|
PR RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR
|
Professional
|
Both
|
$1,821.00
|
|
|
Service Code
|
HCPCS 63661
|
| Min. Negotiated Rate |
$318.16 |
| Max. Negotiated Rate |
$1,183.65 |
| Rate for Payer: Aetna Commercial |
$426.33
|
| Rate for Payer: Aetna Medicare |
$330.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.33
|
| Rate for Payer: BCBS Complete |
$728.40
|
| Rate for Payer: BCBS MAPPO |
$318.16
|
| Rate for Payer: BCN Medicare Advantage |
$318.16
|
| Rate for Payer: Cash Price |
$1,456.80
|
| Rate for Payer: Cash Price |
$1,456.80
|
| Rate for Payer: Cofinity Commercial |
$458.15
|
| Rate for Payer: Cofinity Commercial |
$426.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.07
|
| Rate for Payer: Nomi Health Commercial |
$381.79
|
| Rate for Payer: PACE SWMI |
$318.16
|
| Rate for Payer: PHP Commercial |
$445.42
|
| Rate for Payer: PHP Medicare Advantage |
$318.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,183.65
|
| Rate for Payer: Priority Health Medicare |
$318.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$318.16
|
| Rate for Payer: UHC Medicare Advantage |
$318.16
|
| Rate for Payer: UMR Bronson Commercial |
$837.66
|
|
|
PR RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS
|
Professional
|
Both
|
$1,516.00
|
|
|
Service Code
|
HCPCS 62365
|
| Min. Negotiated Rate |
$288.07 |
| Max. Negotiated Rate |
$985.40 |
| Rate for Payer: Aetna Commercial |
$386.01
|
| Rate for Payer: Aetna Medicare |
$299.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.01
|
| Rate for Payer: BCBS Complete |
$606.40
|
| Rate for Payer: BCBS MAPPO |
$288.07
|
| Rate for Payer: BCN Medicare Advantage |
$288.07
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cash Price |
$1,212.80
|
| Rate for Payer: Cofinity Commercial |
$414.82
|
| Rate for Payer: Cofinity Commercial |
$386.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$288.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$302.47
|
| Rate for Payer: Nomi Health Commercial |
$345.68
|
| Rate for Payer: PACE SWMI |
$288.07
|
| Rate for Payer: PHP Commercial |
$403.30
|
| Rate for Payer: PHP Medicare Advantage |
$288.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$985.40
|
| Rate for Payer: Priority Health Medicare |
$288.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$288.07
|
| Rate for Payer: UHC Medicare Advantage |
$288.07
|
| Rate for Payer: UMR Bronson Commercial |
$697.36
|
|
|
PR RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD
|
Professional
|
Both
|
$1,628.00
|
|
|
Service Code
|
HCPCS 26392
|
| Min. Negotiated Rate |
$651.20 |
| Max. Negotiated Rate |
$1,351.99 |
| Rate for Payer: Aetna Commercial |
$1,258.10
|
| Rate for Payer: Aetna Medicare |
$976.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,351.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,258.10
|
| Rate for Payer: BCBS Complete |
$651.20
|
| Rate for Payer: BCBS MAPPO |
$938.88
|
| Rate for Payer: BCN Medicare Advantage |
$938.88
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cash Price |
$1,302.40
|
| Rate for Payer: Cofinity Commercial |
$1,351.99
|
| Rate for Payer: Cofinity Commercial |
$1,258.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$938.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$985.82
|
| Rate for Payer: Nomi Health Commercial |
$1,126.66
|
| Rate for Payer: PACE SWMI |
$938.88
|
| Rate for Payer: PHP Commercial |
$1,314.43
|
| Rate for Payer: PHP Medicare Advantage |
$938.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,058.20
|
| Rate for Payer: Priority Health Medicare |
$938.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$938.88
|
| Rate for Payer: UHC Medicare Advantage |
$938.88
|
| Rate for Payer: UMR Bronson Commercial |
$748.88
|
|
|
PR RMVL THIERSCH WIRE/SUTURE ANAL CANAL
|
Professional
|
Both
|
$472.00
|
|
|
Service Code
|
HCPCS 46754
|
| Min. Negotiated Rate |
$188.80 |
| Max. Negotiated Rate |
$330.52 |
| Rate for Payer: Aetna Commercial |
$307.57
|
| Rate for Payer: Aetna Medicare |
$238.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.57
|
| Rate for Payer: BCBS Complete |
$188.80
|
| Rate for Payer: BCBS MAPPO |
$229.53
|
| Rate for Payer: BCN Medicare Advantage |
