|
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 |
$125.98 |
| Max. Negotiated Rate |
$738.70 |
| Rate for Payer: Aetna American Axle |
$437.58
|
| Rate for Payer: Aetna Commercial |
$572.22
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$186.63
|
| Rate for Payer: BCN Commercial |
$186.63
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$538.56
|
| 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 |
$235.03
|
| 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 |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$572.22
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$424.12
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$661.59
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$449.17
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: UMR Bronson Commercial |
$249.08
|
| Rate for Payer: VA VA |
$235.03
|
| 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 |
$125.98 |
| Max. Negotiated Rate |
$738.70 |
| Rate for Payer: Aetna American Axle |
$437.58
|
| Rate for Payer: Aetna Commercial |
$572.22
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$186.63
|
| Rate for Payer: BCN Commercial |
$186.63
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$538.56
|
| 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 |
$235.03
|
| 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 |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$572.22
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$424.12
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$661.59
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$449.17
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: UMR Bronson Commercial |
$249.08
|
| Rate for Payer: VA VA |
$235.03
|
| 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 |
$125.98 |
| Max. Negotiated Rate |
$738.70 |
| Rate for Payer: Aetna American Axle |
$437.58
|
| Rate for Payer: Aetna Commercial |
$572.22
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$186.63
|
| Rate for Payer: BCN Commercial |
$186.63
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$538.56
|
| 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 |
$235.03
|
| 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 |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$572.22
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$424.12
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$661.59
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$449.17
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: UMR Bronson Commercial |
$249.08
|
| Rate for Payer: VA VA |
$235.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$504.90
|
|
|
HC UNLISTED PROCEDURE HUMERUS ELBOW
|
Facility
|
IP
|
$673.20
|
|
|
Service Code
|
CPT 24999
|
| Hospital Charge Code |
76100409
|
|
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 MUSCULOSKELETAL SYSTEM GENERAL
|
Facility
|
IP
|
$673.20
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
76100421
|
|
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 MUSCULOSKELETAL SYSTEM GENERAL
|
Facility
|
OP
|
$673.20
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
76100421
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$738.70 |
| Rate for Payer: Aetna American Axle |
$437.58
|
| Rate for Payer: Aetna Commercial |
$572.22
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$186.63
|
| Rate for Payer: BCN Commercial |
$186.63
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$538.56
|
| 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 |
$235.03
|
| 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 |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.22
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$572.22
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$424.12
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$661.59
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$449.17
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: UMR Bronson Commercial |
$249.08
|
| Rate for Payer: VA VA |
$235.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$504.90
|
|
|
HC UNLISTED PROCEDURE NERVOUS SYSTEM 64999
|
Facility
|
IP
|
$726.66
|
|
|
Service Code
|
CPT 64999
|
| Hospital Charge Code |
36100437
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$319.73 |
| Max. Negotiated Rate |
$653.99 |
| Rate for Payer: Aetna American Axle |
$472.33
|
| Rate for Payer: Aetna Commercial |
$617.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$472.33
|
| Rate for Payer: Cash Price |
$581.33
|
| Rate for Payer: Cofinity Commercial |
$508.66
|
| Rate for Payer: Cofinity Commercial |
$624.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$508.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$581.33
|
| Rate for Payer: Healthscope Commercial |
$653.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$508.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$545.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$617.66
|
| Rate for Payer: PHP Commercial |
$617.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.33
|
| Rate for Payer: Priority Health SBD |
$457.80
|
| Rate for Payer: UMR Bronson Commercial |
$319.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$545.00
|
|
|
HC UNLISTED PROCEDURE NERVOUS SYSTEM 64999
|
Facility
|
