|
HC TUBE CHANGE OF CYSTOSTOMY SIMPLE
|
Facility
|
OP
|
$401.88
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
36100253
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$127.14 |
| Max. Negotiated Rate |
$667.69 |
| Rate for Payer: Aetna American Axle |
$261.22
|
| Rate for Payer: Aetna Commercial |
$341.60
|
| Rate for Payer: Aetna Medicare |
$246.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.50
|
| Rate for Payer: BCBS Complete |
$133.50
|
| Rate for Payer: BCBS MAPPO |
$237.20
|
| Rate for Payer: BCN Medicare Advantage |
$237.20
|
| Rate for Payer: Cash Price |
$321.50
|
| Rate for Payer: Cash Price |
$321.50
|
| Rate for Payer: Cofinity Commercial |
$345.62
|
| Rate for Payer: Cofinity Commercial |
$281.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$281.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$321.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.20
|
| Rate for Payer: Healthscope Commercial |
$361.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$281.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$301.41
|
| Rate for Payer: Mclaren Medicaid |
$127.14
|
| Rate for Payer: Mclaren Medicare |
$237.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.06
|
| Rate for Payer: Meridian Medicaid |
$133.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$341.60
|
| Rate for Payer: PACE Medicare |
$225.34
|
| Rate for Payer: PACE SWMI |
$237.20
|
| Rate for Payer: PHP Commercial |
$341.60
|
| Rate for Payer: PHP Medicare Advantage |
$237.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.22
|
| Rate for Payer: Priority Health Medicare |
$237.20
|
| Rate for Payer: Priority Health SBD |
$253.18
|
| Rate for Payer: Railroad Medicare Medicare |
$237.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.20
|
| Rate for Payer: UHC Exchange |
$453.31
|
| Rate for Payer: UHC Medicare Advantage |
$237.20
|
| Rate for Payer: UHCCP Medicaid |
$127.14
|
| Rate for Payer: UMR Bronson Commercial |
$148.70
|
| Rate for Payer: VA VA |
$237.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$301.41
|
|
|
HC TUBE CHANGE OF CYSTOSTOMY SIMPLE
|
Facility
|
IP
|
$401.88
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
36100253
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$176.83 |
| Max. Negotiated Rate |
$361.69 |
| Rate for Payer: Aetna American Axle |
$261.22
|
| Rate for Payer: Aetna Commercial |
$341.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.22
|
| Rate for Payer: Cash Price |
$321.50
|
| Rate for Payer: Cofinity Commercial |
$281.32
|
| Rate for Payer: Cofinity Commercial |
$345.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$281.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$321.50
|
| Rate for Payer: Healthscope Commercial |
$361.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$281.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$301.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$341.60
|
| Rate for Payer: PHP Commercial |
$341.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.22
|
| Rate for Payer: Priority Health SBD |
$253.18
|
| Rate for Payer: UMR Bronson Commercial |
$176.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$301.41
|
|
|
HC TUBE CHANGE URETERO VIA ILEALO
|
Facility
|
IP
|
$2,074.51
|
|
|
Service Code
|
CPT 50688
|
| Hospital Charge Code |
36100248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$912.78 |
| Max. Negotiated Rate |
$1,867.06 |
| Rate for Payer: Aetna American Axle |
$1,348.43
|
| Rate for Payer: Aetna Commercial |
$1,763.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,348.43
|
| Rate for Payer: Cash Price |
$1,659.61
|
| Rate for Payer: Cofinity Commercial |
$1,452.16
|
| Rate for Payer: Cofinity Commercial |
$1,784.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,452.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.61
|
| Rate for Payer: Healthscope Commercial |
$1,867.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,452.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,555.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.33
|
| Rate for Payer: PHP Commercial |
$1,763.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.43
|
| Rate for Payer: Priority Health SBD |
$1,306.94
|
| Rate for Payer: UMR Bronson Commercial |
$912.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,555.88
|
|
|
HC TUBE CHANGE URETERO VIA ILEALO
|
Facility
|
OP
|
$2,074.51
|
|
|
Service Code
|
CPT 50688
|
| Hospital Charge Code |
36100248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$767.57 |
| Max. Negotiated Rate |
$5,623.80 |
| Rate for Payer: Aetna American Axle |
$1,348.43
|
| Rate for Payer: Aetna Commercial |
$1,763.33
|
| Rate for Payer: Aetna Medicare |
