|
HC XEOMIN PER 1 UNIT (INCOBOTULINUMTOXINA)
|
Facility
|
IP
|
$6.94
|
|
|
Service Code
|
HCPCS J0588
|
| Hospital Charge Code |
63600149
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.05 |
| Max. Negotiated Rate |
$6.25 |
| Rate for Payer: Aetna American Axle |
$4.51
|
| Rate for Payer: Aetna Commercial |
$5.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.51
|
| Rate for Payer: Cash Price |
$5.55
|
| Rate for Payer: Cofinity Commercial |
$4.86
|
| Rate for Payer: Cofinity Commercial |
$5.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$4.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.55
|
| Rate for Payer: Healthscope Commercial |
$6.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.90
|
| Rate for Payer: PHP Commercial |
$5.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.51
|
| Rate for Payer: Priority Health SBD |
$4.37
|
| Rate for Payer: UMR Bronson Commercial |
$3.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.20
|
|
|
HC XEOMIN PER 1 UNIT (INCOBOTULINUMTOXINA)
|
Facility
|
OP
|
$6.94
|
|
|
Service Code
|
HCPCS J0588
|
| Hospital Charge Code |
63600149
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$15.93 |
| Rate for Payer: Aetna American Axle |
$4.51
|
| Rate for Payer: Aetna Commercial |
$5.90
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.64
|
| Rate for Payer: BCBS Complete |
$2.99
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$14.37
|
| Rate for Payer: BCN Commercial |
$14.37
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$5.55
|
| Rate for Payer: Cash Price |
$5.55
|
| Rate for Payer: Cofinity Commercial |
$5.97
|
| Rate for Payer: Cofinity Commercial |
$4.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$4.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$6.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.20
|
| Rate for Payer: Mclaren Medicaid |
$2.85
|
| Rate for Payer: Mclaren Medicare |
$5.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.58
|
| Rate for Payer: Meridian Medicaid |
$2.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.90
|
| Rate for Payer: Nomi Health Commercial |
$15.93
|
| Rate for Payer: PACE Medicare |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$5.90
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.37
|
| Rate for Payer: Priority Health Medicare |
$5.31
|
| Rate for Payer: Priority Health Narrow Network |
$12.30
|
| Rate for Payer: Priority Health SBD |
$4.37
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.31
|
| Rate for Payer: UHC Exchange |
$10.15
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHCCP Medicaid |
$2.85
|
| Rate for Payer: UMR Bronson Commercial |
$2.57
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.20
|
|
|
HC XPRESS-WAY CATHETER
|
Facility
|
IP
|
$1,412.71
|
|
| Hospital Charge Code |
27200226
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$621.59 |
| Max. Negotiated Rate |
$1,271.44 |
| Rate for Payer: Aetna American Axle |
$918.26
|
| Rate for Payer: Aetna Commercial |
$1,200.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.26
|
| Rate for Payer: Cash Price |
$1,130.17
|
| Rate for Payer: Cofinity Commercial |
$1,214.93
|
| Rate for Payer: Cofinity Commercial |
$988.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$988.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.17
|
| Rate for Payer: Healthscope Commercial |
$1,271.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$988.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,059.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.80
|
| Rate for Payer: PHP Commercial |
$1,200.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.26
|
| Rate for Payer: Priority Health SBD |
$890.01
|
| Rate for Payer: UMR Bronson Commercial |
$621.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,059.53
|
|
|
HC XPRESS-WAY CATHETER
|
Facility
|
OP
|
$1,412.71
|
|
| Hospital Charge Code |
27200226
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$522.70 |
| Max. Negotiated Rate |
$1,271.44 |
| Rate for Payer: Aetna American Axle |
$918.26
|
| Rate for Payer: Aetna Commercial |
$1,200.80
|
| Rate for Payer: Aetna Medicare |
$706.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.26
|
| Rate for Payer: BCBS Complete |
$565.08
|
| Rate for Payer: Cash Price |
$1,130.17
|
| Rate for Payer: Cofinity Commercial |
$1,214.93
|
| Rate for Payer: Cofinity Commercial |
$988.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$988.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.17
|
| Rate for Payer: Healthscope Commercial |
$1,271.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$988.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,059.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.80
|
| Rate for Payer: PHP Commercial |
$1,200.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.26
|
| Rate for Payer: Priority Health SBD |
$890.01
|
| Rate for Payer: UMR Bronson Commercial |
$522.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,059.53
|
|
|
HC XR ABDOMEN 1 VIEW
|
Facility
|
IP
|
$305.88
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
32000325
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$134.59 |
| Max. Negotiated Rate |
$275.29 |
| Rate for Payer: Aetna American Axle |
$198.82
|
| Rate for Payer: Aetna Commercial |
$260.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.82
|
| Rate for Payer: Cash Price |
$244.70
|
| Rate for Payer: Cofinity Commercial |
$214.12
|
| Rate for Payer: Cofinity Commercial |
$263.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$214.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.70
|
| Rate for Payer: Healthscope Commercial |
$275.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.00
|
| Rate for Payer: PHP Commercial |
$260.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.82
|
| Rate for Payer: Priority Health SBD |
$192.70
|
| Rate for Payer: UMR Bronson Commercial |
$134.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.41
|
|
|
HC XR ABDOMEN 1 VIEW
|
Facility
|
OP
|
$305.88
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
32000325
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$27.84 |
| Max. Negotiated Rate |
$275.29 |
| Rate for Payer: Aetna American Axle |
$198.82
|
| Rate for Payer: Aetna Commercial |
$260.00
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$44.47
|
