|
HC XR WRIST MIN 3 VW
|
Facility
|
IP
|
$408.20
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000082
|
|
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 WRIST MIN 3 VW
|
Facility
|
OP
|
$408.20
|
|
|
Service Code
|
CPT 73110
|
| Hospital Charge Code |
32000082
|
|
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 XTRASORB 6X9 EACH
|
Facility
|
OP
|
$16.26
|
|
| Hospital Charge Code |
27200293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$14.63 |
| Rate for Payer: Aetna American Axle |
$10.57
|
| Rate for Payer: Aetna Commercial |
$13.82
|
| Rate for Payer: Aetna Medicare |
$8.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.57
|
| Rate for Payer: BCBS Complete |
$6.50
|
| Rate for Payer: Cash Price |
$13.01
|
| Rate for Payer: Cofinity Commercial |
$11.38
|
| Rate for Payer: Cofinity Commercial |
$13.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$14.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.82
|
| Rate for Payer: PHP Commercial |
$13.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.57
|
| Rate for Payer: Priority Health SBD |
$10.24
|
| Rate for Payer: UMR Bronson Commercial |
$6.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.20
|
|
|
HC XTRASORB 6X9 EACH
|
Facility
|
IP
|
$16.26
|
|
| Hospital Charge Code |
27200293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.15 |
| Max. Negotiated Rate |
$14.63 |
| Rate for Payer: Aetna American Axle |
$10.57
|
| Rate for Payer: Aetna Commercial |
$13.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.57
|
| Rate for Payer: Cash Price |
$13.01
|
| Rate for Payer: Cofinity Commercial |
$11.38
|
| Rate for Payer: Cofinity Commercial |
$13.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$14.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.82
|
| Rate for Payer: PHP Commercial |
$13.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.57
|
| Rate for Payer: Priority Health SBD |
$10.24
|
| Rate for Payer: UMR Bronson Commercial |
$7.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.20
|
|
|
HC Y ADAPTER WITH VENT
|
Facility
|
IP
|
$53.58
|
|
| Hospital Charge Code |
27006702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.58 |
| Max. Negotiated Rate |
$48.22 |
| Rate for Payer: Aetna American Axle |
$34.83
|
| Rate for Payer: Aetna Commercial |
$45.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.83
|
| Rate for Payer: Cash Price |
$42.86
|
| Rate for Payer: Cofinity Commercial |
$37.51
|
| Rate for Payer: Cofinity Commercial |
$46.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.86
|
| Rate for Payer: Healthscope Commercial |
$48.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.54
|
| Rate for Payer: PHP Commercial |
$45.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.83
|
| Rate for Payer: Priority Health SBD |
$33.76
|
| Rate for Payer: UMR Bronson Commercial |
$23.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.19
|
|
|
HC Y ADAPTER WITH VENT
|
Facility
|
OP
|
$53.58
|
|
| Hospital Charge Code |
27006702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.82 |
| Max. Negotiated Rate |
$48.22 |
| Rate for Payer: Aetna American Axle |
$34.83
|
| Rate for Payer: Aetna Commercial |
$45.54
|
| Rate for Payer: Aetna Medicare |
$26.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.83
|
| Rate for Payer: BCBS Complete |
$21.43
|
| Rate for Payer: Cash Price |
$42.86
|
| Rate for Payer: Cofinity Commercial |
$37.51
|
| Rate for Payer: Cofinity Commercial |
$46.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.86
|
| Rate for Payer: Healthscope Commercial |
$48.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.54
|
| Rate for Payer: PHP Commercial |
$45.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.83
|
| Rate for Payer: Priority Health SBD |
$33.76
|
| Rate for Payer: UMR Bronson Commercial |
$19.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.19
|
|
|
HC YEAST BREWERS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200111
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC YEAST BREWERS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200111
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$9.98
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC YELLOW DOCK IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200112
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC YELLOW DOCK IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200112
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$9.98
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC YELLOW HORNET IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200113
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC YELLOW HORNET IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200113
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$9.98
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC YELLOW JACKET IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200114
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC YELLOW JACKET IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200114
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$9.98
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC Y SET ANTE/RETRO
|
Facility
|
IP
|
$42.08
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.52 |
| Max. Negotiated Rate |
$37.87 |
| Rate for Payer: Aetna American Axle |
$27.35
|
| Rate for Payer: Aetna Commercial |
$35.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.35
|
| Rate for Payer: Cash Price |
$33.66
|