OP
|
$726.66
|
|
|
Service Code
|
CPT 64999
|
| Hospital Charge Code |
36100437
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.02 |
| Max. Negotiated Rate |
$909.03 |
| Rate for Payer: Aetna American Axle |
$472.33
|
| Rate for Payer: Aetna Commercial |
$617.66
|
| Rate for Payer: Aetna Medicare |
$300.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$472.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.52
|
| Rate for Payer: BCBS Complete |
$162.77
|
| Rate for Payer: BCBS MAPPO |
$289.22
|
| Rate for Payer: BCBS Trust/PPO |
$215.74
|
| Rate for Payer: BCN Commercial |
$215.74
|
| Rate for Payer: BCN Medicare Advantage |
$289.22
|
| Rate for Payer: Cash Price |
$581.33
|
| Rate for Payer: Cash Price |
$581.33
|
| Rate for Payer: Cash Price |
$581.33
|
| Rate for Payer: Cofinity Commercial |
$624.93
|
| Rate for Payer: Cofinity Commercial |
$508.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$508.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$581.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.22
|
| Rate for Payer: Healthscope Commercial |
$653.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$508.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$545.00
|
| Rate for Payer: Mclaren Medicaid |
$155.02
|
| Rate for Payer: Mclaren Medicare |
$289.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.68
|
| Rate for Payer: Meridian Medicaid |
$162.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$617.66
|
| Rate for Payer: Nomi Health Commercial |
$607.36
|
| Rate for Payer: PACE Medicare |
$274.76
|
| Rate for Payer: PACE SWMI |
$289.22
|
| Rate for Payer: PHP Commercial |
$617.66
|
| Rate for Payer: PHP Medicare Advantage |
$289.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$472.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.03
|
| Rate for Payer: Priority Health Medicare |
$289.22
|
| Rate for Payer: Priority Health Narrow Network |
$727.22
|
| Rate for Payer: Priority Health SBD |
$457.80
|
| Rate for Payer: Railroad Medicare Medicare |
$289.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$814.13
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$289.22
|
| Rate for Payer: UHC Exchange |
$552.73
|
| Rate for Payer: UHC Medicare Advantage |
$289.22
|
| Rate for Payer: UHCCP Medicaid |
$155.02
|
| Rate for Payer: UMR Bronson Commercial |
$268.86
|
| Rate for Payer: VA VA |
$289.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$545.00
|
|
|
HC UNLISTED PROCEDURE NOSE
|
Facility
|
OP
|
$663.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
76100453
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.95 |
| Max. Negotiated Rate |
$715.11 |
| Rate for Payer: Aetna American Axle |
$430.95
|
| Rate for Payer: Aetna Commercial |
$563.55
|
| Rate for Payer: Aetna Medicare |
$236.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$284.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$284.40
|
| Rate for Payer: BCBS Complete |
$128.05
|
| Rate for Payer: BCBS MAPPO |
$227.52
|
| Rate for Payer: BCBS Trust/PPO |
$165.40
|
| Rate for Payer: BCN Commercial |
$165.40
|
| Rate for Payer: BCN Medicare Advantage |
$227.52
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$570.18
|
| Rate for Payer: Cofinity Commercial |
$464.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$464.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.52
|
| Rate for Payer: Healthscope Commercial |
$596.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$464.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$497.25
|
| Rate for Payer: Mclaren Medicaid |
$121.95
|
| Rate for Payer: Mclaren Medicare |
$227.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.90
|
| Rate for Payer: Meridian Medicaid |
$128.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.55
|
| Rate for Payer: Nomi Health Commercial |
$477.79
|
| Rate for Payer: PACE Medicare |
$216.14
|
| Rate for Payer: PACE SWMI |
$227.52
|
| Rate for Payer: PHP Commercial |
$563.55
|
| Rate for Payer: PHP Medicare Advantage |
$227.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$715.11
|
| Rate for Payer: Priority Health Medicare |
$227.52
|
| Rate for Payer: Priority Health Narrow Network |
$572.09
|
| Rate for Payer: Priority Health SBD |
$417.69
|
| Rate for Payer: Railroad Medicare Medicare |
$227.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$640.45
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.52
|
| Rate for Payer: UHC Exchange |
$434.81
|
| Rate for Payer: UHC Medicare Advantage |
$227.52
|
| Rate for Payer: UHCCP Medicaid |
$121.95
|
| Rate for Payer: UMR Bronson Commercial |
$245.31
|
| Rate for Payer: VA VA |
$227.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$497.25
|
|
|
HC UNLISTED PROCEDURE NOSE
|
Facility
|
IP
|
$663.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
76100453
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$291.72 |
| Max. Negotiated Rate |
$596.70 |
| Rate for Payer: Aetna American Axle |
$430.95
|
| Rate for Payer: Aetna Commercial |
$563.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$430.95
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cofinity Commercial |
$464.10
|
| Rate for Payer: Cofinity Commercial |
$570.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$464.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.40