| Rate for Payer: BCN Commercial |
$44.47
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$244.70
|
| Rate for Payer: Cash Price |
$244.70
|
| Rate for Payer: Cofinity Commercial |
$263.06
|
| Rate for Payer: Cofinity Commercial |
$214.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$214.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$275.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.41
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.00
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$260.00
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$192.70
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.62
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$27.84
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$113.18
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.41
|
|
|
HC XR ABDOMEN 2 VW
|
Facility
|
IP
|
$338.65
|
|
|
Service Code
|
CPT 74019
|
| Hospital Charge Code |
32000326
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$149.01 |
| Max. Negotiated Rate |
$304.78 |
| Rate for Payer: Aetna American Axle |
$220.12
|
| Rate for Payer: Aetna Commercial |
$287.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.12
|
| Rate for Payer: Cash Price |
$270.92
|
| Rate for Payer: Cofinity Commercial |
$237.06
|
| Rate for Payer: Cofinity Commercial |
$291.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$237.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.92
|
| Rate for Payer: Healthscope Commercial |
$304.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$237.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.85
|
| Rate for Payer: PHP Commercial |
$287.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.12
|
| Rate for Payer: Priority Health SBD |
$213.35
|
| Rate for Payer: UMR Bronson Commercial |
$149.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.99
|
|
|
HC XR ABDOMEN 2 VW
|
Facility
|
OP
|
$338.65
|
|
|
Service Code
|
CPT 74019
|
| Hospital Charge Code |
32000326
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$33.65 |
| Max. Negotiated Rate |
$327.48 |
| Rate for Payer: Aetna American Axle |
$220.12
|
| Rate for Payer: Aetna Commercial |
$287.85
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$53.36
|
| Rate for Payer: BCN Commercial |
$53.36
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$270.92
|
| Rate for Payer: Cash Price |
$270.92
|
| Rate for Payer: Cofinity Commercial |
$291.24
|
| Rate for Payer: Cofinity Commercial |
$237.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$237.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$304.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$237.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.99
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.85
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$287.85
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$213.35
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.02
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$33.65
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$125.30
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.99
|
|
|
HC XR ABDOMEN 3 OR MORE VIEWS
|
Facility
|
OP
|
$371.42
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
32000327
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$39.44 |
| Max. Negotiated Rate |
$334.28 |
| Rate for Payer: Aetna American Axle |
$241.42
|
| Rate for Payer: Aetna Commercial |
$315.71
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$62.26
|
| Rate for Payer: BCN Commercial |
$62.26
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$297.14
|
| Rate for Payer: Cash Price |
$297.14
|
| Rate for Payer: Cofinity Commercial |
$319.42
|
| Rate for Payer: Cofinity Commercial |
$259.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$259.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$334.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$259.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$278.56
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$315.71
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$315.71
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$233.99
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.38
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$39.44
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$137.43
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$278.56
|
|
|
HC XR ABDOMEN 3 OR MORE VIEWS
|
Facility
|
IP
|
$371.42
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
32000327
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$163.42 |
| Max. Negotiated Rate |
$334.28 |
| Rate for Payer: Aetna American Axle |
$241.42
|
| Rate for Payer: Aetna Commercial |
$315.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.42
|
| Rate for Payer: Cash Price |
$297.14
|
| Rate for Payer: Cofinity Commercial |
$259.99
|
| Rate for Payer: Cofinity Commercial |
$319.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$259.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.14
|
| Rate for Payer: Healthscope Commercial |
$334.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$259.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$278.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$315.71
|
| Rate for Payer: PHP Commercial |
$315.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.42
|
| Rate for Payer: Priority Health SBD |
$233.99
|
| Rate for Payer: UMR Bronson Commercial |
$163.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$278.56
|
|
|
HC XR ABDOMEN ACUTE
|
Facility
|
OP
|
$490.40
|
|
|
Service Code
|
CPT 74022
|
| Hospital Charge Code |
32000135
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.93 |
| Max. Negotiated Rate |
$441.36 |
| Rate for Payer: Aetna American Axle |
$318.76
|
| Rate for Payer: Aetna Commercial |
$416.84
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$71.83
|
| Rate for Payer: BCN Commercial |
$71.83
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$392.32
|
| Rate for Payer: Cash Price |
$392.32
|
| Rate for Payer: Cofinity Commercial |
$421.74
|
| Rate for Payer: Cofinity Commercial |
$343.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$343.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$441.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$343.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.80