$2,077.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,348.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,497.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,497.34
|
| Rate for Payer: BCBS Complete |
$1,124.40
|
| Rate for Payer: BCBS MAPPO |
$1,997.87
|
| Rate for Payer: BCN Medicare Advantage |
$1,997.87
|
| Rate for Payer: Cash Price |
$1,659.61
|
| Rate for Payer: Cash Price |
$1,659.61
|
| Rate for Payer: Cofinity Commercial |
$1,784.08
|
| Rate for Payer: Cofinity Commercial |
$1,452.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,452.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,659.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,997.87
|
| Rate for Payer: Healthscope Commercial |
$1,867.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,452.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,555.88
|
| Rate for Payer: Mclaren Medicaid |
$1,070.86
|
| Rate for Payer: Mclaren Medicare |
$1,997.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,097.76
|
| Rate for Payer: Meridian Medicaid |
$1,124.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.33
|
| Rate for Payer: PACE Medicare |
$1,897.98
|
| Rate for Payer: PACE SWMI |
$1,997.87
|
| Rate for Payer: PHP Commercial |
$1,763.33
|
| Rate for Payer: PHP Medicare Advantage |
$1,997.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,070.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.43
|
| Rate for Payer: Priority Health Medicare |
$1,997.87
|
| Rate for Payer: Priority Health SBD |
$1,306.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,997.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,623.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,997.87
|
| Rate for Payer: UHC Exchange |
$3,818.13
|
| Rate for Payer: UHC Medicare Advantage |
$1,997.87
|
| Rate for Payer: UHCCP Medicaid |
$1,070.86
|
| Rate for Payer: UMR Bronson Commercial |
$767.57
|
| Rate for Payer: VA VA |
$1,997.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,555.88
|
|
|
HC TUBE CHECK WITH FLUORO
|
Facility
|
OP
|
$219.07
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
36100233
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$81.06 |
| Max. Negotiated Rate |
$663.58 |
| Rate for Payer: Aetna American Axle |
$142.40
|
| Rate for Payer: Aetna Commercial |
$186.21
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$175.26
|
| Rate for Payer: Cash Price |
$175.26
|
| Rate for Payer: Cofinity Commercial |
$188.40
|
| Rate for Payer: Cofinity Commercial |
$153.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$153.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$197.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$153.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.30
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.21
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$186.21
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.40
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$138.01
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$450.52
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: UMR Bronson Commercial |
$81.06
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.30
|
|
|
HC TUBE CHECK WITH FLUORO
|
Facility
|
IP
|
$219.07
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
36100233
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$96.39 |
| Max. Negotiated Rate |
$197.16 |
| Rate for Payer: Aetna American Axle |
$142.40
|
| Rate for Payer: Aetna Commercial |
$186.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.40
|
| Rate for Payer: Cash Price |
$175.26
|
| Rate for Payer: Cofinity Commercial |
$153.35
|
| Rate for Payer: Cofinity Commercial |
$188.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$153.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.26
|
| Rate for Payer: Healthscope Commercial |
$197.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$153.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.21
|
| Rate for Payer: PHP Commercial |
$186.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.40
|
| Rate for Payer: Priority Health SBD |
$138.01
|
| Rate for Payer: UMR Bronson Commercial |
$96.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.30
|
|
|
HC TUBE PLACEMENT NASOG OR OROG W FLUO
|
Facility
|
IP
|
$480.87
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
36100191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$211.58 |
| Max. Negotiated Rate |
$432.78 |
| Rate for Payer: Aetna American Axle |
$312.57
|
| Rate for Payer: Aetna Commercial |
$408.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.57
|
| Rate for Payer: Cash Price |
$384.70
|
| Rate for Payer: Cofinity Commercial |
$336.61
|
| Rate for Payer: Cofinity Commercial |
