|
HC UA DIPSTICK AUTO
|
Facility
|
OP
|
$21.22
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
30700002
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.21 |
| Max. Negotiated Rate |
$25.38 |
| Rate for Payer: UHC Dual Complete DSNP |
$2.25
|
| Rate for Payer: Aetna American Axle |
$13.79
|
| Rate for Payer: Aetna Commercial |
$18.04
|
| Rate for Payer: Aetna Medicare |
$2.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.81
|
| Rate for Payer: BCBS Complete |
$1.27
|
| Rate for Payer: BCBS MAPPO |
$2.25
|
| Rate for Payer: BCBS Trust/PPO |
$2.17
|
| Rate for Payer: BCN Commercial |
$2.17
|
| Rate for Payer: BCN Medicare Advantage |
$2.25
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.25
|
| Rate for Payer: Cofinity Commercial |
$14.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.25
|
| Rate for Payer: Healthscope Commercial |
$19.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$1.21
|
| Rate for Payer: Mclaren Medicare |
$2.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.36
|
| Rate for Payer: Meridian Medicaid |
$1.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.04
|
| Rate for Payer: Nomi Health Commercial |
$3.38
|
| Rate for Payer: PACE Medicare |
$2.14
|
| Rate for Payer: PACE SWMI |
$2.25
|
| Rate for Payer: PHP Commercial |
$18.04
|
| Rate for Payer: PHP Medicare Advantage |
$2.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.31
|
| Rate for Payer: Priority Health Medicare |
$2.25
|
| Rate for Payer: Priority Health Narrow Network |
$1.85
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Railroad Medicare Medicare |
$2.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.70
|
| Rate for Payer: UHC Core |
$25.38
|
| Rate for Payer: UHC Exchange |
$2.25
|
| Rate for Payer: UHC Medicare Advantage |
$2.25
|
| Rate for Payer: UHCCP Medicaid |
$1.21
|
| Rate for Payer: UMR Bronson Commercial |
$7.85
|
| Rate for Payer: VA VA |
$2.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC UA DIPSTICK AUTO
|
Facility
|
IP
|
$21.22
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
30700002
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$19.10 |
| Rate for Payer: Aetna American Axle |
$13.79
|
| Rate for Payer: Aetna Commercial |
$18.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.79
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$14.85
|
| Rate for Payer: Cofinity Commercial |
$18.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.04
|
| Rate for Payer: PHP Commercial |
$18.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.79
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: UMR Bronson Commercial |
$9.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC UA DIPSTICK MANUAL
|
Facility
|
IP
|
$12.48
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
30700009
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$5.49 |
| Max. Negotiated Rate |
$11.23 |
| Rate for Payer: Aetna American Axle |
$8.11
|
| Rate for Payer: Aetna Commercial |
$10.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.11
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$10.73
|
| Rate for Payer: Cofinity Commercial |
$8.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Healthscope Commercial |
$11.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.61
|
| Rate for Payer: PHP Commercial |
$10.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.11
|
| Rate for Payer: Priority Health SBD |
$7.86
|
| Rate for Payer: UMR Bronson Commercial |
$5.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.36
|
|
|
HC UA DIPSTICK MANUAL
|
Facility
|
OP
|
$12.48
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
30700009
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$25.38 |
| Rate for Payer: Aetna American Axle |
$8.11
|
| Rate for Payer: Aetna Commercial |
$10.61
|
| Rate for Payer: Aetna Medicare |
$3.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.35
|
| Rate for Payer: BCBS Complete |
$1.96
|
| Rate for Payer: BCBS MAPPO |
$3.48
|
| Rate for Payer: BCBS Trust/PPO |
$3.35
|
| Rate for Payer: BCN Commercial |
$3.35
|
| Rate for Payer: BCN Medicare Advantage |
$3.48
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$8.74
|
| Rate for Payer: Cofinity Commercial |
$10.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.48
|
| Rate for Payer: Healthscope Commercial |
$11.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.36
|
| Rate for Payer: Mclaren Medicaid |
$1.87
|
| Rate for Payer: Mclaren Medicare |