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.84
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$416.84
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$308.95
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.52
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$45.93
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$181.45
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.80
|
|
|
HC XR ABDOMEN ACUTE
|
Facility
|
IP
|
$490.40
|
|
|
Service Code
|
CPT 74022
|
| Hospital Charge Code |
32000135
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$215.78 |
| Max. Negotiated Rate |
$441.36 |
| Rate for Payer: Aetna American Axle |
$318.76
|
| Rate for Payer: Aetna Commercial |
$416.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.76
|
| Rate for Payer: Cash Price |
$392.32
|
| Rate for Payer: Cofinity Commercial |
$343.28
|
| Rate for Payer: Cofinity Commercial |
$421.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$343.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.32
|
| Rate for Payer: Healthscope Commercial |
$441.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$343.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.84
|
| Rate for Payer: PHP Commercial |
$416.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.76
|
| Rate for Payer: Priority Health SBD |
$308.95
|
| Rate for Payer: UMR Bronson Commercial |
$215.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.80
|
|
|
HC XR AC JOINTS
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 73050
|
| Hospital Charge Code |
32000068
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$26.65 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Aetna American Axle |
$232.30
|
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$41.06
|
| Rate for Payer: BCN Commercial |
$41.06
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Cofinity Commercial |
$250.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$250.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$225.15
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.32
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$26.65
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$132.23
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC XR AC JOINTS
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 73050
|
| Hospital Charge Code |
32000068
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$157.25 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Cofinity Commercial |
$250.17
|
| Rate for Payer: Aetna American Axle |
$232.30
|
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.30
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$250.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health SBD |
$225.15
|
| Rate for Payer: UMR Bronson Commercial |
$157.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC XR ANKLE 1 VW
|
Facility
|
OP
|
$243.21
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000118
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$29.57 |
| Max. Negotiated Rate |
$271.13 |
| Rate for Payer: Aetna American Axle |
$158.09
|
| Rate for Payer: Aetna Commercial |
$206.73
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$50.63
|
| Rate for Payer: BCN Commercial |
$50.63
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$194.57
|
| Rate for Payer: Cash Price |
$194.57
|
| Rate for Payer: Cofinity Commercial |
$209.16
|
| Rate for Payer: Cofinity Commercial |
$170.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$170.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$218.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.41
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.73
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$206.73
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$153.22
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.53
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$29.57
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$89.99
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.41
|
|
|
HC XR ANKLE 1 VW
|
Facility
|
IP
|
$243.21
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000118
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$107.01 |
| Max. Negotiated Rate |
$218.89 |
| Rate for Payer: Aetna American Axle |
$158.09
|
| Rate for Payer: Aetna Commercial |
$206.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.09
|
| Rate for Payer: Cash Price |
$194.57
|
| Rate for Payer: Cofinity Commercial |
$170.25
|
| Rate for Payer: Cofinity Commercial |
$209.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$170.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.57
|
| Rate for Payer: Healthscope Commercial |
$218.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.73
|
| Rate for Payer: PHP Commercial |
$206.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.09
|
| Rate for Payer: Priority Health SBD |
$153.22
|
| Rate for Payer: UMR Bronson Commercial |
$107.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.41
|
|
|
HC XR ANKLE 2 VIEWS
|
Facility
|
OP
|
$255.46
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000117
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$29.57 |
| Max. Negotiated Rate |
$271.13 |
| Rate for Payer: Aetna American Axle |
$166.05
|
| Rate for Payer: Aetna Commercial |
$217.14
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$50.63
|
| Rate for Payer: BCN Commercial |
$50.63
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$204.37
|
| Rate for Payer: Cash Price |
$204.37
|
| Rate for Payer: Cofinity Commercial |
$219.70
|
| Rate for Payer: Cofinity Commercial |
$178.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$178.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$229.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.60
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.14
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$217.14
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$160.94
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.53
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$29.57
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$94.52
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.60
|
|
|
HC XR ANKLE 2 VIEWS
|
Facility
|
IP
|
$255.46
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000117
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$112.40 |
