|
HC XR KNEE 4 VIEWS
|
Facility
|
OP
|
$408.20
|
|
|
Service Code
|
CPT 73564
|
| Hospital Charge Code |
32000108
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$367.38 |
| Rate for Payer: Aetna American Axle |
$265.33
|
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Cofinity Commercial |
$285.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$257.17
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$151.03
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC XR KNEE 4 VIEWS
|
Facility
|
IP
|
$408.20
|
|
|
Service Code
|
CPT 73564
|
| Hospital Charge Code |
32000108
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$179.61 |
| Max. Negotiated Rate |
$367.38 |
| Rate for Payer: Aetna American Axle |
$265.33
|
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.33
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$285.74
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health SBD |
$257.17
|
| Rate for Payer: UMR Bronson Commercial |
$179.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC XR KNEE BIL 1 OR 2 VW
|
Facility
|
IP
|
$340.34
|
|
|
Service Code
|
CPT 73560
|
| Hospital Charge Code |
32000105
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$149.75 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna American Axle |
$221.22
|
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.22
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$238.24
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$238.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health SBD |
$214.41
|
| Rate for Payer: UMR Bronson Commercial |
$149.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.25
|
|
|
HC XR KNEE BIL 1 OR 2 VW
|
Facility
|
OP
|
$340.34
|
|
|
Service Code
|
CPT 73560
|
| Hospital Charge Code |
32000105
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$306.31 |
| Rate for Payer: Aetna American Axle |
$221.22
|
| Rate for Payer: Aetna Commercial |
$289.29
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cash Price |
$272.27
|
| Rate for Payer: Cofinity Commercial |
$292.69
|
| Rate for Payer: Cofinity Commercial |
$238.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$238.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$306.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.25
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.29
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$289.29
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.22
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$214.41
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$125.93
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.25
|
|
|
HC XR KNEE BIL 4 VW
|
Facility
|
OP
|
$437.63
|
|
|
Service Code
|
CPT 73564
|
| Hospital Charge Code |
32000109
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna American Axle |
$284.46
|
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Cofinity Commercial |
$306.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$306.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$306.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$275.71
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$161.92
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC XR KNEE BIL 4 VW
|
Facility
|
IP
|
$437.63
|
|
|
Service Code
|
CPT 73564
|
| Hospital Charge Code |
32000109
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$192.56 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna American Axle |
$284.46
|
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.46
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$306.34
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$306.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$306.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health SBD |
$275.71
|
| Rate for Payer: UMR Bronson Commercial |
$192.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC XR KNEES STANDING AP
|
Facility
|
OP
|
$408.20
|
|
|
Service Code
|
CPT 73565
|
| Hospital Charge Code |
32000110
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$367.38 |
| Rate for Payer: Aetna American Axle |
$265.33
|
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Cofinity Commercial |
$285.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$257.17
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$151.03
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC XR KNEES STANDING AP
|
Facility
|
IP
|
$408.20
|
|
|
Service Code
|
CPT 73565
|
| Hospital Charge Code |
32000110
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$179.61 |
| Max. Negotiated Rate |
$367.38 |
| Rate for Payer: Aetna American Axle |
$265.33
|
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.33
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$285.74
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health SBD |
$257.17
|
| Rate for Payer: UMR Bronson Commercial |
$179.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC XR MANDIBLE LESS THAN 4 VW
|
Facility
|
IP
|
$244.99
|
|
|
Service Code
|
CPT 70100
|
| Hospital Charge Code |
32000005
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$107.80 |
