|
HC WOUND REPAIR SIMPLE UP TO 12.5 CM
|
Facility
|
IP
|
$429.97
|
|
| Hospital Charge Code |
45000073
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$189.19 |
| Max. Negotiated Rate |
$386.97 |
| Rate for Payer: Aetna American Axle |
$279.48
|
| Rate for Payer: Aetna Commercial |
$365.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.48
|
| Rate for Payer: Cash Price |
$343.98
|
| Rate for Payer: Cofinity Advantage |
$300.98
|
| Rate for Payer: Cofinity Commercial |
$369.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.98
|
| Rate for Payer: Healthscope Commercial |
$386.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$322.48
|
| Rate for Payer: PHP Commercial |
$365.47
|
| Rate for Payer: Priority Health SBD |
$270.88
|
| Rate for Payer: UMR Bronson Commercial |
$189.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.48
|
|
|
HC WOUND REPAIR SIMPLE UP TO 12.5 CM
|
Facility
|
OP
|
$429.97
|
|
| Hospital Charge Code |
45000073
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$386.97 |
| Rate for Payer: Aetna American Axle |
$279.48
|
| Rate for Payer: Aetna Commercial |
$365.47
|
| Rate for Payer: Aetna Medicare |
$214.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.48
|
| Rate for Payer: BCBS Complete |
$171.99
|
| Rate for Payer: Cash Price |
$343.98
|
| Rate for Payer: Cash Price |
$343.98
|
| Rate for Payer: Cofinity Advantage |
$300.98
|
| Rate for Payer: Cofinity Commercial |
$369.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.98
|
| Rate for Payer: Healthscope Commercial |
$386.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$343.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$322.48
|
| Rate for Payer: PHP Commercial |
$365.47
|
| Rate for Payer: Priority Health SBD |
$270.88
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: UMR Bronson Commercial |
$159.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.48
|
|
|
HC WRIST-HAND ORTHOSIS
|
Facility
|
IP
|
$124.50
|
|
|
Service Code
|
HCPCS L3908
|
| Hospital Charge Code |
27400016
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$54.78 |
| Max. Negotiated Rate |
$112.05 |
| Rate for Payer: Aetna American Axle |
$80.92
|
| Rate for Payer: Aetna Commercial |
$105.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.92
|
| Rate for Payer: Cash Price |
$99.60
|
| Rate for Payer: Cofinity Advantage |
$87.15
|
| Rate for Payer: Cofinity Commercial |
$107.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.60
|
| Rate for Payer: Healthscope Commercial |
$112.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.38
|
| Rate for Payer: PHP Commercial |
$105.83
|
| Rate for Payer: Priority Health SBD |
$78.44
|
| Rate for Payer: UMR Bronson Commercial |
$54.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.38
|
|
|
HC WRIST-HAND ORTHOSIS
|
Facility
|
OP
|
$124.50
|
|
|
Service Code
|
HCPCS L3908
|
| Hospital Charge Code |
27400016
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$46.06 |
| Max. Negotiated Rate |
$212.66 |
| Rate for Payer: Aetna American Axle |
$80.92
|
| Rate for Payer: Aetna Commercial |
$105.83
|
| Rate for Payer: Aetna Medicare |
$62.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.92
|
| Rate for Payer: BCBS Complete |
$49.80
|
| Rate for Payer: BCBS Trust/PPO |
$212.66
|
| Rate for Payer: BCN Commercial |
$212.66
|
| Rate for Payer: Cash Price |
$99.60
|
| Rate for Payer: Cash Price |
$99.60
|
| Rate for Payer: Cofinity Advantage |
$87.15
|
| Rate for Payer: Cofinity Commercial |
$107.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.60
|
| Rate for Payer: Healthscope Commercial |
$112.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.38
|
| Rate for Payer: PHP Commercial |
$105.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$82.00
|
| Rate for Payer: Priority Health SBD |
$78.44
|
| Rate for Payer: Priority Health Tiered Network |
$65.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.92
|
| Rate for Payer: UHC Core |
$64.86
|
| Rate for Payer: UHC Exchange |
$48.93
|
| Rate for Payer: UMR Bronson Commercial |
$46.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.38
|
|
|
HC XENON 133 PER 10 MCI
|
Facility
|
IP
|
$255.30
|
|
|
Service Code
|
HCPCS A9558
|
| Hospital Charge Code |
34300024
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$112.33 |
| Max. Negotiated Rate |
$229.77 |
| Rate for Payer: Aetna American Axle |
$165.94
|
| Rate for Payer: Aetna Commercial |
$217.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.94
|
| Rate for Payer: Cash Price |
$204.24
|
| Rate for Payer: Cofinity Advantage |
$178.71
|
| Rate for Payer: Cofinity Commercial |
$219.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.24
|
| Rate for Payer: Healthscope Commercial |
$229.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.47
|
| Rate for Payer: PHP Commercial |
$217.00
|
| Rate for Payer: Priority Health SBD |
$160.84
|
| Rate for Payer: UMR Bronson Commercial |
$112.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.47
|
|
|
HC XENON 133 PER 10 MCI
|
Facility
|
OP
|
$255.30
|
|
|
Service Code
|
HCPCS A9558
|
| Hospital Charge Code |
34300024
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$60.05 |
| Max. Negotiated Rate |
$505.38 |
| Rate for Payer: Aetna American Axle |
$165.94
|
| Rate for Payer: Aetna Commercial |
$217.00
|
| Rate for Payer: Aetna Medicare |
