|
HC UA MICROSCOPIC ONLY
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700015
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.63 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna American Axle |
$25.13
|
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna Medicare |
$3.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.81
|
| Rate for Payer: BCBS Complete |
$1.72
|
| Rate for Payer: BCBS MAPPO |
$3.05
|
| Rate for Payer: BCN Medicare Advantage |
$3.05
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Cofinity Commercial |
$27.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.05
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Mclaren Medicaid |
$1.63
|
| Rate for Payer: Mclaren Medicare |
$3.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.20
|
| Rate for Payer: Meridian Medicaid |
$1.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: PACE Medicare |
$2.90
|
| Rate for Payer: PACE SWMI |
$3.05
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: PHP Medicare Advantage |
$3.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health Medicare |
$3.05
|
| Rate for Payer: Priority Health SBD |
$24.36
|
| Rate for Payer: Railroad Medicare Medicare |
$3.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.05
|
| Rate for Payer: UHC Exchange |
$5.83
|
| Rate for Payer: UHC Medicare Advantage |
$3.05
|
| Rate for Payer: UHCCP Medicaid |
$1.63
|
| Rate for Payer: UMR Bronson Commercial |
$14.30
|
| Rate for Payer: VA VA |
$3.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC UA MICROSCOPIC ONLY
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700015
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$17.01 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna American Axle |
$25.13
|
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.13
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$27.06
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health SBD |
$24.36
|
| Rate for Payer: UMR Bronson Commercial |
$17.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC ULTRASOUND EACH 15 MIN
|
Facility
|
OP
|
$84.27
|
|
|
Service Code
|
CPT 97035
|
| Hospital Charge Code |
42000018
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$31.18 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$54.78
|
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: Aetna Medicare |
$42.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.78
|
| Rate for Payer: BCBS Complete |
$33.71
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$72.47
|
| Rate for Payer: Cofinity Commercial |
$58.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$58.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Healthscope Commercial |
$75.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.63
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$71.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.78
|
| Rate for Payer: Priority Health SBD |
$53.09
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$31.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.20
|
|
|
HC ULTRASOUND EACH 15 MIN
|
Facility
|
IP
|
$84.27
|
|
|
Service Code
|
CPT 97035
|
| Hospital Charge Code |
42000018
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$37.08 |
| Max. Negotiated Rate |
$75.84 |
| Rate for Payer: Aetna American Axle |
$54.78
|
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.78
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$58.99
|
| Rate for Payer: Cofinity Commercial |
$72.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$58.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Healthscope Commercial |
$75.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.63
|
| Rate for Payer: PHP Commercial |
$71.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.78
|
| Rate for Payer: Priority Health SBD |
$53.09
|
| Rate for Payer: UMR Bronson Commercial |
$37.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.20
|
|
|
HC ULTRASOUND RF UTERINE FIBROID ABLATION TRANSCERVICAL
|
Facility
|
OP
|
$9,635.14
|
|
|
Service Code
|
CPT 58580
|
| Hospital Charge Code |
36100485
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,565.00 |
| Max. Negotiated Rate |
$20,301.09 |
| Rate for Payer: Aetna American Axle |
$6,262.84
|
| Rate for Payer: Aetna Commercial |
$8,189.87
|
| Rate for Payer: Aetna Medicare |
$7,500.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,262.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,015.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,015.01
|
| Rate for Payer: BCBS Complete |
$4,058.92
|
| Rate for Payer: BCBS MAPPO |
$7,212.01
|
| Rate for Payer: BCN Medicare Advantage |
$7,212.01
|
| Rate for Payer: Cash Price |
$7,708.11
|
| Rate for Payer: Cash Price |
$7,708.11
|
| Rate for Payer: Cofinity Commercial |
$8,286.22
|
| Rate for Payer: Cofinity Commercial |
$6,744.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,744.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,708.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,212.01
|
| Rate for Payer: Healthscope Commercial |
$8,671.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,744.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,226.35