|
| Rate for Payer: Healthscope Commercial |
$596.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$464.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$497.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.55
|
| Rate for Payer: PHP Commercial |
$563.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$430.95
|
| Rate for Payer: Priority Health SBD |
$417.69
|
| Rate for Payer: UMR Bronson Commercial |
$291.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$497.25
|
|
|
HC UNLISTED PROCEDURE SPINE
|
Facility
|
IP
|
$2,904.37
|
|
|
Service Code
|
CPT 22899
|
| Hospital Charge Code |
36100036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,277.92 |
| Max. Negotiated Rate |
$2,613.93 |
| Rate for Payer: Aetna American Axle |
$1,887.84
|
| Rate for Payer: Aetna Commercial |
$2,468.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,887.84
|
| Rate for Payer: Cash Price |
$2,323.50
|
| Rate for Payer: Cofinity Commercial |
$2,033.06
|
| Rate for Payer: Cofinity Commercial |
$2,497.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,033.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,323.50
|
| Rate for Payer: Healthscope Commercial |
$2,613.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,033.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,178.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,468.71
|
| Rate for Payer: PHP Commercial |
$2,468.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,887.84
|
| Rate for Payer: Priority Health SBD |
$1,829.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,277.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,178.28
|
|
|
HC UNLISTED PROCEDURE SPINE
|
Facility
|
OP
|
$2,904.37
|
|
|
Service Code
|
CPT 22899
|
| Hospital Charge Code |
36100036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$2,613.93 |
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: Aetna American Axle |
$1,887.84
|
| Rate for Payer: Aetna Commercial |
$2,468.71
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,887.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$186.63
|
| Rate for Payer: BCN Commercial |
$186.63
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$2,323.50
|
| Rate for Payer: Cash Price |
$2,323.50
|
| Rate for Payer: Cash Price |
$2,323.50
|
| Rate for Payer: Cofinity Commercial |
$2,497.76
|
| Rate for Payer: Cofinity Commercial |
$2,033.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,033.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,323.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$2,613.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,033.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,178.28
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,468.71
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$2,468.71
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,887.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$1,829.75
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$661.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$449.17
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,074.62
|
| Rate for Payer: VA VA |
$235.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,178.28
|
|
|
HC UNLISTED PROC HAND OR FINGER
|
Facility
|
IP
|
$456.97
|
|
|
Service Code
|
CPT 26989
|
| Hospital Charge Code |
36100518
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$201.07 |
| Max. Negotiated Rate |
$411.27 |
| Rate for Payer: Aetna American Axle |
$297.03
|
| Rate for Payer: Aetna Commercial |
$388.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$297.03
|
| Rate for Payer: Cash Price |
$365.58
|
| Rate for Payer: Cofinity Commercial |
$319.88
|
| Rate for Payer: Cofinity Commercial |
$392.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$319.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.58
|
| Rate for Payer: Healthscope Commercial |
$411.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$319.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$342.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.42
|
| Rate for Payer: PHP Commercial |
$388.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.03
|
| Rate for Payer: Priority Health SBD |
$287.89
|
| Rate for Payer: UMR Bronson Commercial |
$201.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$342.73
|
|
|
HC UNLISTED PROC HAND OR FINGER
|
Facility
|
OP
|
$456.97
|
|
|
Service Code
|
CPT 26989
|
| Hospital Charge Code |
36100518
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$738.70 |
| Rate for Payer: Aetna American Axle |
$297.03
|
| Rate for Payer: Aetna Commercial |
$388.42
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$297.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$186.63
|
| Rate for Payer: BCN Commercial |
$186.63
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$365.58
|
| Rate for Payer: Cash Price |
$365.58
|
| Rate for Payer: Cash Price |
$365.58
|
| Rate for Payer: Cofinity Commercial |
$392.99
|
| Rate for Payer: Cofinity Commercial |
$319.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$319.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$411.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$319.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$342.73