| Rate for Payer: Cofinity Commercial |
$29.46
|
| Rate for Payer: Cofinity Commercial |
$36.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.66
|
| Rate for Payer: Healthscope Commercial |
$37.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.77
|
| Rate for Payer: PHP Commercial |
$35.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.35
|
| Rate for Payer: Priority Health SBD |
$26.51
|
| Rate for Payer: UMR Bronson Commercial |
$18.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.56
|
|
|
HC Y SET ANTE/RETRO
|
Facility
|
OP
|
$42.08
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.57 |
| Max. Negotiated Rate |
$37.87 |
| Rate for Payer: Aetna American Axle |
$27.35
|
| Rate for Payer: Aetna Commercial |
$35.77
|
| Rate for Payer: Aetna Medicare |
$21.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.35
|
| Rate for Payer: BCBS Complete |
$16.83
|
| Rate for Payer: Cash Price |
$33.66
|
| Rate for Payer: Cofinity Commercial |
$29.46
|
| Rate for Payer: Cofinity Commercial |
$36.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.66
|
| Rate for Payer: Healthscope Commercial |
$37.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.77
|
| Rate for Payer: PHP Commercial |
$35.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.35
|
| Rate for Payer: Priority Health SBD |
$26.51
|
| Rate for Payer: UMR Bronson Commercial |
$15.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.56
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
IP
|
$50,779.51
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22,342.98 |
| Max. Negotiated Rate |
$45,701.56 |
| Rate for Payer: Aetna American Axle |
$33,006.68
|
| Rate for Payer: Aetna Commercial |
$43,162.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,006.68
|
| Rate for Payer: Cash Price |
$40,623.61
|
| Rate for Payer: Cofinity Commercial |
$35,545.66
|
| Rate for Payer: Cofinity Commercial |
$43,670.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$35,545.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,623.61
|
| Rate for Payer: Healthscope Commercial |
$45,701.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,545.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,084.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,162.58
|
| Rate for Payer: PHP Commercial |
$43,162.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33,006.68
|
| Rate for Payer: Priority Health SBD |
$31,991.09
|
| Rate for Payer: UMR Bronson Commercial |
$22,342.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,084.63
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
OP
|
$50,779.51
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,140.34 |
| Max. Negotiated Rate |
$48,002.12 |
| Rate for Payer: Aetna American Axle |
$33,006.68
|
| Rate for Payer: Aetna Commercial |
$43,162.58
|
| Rate for Payer: Aetna Medicare |
$17,734.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,006.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,316.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,316.09
|
| Rate for Payer: BCBS Complete |
$9,597.36
|
| Rate for Payer: BCBS MAPPO |
$17,052.87
|
| Rate for Payer: BCN Medicare Advantage |
$17,052.87
|
| Rate for Payer: Cash Price |
$40,623.61
|
| Rate for Payer: Cash Price |
$40,623.61
|
| Rate for Payer: Cofinity Commercial |
$43,670.38
|
| Rate for Payer: Cofinity Commercial |
$35,545.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$35,545.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,623.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,052.87
|
| Rate for Payer: Healthscope Commercial |
$45,701.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,545.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,084.63
|
| Rate for Payer: Mclaren Medicaid |
$9,140.34
|
| Rate for Payer: Mclaren Medicare |
$17,052.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17,905.51
|
| Rate for Payer: Meridian Medicaid |
$9,597.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19,610.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,162.58
|
| Rate for Payer: PACE Medicare |
$16,200.23
|
| Rate for Payer: PACE SWMI |
$17,052.87
|
| Rate for Payer: PHP Commercial |
$43,162.58
|
| Rate for Payer: PHP Medicare Advantage |
$17,052.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,140.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33,006.68
|
| Rate for Payer: Priority Health Medicare |
$17,052.87
|
| Rate for Payer: Priority Health SBD |
$31,991.09
|
| Rate for Payer: Railroad Medicare Medicare |
$17,052.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48,002.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,052.87
|
| Rate for Payer: UHC Exchange |
$32,589.74
|
| Rate for Payer: UHC Medicare Advantage |
$17,052.87
|
| Rate for Payer: UHCCP Medicaid |
$9,140.34
|
| Rate for Payer: UMR Bronson Commercial |
$18,788.42
|
| Rate for Payer: VA VA |
$17,052.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,084.63
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
IP
|
$41.82
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Aetna American Axle |
$27.18
|
| Rate for Payer: Aetna Commercial |
$35.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.18
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$29.27
|
| Rate for Payer: Cofinity Commercial |
$35.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$37.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.55
|
| Rate for Payer: PHP Commercial |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.18
