|
HC VORICONAZOLE, S
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
CPT 80285
|
| Hospital Charge Code |
30100707
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.39 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna American Axle |
$59.67
|
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.67
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$64.26
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health SBD |
$57.83
|
| Rate for Payer: UMR Bronson Commercial |
$40.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC VULVECTOMY SIMPLE PARTIAL
|
Facility
|
OP
|
$7,945.53
|
|
|
Service Code
|
CPT 56620
|
| Hospital Charge Code |
36100618
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$564.11 |
| Max. Negotiated Rate |
$9,791.14 |
| Rate for Payer: Aetna American Axle |
$5,164.59
|
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: Aetna Medicare |
$3,239.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,164.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$3,266.78
|
| Rate for Payer: BCN Commercial |
$3,266.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Cofinity Commercial |
$5,561.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,561.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,561.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: Nomi Health Commercial |
$6,542.00
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,791.14
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$7,832.91
|
| Rate for Payer: Priority Health SBD |
$5,005.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.52
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$564.11
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: UMR Bronson Commercial |
$2,939.85
|
| Rate for Payer: VA VA |
$3,115.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC VULVECTOMY SIMPLE PARTIAL
|
Facility
|
IP
|
$7,945.53
|
|
|
Service Code
|
CPT 56620
|
| Hospital Charge Code |
36100618
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,496.03 |
| Max. Negotiated Rate |
$7,150.98 |
| Rate for Payer: Aetna American Axle |
$5,164.59
|
| Rate for Payer: Aetna Commercial |
$6,753.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,164.59
|
| Rate for Payer: Cash Price |
$6,356.42
|
| Rate for Payer: Cofinity Commercial |
$5,561.87
|
| Rate for Payer: Cofinity Commercial |
$6,833.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,561.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,356.42
|
| Rate for Payer: Healthscope Commercial |
$7,150.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,561.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,959.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,753.70
|
| Rate for Payer: PHP Commercial |
$6,753.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,164.59
|
| Rate for Payer: Priority Health SBD |
$5,005.68
|
| Rate for Payer: UMR Bronson Commercial |
$3,496.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,959.15
|
|
|
HC WALNUT IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200065
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC WALNUT IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200065
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC WALNUT TREE IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200116
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC WALNUT TREE IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200116
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC WASHED RED BLOOD CELLS
|
Facility
|
OP
|
$829.72
|
|
|
Service Code
|
HCPCS P9022
|
| Hospital Charge Code |
39000073
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$208.42 |
| Max. Negotiated Rate |
$1,222.15 |
| Rate for Payer: Aetna American Axle |
$539.32
|
| Rate for Payer: Aetna Commercial |
$705.26
|
| Rate for Payer: Aetna Medicare |
$404.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$539.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$486.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$486.06
|
| Rate for Payer: BCBS Complete |
$218.84
|
| Rate for Payer: BCBS MAPPO |
$388.85
|
| Rate for Payer: BCBS Trust/PPO |
$1,050.94
|
| Rate for Payer: BCN Commercial |
$1,050.94
|
| Rate for Payer: BCN Medicare Advantage |
$388.85
|
| Rate for Payer: Cash Price |
$663.78
|
| Rate for Payer: Cash Price |
$663.78
|
| Rate for Payer: Cash Price |
$663.78
|
| Rate for Payer: Cofinity Commercial |
$580.80
|
| Rate for Payer: Cofinity Commercial |
$713.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$580.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$663.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$388.85
|
| Rate for Payer: Healthscope Commercial |
$746.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$580.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$622.29
|
| Rate for Payer: Mclaren Medicaid |
$208.42
|
| Rate for Payer: Mclaren Medicare |
$388.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$408.29
|
| Rate for Payer: Meridian Medicaid |
$218.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$447.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$705.26
|
| Rate for Payer: Nomi Health Commercial |
$1,166.55
|
| Rate for Payer: PACE Medicare |
$369.41
|
| Rate for Payer: PACE SWMI |
$388.85
|
| Rate for Payer: PHP Commercial |
$705.26
|
| Rate for Payer: PHP Medicare Advantage |
$388.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$539.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,222.15
|
| Rate for Payer: Priority Health Medicare |
$388.85
|
| Rate for Payer: Priority Health Narrow Network |
$977.72
|