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.42
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$388.42
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$287.89
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$661.59
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$449.17
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: UMR Bronson Commercial |
$169.08
|
| Rate for Payer: VA VA |
$235.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$342.73
|
|
|
HC UNNA BOOT
|
Facility
|
IP
|
$367.26
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
42000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$161.59 |
| Max. Negotiated Rate |
$330.53 |
| Rate for Payer: Aetna American Axle |
$238.72
|
| Rate for Payer: Aetna Commercial |
$312.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.72
|
| Rate for Payer: Cash Price |
$293.81
|
| Rate for Payer: Cofinity Commercial |
$257.08
|
| Rate for Payer: Cofinity Commercial |
$315.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$257.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.81
|
| Rate for Payer: Healthscope Commercial |
$330.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$257.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$275.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$312.17
|
| Rate for Payer: PHP Commercial |
$312.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.72
|
| Rate for Payer: Priority Health SBD |
$231.37
|
| Rate for Payer: UMR Bronson Commercial |
$161.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$275.44
|
|
|
HC UNNA BOOT
|
Facility
|
OP
|
$367.26
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
42000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$25.47 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$238.72
|
| Rate for Payer: Aetna Commercial |
$312.17
|
| Rate for Payer: Aetna Medicare |
$160.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.25
|
| Rate for Payer: BCBS Complete |
$87.01
|
| Rate for Payer: BCBS MAPPO |
$154.60
|
| Rate for Payer: BCBS Trust/PPO |
$163.48
|
| Rate for Payer: BCN Commercial |
$163.48
|
| Rate for Payer: BCN Medicare Advantage |
$154.60
|
| Rate for Payer: Cash Price |
$293.81
|
| Rate for Payer: Cash Price |
$293.81
|
| Rate for Payer: Cash Price |
$293.81
|
| Rate for Payer: Cofinity Commercial |
$315.84
|
| Rate for Payer: Cofinity Commercial |
$257.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$257.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.60
|
| Rate for Payer: Healthscope Commercial |
$330.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$257.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$275.44
|
| Rate for Payer: Mclaren Medicaid |
$82.87
|
| Rate for Payer: Mclaren Medicare |
$154.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.33
|
| Rate for Payer: Meridian Medicaid |
$87.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$312.17
|
| Rate for Payer: Nomi Health Commercial |
$324.66
|
| Rate for Payer: PACE Medicare |
$146.87
|
| Rate for Payer: PACE SWMI |
$154.60
|
| Rate for Payer: PHP Commercial |
$312.17
|
| Rate for Payer: PHP Medicare Advantage |
$154.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$485.91
|
| Rate for Payer: Priority Health Medicare |
$154.60
|
| Rate for Payer: Priority Health Narrow Network |
$388.73
|
| Rate for Payer: Priority Health SBD |
$231.37
|
| Rate for Payer: Railroad Medicare Medicare |
$154.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.02
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.60
|
| Rate for Payer: UHC Exchange |
$25.47
|
| Rate for Payer: UHC Medicare Advantage |
$154.60
|
| Rate for Payer: UHCCP Medicaid |
$82.87
|
| Rate for Payer: UMR Bronson Commercial |
$135.89
|
| Rate for Payer: VA VA |
$154.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$275.44
|
|
|
HC UPGRADE PACEMAKER
|
Facility
|
OP
|
$9,022.12
|
|
|
Service Code
|
CPT 33214
|
| Hospital Charge Code |
36100063
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$458.20 |
| Max. Negotiated Rate |
$32,227.28 |
| Rate for Payer: Aetna American Axle |
$5,864.38
|
| Rate for Payer: Aetna Commercial |
$7,668.80
|
| Rate for Payer: Aetna Medicare |
$10,663.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,864.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,817.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,817.15
|
| Rate for Payer: BCBS Complete |
$5,770.79
|
| Rate for Payer: BCBS MAPPO |
$10,253.72
|
| Rate for Payer: BCBS Trust/PPO |
$13,771.95
|
| Rate for Payer: BCN Commercial |
$13,771.95
|
| Rate for Payer: BCN Medicare Advantage |
$10,253.72
|
| Rate for Payer: Cash Price |
$7,217.70
|
| Rate for Payer: Cash Price |
$7,217.70
|
| Rate for Payer: Cash Price |
$7,217.70
|
| Rate for Payer: Cofinity Commercial |
$7,759.02
|
| Rate for Payer: Cofinity Commercial |
$6,315.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,315.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,217.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,253.72
|
| Rate for Payer: Healthscope Commercial |
$8,119.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,315.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,766.59
|
| Rate for Payer: Mclaren Medicaid |