|
| Rate for Payer: Priority Health SBD |
$26.35
|
| Rate for Payer: UMR Bronson Commercial |
$18.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.36
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
OP
|
$41.82
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.47 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Aetna American Axle |
$27.18
|
| Rate for Payer: Aetna Commercial |
$35.55
|
| Rate for Payer: Aetna Medicare |
$20.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.18
|
| Rate for Payer: BCBS Complete |
$16.73
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$29.27
|
| Rate for Payer: Cofinity Commercial |
$35.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$37.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.55
|
| Rate for Payer: PHP Commercial |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.18
|
| Rate for Payer: Priority Health SBD |
$26.35
|
| Rate for Payer: UMR Bronson Commercial |
$15.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.36
|
|
|
HC Z ACCESS DEVICE
|
Facility
|
OP
|
$204.86
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.80 |
| Max. Negotiated Rate |
$184.37 |
| Rate for Payer: Aetna American Axle |
$133.16
|
| Rate for Payer: Aetna Commercial |
$174.13
|
| Rate for Payer: Aetna Medicare |
$102.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.16
|
| Rate for Payer: BCBS Complete |
$81.94
|
| Rate for Payer: Cash Price |
$163.89
|
| Rate for Payer: Cofinity Commercial |
$143.40
|
| Rate for Payer: Cofinity Commercial |
$176.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$143.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.89
|
| Rate for Payer: Healthscope Commercial |
$184.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$143.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.13
|
| Rate for Payer: PHP Commercial |
$174.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.16
|
| Rate for Payer: Priority Health SBD |
$129.06
|
| Rate for Payer: UMR Bronson Commercial |
$75.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.65
|
|
|
HC Z ACCESS DEVICE
|
Facility
|
IP
|
$204.86
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.14 |
| Max. Negotiated Rate |
$184.37 |
| Rate for Payer: Aetna American Axle |
$133.16
|
| Rate for Payer: Aetna Commercial |
$174.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.16
|
| Rate for Payer: Cash Price |
$163.89
|
| Rate for Payer: Cofinity Commercial |
$143.40
|
| Rate for Payer: Cofinity Commercial |
$176.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$143.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.89
|
| Rate for Payer: Healthscope Commercial |
$184.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$143.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.13
|
| Rate for Payer: PHP Commercial |
$174.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.16
|
| Rate for Payer: Priority Health SBD |
$129.06
|
| Rate for Payer: UMR Bronson Commercial |
$90.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.65
|
|
|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
IP
|
$6,366.11
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,801.09 |
| Max. Negotiated Rate |
$5,729.50 |
| Rate for Payer: Aetna American Axle |
$4,137.97
|
| Rate for Payer: Aetna Commercial |
$5,411.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,137.97
|
| Rate for Payer: Cash Price |
$5,092.89
|
| Rate for Payer: Cofinity Commercial |
$4,456.28
|
| Rate for Payer: Cofinity Commercial |
$5,474.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,456.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,092.89
|
| Rate for Payer: Healthscope Commercial |
$5,729.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,456.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,774.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,411.19
|
| Rate for Payer: PHP Commercial |
$5,411.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,137.97
|
| Rate for Payer: Priority Health SBD |
$4,010.65
|
| Rate for Payer: UMR Bronson Commercial |
$2,801.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,774.58
|
|
|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
OP
|
$6,366.11
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,355.46 |
| Max. Negotiated Rate |
$5,729.50 |
| Rate for Payer: Aetna American Axle |
$4,137.97
|
| Rate for Payer: Aetna Commercial |
$5,411.19
|
| Rate for Payer: Aetna Medicare |
$3,183.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,137.97
|
| Rate for Payer: BCBS Complete |
$2,546.44
|
| Rate for Payer: Cash Price |
$5,092.89
|
| Rate for Payer: Cofinity Commercial |
$4,456.28
|
| Rate for Payer: Cofinity Commercial |
$5,474.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,456.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,092.89
|
| Rate for Payer: Healthscope Commercial |
$5,729.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,456.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,774.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,411.19
|
| Rate for Payer: PHP Commercial |
$5,411.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,137.97
|
| Rate for Payer: Priority Health SBD |
$4,010.65
|
| Rate for Payer: UMR Bronson Commercial |
$2,355.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,774.58
|
|
|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
IP
|
$437.63
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| 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
|
|
