rate for Payer: Aetna Medicare |
$1,785.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.52
|
| Rate for Payer: BCBS Complete |
$1,428.01
|
| Rate for Payer: Cash Price |
$2,856.02
|
| Rate for Payer: Cofinity Commercial |
$2,499.02
|
| Rate for Payer: Cofinity Commercial |
$3,070.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,499.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.02
|
| Rate for Payer: Healthscope Commercial |
$3,213.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,499.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.53
|
| Rate for Payer: PHP Commercial |
$3,034.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.52
|
| Rate for Payer: Priority Health SBD |
$2,249.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,320.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.52
|
|
|
HC TENOTOMY PERCUTANEOUS ADDUCTOR OR HAMSTRING
|
Facility
|
IP
|
$3,570.03
|
|
| Hospital Charge Code |
36000094
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,570.81 |
| Max. Negotiated Rate |
$3,213.03 |
| Rate for Payer: Aetna American Axle |
$2,320.52
|
| Rate for Payer: Aetna Commercial |
$3,034.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.52
|
| Rate for Payer: Cash Price |
$2,856.02
|
| Rate for Payer: Cofinity Commercial |
$2,499.02
|
| Rate for Payer: Cofinity Commercial |
$3,070.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,499.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.02
|
| Rate for Payer: Healthscope Commercial |
$3,213.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,499.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.53
|
| Rate for Payer: PHP Commercial |
$3,034.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.52
|
| Rate for Payer: Priority Health SBD |
$2,249.12
|
| Rate for Payer: UMR Bronson Commercial |
$1,570.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.52
|
|
|
HC TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT
|
Facility
|
IP
|
$4,590.00
|
|
|
Service Code
|
CPT 26060
|
| Hospital Charge Code |
76100424
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,019.60 |
| Max. Negotiated Rate |
$4,131.00 |
| Rate for Payer: Aetna American Axle |
$2,983.50
|
| Rate for Payer: Aetna Commercial |
$3,901.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,983.50
|
| Rate for Payer: Cash Price |
$3,672.00
|
| Rate for Payer: Cofinity Commercial |
$3,213.00
|
| Rate for Payer: Cofinity Commercial |
$3,947.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,213.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,672.00
|
| Rate for Payer: Healthscope Commercial |
$4,131.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,213.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,442.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,901.50
|
| Rate for Payer: PHP Commercial |
$3,901.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.50
|
| Rate for Payer: Priority Health SBD |
$2,891.70
|
| Rate for Payer: UMR Bronson Commercial |
$2,019.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,442.50
|
|
|
HC TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT
|
Facility
|
OP
|
$4,590.00
|
|
|
Service Code
|
CPT 26060
|
| Hospital Charge Code |
76100424
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$247.45 |
| Max. Negotiated Rate |
$4,928.37 |
| Rate for Payer: Aetna American Axle |
$2,983.50
|
| Rate for Payer: Aetna Commercial |
$3,901.50
|
| Rate for Payer: Aetna Medicare |
$1,630.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,983.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,263.77
|
| Rate for Payer: BCN Commercial |
$1,263.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$3,672.00
|
| Rate for Payer: Cash Price |
$3,672.00
|
| Rate for Payer: Cash Price |
$3,672.00
|
| Rate for Payer: Cofinity Commercial |
$3,947.40
|
| Rate for Payer: Cofinity Commercial |
$3,213.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,213.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,672.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$4,131.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,213.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,442.50
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,901.50
|
| Rate for Payer: Nomi Health Commercial |
$3,292.90
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$3,901.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,928.37
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$3,942.70
|
| Rate for Payer: Priority Health SBD |
$2,891.70
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.20
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Exchange |
$247.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$840.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,698.30
|
| Rate for Payer: VA VA |
$1,568.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,442.50
|
|
|
HC TENOTOMY SHOULDER AREA SINGLE TENDON
|
Facility
|
IP
|
$4,826.31
|
|
| Hospital Charge Code |
36000098
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,123.58 |
| Max. Negotiated Rate |
$4,343.68 |
| Rate for Payer: Aetna American Axle |
$3,137.10
|
| Rate for Payer: Aetna Commercial |
$4,102.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,137.10
|
| Rate for Payer: Cash Price |
$3,861.05
|
| Rate for Payer: Cofinity Commercial |
$3,378.42
|
| Rate for Payer: Cofinity Commercial |
$4,150.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,378.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,861.05
|
| Rate for Payer: Healthscope Commercial |
$4,343.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,378.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,619.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,102.36
|
| Rate for Payer: PHP Commercial |
$4,102.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,137.10
|
| Rate for Payer: Priority Health SBD |
$3,040.58
|
| Rate for Payer: UMR Bronson Commercial |
$2,123.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,619.73
|
|
|
HC TENOTOMY SHOULDER AREA SINGLE TENDON
|
Facility
|
OP
|