$5,495.99
|
| Rate for Payer: Mclaren Medicare |
$10,253.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,766.41
|
| Rate for Payer: Meridian Medicaid |
$5,770.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,791.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,668.80
|
| Rate for Payer: Nomi Health Commercial |
$21,532.81
|
| Rate for Payer: PACE Medicare |
$9,741.03
|
| Rate for Payer: PACE SWMI |
$10,253.72
|
| Rate for Payer: PHP Commercial |
$7,668.80
|
| Rate for Payer: PHP Medicare Advantage |
$10,253.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,495.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,864.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32,227.28
|
| Rate for Payer: Priority Health Medicare |
$10,253.72
|
| Rate for Payer: Priority Health Narrow Network |
$25,781.82
|
| Rate for Payer: Priority Health SBD |
$5,683.94
|
| Rate for Payer: Railroad Medicare Medicare |
$10,253.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$504.02
|
| Rate for Payer: UHC Core |
$18,337.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,253.72
|
| Rate for Payer: UHC Exchange |
$458.20
|
| Rate for Payer: UHC Medicare Advantage |
$10,253.72
|
| Rate for Payer: UHCCP Medicaid |
$5,495.99
|
| Rate for Payer: UMR Bronson Commercial |
$3,338.18
|
| Rate for Payer: VA VA |
$10,253.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,766.59
|
|
|
HC UPGRADE PACEMAKER
|
Facility
|
IP
|
$9,022.12
|
|
|
Service Code
|
CPT 33214
|
| Hospital Charge Code |
36100063
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,969.73 |
| Max. Negotiated Rate |
$8,119.91 |
| Rate for Payer: Aetna American Axle |
$5,864.38
|
| Rate for Payer: Aetna Commercial |
$7,668.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,864.38
|
| Rate for Payer: Cash Price |
$7,217.70
|
| Rate for Payer: Cofinity Commercial |
$6,315.48
|
| Rate for Payer: Cofinity Commercial |
$7,759.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,315.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,217.70
|
| Rate for Payer: Healthscope Commercial |
$8,119.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,315.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,766.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,668.80
|
| Rate for Payer: PHP Commercial |
$7,668.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,864.38
|
| Rate for Payer: Priority Health SBD |
$5,683.94
|
| Rate for Payer: UMR Bronson Commercial |
$3,969.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,766.59
|
|
|
HC UPGRADE TO BI-V PACEMAKER/ICD
|
Facility
|
IP
|
$4,647.80
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
36100069
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,045.03 |
| Max. Negotiated Rate |
$4,183.02 |
| Rate for Payer: Aetna American Axle |
$3,021.07
|
| Rate for Payer: Aetna Commercial |
$3,950.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,021.07
|
| Rate for Payer: Cash Price |
$3,718.24
|
| Rate for Payer: Cofinity Commercial |
$3,253.46
|
| Rate for Payer: Cofinity Commercial |
$3,997.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,253.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,718.24
|
| Rate for Payer: Healthscope Commercial |
$4,183.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,253.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,485.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,950.63
|
| Rate for Payer: PHP Commercial |
$3,950.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,021.07
|
| Rate for Payer: Priority Health SBD |
$2,928.11
|
| Rate for Payer: UMR Bronson Commercial |
$2,045.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,485.85
|
|
|
HC UPGRADE TO BI-V PACEMAKER/ICD
|
Facility
|
OP
|
$4,647.80
|
|
|
Service Code
|
CPT 33224
|
| Hospital Charge Code |
36100069
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$491.08 |
| Max. Negotiated Rate |
$32,227.28 |
| Rate for Payer: Aetna American Axle |
$3,021.07
|
| Rate for Payer: Aetna Commercial |
$3,950.63
|
| Rate for Payer: Aetna Medicare |
$10,663.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,021.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,817.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,817.15
|
| Rate for Payer: BCBS Complete |
$5,770.79
|
| Rate for Payer: BCBS MAPPO |
$10,253.72
|
| Rate for Payer: BCBS Trust/PPO |
$18,344.78
|
| Rate for Payer: BCN Commercial |
$18,344.78
|
| Rate for Payer: BCN Medicare Advantage |
$10,253.72
|
| Rate for Payer: Cash Price |
$3,718.24
|
| Rate for Payer: Cash Price |
$3,718.24
|
| Rate for Payer: Cash Price |
$3,718.24
|
| Rate for Payer: Cofinity Commercial |
$3,997.11
|
| Rate for Payer: Cofinity Commercial |
$3,253.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,253.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,718.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,253.72
|
| Rate for Payer: Healthscope Commercial |
$4,183.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,253.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,485.85
|
| Rate for Payer: Mclaren Medicaid |
$5,495.99
|
| Rate for Payer: Mclaren Medicare |
$10,253.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,766.41
|
| Rate for Payer: Meridian Medicaid |