| Rate for Payer: Priority Health SBD |
$522.72
|
| Rate for Payer: Railroad Medicare Medicare |
$388.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,094.57
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$388.85
|
| Rate for Payer: UHC Exchange |
$743.13
|
| Rate for Payer: UHC Medicare Advantage |
$388.85
|
| Rate for Payer: UHCCP Medicaid |
$208.42
|
| Rate for Payer: UMR Bronson Commercial |
$307.00
|
| Rate for Payer: VA VA |
$388.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$622.29
|
|
|
HC WASHED RED BLOOD CELLS
|
Facility
|
IP
|
$829.72
|
|
|
Service Code
|
HCPCS P9022
|
| Hospital Charge Code |
39000073
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$365.08 |
| Max. Negotiated Rate |
$746.75 |
| Rate for Payer: Aetna American Axle |
$539.32
|
| Rate for Payer: Aetna Commercial |
$705.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$539.32
|
| Rate for Payer: Cash Price |
$663.78
|
| Rate for Payer: Cofinity Commercial |
$580.80
|
| Rate for Payer: Cofinity Commercial |
$713.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$580.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$663.78
|
| Rate for Payer: Healthscope Commercial |
$746.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$580.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$622.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$705.26
|
| Rate for Payer: PHP Commercial |
$705.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$539.32
|
| Rate for Payer: Priority Health SBD |
$522.72
|
| Rate for Payer: UMR Bronson Commercial |
$365.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$622.29
|
|
|
HC WATCH PAT
|
Facility
|
IP
|
$680.81
|
|
|
Service Code
|
CPT 95800
|
| Hospital Charge Code |
92000015
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$299.56 |
| Max. Negotiated Rate |
$612.73 |
| Rate for Payer: Aetna American Axle |
$442.53
|
| Rate for Payer: Aetna Commercial |
$578.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$442.53
|
| Rate for Payer: Cash Price |
$544.65
|
| Rate for Payer: Cofinity Commercial |
$476.57
|
| Rate for Payer: Cofinity Commercial |
$585.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$476.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$544.65
|
| Rate for Payer: Healthscope Commercial |
$612.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$476.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$510.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$578.69
|
| Rate for Payer: PHP Commercial |
$578.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.53
|
| Rate for Payer: Priority Health SBD |
$428.91
|
| Rate for Payer: UMR Bronson Commercial |
$299.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$510.61
|
|
|
HC WATCH PAT
|
Facility
|
OP
|
$680.81
|
|
|
Service Code
|
CPT 95800
|
| Hospital Charge Code |
92000015
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$82.17 |
| Max. Negotiated Rate |
$983.00 |
| Rate for Payer: Aetna American Axle |
$442.53
|
| Rate for Payer: Aetna Commercial |
$578.69
|
| Rate for Payer: Aetna Medicare |
$159.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$442.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$411.57
|
| Rate for Payer: BCN Commercial |
$411.57
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$544.65
|
| Rate for Payer: Cash Price |
$544.65
|
| Rate for Payer: Cash Price |
$544.65
|
| Rate for Payer: Cofinity Commercial |
$476.57
|
| Rate for Payer: Cofinity Commercial |
$585.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$476.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$544.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$612.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$476.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$510.61
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$578.69
|
| Rate for Payer: Nomi Health Commercial |
$459.90
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$578.69
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.80
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$385.44
|
| Rate for Payer: Priority Health SBD |
$428.91
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.07
|
| Rate for Payer: UHC Core |
$983.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$124.61
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: UMR Bronson Commercial |
$251.90
|
| Rate for Payer: VA VA |
$153.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$510.61
|
|
|
HC WBC BUFFY COAT
|
Facility
|
IP
|
$46.31
|
|
|
Service Code
|
CPT 85009
|
| Hospital Charge Code |
30500004
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$20.38 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna American Axle |
$30.10
|
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.10
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$32.42
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health SBD |
$29.18
|
| Rate for Payer: UMR Bronson Commercial |
$20.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.73
|
|
|
HC WBC BUFFY COAT
|
Facility
|
OP
|
$46.31
|
|
|
Service Code
|
CPT 85009
|
| Hospital Charge Code |
30500004
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.72 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna American Axle |
$30.10
|
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: Aetna Medicare |
$5.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.34
|
| Rate for Payer: BCBS Complete |
$2.85
|
| Rate for Payer: BCBS MAPPO |
$5.07
|
| Rate for Payer: BCBS Trust/PPO |
$4.88
|
| Rate for Payer: BCN Commercial |
$4.88
|
| Rate for Payer: BCN Medicare Advantage |