| Max. Negotiated Rate |
$220.49 |
| Rate for Payer: Aetna American Axle |
$159.24
|
| Rate for Payer: Aetna Commercial |
$208.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.24
|
| Rate for Payer: Cash Price |
$195.99
|
| Rate for Payer: Cofinity Commercial |
$171.49
|
| Rate for Payer: Cofinity Commercial |
$210.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.99
|
| Rate for Payer: Healthscope Commercial |
$220.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.24
|
| Rate for Payer: PHP Commercial |
$208.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.24
|
| Rate for Payer: Priority Health SBD |
$154.34
|
| Rate for Payer: UMR Bronson Commercial |
$107.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.74
|
|
|
HC XR MANDIBLE LESS THAN 4 VW
|
Facility
|
OP
|
$244.99
|
|
|
Service Code
|
CPT 70100
|
| Hospital Charge Code |
32000005
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$159.24
|
| Rate for Payer: Aetna Commercial |
$208.24
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$195.99
|
| Rate for Payer: Cash Price |
$195.99
|
| Rate for Payer: Cofinity Commercial |
$210.69
|
| Rate for Payer: Cofinity Commercial |
$171.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$220.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.74
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.24
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$208.24
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.24
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$154.34
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$90.65
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.74
|
|
|
HC XR MANDIBLE MIN 4 VW
|
Facility
|
IP
|
$459.55
|
|
|
Service Code
|
CPT 70110
|
| Hospital Charge Code |
32000006
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$202.20 |
| Max. Negotiated Rate |
$413.60 |
| Rate for Payer: Aetna American Axle |
$298.71
|
| Rate for Payer: Aetna Commercial |
$390.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.71
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cofinity Commercial |
$321.69
|
| Rate for Payer: Cofinity Commercial |
$395.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$321.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.64
|
| Rate for Payer: Healthscope Commercial |
$413.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$321.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.62
|
| Rate for Payer: PHP Commercial |
$390.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.71
|
| Rate for Payer: Priority Health SBD |
$289.52
|
| Rate for Payer: UMR Bronson Commercial |
$202.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.66
|
|
|
HC XR MANDIBLE MIN 4 VW
|
Facility
|
OP
|
$459.55
|
|
|
Service Code
|
CPT 70110
|
| Hospital Charge Code |
32000006
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$413.60 |
| Rate for Payer: Aetna American Axle |
$298.71
|
| Rate for Payer: Aetna Commercial |
$390.62
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cofinity Commercial |
$395.21
|
| Rate for Payer: Cofinity Commercial |
$321.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$321.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$413.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$321.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$344.66
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.62
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$390.62
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.71
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$289.52
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$170.03
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$344.66
|
|
|
HC XR MASTOIDS 3 VW PER SIDE
|
Facility
|
OP
|
$117.98
|
|
|
Service Code
|
CPT 70130
|
| Hospital Charge Code |
32000008
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$43.65 |
| Max. Negotiated Rate |
$291.93 |
| Rate for Payer: Aetna American Axle |
$76.69
|
| Rate for Payer: Aetna Commercial |
$100.28
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$94.38
|
| Rate for Payer: Cash Price |
$94.38
|
| Rate for Payer: Cofinity Commercial |
$82.59
|
| Rate for Payer: Cofinity Commercial |
$101.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$106.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.48
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.28
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$100.28
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.69
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$74.33
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$43.65
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.48
|
|
|
HC XR MASTOIDS 3 VW PER SIDE
|
Facility
|
IP
|
$117.98
|
|
|
Service Code
|
CPT 70130
|
| Hospital Charge Code |
32000008
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$51.91 |
| Max. Negotiated Rate |
$106.18 |
| Rate for Payer: Aetna American Axle |
$76.69
|
| Rate for Payer: Aetna Commercial |
$100.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.69
|
| Rate for Payer: Cash Price |
$94.38
|
| Rate for Payer: Cofinity Commercial |