$229.53
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cash Price |
$377.60
|
| Rate for Payer: Cofinity Commercial |
$330.52
|
| Rate for Payer: Cofinity Commercial |
$307.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$229.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$241.01
|
| Rate for Payer: Nomi Health Commercial |
$275.44
|
| Rate for Payer: PACE SWMI |
$229.53
|
| Rate for Payer: PHP Commercial |
$321.34
|
| Rate for Payer: PHP Medicare Advantage |
$229.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$306.80
|
| Rate for Payer: Priority Health Medicare |
$229.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$229.53
|
| Rate for Payer: UHC Medicare Advantage |
$229.53
|
| Rate for Payer: UMR Bronson Commercial |
$217.12
|
|
|
PR RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR
|
Professional
|
Both
|
$1,678.00
|
|
|
Service Code
|
HCPCS 33234
|
| Min. Negotiated Rate |
$459.28 |
| Max. Negotiated Rate |
$1,090.70 |
| Rate for Payer: Aetna Commercial |
$615.44
|
| Rate for Payer: Aetna Medicare |
$477.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$661.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$615.44
|
| Rate for Payer: BCBS Complete |
$671.20
|
| Rate for Payer: BCBS MAPPO |
$459.28
|
| Rate for Payer: BCN Medicare Advantage |
$459.28
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cash Price |
$1,342.40
|
| Rate for Payer: Cofinity Commercial |
$661.36
|
| Rate for Payer: Cofinity Commercial |
$615.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$459.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$482.24
|
| Rate for Payer: Nomi Health Commercial |
$551.14
|
| Rate for Payer: PACE SWMI |
$459.28
|
| Rate for Payer: PHP Commercial |
$642.99
|
| Rate for Payer: PHP Medicare Advantage |
$459.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,090.70
|
| Rate for Payer: Priority Health Medicare |
$459.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$459.28
|
| Rate for Payer: UHC Medicare Advantage |
$459.28
|
| Rate for Payer: UMR Bronson Commercial |
$771.88
|
|
|
PR RMVL TRANSVNS PM ELTRD DUAL LEAD SYS
|
Professional
|
Both
|
$1,327.00
|
|
|
Service Code
|
HCPCS 33235
|
| Min. Negotiated Rate |
$530.80 |
| Max. Negotiated Rate |
$867.82 |
| Rate for Payer: Aetna Commercial |
$807.55
|
| Rate for Payer: Aetna Medicare |
$626.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$867.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$807.55
|
| Rate for Payer: BCBS Complete |
$530.80
|
| Rate for Payer: BCBS MAPPO |
$602.65
|
| Rate for Payer: BCN Medicare Advantage |
$602.65
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cash Price |
$1,061.60
|
| Rate for Payer: Cofinity Commercial |
$867.82
|
| Rate for Payer: Cofinity Commercial |
$807.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$632.78
|
| Rate for Payer: Nomi Health Commercial |
$723.18
|
| Rate for Payer: PACE SWMI |
$602.65
|
| Rate for Payer: PHP Commercial |
$843.71
|
| Rate for Payer: PHP Medicare Advantage |
$602.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$862.55
|
| Rate for Payer: Priority Health Medicare |
$602.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$602.65
|
| Rate for Payer: UHC Medicare Advantage |
$602.65
|
| Rate for Payer: UMR Bronson Commercial |
$610.42
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Professional
|
Both
|
$716.00
|
|
|
Service Code
|
HCPCS 36590
|
| Min. Negotiated Rate |
$179.91 |
| Max. Negotiated Rate |
$465.40 |
| Rate for Payer: Aetna Commercial |
$241.08
|
| Rate for Payer: Aetna Medicare |
$187.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.08
|
| Rate for Payer: BCBS Complete |
$286.40
|
| Rate for Payer: BCBS MAPPO |
$179.91
|
| Rate for Payer: BCN Medicare Advantage |
$179.91
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$259.07
|
| Rate for Payer: Cofinity Commercial |
$241.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.91
|
| Rate for Payer: Nomi Health Commercial |
$215.89
|
| Rate for Payer: PACE SWMI |
$179.91
|
| Rate for Payer: PHP Commercial |
$251.87
|
| Rate for Payer: PHP Medicare Advantage |
$179.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health Medicare |