$127.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.94
|
| Rate for Payer: BCBS Complete |
$102.12
|
| Rate for Payer: BCBS Trust/PPO |
$60.05
|
| Rate for Payer: BCN Commercial |
$60.05
|
| Rate for Payer: Cash Price |
$204.24
|
| Rate for Payer: Cash Price |
$204.24
|
| Rate for Payer: Cofinity Advantage |
$178.71
|
| Rate for Payer: Cofinity Commercial |
$219.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.24
|
| Rate for Payer: Healthscope Commercial |
$229.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.47
|
| Rate for Payer: PHP Commercial |
$217.00
|
| Rate for Payer: Priority Health SBD |
$160.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$505.38
|
| Rate for Payer: UHC Core |
$505.38
|
| Rate for Payer: UHC Exchange |
$505.38
|
| Rate for Payer: UMR Bronson Commercial |
$94.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.47
|
|
|
HC XEOMIN PER 1 UNIT (INCOBOTULINUMTOXINA)
|
Facility
|
IP
|
$7.08
|
|
|
Service Code
|
HCPCS J0588
|
| Hospital Charge Code |
63600149
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$6.37 |
| Rate for Payer: Aetna American Axle |
$4.60
|
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.60
|
| Rate for Payer: Cash Price |
$5.66
|
| Rate for Payer: Cofinity Advantage |
$4.96
|
| Rate for Payer: Cofinity Commercial |
$6.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.66
|
| Rate for Payer: Healthscope Commercial |
$6.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.31
|
| Rate for Payer: PHP Commercial |
$6.02
|
| Rate for Payer: Priority Health SBD |
$4.46
|
| Rate for Payer: UMR Bronson Commercial |
$3.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.31
|
|
|
HC XEOMIN PER 1 UNIT (INCOBOTULINUMTOXINA)
|
Facility
|
OP
|
$7.08
|
|
|
Service Code
|
HCPCS J0588
|
| Hospital Charge Code |
63600149
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.62 |
| Max. Negotiated Rate |
$17.56 |
| Rate for Payer: Aetna American Axle |
$4.60
|
| Rate for Payer: Aetna Commercial |
$6.02
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.61
|
| Rate for Payer: BCBS Complete |
$2.91
|
| Rate for Payer: BCBS MAPPO |
$5.29
|
| Rate for Payer: BCBS Trust/PPO |
$17.03
|
| Rate for Payer: BCN Commercial |
$17.03
|
| Rate for Payer: BCN Medicare Advantage |
$5.29
|
| Rate for Payer: Cash Price |
$5.66
|
| Rate for Payer: Cash Price |
$5.66
|
| Rate for Payer: Cofinity Advantage |
$4.96
|
| Rate for Payer: Cofinity Commercial |
$6.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.29
|
| Rate for Payer: Healthscope Commercial |
$6.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.31
|
| Rate for Payer: Mclaren Medicaid |
$5.29
|
| Rate for Payer: Mclaren Medicare |
$5.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.55
|
| Rate for Payer: Meridian Medicaid |
$5.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.02
|
| Rate for Payer: Nomi Health Commercial |
$15.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.31
|
| Rate for Payer: PACE Medicare |
$5.03
|
| Rate for Payer: PACE SWMI |
$5.29
|
| Rate for Payer: PHP Commercial |
$6.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.56
|
| Rate for Payer: Priority Health Medicare |
$5.29
|
| Rate for Payer: Priority Health SBD |
$4.46
|
| Rate for Payer: Priority Health Tiered Network |
$14.05
|
| Rate for Payer: Railroad Medicare Medicare |
$5.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.78
|
| Rate for Payer: UHC Core |
$5.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.29
|
| Rate for Payer: UHC Exchange |
$5.78
|
| Rate for Payer: UHC Medicaid |
$2.77
|
| Rate for Payer: UHCCP Medicaid |
$2.77
|
| Rate for Payer: UMR Bronson Commercial |
$2.62
|
| Rate for Payer: VA VA |
$5.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.31
|
|
|
HC XPRESS-WAY CATHETER
|
Facility
|
IP
|
$1,440.96
|
|
| Hospital Charge Code |
27200226
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$634.02 |
| Max. Negotiated Rate |
$1,296.86 |
| Rate for Payer: Aetna American Axle |
$936.62
|
| Rate for Payer: Aetna Commercial |
$1,224.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$936.62
|
| Rate for Payer: Cash Price |
$1,152.77
|
| Rate for Payer: Cofinity Advantage |
$1,008.67
|
| Rate for Payer: Cofinity Commercial |
$1,239.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,152.77
|
| Rate for Payer: Healthscope Commercial |
$1,296.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,008.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,080.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,224.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,080.72
|
| Rate for Payer: PHP Commercial |
$1,224.82
|
| Rate for Payer: Priority Health SBD |
$907.80
|
| Rate for Payer: UMR Bronson Commercial |
$634.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,080.72
|
|
|
HC XPRESS-WAY CATHETER
|
Facility
|
OP
|
$1,440.96
|
|
| Hospital Charge Code |
27200226
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$533.16 |
| Max. Negotiated Rate |
$1,296.86 |
| Rate for Payer: Aetna American Axle |
$936.62
|
| Rate for Payer: Aetna Commercial |
$1,224.82
|
| Rate for Payer: Aetna Medicare |
$720.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$936.62
|
| Rate for Payer: BCBS Complete |
$576.38
|
| Rate for Payer: Cash Price |
$1,152.77
|
| Rate for Payer: Cofinity Advantage |
$1,008.67
|