$101.46
|
| Rate for Payer: Cofinity Commercial |
$82.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.38
|
| Rate for Payer: Healthscope Commercial |
$106.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.28
|
| Rate for Payer: PHP Commercial |
$100.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.69
|
| Rate for Payer: Priority Health SBD |
$74.33
|
| Rate for Payer: UMR Bronson Commercial |
$51.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.48
|
|
|
HC XR MASTOIDS LESS THAN 3 VW
|
Facility
|
IP
|
$111.60
|
|
|
Service Code
|
CPT 70120
|
| Hospital Charge Code |
32000007
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$49.10 |
| Max. Negotiated Rate |
$100.44 |
| Rate for Payer: Aetna American Axle |
$72.54
|
| Rate for Payer: Aetna Commercial |
$94.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.54
|
| Rate for Payer: Cash Price |
$89.28
|
| Rate for Payer: Cofinity Commercial |
$78.12
|
| Rate for Payer: Cofinity Commercial |
$95.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$78.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.28
|
| Rate for Payer: Healthscope Commercial |
$100.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.86
|
| Rate for Payer: PHP Commercial |
$94.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.54
|
| Rate for Payer: Priority Health SBD |
$70.31
|
| Rate for Payer: UMR Bronson Commercial |
$49.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.70
|
|
|
HC XR MASTOIDS LESS THAN 3 VW
|
Facility
|
OP
|
$111.60
|
|
|
Service Code
|
CPT 70120
|
| Hospital Charge Code |
32000007
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$41.29 |
| Max. Negotiated Rate |
$291.93 |
| Rate for Payer: Aetna American Axle |
$72.54
|
| Rate for Payer: Aetna Commercial |
$94.86
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$89.28
|
| Rate for Payer: Cash Price |
$89.28
|
| Rate for Payer: Cofinity Commercial |
$95.98
|
| Rate for Payer: Cofinity Commercial |
$78.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$78.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$100.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.70
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.86
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$94.86
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.54
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$70.31
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$41.29
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.70
|
|
|
HC XR MED EXAM REVIEW
|
Facility
|
OP
|
$594.89
|
|
| Hospital Charge Code |
32000265
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$220.11 |
| Max. Negotiated Rate |
$535.40 |
| Rate for Payer: Aetna American Axle |
$386.68
|
| Rate for Payer: Aetna Commercial |
$505.66
|
| Rate for Payer: Aetna Medicare |
$297.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.68
|
| Rate for Payer: BCBS Complete |
$237.96
|
| Rate for Payer: Cash Price |
$475.91
|
| Rate for Payer: Cash Price |
$475.91
|
| Rate for Payer: Cofinity Commercial |
$511.61
|
| Rate for Payer: Cofinity Commercial |
$416.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$416.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.91
|
| Rate for Payer: Healthscope Commercial |
$535.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$416.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.66
|
| Rate for Payer: PHP Commercial |
$505.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.68
|
| Rate for Payer: Priority Health SBD |
$374.78
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UMR Bronson Commercial |
$220.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.17
|
|
|
HC XR MED EXAM REVIEW
|
Facility
|
IP
|
$594.89
|
|
| Hospital Charge Code |
32000265
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$261.75 |
| Max. Negotiated Rate |
$535.40 |
| Rate for Payer: Aetna American Axle |
$386.68
|
| Rate for Payer: Aetna Commercial |
$505.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.68
|
| Rate for Payer: Cash Price |
$475.91
|
| Rate for Payer: Cofinity Commercial |
$416.42
|
| Rate for Payer: Cofinity Commercial |
$511.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$416.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.91
|
| Rate for Payer: Healthscope Commercial |
$535.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$416.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.66
|
| Rate for Payer: PHP Commercial |
$505.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$386.68
|
| Rate for Payer: Priority Health SBD |
$374.78
|
| Rate for Payer: UMR Bronson Commercial |
$261.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.17
|
|
|
HC XR MYELOGRAM CERVICAL
|
Facility
|
OP
|
$1,011.61
|
|
|
Service Code
|
CPT 72240
|
| Hospital Charge Code |
32000053
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$2,168.96 |
| Rate for Payer: Aetna American Axle |
$657.55
|
| Rate for Payer: Aetna Commercial |
$859.87
|
| Rate for Payer: Aetna Medicare |