$413.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$336.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.70
|
| Rate for Payer: Healthscope Commercial |
$432.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$336.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$408.74
|
| Rate for Payer: PHP Commercial |
$408.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.57
|
| Rate for Payer: Priority Health SBD |
$302.95
|
| Rate for Payer: UMR Bronson Commercial |
$211.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.65
|
|
|
HC TUBE PLACEMENT NASOG OR OROG W FLUO
|
Facility
|
OP
|
$480.87
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
36100191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$177.92 |
| Max. Negotiated Rate |
$1,095.50 |
| Rate for Payer: Aetna American Axle |
$312.57
|
| Rate for Payer: Aetna Commercial |
$408.74
|
| Rate for Payer: Aetna Medicare |
$404.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$486.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$486.48
|
| Rate for Payer: BCBS Complete |
$219.03
|
| Rate for Payer: BCBS MAPPO |
$389.18
|
| Rate for Payer: BCN Medicare Advantage |
$389.18
|
| Rate for Payer: Cash Price |
$384.70
|
| Rate for Payer: Cash Price |
$384.70
|
| Rate for Payer: Cofinity Commercial |
$413.55
|
| Rate for Payer: Cofinity Commercial |
$336.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$336.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$384.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.18
|
| Rate for Payer: Healthscope Commercial |
$432.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$336.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$360.65
|
| Rate for Payer: Mclaren Medicaid |
$208.60
|
| Rate for Payer: Mclaren Medicare |
$389.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$408.64
|
| Rate for Payer: Meridian Medicaid |
$219.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$447.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$408.74
|
| Rate for Payer: PACE Medicare |
$369.72
|
| Rate for Payer: PACE SWMI |
$389.18
|
| Rate for Payer: PHP Commercial |
$408.74
|
| Rate for Payer: PHP Medicare Advantage |
$389.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.57
|
| Rate for Payer: Priority Health Medicare |
$389.18
|
| Rate for Payer: Priority Health SBD |
$302.95
|
| Rate for Payer: Railroad Medicare Medicare |
$389.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,095.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.18
|
| Rate for Payer: UHC Exchange |
$743.76
|
| Rate for Payer: UHC Medicare Advantage |
$389.18
|
| Rate for Payer: UHCCP Medicaid |
$208.60
|
| Rate for Payer: UMR Bronson Commercial |
$177.92
|
| Rate for Payer: VA VA |
$389.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.65
|
|
|
HC TUBE REPLACEMENT BY PHYSICIAN
|
Facility
|
OP
|
$309.38
|
|
| Hospital Charge Code |
45000055
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$114.47 |
| Max. Negotiated Rate |
$278.44 |
| Rate for Payer: Aetna American Axle |
$201.10
|
| Rate for Payer: Aetna Commercial |
$262.97
|
| Rate for Payer: Aetna Medicare |
$154.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.10
|
| Rate for Payer: BCBS Complete |
$123.75
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cofinity Commercial |
$216.57
|
| Rate for Payer: Cofinity Commercial |
$266.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$216.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.50
|
| Rate for Payer: Healthscope Commercial |
$278.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$216.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.97
|
| Rate for Payer: PHP Commercial |
$262.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.10
|
| Rate for Payer: Priority Health SBD |
$194.91
|
| Rate for Payer: UMR Bronson Commercial |
$114.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.03
|
|
|
HC TUBE REPLACEMENT BY PHYSICIAN
|
Facility
|
IP
|
$309.38
|
|
| Hospital Charge Code |
45000055
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$136.13 |
| Max. Negotiated Rate |
$278.44 |
| Rate for Payer: Aetna American Axle |
$201.10
|
| Rate for Payer: Aetna Commercial |
$262.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$201.10
|
| Rate for Payer: Cash Price |
$247.50
|
| Rate for Payer: Cofinity Commercial |
$216.57
|
| Rate for Payer: Cofinity Commercial |
$266.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$216.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.50
|
| Rate for Payer: Healthscope Commercial |
$278.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$216.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$232.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.97
|
| Rate for Payer: PHP Commercial |