| Rate for Payer: Cofinity Commercial |
$1,239.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,152.77
|
| Rate for Payer: Healthscope Commercial |
$1,296.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,008.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,080.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,152.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,224.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,080.72
|
| Rate for Payer: PHP Commercial |
$1,224.82
|
| Rate for Payer: Priority Health SBD |
$907.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$936.62
|
| Rate for Payer: UHC Core |
$750.74
|
| Rate for Payer: UHC Exchange |
$566.30
|
| Rate for Payer: UMR Bronson Commercial |
$533.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,080.72
|
|
|
HC XR ABDOMEN 1 VIEW
|
Facility
|
OP
|
$312.00
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
32000325
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$280.80 |
| Rate for Payer: Aetna American Axle |
$202.80
|
| Rate for Payer: Aetna Commercial |
$265.20
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$52.54
|
| Rate for Payer: BCN Commercial |
$52.54
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cofinity Advantage |
$218.40
|
| Rate for Payer: Cofinity Commercial |
$268.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$280.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$218.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.00
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.20
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.00
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$265.20
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$196.56
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.80
|
| Rate for Payer: UHC Core |
$162.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$122.62
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$115.44
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.00
|
|
|
HC XR ABDOMEN 1 VIEW
|
Facility
|
IP
|
$312.00
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
32000325
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$137.28 |
| Max. Negotiated Rate |
$280.80 |
| Rate for Payer: Aetna American Axle |
$202.80
|
| Rate for Payer: Aetna Commercial |
$265.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.80
|
| Rate for Payer: Cash Price |
$249.60
|
| Rate for Payer: Cofinity Advantage |
$218.40
|
| Rate for Payer: Cofinity Commercial |
$268.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.60
|
| Rate for Payer: Healthscope Commercial |
$280.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$218.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.00
|
| Rate for Payer: PHP Commercial |
$265.20
|
| Rate for Payer: Priority Health SBD |
$196.56
|
| Rate for Payer: UMR Bronson Commercial |
$137.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.00
|
|
|
HC XR ABDOMEN 2 VW
|
Facility
|
OP
|
$345.42
|
|
|
Service Code
|
CPT 74019
|
| Hospital Charge Code |
32000326
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$336.87 |
| Rate for Payer: Aetna American Axle |
$224.52
|
| Rate for Payer: Aetna Commercial |
$293.61
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.52
|
| 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 |
$64.03
|
| Rate for Payer: BCN Commercial |
$64.03
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$276.34
|
| Rate for Payer: Cash Price |
$276.34
|
| Rate for Payer: Cofinity Advantage |
$241.79
|
| Rate for Payer: Cofinity Commercial |
$297.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$310.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.06
|
| 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 |
$293.61
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.06
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$293.61
|
| 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 |
$217.61
|
| 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) |
$224.52
|
| Rate for Payer: UHC Core |
$179.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$135.75
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$127.81
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.06
|
|
|
HC XR ABDOMEN 2 VW
|
Facility
|
IP
|
$345.42
|
|
|
Service Code
|
CPT 74019
|
| Hospital Charge Code |
32000326
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$151.98 |
| Max. Negotiated Rate |
$310.88 |
| Rate for Payer: Aetna American Axle |
$224.52
|
| Rate for Payer: Aetna Commercial |
$293.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.52
|
| Rate for Payer: Cash Price |
$276.34
|
| Rate for Payer: Cofinity Advantage |
$241.79
|
| Rate for Payer: Cofinity Commercial |
$297.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.34
|
| Rate for Payer: Healthscope Commercial |
$310.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.06
|
| Rate for Payer: PHP Commercial |
$293.61
|
| Rate for Payer: Priority Health SBD |
$217.61
|
| Rate for Payer: UMR Bronson Commercial |
$151.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.06
|
|
|
HC XR ABDOMEN 3 OR MORE VIEWS
|
Facility
|
IP
|
$378.85
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
32000327
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$166.69 |
| Max. Negotiated Rate |
$340.96 |
| Rate for Payer: Aetna American Axle |
$246.25
|
| Rate for Payer: Aetna Commercial |