$801.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$657.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$963.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$963.16
|
| Rate for Payer: BCBS Complete |
$433.65
|
| Rate for Payer: BCBS MAPPO |
$770.53
|
| Rate for Payer: BCN Medicare Advantage |
$770.53
|
| Rate for Payer: Cash Price |
$809.29
|
| Rate for Payer: Cash Price |
$809.29
|
| Rate for Payer: Cofinity Commercial |
$869.98
|
| Rate for Payer: Cofinity Commercial |
$708.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$708.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$770.53
|
| Rate for Payer: Healthscope Commercial |
$910.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$708.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$758.71
|
| Rate for Payer: Mclaren Medicaid |
$413.00
|
| Rate for Payer: Mclaren Medicare |
$770.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$809.06
|
| Rate for Payer: Meridian Medicaid |
$433.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$886.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.87
|
| Rate for Payer: PACE Medicare |
$732.00
|
| Rate for Payer: PACE SWMI |
$770.53
|
| Rate for Payer: PHP Commercial |
$859.87
|
| Rate for Payer: PHP Medicare Advantage |
$770.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$413.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.55
|
| Rate for Payer: Priority Health Medicare |
$770.53
|
| Rate for Payer: Priority Health SBD |
$637.31
|
| Rate for Payer: Railroad Medicare Medicare |
$770.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,168.96
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$770.53
|
| Rate for Payer: UHC Exchange |
$1,472.56
|
| Rate for Payer: UHC Medicare Advantage |
$770.53
|
| Rate for Payer: UHCCP Medicaid |
$413.00
|
| Rate for Payer: UMR Bronson Commercial |
$374.30
|
| Rate for Payer: VA VA |
$770.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$758.71
|
|
|
HC XR MYELOGRAM CERVICAL
|
Facility
|
IP
|
$1,011.61
|
|
|
Service Code
|
CPT 72240
|
| Hospital Charge Code |
32000053
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$445.11 |
| Max. Negotiated Rate |
$910.45 |
| Rate for Payer: Aetna American Axle |
$657.55
|
| Rate for Payer: Aetna Commercial |
$859.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$657.55
|
| Rate for Payer: Cash Price |
$809.29
|
| Rate for Payer: Cofinity Commercial |
$708.13
|
| Rate for Payer: Cofinity Commercial |
$869.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$708.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$809.29
|
| Rate for Payer: Healthscope Commercial |
$910.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$708.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$758.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$859.87
|
| Rate for Payer: PHP Commercial |
$859.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$657.55
|
| Rate for Payer: Priority Health SBD |
$637.31
|
| Rate for Payer: UMR Bronson Commercial |
$445.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$758.71
|
|
|
HC XR NASAL FACIAL BONES LESS THAN 3 VW
|
Facility
|
OP
|
$135.98
|
|
|
Service Code
|
CPT 70140
|
| Hospital Charge Code |
32000009
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$88.39
|
| Rate for Payer: Aetna Commercial |
$115.58
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$108.78
|
| Rate for Payer: Cash Price |
$108.78
|
| Rate for Payer: Cofinity Commercial |
$95.19
|
| Rate for Payer: Cofinity Commercial |
$116.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$95.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$122.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.98
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.58
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$115.58
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.39
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$85.67
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$50.31
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.98
|
|
|
HC XR NASAL FACIAL BONES LESS THAN 3 VW
|
Facility
|
IP
|
$135.98
|
|
|
Service Code
|
CPT 70140
|
| Hospital Charge Code |
32000009
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.83 |
| Max. Negotiated Rate |
$122.38 |
| Rate for Payer: Aetna American Axle |
$88.39
|
| Rate for Payer: Aetna Commercial |
$115.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.39
|
| Rate for Payer: Cash Price |
$108.78
|
| Rate for Payer: Cofinity Commercial |
$116.94
|
| Rate for Payer: Cofinity Commercial |
$95.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$95.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.78
|
| Rate for Payer: Healthscope Commercial |
$122.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.58
|
| Rate for Payer: PHP Commercial |
$115.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$88.39
|
| Rate for Payer: Priority Health SBD |
$85.67
|
| Rate for Payer: UMR Bronson Commercial |
$59.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.98
|
|
|
HC XR NEPHROTOMOGRAPHY
|
Facility
|
IP
|
$1,224.73
|
|
|
Service Code
|
CPT 74415
|
| Hospital Charge Code |
32000159