$3.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.65
|
| Rate for Payer: Meridian Medicaid |
$1.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.61
|
| Rate for Payer: Nomi Health Commercial |
$5.22
|
| Rate for Payer: PACE Medicare |
$3.31
|
| Rate for Payer: PACE SWMI |
$3.48
|
| Rate for Payer: PHP Commercial |
$10.61
|
| Rate for Payer: PHP Medicare Advantage |
$3.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.48
|
| Rate for Payer: Priority Health Medicare |
$3.48
|
| Rate for Payer: Priority Health Narrow Network |
$2.78
|
| Rate for Payer: Priority Health SBD |
$7.86
|
| Rate for Payer: Railroad Medicare Medicare |
$3.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.18
|
| Rate for Payer: UHC Core |
$25.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.48
|
| Rate for Payer: UHC Exchange |
$3.48
|
| Rate for Payer: UHC Medicare Advantage |
$3.48
|
| Rate for Payer: UHCCP Medicaid |
$1.87
|
| Rate for Payer: UMR Bronson Commercial |
$4.62
|
| Rate for Payer: VA VA |
$3.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.36
|
|
|
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 |
$42.16 |
| 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: BCBS Trust/PPO |
$2.94
|
| Rate for Payer: BCN Commercial |
$2.94
|
| 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: Nomi Health Commercial |
$4.58
|
| 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 HMO/PPO/Tiered Network |
$3.14
|
| Rate for Payer: Priority Health Medicare |
$3.05
|
| Rate for Payer: Priority Health Narrow Network |
$2.51
|
| Rate for Payer: Priority Health SBD |
$24.36
|
| Rate for Payer: Railroad Medicare Medicare |
$3.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.66
|
| Rate for Payer: UHC Core |
$42.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.05
|
| Rate for Payer: UHC Exchange |
$3.05
|
| 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
|
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 EACH 15 MIN
|
Facility
|
OP
|
$84.27
|
|
|
Service Code
|
CPT 97035
|
| Hospital Charge Code |
42000018
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$9.60 |
| 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 |
$42.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.78
|
| Rate for Payer: BCBS Complete |
$33.71
|
| Rate for Payer: BCBS Trust/PPO |
$11.35
|
| Rate for Payer: BCN Commercial |
$11.35
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cash Price |
$67.42
|
| 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: 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 HMO/PPO/Tiered Network |
$12.00
|
| Rate for Payer: Priority Health Narrow Network |
$9.60
|
| Rate for Payer: Priority Health SBD |
$53.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.55
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$13.23
|
| Rate for Payer: UMR Bronson Commercial |
$31.18
|
| 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 |
$384.13 |
| Max. Negotiated Rate |
$22,771.83 |
| Rate for Payer: Aetna American Axle |
$6,262.84
|
| Rate for Payer: Aetna Commercial |
$8,189.87
|
| Rate for Payer: Aetna Medicare |
$7,535.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,262.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,056.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,056.61
|
| Rate for Payer: BCBS Complete |
$4,077.65
|
| Rate for Payer: BCBS MAPPO |
$7,245.29
|
| Rate for Payer: BCBS Trust/PPO |
$6,243.40
|
| Rate for Payer: BCN Commercial |
$6,243.40
|
| Rate for Payer: BCN Medicare Advantage |
$7,245.29
|
| Rate for Payer: Cash Price |
$7,708.11
|
| 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 |
$7,245.29
|
| 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 |
$7,226.36
|
| Rate for Payer: Mclaren Medicaid |
$3,883.48
|
| Rate for Payer: Mclaren Medicare |
$7,245.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,607.55
|
| Rate for Payer: Meridian Medicaid |
$4,077.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,332.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,189.87
|
| Rate for Payer: Nomi Health Commercial |
$15,215.11
|
| Rate for Payer: PACE Medicare |
$6,883.03
|
| Rate for Payer: PACE SWMI |
$7,245.29
|
| Rate for Payer: PHP Commercial |
$8,189.87
|
| Rate for Payer: PHP Medicare Advantage |
$7,245.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,883.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,262.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22,771.83
