|
HC XR URETHROGRAM RETROGRADE
|
Facility
|
IP
|
$576.94
|
|
|
Service Code
|
CPT 74450
|
| Hospital Charge Code |
32000165
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$253.85 |
| Max. Negotiated Rate |
$519.25 |
| Rate for Payer: Aetna American Axle |
$375.01
|
| Rate for Payer: Aetna Commercial |
$490.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.01
|
| Rate for Payer: Cash Price |
$461.55
|
| Rate for Payer: Cofinity Advantage |
$403.86
|
| Rate for Payer: Cofinity Commercial |
$496.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.55
|
| Rate for Payer: Healthscope Commercial |
$519.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$403.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$432.70
|
| Rate for Payer: PHP Commercial |
$490.40
|
| Rate for Payer: Priority Health SBD |
$363.47
|
| Rate for Payer: UMR Bronson Commercial |
$253.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.70
|
|
|
HC XR URETHROGRAM RETROGRADE
|
Facility
|
OP
|
$576.94
|
|
|
Service Code
|
CPT 74450
|
| Hospital Charge Code |
32000165
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$768.83 |
| Rate for Payer: Aetna American Axle |
$375.01
|
| Rate for Payer: Aetna Commercial |
$490.40
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$372.56
|
| Rate for Payer: BCN Commercial |
$372.56
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$461.55
|
| Rate for Payer: Cash Price |
$461.55
|
| Rate for Payer: Cofinity Advantage |
$403.86
|
| Rate for Payer: Cofinity Commercial |
$496.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$519.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$403.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.70
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$490.40
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$432.70
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$490.40
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$363.47
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.01
|
| Rate for Payer: UHC Core |
$300.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$226.74
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: UMR Bronson Commercial |
$213.47
|
| Rate for Payer: VA VA |
$237.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.70
|
|
|
HC XR UROGRAPHY INF
|
Facility
|
IP
|
$808.74
|
|
|
Service Code
|
CPT 74410
|
| Hospital Charge Code |
32000293
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$355.85 |
| Max. Negotiated Rate |
$727.87 |
| Rate for Payer: Aetna American Axle |
$525.68
|
| Rate for Payer: Aetna Commercial |
$687.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$525.68
|
| Rate for Payer: Cash Price |
$646.99
|
| Rate for Payer: Cofinity Advantage |
$566.12
|
| Rate for Payer: Cofinity Commercial |
$695.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$646.99
|
| Rate for Payer: Healthscope Commercial |
$727.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$566.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$606.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$687.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$606.55
|
| Rate for Payer: PHP Commercial |
$687.43
|
| Rate for Payer: Priority Health SBD |
$509.51
|
| Rate for Payer: UMR Bronson Commercial |
$355.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$606.55
|
|
|
HC XR UROGRAPHY INF
|
Facility
|
OP
|
$808.74
|
|
|
Service Code
|
CPT 74410
|
| Hospital Charge Code |
32000293
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$727.87 |
| Rate for Payer: Aetna American Axle |
$525.68
|
| Rate for Payer: Aetna Commercial |
$687.43
|
| Rate for Payer: Aetna Medicare |
$181.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$525.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$285.66
|
| Rate for Payer: BCN Commercial |
$285.66
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$646.99
|
| Rate for Payer: Cash Price |
$646.99
|
| Rate for Payer: Cofinity Advantage |
$566.12
|
| Rate for Payer: Cofinity Commercial |
$695.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$646.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$727.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$566.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$606.55
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$687.43
|
| Rate for Payer: Nomi Health Commercial |
$524.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$606.55
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$687.43
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$565.19
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health SBD |
$509.51
|
| Rate for Payer: Priority Health Tiered Network |
$452.15
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$525.68
|
| Rate for Payer: UHC Core |
$421.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$317.83
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: UMR Bronson Commercial |
$299.23
|
| Rate for Payer: VA VA |
$174.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$606.55
|
|
|
HC XR WRIST 2 VW
|
Facility
|
IP
|
$260.57
|
|
|
Service Code
|
CPT 73100
|
| Hospital Charge Code |
32000080
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$114.65 |
| Max. Negotiated Rate |
$234.51 |
| Rate for Payer: Aetna American Axle |
$169.37
|
| Rate for Payer: Aetna Commercial |
$221.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.37
|
| Rate for Payer: Cash Price |
$208.46
|
| Rate for Payer: Cofinity Advantage |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$224.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.46
|
| Rate for Payer: Healthscope Commercial |
$234.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.43
|
| Rate for Payer: PHP Commercial |
$221.48
|
| Rate for Payer: Priority Health SBD |
$164.16
|
| Rate for Payer: UMR Bronson Commercial |
$114.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.43
|
|
|
HC XR WRIST 2 VW
|
Facility
|
OP
|
$260.57
|
|
|
Service Code
|
CPT 73100
|
| Hospital Charge Code |
32000080
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$280.42 |
| Rate for Payer: Aetna American Axle |
$169.37
|
| Rate for Payer: Aetna Commercial |