|
| Rate for Payer: Mclaren Medicaid |
$3,865.64
|
| Rate for Payer: Mclaren Medicare |
$7,212.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,572.61
|
| Rate for Payer: Meridian Medicaid |
$4,058.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,293.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,189.87
|
| Rate for Payer: PACE Medicare |
$6,851.41
|
| Rate for Payer: PACE SWMI |
$7,212.01
|
| Rate for Payer: PHP Commercial |
$8,189.87
|
| Rate for Payer: PHP Medicare Advantage |
$7,212.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,865.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,262.84
|
| Rate for Payer: Priority Health Medicare |
$7,212.01
|
| Rate for Payer: Priority Health SBD |
$6,070.14
|
| Rate for Payer: Railroad Medicare Medicare |
$7,212.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20,301.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,212.01
|
| Rate for Payer: UHC Exchange |
$13,782.87
|
| Rate for Payer: UHC Medicare Advantage |
$7,212.01
|
| Rate for Payer: UHCCP Medicaid |
$3,865.64
|
| Rate for Payer: UMR Bronson Commercial |
$3,565.00
|
| Rate for Payer: VA VA |
$7,212.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,226.35
|
|
|
HC ULTRASOUND RF UTERINE FIBROID ABLATION TRANSCERVICAL
|
Facility
|
IP
|
$9,635.14
|
|
|
Service Code
|
CPT 58580
|
| Hospital Charge Code |
36100485
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,239.46 |
| Max. Negotiated Rate |
$8,671.63 |
| Rate for Payer: Aetna American Axle |
$6,262.84
|
| Rate for Payer: Aetna Commercial |
$8,189.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,262.84
|
| Rate for Payer: Cash Price |
$7,708.11
|
| Rate for Payer: Cofinity Commercial |
$6,744.60
|
| Rate for Payer: Cofinity Commercial |
$8,286.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,744.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,708.11
|
| Rate for Payer: Healthscope Commercial |
$8,671.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,744.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,226.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,189.87
|
| Rate for Payer: PHP Commercial |
$8,189.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,262.84
|
| Rate for Payer: Priority Health SBD |
$6,070.14
|
| Rate for Payer: UMR Bronson Commercial |
$4,239.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,226.35
|
|
|
HC ULTRATAG RBC PER STUDY
|
Facility
|
OP
|
$244.45
|
|
|
Service Code
|
HCPCS A9560
|
| Hospital Charge Code |
34300023
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$90.45 |
| Max. Negotiated Rate |
$220.00 |
| Rate for Payer: Aetna American Axle |
$158.89
|
| Rate for Payer: Aetna Commercial |
$207.78
|
| Rate for Payer: Aetna Medicare |
$122.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.89
|
| Rate for Payer: BCBS Complete |
$97.78
|
| Rate for Payer: Cash Price |
$195.56
|
| Rate for Payer: Cofinity Commercial |
$171.12
|
| Rate for Payer: Cofinity Commercial |
$210.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.56
|
| Rate for Payer: Healthscope Commercial |
$220.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.78
|
| Rate for Payer: PHP Commercial |
$207.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.89
|
| Rate for Payer: Priority Health SBD |
$154.00
|
| Rate for Payer: UMR Bronson Commercial |
$90.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.34
|
|
|
HC ULTRATAG RBC PER STUDY
|
Facility
|
IP
|
$244.45
|
|
|
Service Code
|
HCPCS A9560
|
| Hospital Charge Code |
34300023
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$107.56 |
| Max. Negotiated Rate |
$220.00 |
| Rate for Payer: Aetna American Axle |
$158.89
|
| Rate for Payer: Aetna Commercial |
$207.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.89
|
| Rate for Payer: Cash Price |
$195.56
|
| Rate for Payer: Cofinity Commercial |
$171.12
|
| Rate for Payer: Cofinity Commercial |
$210.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.56
|
| Rate for Payer: Healthscope Commercial |
$220.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.78
|
| Rate for Payer: PHP Commercial |
$207.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.89
|
| Rate for Payer: Priority Health SBD |
$154.00
|
| Rate for Payer: UMR Bronson Commercial |
$107.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.34
|
|
|
HC UMBILICAL ARTERY CATHETER
|
Facility
|
IP
|
$213.64
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
36100602
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$94.00 |
| Max. Negotiated Rate |
$192.28 |
| Rate for Payer: Aetna American Axle |
$138.87
|
| Rate for Payer: Aetna Commercial |
$181.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.87
|
| Rate for Payer: Cash Price |
$170.91
|
| Rate for Payer: Cofinity Commercial |
$149.55
|
| Rate for Payer: Cofinity Commercial |
$183.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.91
|
| Rate for Payer: Healthscope Commercial |
$192.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.59
|
| Rate for Payer: PHP Commercial |
$181.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.87
|
| Rate for Payer: Priority Health SBD |