$5,770.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,791.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,950.63
|
| Rate for Payer: Nomi Health Commercial |
$21,532.81
|
| Rate for Payer: PACE Medicare |
$9,741.03
|
| Rate for Payer: PACE SWMI |
$10,253.72
|
| Rate for Payer: PHP Commercial |
$3,950.63
|
| Rate for Payer: PHP Medicare Advantage |
$10,253.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,495.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,021.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32,227.28
|
| Rate for Payer: Priority Health Medicare |
$10,253.72
|
| Rate for Payer: Priority Health Narrow Network |
$25,781.82
|
| Rate for Payer: Priority Health SBD |
$2,928.11
|
| Rate for Payer: Railroad Medicare Medicare |
$10,253.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$540.19
|
| Rate for Payer: UHC Core |
$18,337.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,253.72
|
| Rate for Payer: UHC Exchange |
$491.08
|
| Rate for Payer: UHC Medicare Advantage |
$10,253.72
|
| Rate for Payer: UHCCP Medicaid |
$5,495.99
|
| Rate for Payer: UMR Bronson Commercial |
$1,719.69
|
| Rate for Payer: VA VA |
$10,253.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,485.85
|
|
|
HC UREA NITROGEN BUN
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
30100450
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.16 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna American Axle |
$13.53
|
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: UMR Bronson Commercial |
$9.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC UREA NITROGEN BUN
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
30100450
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna American Axle |
$13.53
|
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$4.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.94
|
| Rate for Payer: BCBS Complete |
$2.22
|
| Rate for Payer: BCBS MAPPO |
$3.95
|
| Rate for Payer: BCN Medicare Advantage |
$3.95
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.95
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$2.12
|
| Rate for Payer: Mclaren Medicare |
$3.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.15
|
| Rate for Payer: Meridian Medicaid |
$2.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$5.92
|
| Rate for Payer: PACE Medicare |
$3.75
|
| Rate for Payer: PACE SWMI |
$3.95
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$3.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.95
|
| Rate for Payer: Priority Health Medicare |
$3.95
|
| Rate for Payer: Priority Health Narrow Network |
$3.16
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: Railroad Medicare Medicare |
$3.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.95
|
| Rate for Payer: UHC Exchange |
$3.95
|
| Rate for Payer: UHC Medicare Advantage |
$3.95
|
| Rate for Payer: UHCCP Medicaid |
$2.12
|
| Rate for Payer: UMR Bronson Commercial |
$7.70
|
| Rate for Payer: VA VA |
$3.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC UREA NITROGEN BUN URINE
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 84540
|
| Hospital Charge Code |
30100451
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.98 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna American Axle |
$25.63
|
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna Medicare |
$5.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.95
|
| Rate for Payer: BCBS Complete |
$3.13
|
| Rate for Payer: BCBS MAPPO |
$5.56
|
| Rate for Payer: BCBS Trust/PPO |
$5.36
|
| Rate for Payer: BCN Commercial |
$5.36
|
| Rate for Payer: BCN Medicare Advantage |
$5.56
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Cofinity Commercial |
$27.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.56
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Mclaren Medicaid |
$2.98
|
| Rate for Payer: Mclaren Medicare |
$5.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.84
|
| Rate for Payer: Meridian Medicaid |
$3.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$8.34
|
| Rate for Payer: PACE Medicare |
$5.28
|
| Rate for Payer: PACE SWMI |
$5.56
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: PHP Medicare Advantage |
$5.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.56
|
| Rate for Payer: Priority Health Medicare |
$5.56
|
| Rate for Payer: Priority Health Narrow Network |
$4.45
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: Railroad Medicare Medicare |
$5.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.56
|
| Rate for Payer: UHC Exchange |
$5.56
|
| Rate for Payer: UHC Medicare Advantage |
$5.56
|
| Rate for Payer: UHCCP Medicaid |
$2.98
|
| Rate for Payer: UMR Bronson Commercial |
$14.59
|
| Rate for Payer: VA VA |
$5.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC UREA NITROGEN BUN URINE
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 84540
|
| Hospital Charge Code |
30100451
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.35 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna American Axle |
$25.63
|
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.63
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: UMR Bronson Commercial |
$17.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