$5.07
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Cofinity Commercial |
$32.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.07
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.73
|
| Rate for Payer: Mclaren Medicaid |
$2.72
|
| Rate for Payer: Mclaren Medicare |
$5.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.32
|
| Rate for Payer: Meridian Medicaid |
$2.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: Nomi Health Commercial |
$7.60
|
| Rate for Payer: PACE Medicare |
$4.82
|
| Rate for Payer: PACE SWMI |
$5.07
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: PHP Medicare Advantage |
$5.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.07
|
| Rate for Payer: Priority Health Medicare |
$5.07
|
| Rate for Payer: Priority Health Narrow Network |
$4.06
|
| Rate for Payer: Priority Health SBD |
$29.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.07
|
| Rate for Payer: UHC Exchange |
$5.07
|
| Rate for Payer: UHC Medicare Advantage |
$5.07
|
| Rate for Payer: UHCCP Medicaid |
$2.72
|
| Rate for Payer: UMR Bronson Commercial |
$17.13
|
| Rate for Payer: VA VA |
$5.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.73
|
|
|
HC WBC COUNT
|
Facility
|
IP
|
$27.05
|
|
|
Service Code
|
CPT 85048
|
| Hospital Charge Code |
30500011
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.90 |
| Max. Negotiated Rate |
$24.34 |
| Rate for Payer: Aetna American Axle |
$17.58
|
| Rate for Payer: Aetna Commercial |
$22.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.58
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cofinity Commercial |
$18.94
|
| Rate for Payer: Cofinity Commercial |
$23.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.64
|
| Rate for Payer: Healthscope Commercial |
$24.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.99
|
| Rate for Payer: PHP Commercial |
$22.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.58
|
| Rate for Payer: Priority Health SBD |
$17.04
|
| Rate for Payer: UMR Bronson Commercial |
$11.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.29
|
|
|
HC WBC COUNT
|
Facility
|
OP
|
$27.05
|
|
|
Service Code
|
CPT 85048
|
| Hospital Charge Code |
30500011
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$24.34 |
| Rate for Payer: Aetna American Axle |
$17.58
|
| Rate for Payer: Aetna Commercial |
$22.99
|
| Rate for Payer: Aetna Medicare |
$2.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.18
|
| Rate for Payer: BCBS Complete |
$1.43
|
| Rate for Payer: BCBS MAPPO |
$2.54
|
| Rate for Payer: BCBS Trust/PPO |
$2.45
|
| Rate for Payer: BCN Commercial |
$2.45
|
| Rate for Payer: BCN Medicare Advantage |
$2.54
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cash Price |
$21.64
|
| Rate for Payer: Cofinity Commercial |
$23.26
|
| Rate for Payer: Cofinity Commercial |
$18.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.54
|
| Rate for Payer: Healthscope Commercial |
$24.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.29
|
| Rate for Payer: Mclaren Medicaid |
$1.36
|
| Rate for Payer: Mclaren Medicare |
$2.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.67
|
| Rate for Payer: Meridian Medicaid |
$1.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.99
|
| Rate for Payer: Nomi Health Commercial |
$3.81
|
| Rate for Payer: PACE Medicare |
$2.41
|
| Rate for Payer: PACE SWMI |
$2.54
|
| Rate for Payer: PHP Commercial |
$22.99
|
| Rate for Payer: PHP Medicare Advantage |
$2.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.61
|
| Rate for Payer: Priority Health Medicare |
$2.54
|
| Rate for Payer: Priority Health Narrow Network |
$2.09
|
| Rate for Payer: Priority Health SBD |
$17.04
|
| Rate for Payer: Railroad Medicare Medicare |
$2.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.54
|
| Rate for Payer: UHC Exchange |
$2.54
|
| Rate for Payer: UHC Medicare Advantage |
$2.54
|
| Rate for Payer: UHCCP Medicaid |
$1.36
|
| Rate for Payer: UMR Bronson Commercial |
$10.01
|
| Rate for Payer: VA VA |
$2.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.29
|
|
|
HC WC EVAL JOB SITE ANALYSIS EACH 30 MIN
|
Facility
|
IP
|
$220.22
|
|
| Hospital Charge Code |
42000045
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$96.90 |
| Max. Negotiated Rate |
$198.20 |
| Rate for Payer: Aetna American Axle |
$143.14
|
| Rate for Payer: Aetna Commercial |
$187.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.14
|
| Rate for Payer: Cash Price |
$176.18
|
| Rate for Payer: Cofinity Commercial |
$154.15
|
| Rate for Payer: Cofinity Commercial |
$189.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$154.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.18
|
| Rate for Payer: Healthscope Commercial |
$198.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.19
|
| Rate for Payer: PHP Commercial |
$187.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.14
|
| Rate for Payer: Priority Health SBD |
$138.74
|
| Rate for Payer: UMR Bronson Commercial |
$96.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.16
|
|
|
HC WC EVAL JOB SITE ANALYSIS EACH 30 MIN
|
Facility
|
OP
|
$220.22
|
|
| Hospital Charge Code |
42000045
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$81.48 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$143.14
|
| Rate for Payer: Aetna Commercial |
$187.19
|
| Rate for Payer: Aetna Medicare |
$110.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.14
|
| Rate for Payer: BCBS Complete |
$88.09
|
| Rate for Payer: Cash Price |
$176.18
|
| Rate for Payer: Cash Price |
$176.18
|
| Rate for Payer: Cofinity Commercial |
$189.39