$262.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.10
|
| Rate for Payer: Priority Health SBD |
$194.91
|
| Rate for Payer: UMR Bronson Commercial |
$136.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$232.03
|
|
|
HC TUBING 1/2
|
Facility
|
OP
|
$18.36
|
|
| Hospital Charge Code |
27000663
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.79 |
| Max. Negotiated Rate |
$16.52 |
| Rate for Payer: Aetna American Axle |
$11.93
|
| Rate for Payer: Aetna Commercial |
$15.61
|
| Rate for Payer: Aetna Medicare |
$9.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.93
|
| Rate for Payer: BCBS Complete |
$7.34
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$12.85
|
| Rate for Payer: Cofinity Commercial |
$15.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Healthscope Commercial |
$16.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.61
|
| Rate for Payer: PHP Commercial |
$15.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.93
|
| Rate for Payer: Priority Health SBD |
$11.57
|
| Rate for Payer: UMR Bronson Commercial |
$6.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.77
|
|
|
HC TUBING 1/2
|
Facility
|
IP
|
$18.36
|
|
| Hospital Charge Code |
27000663
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$16.52 |
| Rate for Payer: Aetna American Axle |
$11.93
|
| Rate for Payer: Aetna Commercial |
$15.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.93
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$12.85
|
| Rate for Payer: Cofinity Commercial |
$15.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Healthscope Commercial |
$16.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.61
|
| Rate for Payer: PHP Commercial |
$15.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.93
|
| Rate for Payer: Priority Health SBD |
$11.57
|
| Rate for Payer: UMR Bronson Commercial |
$8.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.77
|
|
|
HC TUBING 1/4
|
Facility
|
IP
|
$24.48
|
|
| Hospital Charge Code |
27000162
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.77 |
| Max. Negotiated Rate |
$22.03 |
| Rate for Payer: Aetna American Axle |
$15.91
|
| Rate for Payer: Aetna Commercial |
$20.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.91
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$21.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$22.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.81
|
| Rate for Payer: PHP Commercial |
$20.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.91
|
| Rate for Payer: Priority Health SBD |
$15.42
|
| Rate for Payer: UMR Bronson Commercial |
$10.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.36
|
|
|
HC TUBING 1/4
|
Facility
|
OP
|
$24.48
|
|
| Hospital Charge Code |
27000162
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.06 |
| Max. Negotiated Rate |
$22.03 |
| Rate for Payer: Aetna American Axle |
$15.91
|
| Rate for Payer: Aetna Commercial |
$20.81
|
| Rate for Payer: Aetna Medicare |
$12.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.91
|
| Rate for Payer: BCBS Complete |
$9.79
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$21.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$22.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.81
|
| Rate for Payer: PHP Commercial |
$20.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.91
|
| Rate for Payer: Priority Health SBD |
$15.42
|
| Rate for Payer: UMR Bronson Commercial |
$9.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.36
|
|
|
HC TUBING 3/8
|
Facility
|
OP
|
$29.07
|
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.76 |
| Max. Negotiated Rate |
$26.16 |
| Rate for Payer: Aetna American Axle |
$18.90
|
| Rate for Payer: Aetna Commercial |
$24.71
|
| Rate for Payer: Aetna Medicare |
$14.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.90
|
| Rate for Payer: BCBS Complete |
$11.63
|
| Rate for Payer: Cash Price |
$23.26
|
| Rate for Payer: Cofinity Commercial |
$20.35
|
| Rate for Payer: Cofinity Commercial |
$25.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.26
|
| Rate for Payer: Healthscope Commercial |
$26.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.71
|
| Rate for Payer: PHP Commercial |
$24.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.90
|
| Rate for Payer: Priority Health SBD |
$18.31
|
| Rate for Payer: UMR Bronson Commercial |
$10.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.80
|
|
|
HC TUBING 3/8
|
Facility
|
IP
|
$29.07
|
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.79 |
| Max. Negotiated Rate |
$26.16 |
| Rate for Payer: Aetna American Axle |
$18.90
|
| Rate for Payer: Aetna Commercial |
$24.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.90
|
| Rate for Payer: Cash Price |