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$538.88 |
| Max. Negotiated Rate |
$1,102.26 |
| Rate for Payer: Aetna American Axle |
$796.07
|
| Rate for Payer: Aetna Commercial |
$1,041.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$796.07
|
| Rate for Payer: Cash Price |
$979.78
|
| Rate for Payer: Cofinity Commercial |
$1,053.27
|
| Rate for Payer: Cofinity Commercial |
$857.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$857.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$979.78
|
| Rate for Payer: Healthscope Commercial |
$1,102.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$857.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$918.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.02
|
| Rate for Payer: PHP Commercial |
$1,041.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.07
|
| Rate for Payer: Priority Health SBD |
$771.58
|
| Rate for Payer: UMR Bronson Commercial |
$538.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$918.55
|
|
|
HC XR NEPHROTOMOGRAPHY
|
Facility
|
OP
|
$1,224.73
|
|
|
Service Code
|
CPT 74415
|
| Hospital Charge Code |
32000159
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$1,102.26 |
| Rate for Payer: Aetna American Axle |
$796.07
|
| Rate for Payer: Aetna Commercial |
$1,041.02
|
| Rate for Payer: Aetna Medicare |
$180.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$796.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$217.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$217.03
|
| Rate for Payer: BCBS Complete |
$97.71
|
| Rate for Payer: BCBS MAPPO |
$173.62
|
| Rate for Payer: BCN Medicare Advantage |
$173.62
|
| Rate for Payer: Cash Price |
$979.78
|
| Rate for Payer: Cash Price |
$979.78
|
| Rate for Payer: Cofinity Commercial |
$857.31
|
| Rate for Payer: Cofinity Commercial |
$1,053.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$857.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$979.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$173.62
|
| Rate for Payer: Healthscope Commercial |
$1,102.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$857.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$918.55
|
| Rate for Payer: Mclaren Medicaid |
$93.06
|
| Rate for Payer: Mclaren Medicare |
$173.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$182.30
|
| Rate for Payer: Meridian Medicaid |
$97.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.02
|
| Rate for Payer: PACE Medicare |
$164.94
|
| Rate for Payer: PACE SWMI |
$173.62
|
| Rate for Payer: PHP Commercial |
$1,041.02
|
| Rate for Payer: PHP Medicare Advantage |
$173.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.07
|
| Rate for Payer: Priority Health Medicare |
$173.62
|
| Rate for Payer: Priority Health SBD |
$771.58
|
| Rate for Payer: Railroad Medicare Medicare |
$173.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$173.62
|
| Rate for Payer: UHC Exchange |
$331.81
|
| Rate for Payer: UHC Medicare Advantage |
$173.62
|
| Rate for Payer: UHCCP Medicaid |
$93.06
|
| Rate for Payer: UMR Bronson Commercial |
$453.15
|
| Rate for Payer: VA VA |
$173.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$918.55
|
|
|
HC XR OPTIC FORAMINA
|
Facility
|
OP
|
$272.22
|
|
|
Service Code
|
CPT 70190
|
| Hospital Charge Code |
32000286
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.03 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$176.94
|
| Rate for Payer: Aetna Commercial |
$231.39
|
| Rate for Payer: Aetna Medicare |
$89.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.34
|
| Rate for Payer: BCBS Complete |
$48.33
|
| Rate for Payer: BCBS MAPPO |
$85.87
|
| Rate for Payer: BCN Medicare Advantage |
$85.87
|
| Rate for Payer: Cash Price |
$217.78
|
| Rate for Payer: Cash Price |
$217.78
|
| Rate for Payer: Cofinity Commercial |
$234.11
|
| Rate for Payer: Cofinity Commercial |
$190.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$190.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.87
|
| Rate for Payer: Healthscope Commercial |
$245.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.16
|
| Rate for Payer: Mclaren Medicaid |
$46.03
|
| Rate for Payer: Mclaren Medicare |
$85.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.16
|
| Rate for Payer: Meridian Medicaid |
$48.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.39
|
| Rate for Payer: PACE Medicare |
$81.58
|
| Rate for Payer: PACE SWMI |
$85.87
|
| Rate for Payer: PHP Commercial |
$231.39
|
| Rate for Payer: PHP Medicare Advantage |
$85.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.94
|
| Rate for Payer: Priority Health Medicare |
$85.87
|
| Rate for Payer: Priority Health SBD |
$171.50
|
| Rate for Payer: Railroad Medicare Medicare |
$85.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.72
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.87
|
| Rate for Payer: UHC Exchange |
$164.11
|
| Rate for Payer: UHC Medicare Advantage |
$85.87
|
| Rate for Payer: UHCCP Medicaid |
$46.03
|
| Rate for Payer: UMR Bronson Commercial |
$100.72
|
| Rate for Payer: VA VA |
$85.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.16
|
|