|
| Rate for Payer: Cofinity Commercial |
$154.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$154.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$176.18
|
| Rate for Payer: Healthscope Commercial |
$198.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$154.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$165.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.19
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$187.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.14
|
| Rate for Payer: Priority Health SBD |
$138.74
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$81.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$165.16
|
|
|
HC WC EVAL JOB SITE ANALYSIS FIRST 60 MIN
|
Facility
|
IP
|
$298.86
|
|
| Hospital Charge Code |
42000044
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$131.50 |
| Max. Negotiated Rate |
$268.97 |
| Rate for Payer: Aetna American Axle |
$194.26
|
| Rate for Payer: Aetna Commercial |
$254.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.26
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$209.20
|
| Rate for Payer: Cofinity Commercial |
$257.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$209.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Healthscope Commercial |
$268.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$209.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.03
|
| Rate for Payer: PHP Commercial |
$254.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.26
|
| Rate for Payer: Priority Health SBD |
$188.28
|
| Rate for Payer: UMR Bronson Commercial |
$131.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.14
|
|
|
HC WC EVAL JOB SITE ANALYSIS FIRST 60 MIN
|
Facility
|
OP
|
$298.86
|
|
| Hospital Charge Code |
42000044
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$110.58 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$194.26
|
| Rate for Payer: Aetna Commercial |
$254.03
|
| Rate for Payer: Aetna Medicare |
$149.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.26
|
| Rate for Payer: BCBS Complete |
$119.54
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$257.02
|
| Rate for Payer: Cofinity Commercial |
$209.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$209.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Healthscope Commercial |
$268.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$209.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.03
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$254.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.26
|
| Rate for Payer: Priority Health SBD |
$188.28
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$110.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.14
|
|
|
HC WC UNLISTED BREAST PROCEDURE
|
Facility
|
OP
|
$2,225.11
|
|
|
Service Code
|
CPT 19499
|
| Hospital Charge Code |
36100321
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$823.29 |
| Max. Negotiated Rate |
$11,792.02 |
| Rate for Payer: Aetna American Axle |
$1,446.32
|
| Rate for Payer: Aetna Commercial |
$1,891.34
|
| Rate for Payer: Aetna Medicare |
$3,901.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,446.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,689.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,689.81
|
| Rate for Payer: BCBS Complete |
$2,111.54
|
| Rate for Payer: BCBS MAPPO |
$3,751.85
|
| Rate for Payer: BCBS Trust/PPO |
$2,334.49
|
| Rate for Payer: BCN Commercial |
$2,334.49
|
| Rate for Payer: BCN Medicare Advantage |
$3,751.85
|
| Rate for Payer: Cash Price |
$1,780.09
|
| Rate for Payer: Cash Price |
$1,780.09
|
| Rate for Payer: Cash Price |
$1,780.09
|
| Rate for Payer: Cofinity Commercial |
$1,913.59
|
| Rate for Payer: Cofinity Commercial |
$1,557.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,557.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,780.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,751.85
|
| Rate for Payer: Healthscope Commercial |
$2,002.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,557.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,668.83
|
| Rate for Payer: Mclaren Medicaid |
$2,010.99
|
| Rate for Payer: Mclaren Medicare |
$3,751.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,939.44
|
| Rate for Payer: Meridian Medicaid |
$2,111.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,314.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,891.34
|
| Rate for Payer: Nomi Health Commercial |
$7,878.88
|
| Rate for Payer: PACE Medicare |
$3,564.26
|
| Rate for Payer: PACE SWMI |
$3,751.85
|
| Rate for Payer: PHP Commercial |
$1,891.34
|
| Rate for Payer: PHP Medicare Advantage |
$3,751.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,010.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,446.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11,792.02
|
| Rate for Payer: Priority Health Medicare |
$3,751.85
|
| Rate for Payer: Priority Health Narrow Network |
$9,433.62
|
| Rate for Payer: Priority Health SBD |
$1,401.82
|
| Rate for Payer: Railroad Medicare Medicare |
$3,751.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,561.08
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,751.85
|
| Rate for Payer: UHC Exchange |
$7,170.16
|
| Rate for Payer: UHC Medicare Advantage |
$3,751.85
|
| Rate for Payer: UHCCP Medicaid |
$2,010.99
|
| Rate for Payer: UMR Bronson Commercial |
$823.29
|
| Rate for Payer: VA VA |
$3,751.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,668.83
|
|
|
HC WC UNLISTED BREAST PROCEDURE
|
Facility
|
IP
|
$2,225.11
|
|
|
Service Code
|
CPT 19499
|
| Hospital Charge Code |