|
| Rate for Payer: Priority Health Medicare |
$7,245.29
|
| Rate for Payer: Priority Health Narrow Network |
$18,217.46
|
| Rate for Payer: Priority Health SBD |
$6,070.14
|
| Rate for Payer: Railroad Medicare Medicare |
$7,245.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$422.54
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,245.29
|
| Rate for Payer: UHC Exchange |
$384.13
|
| Rate for Payer: UHC Medicare Advantage |
$7,245.29
|
| Rate for Payer: UHCCP Medicaid |
$3,883.48
|
| Rate for Payer: UMR Bronson Commercial |
$3,565.00
|
| Rate for Payer: VA VA |
$7,245.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,226.36
|
|
|
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 |
$7,226.36
|
| 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 |
$7,226.36
|
|
|
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 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: BCBS Trust/PPO |
$143.98
|
| Rate for Payer: BCN Commercial |
$143.98
|
| Rate for Payer: Cash Price |
$195.56
|
| 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 UMBILICAL ARTERY CATHETER
|
Facility
|
OP
|
$213.64
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
36100602
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$64.90 |
| Max. Negotiated Rate |
$1,879.00 |
| 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: BCBS Trust/PPO |
$269.13
|
| Rate for Payer: BCN Commercial |
$269.13
|
| Rate for Payer: Cash Price |
$170.91
|
| Rate for Payer: Cash Price |
$170.91
|
| Rate for Payer: Cash Price |
$170.91
|
| Rate for Payer: Cofinity Commercial |
$183.73
|
| Rate for Payer: Cofinity Commercial |
$149.55
|
| 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: UHC All Payor (Choice/PPO) |
$71.39
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UHC Exchange |
$64.90
|
| Rate for Payer: UMR Bronson Commercial |
$79.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.23
|
|
|
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 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 |
$50.70 |
| Max. Negotiated Rate |
$700.00 |
| 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: BCBS Trust/PPO |
$312.09
|
| Rate for Payer: BCN Commercial |
$312.09
|
| Rate for Payer: Cash Price |
$170.91
|
| Rate for Payer: Cash Price |
$170.91
|
| Rate for Payer: Cash Price |
$170.91
|
| Rate for Payer: Cofinity Commercial |
$183.73
|
| Rate for Payer: Cofinity Commercial |
$149.55
|
| 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: UHC All Payor (Choice/PPO) |
$55.77
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$50.70
|
| 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
|
IP
|
$330.35
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300007
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$145.35 |
| Max. Negotiated Rate |
$297.32 |
| 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 |
$231.24
|
| Rate for Payer: Cofinity Commercial |
$284.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$231.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.28
|
| Rate for Payer: Healthscope Commercial |
$297.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$231.24
|
| 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 SCREENING MAMM WITH CAD
|
Facility
|
OP
|
$330.35
|
|
|
Service Code
|
HCPCS 77067
|
| Hospital Charge Code |
40300007
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$80.39 |
| 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: BCBS Trust/PPO |
$189.52
|
| Rate for Payer: BCCCP Commercial |
$119.92
|
| Rate for Payer: BCN Commercial |
$189.52
|
| Rate for Payer: Cash Price |
$264.28
|
| 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 |
$231.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$231.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.28
|
| Rate for Payer: Healthscope Commercial |
$297.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$231.24
|
| 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 HMO/PPO/Tiered Network |
$100.49
|
| Rate for Payer: Priority Health Narrow Network |
$80.39
|
| Rate for Payer: Priority Health SBD |
$208.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.91
|
| Rate for Payer: UHC Core |
$332.00
|
| Rate for Payer: UHC Exchange |
$117.19
|
| Rate for Payer: UMR Bronson Commercial |
$122.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.76
|
|
|
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 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: BCBS Trust/PPO |