$134.59
|
| Rate for Payer: UMR Bronson Commercial |
$94.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.23
|
|
|
HC UMBILICAL ARTERY CATHETER
|
Facility
|
OP
|
$213.64
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
36100602
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$192.28 |
| Rate for Payer: Aetna American Axle |
$138.87
|
| Rate for Payer: Aetna Commercial |
$181.59
|
| Rate for Payer: Aetna Medicare |
$106.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.87
|
| Rate for Payer: BCBS Complete |
$85.46
|
| Rate for Payer: Cash Price |
$170.91
|
| Rate for Payer: Cofinity Commercial |
$149.55
|
| Rate for Payer: Cofinity Commercial |
$183.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.91
|
| Rate for Payer: Healthscope Commercial |
$192.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.59
|
| Rate for Payer: PHP Commercial |
$181.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.87
|
| Rate for Payer: Priority Health SBD |
$134.59
|
| Rate for Payer: UMR Bronson Commercial |
$79.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.23
|
|
|
HC UMBILICAL VEIN CATHETER
|
Facility
|
IP
|
$213.64
|
|
|
Service Code
|
CPT 36510
|
| Hospital Charge Code |
36100584
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$94.00 |
| Max. Negotiated Rate |
$192.28 |
| Rate for Payer: Aetna American Axle |
$138.87
|
| Rate for Payer: Aetna Commercial |
$181.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.87
|
| Rate for Payer: Cash Price |
$170.91
|
| Rate for Payer: Cofinity Commercial |
$149.55
|
| Rate for Payer: Cofinity Commercial |
$183.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.91
|
| Rate for Payer: Healthscope Commercial |
$192.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.59
|
| Rate for Payer: PHP Commercial |
$181.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.87
|
| Rate for Payer: Priority Health SBD |
$134.59
|
| Rate for Payer: UMR Bronson Commercial |
$94.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.23
|
|
|
HC UMBILICAL VEIN CATHETER
|
Facility
|
OP
|
$213.64
|
|
|
Service Code
|
CPT 36510
|
| Hospital Charge Code |
36100584
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$79.05 |
| Max. Negotiated Rate |
$192.28 |
| Rate for Payer: Aetna American Axle |
$138.87
|
| Rate for Payer: Aetna Commercial |
$181.59
|
| Rate for Payer: Aetna Medicare |
$106.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.87
|
| Rate for Payer: BCBS Complete |
$85.46
|
| Rate for Payer: Cash Price |
$170.91
|
| Rate for Payer: Cofinity Commercial |
$149.55
|
| Rate for Payer: Cofinity Commercial |
$183.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.91
|
| Rate for Payer: Healthscope Commercial |
$192.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.59
|
| Rate for Payer: PHP Commercial |
$181.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.87
|
| Rate for Payer: Priority Health SBD |
$134.59
|
| Rate for Payer: UMR Bronson Commercial |
$79.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.23
|
|
|
HC UNILATERAL SCREENING MAMM WITH CAD
|
Facility
|
OP
|
$330.35
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300007
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$122.23 |
| Max. Negotiated Rate |
$332.00 |
| Rate for Payer: Aetna American Axle |
$214.73
|
| Rate for Payer: Aetna Commercial |
$280.80
|
| Rate for Payer: Aetna Medicare |
$165.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.73
|
| Rate for Payer: BCBS Complete |
$132.14
|
| Rate for Payer: Cash Price |
$264.28
|
| Rate for Payer: Cash Price |
$264.28
|
| Rate for Payer: Cofinity Commercial |
$284.10
|
| Rate for Payer: Cofinity Commercial |
$231.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$231.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.28
|
| Rate for Payer: Healthscope Commercial |
$297.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$231.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.80
|
| Rate for Payer: PHP Commercial |
$280.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.73
|
| Rate for Payer: Priority Health SBD |
$208.12
|
| Rate for Payer: UHC Core |
$332.00
|
| Rate for Payer: UMR Bronson Commercial |
$122.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.76
|
|
|
HC UNILATERAL SCREENING MAMM WITH CAD
|
Facility
|
IP
|
$330.35
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300007
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$145.35 |
| Max. Negotiated Rate |
$297.31 |
| Rate for Payer: Aetna American Axle |
$214.73
|
| Rate for Payer: Aetna Commercial |
$280.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.73
|
| Rate for Payer: Cash Price |
$264.28
|
| Rate for Payer: Cofinity Commercial |
$231.25
|
| Rate for Payer: Cofinity Commercial |
$284.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$231.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.28
|
| Rate for Payer: Healthscope Commercial |
$297.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$231.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.80
|
| Rate for Payer: PHP Commercial |
$280.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.73
|