36100321
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$979.05 |
| Max. Negotiated Rate |
$2,002.60 |
| Rate for Payer: Aetna American Axle |
$1,446.32
|
| Rate for Payer: Aetna Commercial |
$1,891.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,446.32
|
| Rate for Payer: Cash Price |
$1,780.09
|
| Rate for Payer: Cofinity Commercial |
$1,557.58
|
| Rate for Payer: Cofinity Commercial |
$1,913.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,557.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,780.09
|
| Rate for Payer: Healthscope Commercial |
$2,002.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,557.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,668.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,891.34
|
| Rate for Payer: PHP Commercial |
$1,891.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,446.32
|
| Rate for Payer: Priority Health SBD |
$1,401.82
|
| Rate for Payer: UMR Bronson Commercial |
$979.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,668.83
|
|
|
HC WEDGE EXCISION SKIN NAIL FOLD
|
Facility
|
IP
|
$575.70
|
|
|
Service Code
|
CPT 11765
|
| Hospital Charge Code |
76100313
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$253.31 |
| Max. Negotiated Rate |
$518.13 |
| Rate for Payer: Aetna American Axle |
$374.20
|
| Rate for Payer: Aetna Commercial |
$489.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.20
|
| Rate for Payer: Cash Price |
$460.56
|
| Rate for Payer: Cofinity Commercial |
$402.99
|
| Rate for Payer: Cofinity Commercial |
$495.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$402.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$460.56
|
| Rate for Payer: Healthscope Commercial |
$518.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$402.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$431.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.34
|
| Rate for Payer: PHP Commercial |
$489.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.20
|
| Rate for Payer: Priority Health SBD |
$362.69
|
| Rate for Payer: UMR Bronson Commercial |
$253.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$431.78
|
|
|
HC WEDGE EXCISION SKIN NAIL FOLD
|
Facility
|
OP
|
$575.70
|
|
|
Service Code
|
CPT 11765
|
| Hospital Charge Code |
76100313
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$87.94 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna American Axle |
$374.20
|
| Rate for Payer: Aetna Commercial |
$489.34
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$418.44
|
| Rate for Payer: BCN Commercial |
$418.44
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$460.56
|
| Rate for Payer: Cash Price |
$460.56
|
| Rate for Payer: Cash Price |
$460.56
|
| Rate for Payer: Cofinity Commercial |
$402.99
|
| Rate for Payer: Cofinity Commercial |
$495.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$402.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$460.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$518.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$402.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$431.78
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.34
|
| Rate for Payer: Nomi Health Commercial |
$1,174.35
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$489.34
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$362.69
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.73
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Exchange |
$87.94
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$209.82
|
| Rate for Payer: UMR Bronson Commercial |
$213.01
|
| Rate for Payer: VA VA |
$391.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$431.78
|
|
|
HC WEST NILE VIRUS AB IGG & IGM
|
Facility
|
IP
|
$32.25
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200329
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.19 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna American Axle |
$20.96
|
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.96
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$22.58
|
| Rate for Payer: Cofinity Commercial |
$27.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.96
|
| Rate for Payer: Priority Health SBD |
$20.32
|
| Rate for Payer: UMR Bronson Commercial |
$14.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.19
|
|
|
HC WEST NILE VIRUS AB IGG & IGM
|
Facility
|
OP
|
$32.25
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200329
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna American Axle |
$20.96
|
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna Medicare |
$17.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCBS Trust/PPO |
$16.24
|
| Rate for Payer: BCN Commercial |
$16.24
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$27.74
|
| Rate for Payer: Cofinity Commercial |
$22.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.19
|
| Rate for Payer: Mclaren Medicaid |
$9.03
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: Meridian Medicaid |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Nomi Health Commercial |
$25.28
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.85
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health Narrow Network |
$13.48
|
| Rate for Payer: Priority Health SBD |
$20.32
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.85
|
| Rate for Payer: UHC Exchange |
$16.85
|
| Rate for Payer: UHC Medicare Advantage |
$16.85
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: UMR Bronson Commercial |
$11.93
|
| Rate for Payer: VA VA |
$16.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.19
|
|