$23.26
|
| Rate for Payer: Cofinity Commercial |
$20.35
|
| Rate for Payer: Cofinity Commercial |
$25.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.26
|
| Rate for Payer: Healthscope Commercial |
$26.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.71
|
| Rate for Payer: PHP Commercial |
$24.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.90
|
| Rate for Payer: Priority Health SBD |
$18.31
|
| Rate for Payer: UMR Bronson Commercial |
$12.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.80
|
|
|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
IP
|
$210.29
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$92.53 |
| Max. Negotiated Rate |
$189.26 |
| Rate for Payer: Aetna American Axle |
$136.69
|
| Rate for Payer: Aetna Commercial |
$178.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.69
|
| Rate for Payer: Cash Price |
$168.23
|
| Rate for Payer: Cofinity Commercial |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$180.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$147.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.23
|
| Rate for Payer: Healthscope Commercial |
$189.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$147.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.75
|
| Rate for Payer: PHP Commercial |
$178.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.69
|
| Rate for Payer: Priority Health SBD |
$132.48
|
| Rate for Payer: UMR Bronson Commercial |
$92.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.72
|
|
|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
OP
|
$210.29
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$77.81 |
| Max. Negotiated Rate |
$470.43 |
| Rate for Payer: Aetna American Axle |
$136.69
|
| Rate for Payer: Aetna Commercial |
$178.75
|
| Rate for Payer: Aetna Medicare |
$173.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$208.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$208.90
|
| Rate for Payer: BCBS Complete |
$94.06
|
| Rate for Payer: BCBS MAPPO |
$167.12
|
| Rate for Payer: BCN Medicare Advantage |
$167.12
|
| Rate for Payer: Cash Price |
$168.23
|
| Rate for Payer: Cash Price |
$168.23
|
| Rate for Payer: Cofinity Commercial |
$180.85
|
| Rate for Payer: Cofinity Commercial |
$147.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$147.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.12
|
| Rate for Payer: Healthscope Commercial |
$189.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$147.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.72
|
| Rate for Payer: Mclaren Medicaid |
$89.58
|
| Rate for Payer: Mclaren Medicare |
$167.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.48
|
| Rate for Payer: Meridian Medicaid |
$94.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$192.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.75
|
| Rate for Payer: PACE Medicare |
$158.76
|
| Rate for Payer: PACE SWMI |
$167.12
|
| Rate for Payer: PHP Commercial |
$178.75
|
| Rate for Payer: PHP Medicare Advantage |
$167.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.69
|
| Rate for Payer: Priority Health Medicare |
$167.12
|
| Rate for Payer: Priority Health SBD |
$132.48
|
| Rate for Payer: Railroad Medicare Medicare |
$167.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$470.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.12
|
| Rate for Payer: UHC Exchange |
$319.38
|
| Rate for Payer: UHC Medicare Advantage |
$167.12
|
| Rate for Payer: UHCCP Medicaid |
$89.58
|
| Rate for Payer: UMR Bronson Commercial |
$77.81
|
| Rate for Payer: VA VA |
$167.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.72
|
|
|
HC TUNA IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200067
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$9.98
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC TUNA IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200067
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC TVT DEVICE KIT
|
Facility
|
OP
|
$4,168.20
|
|
|
Service Code
|
HCPCS C2631
|
| Hospital Charge Code |
27200076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,542.23 |
| Max. Negotiated Rate |
$3,751.38 |
| Rate for Payer: Aetna American Axle |
$2,709.33
|
| Rate for Payer: Aetna Commercial |
$3,542.97
|
| Rate for Payer: Aetna Medicare |
$2,084.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,709.33
|
| Rate for Payer: BCBS Complete |
$1,667.28
|
| Rate for Payer: Cash Price |
$3,334.56
|
| Rate for Payer: Cofinity Commercial |
$2,917.74
|
| Rate for Payer: Cofinity Commercial |
$3,584.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,917.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,334.56
|
| Rate for Payer: Healthscope Commercial |