| Rate for Payer: Priority Health SBD |
$208.12
|
| Rate for Payer: UMR Bronson Commercial |
$145.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.76
|
|
|
HC UNILATERAL TOMOSYNTHESIS
|
Facility
|
OP
|
$103.21
|
|
|
Service Code
|
CPT 77061
|
| Hospital Charge Code |
32000299
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$38.19 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$67.09
|
| Rate for Payer: Aetna Commercial |
$87.73
|
| Rate for Payer: Aetna Medicare |
$51.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.09
|
| Rate for Payer: BCBS Complete |
$41.28
|
| Rate for Payer: Cash Price |
$82.57
|
| Rate for Payer: Cash Price |
$82.57
|
| Rate for Payer: Cofinity Commercial |
$88.76
|
| Rate for Payer: Cofinity Commercial |
$72.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.57
|
| Rate for Payer: Healthscope Commercial |
$92.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.73
|
| Rate for Payer: PHP Commercial |
$87.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.09
|
| Rate for Payer: Priority Health SBD |
$65.02
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UMR Bronson Commercial |
$38.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.41
|
|
|
HC UNILATERAL TOMOSYNTHESIS
|
Facility
|
IP
|
$103.21
|
|
|
Service Code
|
CPT 77061
|
| Hospital Charge Code |
32000299
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.41 |
| Max. Negotiated Rate |
$92.89 |
| Rate for Payer: Aetna American Axle |
$67.09
|
| Rate for Payer: Aetna Commercial |
$87.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.09
|
| Rate for Payer: Cash Price |
$82.57
|
| Rate for Payer: Cofinity Commercial |
$72.25
|
| Rate for Payer: Cofinity Commercial |
$88.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.57
|
| Rate for Payer: Healthscope Commercial |
$92.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.73
|
| Rate for Payer: PHP Commercial |
$87.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.09
|
| Rate for Payer: Priority Health SBD |
$65.02
|
| Rate for Payer: UMR Bronson Commercial |
$45.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.41
|
|
|
HC UNILAT PERC IMPLANT NEUROSTIM ELTRD, SACRAL NERVE W/IMAG
|
Facility
|
IP
|
$9,655.64
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100247
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,248.48 |
| Max. Negotiated Rate |
$8,690.08 |
| Rate for Payer: Aetna American Axle |
$6,276.17
|
| Rate for Payer: Aetna Commercial |
$8,207.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,276.17
|
| Rate for Payer: Cash Price |
$7,724.51
|
| Rate for Payer: Cofinity Commercial |
$6,758.95
|
| Rate for Payer: Cofinity Commercial |
$8,303.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,758.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,724.51
|
| Rate for Payer: Healthscope Commercial |
$8,690.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,758.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,241.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,207.29
|
| Rate for Payer: PHP Commercial |
$8,207.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,276.17
|
| Rate for Payer: Priority Health SBD |
$6,083.05
|
| Rate for Payer: UMR Bronson Commercial |
$4,248.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,241.73
|
|
|
HC UNILAT PERC IMPLANT NEUROSTIM ELTRD, SACRAL NERVE W/IMAG
|
Facility
|
OP
|
$9,655.64
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100247
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,430.76 |
| Max. Negotiated Rate |
$18,017.25 |
| Rate for Payer: Aetna American Axle |
$6,276.17
|
| Rate for Payer: Aetna Commercial |
$8,207.29
|
| Rate for Payer: Aetna Medicare |
$6,656.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,276.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,000.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,000.84
|
| Rate for Payer: BCBS Complete |
$3,602.30
|
| Rate for Payer: BCBS MAPPO |
$6,400.67
|
| Rate for Payer: BCN Medicare Advantage |
$6,400.67
|
| Rate for Payer: Cash Price |
$7,724.51
|
| Rate for Payer: Cash Price |
$7,724.51
|
| Rate for Payer: Cofinity Commercial |
$8,303.85
|
| Rate for Payer: Cofinity Commercial |
$6,758.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,758.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,724.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,400.67
|
| Rate for Payer: Healthscope Commercial |
$8,690.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,758.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,241.73
|
| Rate for Payer: Mclaren Medicaid |
$3,430.76
|
| Rate for Payer: Mclaren Medicare |
$6,400.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,720.70
|
| Rate for Payer: Meridian Medicaid |
$3,602.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,360.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,207.29
|
| Rate for Payer: PACE Medicare |
$6,080.64
|
| Rate for Payer: PACE SWMI |
$6,400.67
|
| Rate for Payer: PHP Commercial |
$8,207.29
|
| Rate for Payer: PHP Medicare Advantage |
$6,400.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,430.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,276.17
|
