|
HC TSH RECEPTOR ANTIBODIES
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100256
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna American Axle |
$43.96
|
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$47.34
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: UMR Bronson Commercial |
$29.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC TSH RECEPTOR ANTIBODIES
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100256
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna American Axle |
$43.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$16.64
|
| Rate for Payer: BCN Commercial |
$16.64
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Cofinity Commercial |
$47.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$25.90
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$13.82
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$17.27
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: UMR Bronson Commercial |
$25.02
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC TSH THYROID STIMULATING HORMONE
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
30100438
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna American Axle |
$30.43
|
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: UMR Bronson Commercial |
$20.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC TSH THYROID STIMULATING HORMONE
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
30100438
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.80
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$9.00
|
| Rate for Payer: Mclaren Medicare |
$16.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.64
|
| Rate for Payer: Meridian Medicaid |
$9.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$25.20
|
| Rate for Payer: PACE Medicare |
$15.96
|
| Rate for Payer: PACE SWMI |
$16.80
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$16.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.29
|
| Rate for Payer: Priority Health Medicare |
$16.80
|
| Rate for Payer: Priority Health Narrow Network |
$13.83
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: Railroad Medicare Medicare |
$16.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.80
|
| Rate for Payer: UHC Exchange |
$16.80
|
| Rate for Payer: UHC Medicare Advantage |
$16.80
|
| Rate for Payer: UHCCP Medicaid |
$9.00
|
| Rate for Payer: UMR Bronson Commercial |
$17.32
|
| Rate for Payer: VA VA |
$16.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
| Rate for Payer: Aetna American Axle |
$30.43
|
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$17.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.00
|
| Rate for Payer: BCBS Complete |
$9.46
|
| Rate for Payer: BCBS MAPPO |
$16.80
|
| Rate for Payer: BCBS Trust/PPO |
$16.19
|
| Rate for Payer: BCN Commercial |
$16.19
|
| Rate for Payer: BCN Medicare Advantage |
$16.80
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
|
|
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 |
$49.50 |
| Max. Negotiated Rate |
$748.94 |
| Rate for Payer: Aetna American Axle |
$261.22
|
| Rate for Payer: Aetna Commercial |
$341.60
|
| Rate for Payer: Aetna Medicare |
$247.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.86
|
| Rate for Payer: BCBS Complete |
$134.11
|
| Rate for Payer: BCBS MAPPO |
$238.29
|
| Rate for Payer: BCBS Trust/PPO |
$241.00
|
| Rate for Payer: BCN Commercial |
$241.00
|
| Rate for Payer: BCN Medicare Advantage |
$238.29
|
| Rate for Payer: Cash Price |
$321.50
|
| 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 |
$238.29
|
| 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 |
$127.72
|
| Rate for Payer: Mclaren Medicare |
$238.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$250.20
|
| Rate for Payer: Meridian Medicaid |
$134.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$274.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$341.60
|
| Rate for Payer: Nomi Health Commercial |
$500.41
|
| Rate for Payer: PACE Medicare |
$226.38
|
| Rate for Payer: PACE SWMI |
$238.29
|
| Rate for Payer: PHP Commercial |
$341.60
|
| Rate for Payer: PHP Medicare Advantage |
$238.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$748.94
|
| Rate for Payer: Priority Health Medicare |
$238.29
|
| Rate for Payer: Priority Health Narrow Network |
$599.15
|
| Rate for Payer: Priority Health SBD |
$253.18
|
| Rate for Payer: Railroad Medicare Medicare |
$238.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.45
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$238.29
|
| Rate for Payer: UHC Exchange |
$49.50
|
| Rate for Payer: UHC Medicare Advantage |
$238.29
|
| Rate for Payer: UHCCP Medicaid |
$127.72
|
| Rate for Payer: UMR Bronson Commercial |
$148.70
|
| Rate for Payer: VA VA |
$238.29
|
| 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 |
$73.52 |
| Max. Negotiated Rate |
$6,308.24 |
| Rate for Payer: Aetna American Axle |
$1,348.43
|
| Rate for Payer: Aetna Commercial |
$1,763.33
|
| Rate for Payer: Aetna Medicare |
$2,087.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,348.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,358.68
|
| Rate for Payer: BCN Commercial |
$1,358.68
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$1,659.61
|
| 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 |
$2,007.09
|
| 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 |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,763.33
|
| Rate for Payer: Nomi Health Commercial |
$4,214.89
|
| Rate for Payer: PACE Medicare |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Commercial |
$1,763.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,348.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,308.24
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$5,046.59
|
| Rate for Payer: Priority Health SBD |
$1,306.94
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.87
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$73.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: UMR Bronson Commercial |