$3,751.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,917.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,126.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,542.97
|
| Rate for Payer: PHP Commercial |
$3,542.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,709.33
|
| Rate for Payer: Priority Health SBD |
$2,625.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,542.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,126.15
|
|
|
HC TVT DEVICE KIT
|
Facility
|
IP
|
$4,168.20
|
|
|
Service Code
|
HCPCS C2631
|
| Hospital Charge Code |
27200076
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,834.01 |
| Max. Negotiated Rate |
$3,751.38 |
| Rate for Payer: Aetna American Axle |
$2,709.33
|
| Rate for Payer: Aetna Commercial |
$3,542.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,709.33
|
| Rate for Payer: Cash Price |
$3,334.56
|
| Rate for Payer: Cofinity Commercial |
$2,917.74
|
| Rate for Payer: Cofinity Commercial |
$3,584.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,917.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,334.56
|
| Rate for Payer: Healthscope Commercial |
$3,751.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,917.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,126.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,542.97
|
| Rate for Payer: PHP Commercial |
$3,542.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,709.33
|
| Rate for Payer: Priority Health SBD |
$2,625.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,834.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,126.15
|
|
|
HC TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Facility
|
IP
|
$3,672.00
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
36100620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,615.68 |
| Max. Negotiated Rate |
$3,304.80 |
| Rate for Payer: Aetna American Axle |
$2,386.80
|
| Rate for Payer: Aetna Commercial |
$3,121.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,386.80
|
| Rate for Payer: Cash Price |
$2,937.60
|
| Rate for Payer: Cofinity Commercial |
$2,570.40
|
| Rate for Payer: Cofinity Commercial |
$3,157.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,570.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,937.60
|
| Rate for Payer: Healthscope Commercial |
$3,304.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,570.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,754.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,121.20
|
| Rate for Payer: PHP Commercial |
$3,121.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,386.80
|
| Rate for Payer: Priority Health SBD |
$2,313.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,615.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,754.00
|
|
|
HC TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE
|
Facility
|
OP
|
$3,672.00
|
|
|
Service Code
|
CPT 61107
|
| Hospital Charge Code |
36100620
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,358.64 |
| Max. Negotiated Rate |
$3,304.80 |
| Rate for Payer: Aetna American Axle |
$2,386.80
|
| Rate for Payer: Aetna Commercial |
$3,121.20
|
| Rate for Payer: Aetna Medicare |
$1,836.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,386.80
|
| Rate for Payer: BCBS Complete |
$1,468.80
|
| Rate for Payer: Cash Price |
$2,937.60
|
| Rate for Payer: Cofinity Commercial |
$2,570.40
|
| Rate for Payer: Cofinity Commercial |
$3,157.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,570.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,937.60
|
| Rate for Payer: Healthscope Commercial |
$3,304.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,570.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,754.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,121.20
|
| Rate for Payer: PHP Commercial |
$3,121.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,386.80
|
| Rate for Payer: Priority Health SBD |
$2,313.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,358.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,754.00
|
|
|
HC TX INCOMPLETE AB ANY TRI SURG
|
Facility
|
IP
|
$7,945.53
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
76100342
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,496.03 |
| Max. Negotiated Rate |
$7,150.98 |
| Rate for Payer: Aetna American Axle |
$5,164.59
|
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,164.59
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$5,561.87
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,561.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,561.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health SBD |
$5,005.68
|
| Rate for Payer: UMR Bronson Commercial |
$3,496.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