$221.48
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$63.21
|
| Rate for Payer: BCN Commercial |
$63.21
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$208.46
|
| Rate for Payer: Cash Price |
$208.46
|
| Rate for Payer: Cofinity Advantage |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$224.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$234.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.43
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.48
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.43
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$221.48
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$164.16
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.37
|
| Rate for Payer: UHC Core |
$135.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$102.40
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$96.41
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.43
|
|
|
HC XR WRIST BIL 2 VW
|
Facility
|
OP
|
$297.68
|
|
|
Service Code
|
CPT 73100
|
| Hospital Charge Code |
32000081
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$280.42 |
| Rate for Payer: Aetna American Axle |
$193.49
|
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$63.21
|
| Rate for Payer: BCN Commercial |
$63.21
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Advantage |
$208.38
|
| Rate for Payer: Cofinity Commercial |
$256.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$267.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.26
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$253.03
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$187.54
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.49
|
| Rate for Payer: UHC Core |
$155.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$116.99
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$110.14
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.26
|
|
|
HC XR WRIST BIL 2 VW
|
Facility
|
IP
|
$297.68
|
|
|
Service Code
|
CPT 73100
|
| Hospital Charge Code |
32000081
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$130.98 |
| Max. Negotiated Rate |
$267.91 |
| Rate for Payer: Aetna American Axle |
$193.49
|
| Rate for Payer: Aetna Commercial |
$253.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$193.49
|
| Rate for Payer: Cash Price |
$238.14
|
| Rate for Payer: Cofinity Advantage |
$208.38
|
| Rate for Payer: Cofinity Commercial |
$256.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.14
|
| Rate for Payer: Healthscope Commercial |
$267.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$208.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.26
|
| Rate for Payer: PHP Commercial |
$253.03
|
| Rate for Payer: Priority Health SBD |
$187.54
|
| Rate for Payer: UMR Bronson Commercial |
$130.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.26
|
|
|
HC XR WRIST BIL MIN 3 VW
|
Facility
|
IP
|
$460.68
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000083
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$202.70 |
| Max. Negotiated Rate |
$414.61 |
| Rate for Payer: Aetna American Axle |
$299.44
|
| Rate for Payer: Aetna Commercial |
$391.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.44
|
| Rate for Payer: Cash Price |
$368.54
|
| Rate for Payer: Cofinity Advantage |
$322.48
|
| Rate for Payer: Cofinity Commercial |
$396.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.54
|
| Rate for Payer: Healthscope Commercial |
$414.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$322.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.51
|
| Rate for Payer: PHP Commercial |
$391.58
|
| Rate for Payer: Priority Health SBD |
$290.23
|
| Rate for Payer: UMR Bronson Commercial |
$202.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.51
|
|
|
HC XR WRIST BIL MIN 3 VW
|
Facility
|
OP
|
$460.68
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000083
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$414.61 |
| Rate for Payer: Aetna American Axle |
$299.44
|
| Rate for Payer: Aetna Commercial |
$391.58
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$81.27
|
| Rate for Payer: BCN Commercial |
$81.27
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$368.54
|
| Rate for Payer: Cash Price |
$368.54
|
| Rate for Payer: Cofinity Advantage |
$322.48
|
| Rate for Payer: Cofinity Commercial |
$396.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$414.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$322.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.51
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.58
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.51
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$391.58
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$290.23
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.44
|
| Rate for Payer: UHC Core |
$240.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$181.05
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$170.45
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.51
|
|
|
HC XR WRIST MIN 3 VW
|
Facility
|
OP
|
$416.36
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000082
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna American Axle |
$270.63
|
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCBS Trust/PPO |
$81.27
|
| Rate for Payer: BCN Commercial |
$81.27
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Advantage |
$291.45
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$262.31
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.63
|
| Rate for Payer: UHC Core |
$216.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$163.63
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$154.05
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC XR WRIST MIN 3 VW
|
Facility
|
IP
|
$416.36
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000082
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$183.20 |
| Max. Negotiated Rate |
$374.72 |
| Rate for Payer: Aetna American Axle |
$270.63
|
| Rate for Payer: Aetna Commercial |
$353.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.63
|
| Rate for Payer: Cash Price |
$333.09
|