$53.70
|
| Rate for Payer: BCN Commercial |
$53.70
|
| 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 HMO/PPO/Tiered Network |
$95.11
|
| Rate for Payer: Priority Health Narrow Network |
$76.09
|
| 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 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 |
$292.46 |
| Max. Negotiated Rate |
$20,210.02 |
| Rate for Payer: Aetna American Axle |
$6,276.17
|
| Rate for Payer: Aetna Commercial |
$8,207.29
|
| Rate for Payer: Aetna Medicare |
$6,687.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,276.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,037.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,037.75
|
| Rate for Payer: BCBS Complete |
$3,618.92
|
| Rate for Payer: BCBS MAPPO |
$6,430.20
|
| Rate for Payer: BCBS Trust/PPO |
$8,083.44
|
| Rate for Payer: BCN Commercial |
$8,083.44
|
| Rate for Payer: BCN Medicare Advantage |
$6,430.20
|
| Rate for Payer: Cash Price |
$7,724.51
|
| 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 |
$6,430.20
|
| 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 |
$3,446.59
|
| Rate for Payer: Mclaren Medicare |
$6,430.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,751.71
|
| Rate for Payer: Meridian Medicaid |
$3,618.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,394.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,207.29
|
| Rate for Payer: Nomi Health Commercial |
$13,503.42
|
| Rate for Payer: PACE Medicare |
$6,108.69
|
| Rate for Payer: PACE SWMI |
$6,430.20
|
| Rate for Payer: PHP Commercial |
$8,207.29
|
| Rate for Payer: PHP Medicare Advantage |
$6,430.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,446.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,276.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,210.02
|
| Rate for Payer: Priority Health Medicare |
$6,430.20
|
| Rate for Payer: Priority Health Narrow Network |
$16,168.02
|
| Rate for Payer: Priority Health SBD |
$6,083.05
|
| Rate for Payer: Railroad Medicare Medicare |
$6,430.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.71
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,430.20
|
| Rate for Payer: UHC Exchange |
$292.46
|
| Rate for Payer: UHC Medicare Advantage |
$6,430.20
|
| Rate for Payer: UHCCP Medicaid |
$3,446.59
|
| Rate for Payer: UMR Bronson Commercial |
$3,572.59
|
| Rate for Payer: VA VA |
$6,430.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,241.73
|
|
|
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 UNLISTED FEMALE GENITAL SYSTEM
|
Facility
|
OP
|
$1,125.34
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
36100387
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$105.65 |
| 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 |
$204.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$246.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$246.38
|
| Rate for Payer: BCBS Complete |
$110.93
|
| Rate for Payer: BCBS MAPPO |
$197.10
|
| Rate for Payer: BCBS Trust/PPO |
$142.15
|
| Rate for Payer: BCN Commercial |
$142.15
|
| Rate for Payer: BCN Medicare Advantage |
$197.10
|
| Rate for Payer: Cash Price |
$900.27
|
| 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 |
$197.10
|
| 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 |
$105.65
|
| Rate for Payer: Mclaren Medicare |
$197.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.96
|
| Rate for Payer: Meridian Medicaid |
$110.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.54
|
| Rate for Payer: Nomi Health Commercial |
$413.91
|
| Rate for Payer: PACE Medicare |
$187.24
|
| Rate for Payer: PACE SWMI |
$197.10
|
| Rate for Payer: PHP Commercial |
$956.54
|
| Rate for Payer: PHP Medicare Advantage |
$197.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$731.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$619.50
|
| Rate for Payer: Priority Health Medicare |
$197.10
|
| Rate for Payer: Priority Health Narrow Network |
$495.60
|
| Rate for Payer: Priority Health SBD |
$708.96
|
| Rate for Payer: Railroad Medicare Medicare |
$197.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$554.82
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.10
|
| Rate for Payer: UHC Exchange |
$376.68
|
| Rate for Payer: UHC Medicare Advantage |
$197.10
|
| Rate for Payer: UHCCP Medicaid |
$105.65
|
| Rate for Payer: UMR Bronson Commercial |
$416.38
|
| Rate for Payer: VA VA |
$197.10
|
| 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
|
|