$322.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.25
|
| Rate for Payer: Cash Price |
$303.08
|
| Rate for Payer: Cofinity Advantage |
$265.19
|
| Rate for Payer: Cofinity Commercial |
$325.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.08
|
| Rate for Payer: Healthscope Commercial |
$340.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$265.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$284.14
|
| Rate for Payer: PHP Commercial |
$322.02
|
| Rate for Payer: Priority Health SBD |
$238.68
|
| Rate for Payer: UMR Bronson Commercial |
$166.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.14
|
|
|
HC XR ABDOMEN 3 OR MORE VIEWS
|
Facility
|
OP
|
$378.85
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
32000327
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$340.96 |
| Rate for Payer: Aetna American Axle |
$246.25
|
| Rate for Payer: Aetna Commercial |
$322.02
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.25
|
| 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 |
$73.87
|
| Rate for Payer: BCN Commercial |
$73.87
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$303.08
|
| Rate for Payer: Cash Price |
$303.08
|
| Rate for Payer: Cofinity Advantage |
$265.19
|
| Rate for Payer: Cofinity Commercial |
$325.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$340.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$265.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.14
|
| 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 |
$322.02
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$284.14
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$322.02
|
| 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 |
$238.68
|
| 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) |
$246.25
|
| Rate for Payer: UHC Core |
$197.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$148.89
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$140.17
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.14
|
|
|
HC XR ABDOMEN ACUTE
|
Facility
|
IP
|
$500.21
|
|
|
Service Code
|
CPT 74022
|
| Hospital Charge Code |
32000135
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$220.09 |
| Max. Negotiated Rate |
$450.19 |
| Rate for Payer: Aetna American Axle |
$325.14
|
| Rate for Payer: Aetna Commercial |
$425.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.14
|
| Rate for Payer: Cash Price |
$400.17
|
| Rate for Payer: Cofinity Advantage |
$350.15
|
| Rate for Payer: Cofinity Commercial |
$430.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.17
|
| Rate for Payer: Healthscope Commercial |
$450.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.16
|
| Rate for Payer: PHP Commercial |
$425.18
|
| Rate for Payer: Priority Health SBD |
$315.13
|
| Rate for Payer: UMR Bronson Commercial |
$220.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.16
|
|
|
HC XR ABDOMEN ACUTE
|
Facility
|
OP
|
$500.21
|
|
|
Service Code
|
CPT 74022
|
| Hospital Charge Code |
32000135
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$450.19 |
| Rate for Payer: Aetna American Axle |
$325.14
|
| Rate for Payer: Aetna Commercial |
$425.18
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.14
|
| 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 |
$85.37
|
| Rate for Payer: BCN Commercial |
$85.37
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$400.17
|
| Rate for Payer: Cash Price |
$400.17
|
| Rate for Payer: Cofinity Advantage |
$350.15
|
| Rate for Payer: Cofinity Commercial |
$430.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$450.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.16
|
| 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 |
$425.18
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.16
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$425.18
|
| 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 |
$315.13
|
| 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) |
$325.14
|
| Rate for Payer: UHC Core |
$260.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$196.58
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$185.08
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.16
|
|
|
HC XR AC JOINTS
|
Facility
|
IP
|
$364.53
|
|
|
Service Code
|
CPT 73050
|
| Hospital Charge Code |
32000068
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$160.39 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna American Axle |
$236.94
|
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.94
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Advantage |
$255.17
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$255.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: Priority Health SBD |
$229.65
|
| Rate for Payer: UMR Bronson Commercial |
$160.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC XR AC JOINTS
|
Facility
|
OP
|
$364.53
|
|
|
Service Code
|
CPT 73050
|
| Hospital Charge Code |
32000068
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$328.08 |
| Rate for Payer: Aetna American Axle |
$236.94
|
| Rate for Payer: Aetna Commercial |
$309.85
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$49.26
|
| Rate for Payer: BCN Commercial |
$49.26
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cash Price |
$291.62
|
| Rate for Payer: Cofinity Advantage |
$255.17
|
| Rate for Payer: Cofinity Commercial |