$4,826.31
|
|
| Hospital Charge Code |
36000098
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,785.73 |
| Max. Negotiated Rate |
$4,343.68 |
| Rate for Payer: Aetna American Axle |
$3,137.10
|
| Rate for Payer: Aetna Commercial |
$4,102.36
|
| Rate for Payer: Aetna Medicare |
$2,413.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,137.10
|
| Rate for Payer: BCBS Complete |
$1,930.52
|
| Rate for Payer: Cash Price |
$3,861.05
|
| Rate for Payer: Cofinity Commercial |
$3,378.42
|
| Rate for Payer: Cofinity Commercial |
$4,150.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,378.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,861.05
|
| Rate for Payer: Healthscope Commercial |
$4,343.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,378.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,619.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,102.36
|
| Rate for Payer: PHP Commercial |
$4,102.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,137.10
|
| Rate for Payer: Priority Health SBD |
$3,040.58
|
| Rate for Payer: UMR Bronson Commercial |
$1,785.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,619.73
|
|
|
HC TENOTOMY TOE SINGLE TENDON
|
Facility
|
OP
|
$2,219.15
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
45000092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$163.83 |
| Max. Negotiated Rate |
$4,928.37 |
| Rate for Payer: Aetna American Axle |
$1,442.45
|
| Rate for Payer: Aetna Commercial |
$1,886.28
|
| Rate for Payer: Aetna Medicare |
$1,630.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,442.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$163.83
|
| Rate for Payer: BCN Commercial |
$163.83
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$1,775.32
|
| Rate for Payer: Cash Price |
$1,775.32
|
| Rate for Payer: Cash Price |
$1,775.32
|
| Rate for Payer: Cofinity Commercial |
$1,908.47
|
| Rate for Payer: Cofinity Commercial |
$1,553.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,553.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,775.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$1,997.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,553.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,664.36
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,886.28
|
| Rate for Payer: Nomi Health Commercial |
$3,292.90
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$1,886.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,442.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,928.37
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$3,942.70
|
| Rate for Payer: Priority Health SBD |
$1,398.06
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.26
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Exchange |
$199.33
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$840.47
|
| Rate for Payer: UMR Bronson Commercial |
$821.09
|
| Rate for Payer: VA VA |
$1,568.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,664.36
|
|
|
HC TENOTOMY TOE SINGLE TENDON
|
Facility
|
IP
|
$2,219.15
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
45000092
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$976.43 |
| Max. Negotiated Rate |
$1,997.24 |
| Rate for Payer: Aetna American Axle |
$1,442.45
|
| Rate for Payer: Aetna Commercial |
$1,886.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,442.45
|
| Rate for Payer: Cash Price |
$1,775.32
|
| Rate for Payer: Cofinity Commercial |
$1,553.40
|
| Rate for Payer: Cofinity Commercial |
$1,908.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,553.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,775.32
|
| Rate for Payer: Healthscope Commercial |
$1,997.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,553.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,664.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,886.28
|
| Rate for Payer: PHP Commercial |
$1,886.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,442.45
|
| Rate for Payer: Priority Health SBD |
$1,398.06
|
| Rate for Payer: UMR Bronson Commercial |
$976.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,664.36
|
|
|
HC TESTOSTERONE BIOAVAILABLE
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100429
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.33 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: UMR Bronson Commercial |
$34.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC TESTOSTERONE BIOAVAILABLE
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 84402
|
| Hospital Charge Code |
30100429
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.65 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$26.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.84
|
| Rate for Payer: BCBS Complete |
$14.33
|
| Rate for Payer: BCBS MAPPO |
$25.47
|
| Rate for Payer: BCBS Trust/PPO |
$24.54
|
| Rate for Payer: BCN Commercial |
$24.54
|
| Rate for Payer: BCN Medicare Advantage |
$25.47
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Cofinity Commercial |
$54.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.47
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$13.65
|
| Rate for Payer: Mclaren Medicare |
$25.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.74
|
| Rate for Payer: Meridian Medicaid |
$14.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$38.20
|
| Rate for Payer: PACE Medicare |
$24.20
|
| Rate for Payer: PACE SWMI |
$25.47
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$25.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.21
|
| Rate for Payer: Priority Health Medicare |
$25.47
|
| Rate for Payer: Priority Health Narrow Network |
$20.97
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: Railroad Medicare Medicare |
$25.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.47
|
| Rate for Payer: UHC Exchange |
$25.47
|
| Rate for Payer: UHC Medicare Advantage |
$25.47
|
| Rate for Payer: UHCCP Medicaid |
$13.65
|
| Rate for Payer: UMR Bronson Commercial |
$28.87
|
| Rate for Payer: VA VA |
$25.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