| Rate for Payer: Cofinity Advantage |
$291.45
|
| Rate for Payer: Cofinity Commercial |
$358.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.09
|
| Rate for Payer: Healthscope Commercial |
$374.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.27
|
| Rate for Payer: PHP Commercial |
$353.91
|
| Rate for Payer: Priority Health SBD |
$262.31
|
| Rate for Payer: UMR Bronson Commercial |
$183.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.27
|
|
|
HC XTRASORB 6X9 EACH
|
Facility
|
IP
|
$16.59
|
|
| Hospital Charge Code |
27200293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.30 |
| Max. Negotiated Rate |
$14.93 |
| Rate for Payer: Aetna American Axle |
$10.78
|
| Rate for Payer: Aetna Commercial |
$14.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.78
|
| Rate for Payer: Cash Price |
$13.27
|
| Rate for Payer: Cofinity Advantage |
$11.61
|
| Rate for Payer: Cofinity Commercial |
$14.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$14.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.44
|
| Rate for Payer: PHP Commercial |
$14.10
|
| Rate for Payer: Priority Health SBD |
$10.45
|
| Rate for Payer: UMR Bronson Commercial |
$7.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.44
|
|
|
HC XTRASORB 6X9 EACH
|
Facility
|
OP
|
$16.59
|
|
| Hospital Charge Code |
27200293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.14 |
| Max. Negotiated Rate |
$14.93 |
| Rate for Payer: Aetna American Axle |
$10.78
|
| Rate for Payer: Aetna Commercial |
$14.10
|
| Rate for Payer: Aetna Medicare |
$8.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.78
|
| Rate for Payer: BCBS Complete |
$6.64
|
| Rate for Payer: Cash Price |
$13.27
|
| Rate for Payer: Cofinity Advantage |
$11.61
|
| Rate for Payer: Cofinity Commercial |
$14.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$14.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.44
|
| Rate for Payer: PHP Commercial |
$14.10
|
| Rate for Payer: Priority Health SBD |
$10.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.78
|
| Rate for Payer: UHC Core |
$8.64
|
| Rate for Payer: UHC Exchange |
$6.52
|
| Rate for Payer: UMR Bronson Commercial |
$6.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.44
|
|
|
HC Y ADAPTER WITH VENT
|
Facility
|
OP
|
$54.65
|
|
| Hospital Charge Code |
27006702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.22 |
| Max. Negotiated Rate |
$49.19 |
| Rate for Payer: Aetna American Axle |
$35.52
|
| Rate for Payer: Aetna Commercial |
$46.45
|
| Rate for Payer: Aetna Medicare |
$27.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.52
|
| Rate for Payer: BCBS Complete |
$21.86
|
| Rate for Payer: Cash Price |
$43.72
|
| Rate for Payer: Cofinity Advantage |
$38.26
|
| Rate for Payer: Cofinity Commercial |
$47.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.72
|
| Rate for Payer: Healthscope Commercial |
$49.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.99
|
| Rate for Payer: PHP Commercial |
$46.45
|
| Rate for Payer: Priority Health SBD |
$34.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.52
|
| Rate for Payer: UHC Core |
$28.47
|
| Rate for Payer: UHC Exchange |
$21.48
|
| Rate for Payer: UMR Bronson Commercial |
$20.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.99
|
|
|
HC Y ADAPTER WITH VENT
|
Facility
|
IP
|
$54.65
|
|
| Hospital Charge Code |
27006702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.05 |
| Max. Negotiated Rate |
$49.19 |
| Rate for Payer: Aetna American Axle |
$35.52
|
| Rate for Payer: Aetna Commercial |
$46.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.52
|
| Rate for Payer: Cash Price |
$43.72
|
| Rate for Payer: Cofinity Advantage |
$38.26
|
| Rate for Payer: Cofinity Commercial |
$47.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.72
|
| Rate for Payer: Healthscope Commercial |
$49.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.99
|
| Rate for Payer: PHP Commercial |
$46.45
|
| Rate for Payer: Priority Health SBD |
$34.43
|
| Rate for Payer: UMR Bronson Commercial |
$24.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.99
|
|
|
HC YEAST BREWERS IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200111
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC YEAST BREWERS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200111
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC YELLOW DOCK IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200112
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC YELLOW DOCK IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200112
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC YELLOW HORNET IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200113
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC YELLOW HORNET IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200113
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC YELLOW JACKET IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200114
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC YELLOW JACKET IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200114
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC Y SET ANTE/RETRO
|
Facility
|
OP
|
$42.92
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.88 |
| Max. Negotiated Rate |
$38.63 |
| Rate for Payer: Aetna American Axle |
$27.90
|
| Rate for Payer: Aetna Commercial |
$36.48
|
| Rate for Payer: Aetna Medicare |
$21.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.90
|
| Rate for Payer: BCBS Complete |
$17.17
|
| Rate for Payer: Cash Price |
$34.34
|
| Rate for Payer: Cofinity Advantage |
$30.04
|
| Rate for Payer: Cofinity Commercial |
$36.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.34
|
| Rate for Payer: Healthscope Commercial |
$38.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.19
|
| Rate for Payer: PHP Commercial |
$36.48
|
| Rate for Payer: Priority Health SBD |
$27.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.90
|
| Rate for Payer: UHC Core |
$22.36
|
| Rate for Payer: UHC Exchange |
$16.87
|
| Rate for Payer: UMR Bronson Commercial |
$15.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.19
|
|