$313.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$328.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$255.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.40
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.85
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$273.40
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$309.85
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$229.65
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.94
|
| Rate for Payer: UHC Core |
$189.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$143.26
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$134.88
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.40
|
|
|
HC XR ANKLE 1 VW
|
Facility
|
OP
|
$248.07
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000118
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$280.42 |
| Rate for Payer: Aetna American Axle |
$161.25
|
| Rate for Payer: Aetna Commercial |
$210.86
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$59.93
|
| Rate for Payer: BCN Commercial |
$59.93
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$198.46
|
| Rate for Payer: Cash Price |
$198.46
|
| Rate for Payer: Cofinity Advantage |
$173.65
|
| Rate for Payer: Cofinity Commercial |
$213.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$223.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.05
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.86
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.05
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$210.86
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$156.28
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.25
|
| Rate for Payer: UHC Core |
$129.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$97.49
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$91.79
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.05
|
|
|
HC XR ANKLE 1 VW
|
Facility
|
IP
|
$248.07
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000118
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$109.15 |
| Max. Negotiated Rate |
$223.26 |
| Rate for Payer: Aetna American Axle |
$161.25
|
| Rate for Payer: Aetna Commercial |
$210.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.25
|
| Rate for Payer: Cash Price |
$198.46
|
| Rate for Payer: Cofinity Advantage |
$173.65
|
| Rate for Payer: Cofinity Commercial |
$213.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.46
|
| Rate for Payer: Healthscope Commercial |
$223.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.05
|
| Rate for Payer: PHP Commercial |
$210.86
|
| Rate for Payer: Priority Health SBD |
$156.28
|
| Rate for Payer: UMR Bronson Commercial |
$109.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.05
|
|
|
HC XR ANKLE 2 VIEWS
|
Facility
|
OP
|
$260.57
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000117
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$280.42 |
| Rate for Payer: Aetna American Axle |
$169.37
|
| Rate for Payer: Aetna Commercial |
$221.48
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$59.93
|
| Rate for Payer: BCN Commercial |
$59.93
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$208.46
|
| Rate for Payer: Cash Price |
$208.46
|
| Rate for Payer: Cofinity Advantage |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$224.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$234.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.43
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.48
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.43
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$221.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$164.16
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.37
|
| Rate for Payer: UHC Core |
$135.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$102.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$96.41
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.43
|
|
|
HC XR ANKLE 2 VIEWS
|
Facility
|
IP
|
$260.57
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000117
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$114.65 |
| Max. Negotiated Rate |
$234.51 |
| Rate for Payer: Aetna American Axle |
$169.37
|
| Rate for Payer: Aetna Commercial |
$221.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.37
|
| Rate for Payer: Cash Price |
$208.46
|
| Rate for Payer: Cofinity Advantage |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$224.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.46
|
| Rate for Payer: Healthscope Commercial |
$234.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.43
|
| Rate for Payer: PHP Commercial |
$221.48
|
| Rate for Payer: Priority Health SBD |
$164.16
|
| Rate for Payer: UMR Bronson Commercial |
$114.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.43
|
|
|
HC XR ANKLE 2 VIEWS BILATERAL
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000339
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$112.16 |
| Max. Negotiated Rate |
$229.41 |
| Rate for Payer: Aetna American Axle |
$165.69
|
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.69
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Advantage |
$178.43
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: Priority Health SBD |
$160.59
|
| Rate for Payer: UMR Bronson Commercial |
$112.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.18
|
|