| Rate for Payer: Priority Health Medicare |
$6,400.67
|
| Rate for Payer: Priority Health SBD |
$6,083.05
|
| Rate for Payer: Railroad Medicare Medicare |
$6,400.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,017.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,400.67
|
| Rate for Payer: UHC Exchange |
$12,232.32
|
| Rate for Payer: UHC Medicare Advantage |
$6,400.67
|
| Rate for Payer: UHCCP Medicaid |
$3,430.76
|
| Rate for Payer: UMR Bronson Commercial |
$3,572.59
|
| Rate for Payer: VA VA |
$6,400.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,241.73
|
|
|
HC UNLISTED FEMALE GENITAL SYSTEM
|
Facility
|
OP
|
$1,125.34
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
36100387
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$105.16 |
| Max. Negotiated Rate |
$1,012.81 |
| Rate for Payer: Aetna American Axle |
$731.47
|
| Rate for Payer: Aetna Commercial |
$956.54
|
| Rate for Payer: Aetna Medicare |
$204.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$245.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$245.25
|
| Rate for Payer: BCBS Complete |
$110.42
|
| Rate for Payer: BCBS MAPPO |
$196.20
|
| Rate for Payer: BCN Medicare Advantage |
$196.20
|
| Rate for Payer: Cash Price |
$900.27
|
| Rate for Payer: Cash Price |
$900.27
|
| Rate for Payer: Cofinity Commercial |
$967.79
|
| Rate for Payer: Cofinity Commercial |
$787.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$787.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.20
|
| Rate for Payer: Healthscope Commercial |
$1,012.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$787.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$844.00
|
| Rate for Payer: Mclaren Medicaid |
$105.16
|
| Rate for Payer: Mclaren Medicare |
$196.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.01
|
| Rate for Payer: Meridian Medicaid |
$110.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$225.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.54
|
| Rate for Payer: PACE Medicare |
$186.39
|
| Rate for Payer: PACE SWMI |
$196.20
|
| Rate for Payer: PHP Commercial |
$956.54
|
| Rate for Payer: PHP Medicare Advantage |
$196.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.47
|
| Rate for Payer: Priority Health Medicare |
$196.20
|
| Rate for Payer: Priority Health SBD |
$708.96
|
| Rate for Payer: Railroad Medicare Medicare |
$196.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$552.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.20
|
| Rate for Payer: UHC Exchange |
$374.96
|
| Rate for Payer: UHC Medicare Advantage |
$196.20
|
| Rate for Payer: UHCCP Medicaid |
$105.16
|
| Rate for Payer: UMR Bronson Commercial |
$416.38
|
| Rate for Payer: VA VA |
$196.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$844.00
|
|
|
HC UNLISTED FEMALE GENITAL SYSTEM
|
Facility
|
IP
|
$1,125.34
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
36100387
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$495.15 |
| Max. Negotiated Rate |
$1,012.81 |
| Rate for Payer: Aetna American Axle |
$731.47
|
| Rate for Payer: Aetna Commercial |
$956.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.47
|
| Rate for Payer: Cash Price |
$900.27
|
| Rate for Payer: Cofinity Commercial |
$787.74
|
| Rate for Payer: Cofinity Commercial |
$967.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$787.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.27
|
| Rate for Payer: Healthscope Commercial |
$1,012.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$787.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$844.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.54
|
| Rate for Payer: PHP Commercial |
$956.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.47
|
| Rate for Payer: Priority Health SBD |
$708.96
|
| Rate for Payer: UMR Bronson Commercial |
$495.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$844.00
|
|
|
HC UNLISTED PROCEDURE, FEMUR OR KNEE
|
Facility
|
IP
|
$673.20
|
|
|
Service Code
|
CPT 27599
|
| Hospital Charge Code |
76100418
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$296.21 |
| Max. Negotiated Rate |
$605.88 |
| Rate for Payer: Aetna American Axle |
$437.58
|
| Rate for Payer: Aetna Commercial |
$572.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.58
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$471.24
|
| Rate for Payer: Cofinity Commercial |
$578.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$471.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Healthscope Commercial |
$605.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$471.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$504.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: PHP Commercial |
$572.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health SBD |
$424.12
|
| Rate for Payer: UMR Bronson Commercial |
$296.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$504.90
|
|
|
HC UNLISTED PROCEDURE, FEMUR OR KNEE
|
Facility
|
OP
|
$673.20
|
|
|
Service Code
|
CPT 27599
|
| Hospital Charge Code |
76100418
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.40 |
| Max. Negotiated Rate |
$658.55 |
| Rate for Payer: Aetna American Axle |