| Max. Negotiated Rate |
$229.91 |
| Rate for Payer: Aetna American Axle |
$166.05
|
| Rate for Payer: Aetna Commercial |
$217.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.05
|
| Rate for Payer: Cash Price |
$204.37
|
| Rate for Payer: Cofinity Commercial |
$178.82
|
| Rate for Payer: Cofinity Commercial |
$219.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$178.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.37
|
| Rate for Payer: Healthscope Commercial |
$229.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.14
|
| Rate for Payer: PHP Commercial |
$217.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.05
|
| Rate for Payer: Priority Health SBD |
$160.94
|
| Rate for Payer: UMR Bronson Commercial |
$112.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.60
|
|
|
HC XR ANKLE 2 VIEWS BILATERAL
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000339
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$109.96 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna American Axle |
$162.44
|
| Rate for Payer: Aetna Commercial |
$212.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.44
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$174.93
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$174.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.42
|
| Rate for Payer: PHP Commercial |
$212.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health SBD |
$157.44
|
| Rate for Payer: UMR Bronson Commercial |
$109.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
|
HC XR ANKLE 2 VIEWS BILATERAL
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000339
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$29.57 |
| Max. Negotiated Rate |
$271.13 |
| Rate for Payer: Aetna American Axle |
$162.44
|
| Rate for Payer: Aetna Commercial |
$212.42
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$50.63
|
| Rate for Payer: BCN Commercial |
$50.63
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Cofinity Commercial |
$174.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$174.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.42
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$212.42
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$157.44
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.53
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$29.57
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$92.46
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
|
HC XR ANKLE BIL 2 VW
|
Facility
|
IP
|
$291.84
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000120
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$128.41 |
| Max. Negotiated Rate |
$262.66 |
| Rate for Payer: Aetna American Axle |
$189.70
|
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.70
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$204.29
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$204.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health SBD |
$183.86
|
| Rate for Payer: UMR Bronson Commercial |
$128.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
|
HC XR ANKLE BIL 2 VW
|
Facility
|
OP
|
$291.84
|
|
|
Service Code
|
CPT 73600
|
| Hospital Charge Code |
32000120
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$29.57 |
| Max. Negotiated Rate |
$271.13 |
| Rate for Payer: Aetna American Axle |
$189.70
|
| Rate for Payer: Aetna Commercial |
$248.06
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$50.63
|
| Rate for Payer: BCN Commercial |
$50.63
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cash Price |
$233.47
|
| Rate for Payer: Cofinity Commercial |
$250.98
|
| Rate for Payer: Cofinity Commercial |
$204.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$204.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$262.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.88
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.06
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$248.06
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$183.86
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.53
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$29.57
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$107.98
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.88
|
|
|
HC XR ANKLE BIL MIN 3 VW
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000122
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$33.48 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna American Axle |
$252.66
|
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$58.15
|
| Rate for Payer: BCN Commercial |
$58.15
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Cofinity Commercial |
$272.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$272.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$244.89
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.83
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$33.48
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$143.82
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC XR ANKLE BIL MIN 3 VW
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000122
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$171.03 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna American Axle |
$252.66
|
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$272.10
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$272.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health SBD |
$244.89
|
| Rate for Payer: UMR Bronson Commercial |
$171.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC XR ANKLE MIN 3 VIEWS
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 73610
|
| Hospital Charge Code |
32000121
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$33.48 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: Aetna American Axle |
$232.30
|
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$58.15
|
| Rate for Payer: BCN Commercial |
$58.15
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Cofinity Commercial |
$250.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$250.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$225.15
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.83
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Exchange |
$33.48
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$132.23
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