$767.57
|
| Rate for Payer: VA VA |
$2,007.09
|
| 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 |
$28.87 |
| Max. Negotiated Rate |
$744.36 |
| Rate for Payer: Aetna American Axle |
$142.40
|
| Rate for Payer: Aetna Commercial |
$186.21
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$299.98
|
| Rate for Payer: BCN Commercial |
$299.98
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$175.26
|
| Rate for Payer: Cash Price |
$175.26
|
| 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: Health Alliance Plan Medicare Advantage |
$236.83
|
| 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 |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.21
|
| Rate for Payer: Nomi Health Commercial |
$710.49
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$186.21
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.36
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$595.49
|
| Rate for Payer: Priority Health SBD |
$138.01
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.76
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$28.87
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: UMR Bronson Commercial |
$81.06
|
| Rate for Payer: VA VA |
$236.83
|
| 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 |
$38.42 |
| Max. Negotiated Rate |
$1,228.82 |
| Rate for Payer: Aetna American Axle |
$312.57
|
| Rate for Payer: Aetna Commercial |
$408.74
|
| Rate for Payer: Aetna Medicare |
$406.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$312.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$488.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$488.71
|
| Rate for Payer: BCBS Complete |
$220.04
|
| Rate for Payer: BCBS MAPPO |
$390.97
|
| Rate for Payer: BCBS Trust/PPO |
$423.48
|
| Rate for Payer: BCN Commercial |
$423.48
|
| Rate for Payer: BCN Medicare Advantage |
$390.97
|
| Rate for Payer: Cash Price |
$384.70
|
| Rate for Payer: Cash Price |
$384.70
|
| 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: Health Alliance Plan Medicare Advantage |
$390.97
|
| 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 |
$209.56
|
| Rate for Payer: Mclaren Medicare |
$390.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$410.52
|
| Rate for Payer: Meridian Medicaid |
$220.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$449.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$408.74
|
| Rate for Payer: Nomi Health Commercial |
$1,172.91
|
| Rate for Payer: PACE Medicare |
$371.42
|
| Rate for Payer: PACE SWMI |
$390.97
|
| Rate for Payer: PHP Commercial |
$408.74
|
| Rate for Payer: PHP Medicare Advantage |
$390.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,228.82
|
| Rate for Payer: Priority Health Medicare |
$390.97
|
| Rate for Payer: Priority Health Narrow Network |
$983.06
|
| Rate for Payer: Priority Health SBD |
$302.95
|
| Rate for Payer: Railroad Medicare Medicare |
$390.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.26
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$390.97
|
| Rate for Payer: UHC Exchange |
$38.42
|
| Rate for Payer: UHC Medicare Advantage |
$390.97
|
| Rate for Payer: UHCCP Medicaid |
$209.56
|
| Rate for Payer: UMR Bronson Commercial |
$177.92
|
| Rate for Payer: VA VA |
$390.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$360.65
|
|
|
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 |
$232.04
|
| 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 |
$232.04
|
|
|
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 |
$232.04
|
| 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 |
$232.04
|
|
|
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
|
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 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 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
|
OP
|
$210.29
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$77.81 |
| Max. Negotiated Rate |
$527.71 |
| Rate for Payer: Aetna American Axle |
$136.69
|
| Rate for Payer: Aetna Commercial |
$178.75
|
| Rate for Payer: Aetna Medicare |
$174.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.88
|
| Rate for Payer: BCBS Complete |
$94.49
|
| Rate for Payer: BCBS MAPPO |
$167.90
|
| Rate for Payer: BCBS Trust/PPO |
$123.67
|
| Rate for Payer: BCCCP Commercial |
$110.97
|
| Rate for Payer: BCN Commercial |
$123.67
|
| Rate for Payer: BCN Medicare Advantage |
$167.90
|
| 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 |
$167.90
|
| 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 |
$89.99
|
| Rate for Payer: Mclaren Medicare |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.30
|
| Rate for Payer: Meridian Medicaid |
$94.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.75
|
| Rate for Payer: Nomi Health Commercial |
$503.70
|
| Rate for Payer: PACE Medicare |
$159.50
|
| Rate for Payer: PACE SWMI |
$167.90
|
| Rate for Payer: PHP Commercial |
$178.75
|
| Rate for Payer: PHP Medicare Advantage |
$167.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$527.71
|
| Rate for Payer: Priority Health Medicare |
$167.90
|
| Rate for Payer: Priority Health Narrow Network |
$422.17
|
| Rate for Payer: Priority Health SBD |
$132.48
|
| Rate for Payer: Railroad Medicare Medicare |
$167.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.90
|
| Rate for Payer: UHC Exchange |
$110.33
|
| Rate for Payer: UHC Medicare Advantage |
$167.90
|
| Rate for Payer: UHCCP Medicaid |
$89.99
|
| Rate for Payer: UMR Bronson Commercial |
$77.81
|
| Rate for Payer: VA VA |
$167.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.72
|
|
|
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 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 |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| 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: Nomi Health Commercial |
$7.83
|
| 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 HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| 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
|
|