$437.58
|
| Rate for Payer: Aetna Commercial |
$572.22
|
| Rate for Payer: Aetna Medicare |
$243.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$578.95
|
| Rate for Payer: Cofinity Commercial |
$471.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$471.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$605.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$471.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$504.90
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$572.22
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health Medicare |
$233.95
|
| Rate for Payer: Priority Health SBD |
$424.12
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$658.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$447.10
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: UMR Bronson Commercial |
$249.08
|
| Rate for Payer: VA VA |
$233.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$504.90
|
|
|
HC UNLISTED PROCEDURE FOREARM WRIST
|
Facility
|
IP
|
$673.20
|
|
|
Service Code
|
CPT 25999
|
| Hospital Charge Code |
76100410
|
| Min. Negotiated Rate |
$296.21 |
| Max. Negotiated Rate |
$605.88 |
| Rate for Payer: Aetna American Axle |
$437.58
|
| Rate for Payer: Aetna Commercial |
$572.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.58
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$471.24
|
| Rate for Payer: Cofinity Commercial |
$578.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$471.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Healthscope Commercial |
$605.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$471.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$504.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: PHP Commercial |
$572.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health SBD |
$424.12
|
| Rate for Payer: UMR Bronson Commercial |
$296.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$504.90
|
|
|
HC UNLISTED PROCEDURE FOREARM WRIST
|
Facility
|
OP
|
$673.20
|
|
|
Service Code
|
CPT 25999
|
| Hospital Charge Code |
76100410
|
| Min. Negotiated Rate |
$125.40 |
| Max. Negotiated Rate |
$658.55 |
| Rate for Payer: Aetna American Axle |
$437.58
|
| Rate for Payer: Aetna Commercial |
$572.22
|
| Rate for Payer: Aetna Medicare |
$243.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$578.95
|
| Rate for Payer: Cofinity Commercial |
$471.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$471.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$605.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$471.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$504.90
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$572.22
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health Medicare |
$233.95
|
| Rate for Payer: Priority Health SBD |
$424.12
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$658.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$447.10
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: UMR Bronson Commercial |
$249.08
|
| Rate for Payer: VA VA |
$233.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$504.90
|
|
|
HC UNLISTED PROCEDURE HUMERUS ELBOW
|
Facility
|
OP
|
$673.20
|
|
|
Service Code
|
CPT 24999
|
| Hospital Charge Code |
76100409
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.40 |
| Max. Negotiated Rate |
$658.55 |
| Rate for Payer: Aetna American Axle |
$437.58
|
| Rate for Payer: Aetna Commercial |
$572.22
|
| Rate for Payer: Aetna Medicare |
$243.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.44
|
| Rate for Payer: BCBS Complete |
$131.67
|
| Rate for Payer: BCBS MAPPO |
$233.95
|
| Rate for Payer: BCN Medicare Advantage |
$233.95
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cash Price |
$538.56
|
| Rate for Payer: Cofinity Commercial |
$578.95
|
| Rate for Payer: Cofinity Commercial |
$471.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$471.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.95
|
| Rate for Payer: Healthscope Commercial |
$605.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$471.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$504.90
|
| Rate for Payer: Mclaren Medicaid |
$125.40
|
| Rate for Payer: Mclaren Medicare |
$233.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.65
|
| Rate for Payer: Meridian Medicaid |
$131.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$269.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: PACE Medicare |
$222.25
|
| Rate for Payer: PACE SWMI |
$233.95
|
| Rate for Payer: PHP Commercial |
$572.22
|
| Rate for Payer: PHP Medicare Advantage |
$233.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health Medicare |
$233.95
|
| Rate for Payer: Priority Health SBD |
$424.12
|
| Rate for Payer: Railroad Medicare Medicare |
$233.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$658.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$233.95
|
| Rate for Payer: UHC Exchange |
$447.10
|
| Rate for Payer: UHC Medicare Advantage |
$233.95
|
| Rate for Payer: UHCCP Medicaid |
$125.40
|
| Rate for Payer: UMR Bronson Commercial |
$249.08
|
| Rate for Payer: VA VA |
$233.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$504.90
|
|