$179.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.91
|
| Rate for Payer: UHC Medicare Advantage |
$179.91
|
| Rate for Payer: UMR Bronson Commercial |
$329.36
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Facility
|
IP
|
$716.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36590
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$315.04 |
| Max. Negotiated Rate |
$644.40 |
| Rate for Payer: Aetna American Axle |
$465.40
|
| Rate for Payer: Aetna Commercial |
$608.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$465.40
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$501.20
|
| Rate for Payer: Cofinity Commercial |
$615.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$501.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$572.80
|
| Rate for Payer: Healthscope Commercial |
$644.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$501.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$537.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$608.60
|
| Rate for Payer: PHP Commercial |
$608.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health SBD |
$451.08
|
| Rate for Payer: UMR Bronson Commercial |
$315.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$537.00
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Facility
|
OP
|
$716.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
36590
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$264.92 |
| Max. Negotiated Rate |
$4,264.69 |
| Rate for Payer: Aetna American Axle |
$465.40
|
| Rate for Payer: Aetna Commercial |
$608.60
|
| Rate for Payer: Aetna Medicare |
$1,575.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$465.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,893.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,893.80
|
| Rate for Payer: BCBS Complete |
$852.66
|
| Rate for Payer: BCBS MAPPO |
$1,515.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,515.04
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$615.76
|
| Rate for Payer: Cofinity Commercial |
$501.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$501.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$572.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$644.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$501.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$537.00
|
| Rate for Payer: Mclaren Medicaid |
$812.06
|
| Rate for Payer: Mclaren Medicare |
$1,515.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,590.79
|
| Rate for Payer: Meridian Medicaid |
$852.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,742.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$608.60
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$608.60
|
| Rate for Payer: PHP Medicare Advantage |
$1,515.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health SBD |
$451.08
|
| Rate for Payer: Railroad Medicare Medicare |
$1,515.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,264.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,515.04
|
| Rate for Payer: UHC Exchange |
$2,895.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,515.04
|
| Rate for Payer: UHCCP Medicaid |
$812.06
|
| Rate for Payer: UMR Bronson Commercial |
$264.92
|
| Rate for Payer: VA VA |
$1,515.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$537.00
|
|
|
PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ
|
Professional
|
Both
|
$716.00
|
|
|
Service Code
|
HCPCS 36590
|
| Hospital Charge Code |
36590
|
| Min. Negotiated Rate |
$179.91 |
| Max. Negotiated Rate |
$465.40 |
| Rate for Payer: Aetna Commercial |
$241.08
|
| Rate for Payer: Aetna Medicare |
$187.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.07
|
| Rate for Payer: BCBS Complete |
$286.40
|
| Rate for Payer: BCBS MAPPO |
$179.91
|
| Rate for Payer: BCN Medicare Advantage |
$179.91
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cash Price |
$572.80
|
| Rate for Payer: Cofinity Commercial |
$259.07
|
| Rate for Payer: Cofinity Commercial |
$241.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.91
|
| Rate for Payer: Nomi Health Commercial |
$215.89
|
| Rate for Payer: PACE SWMI |
$179.91
|
| Rate for Payer: PHP Commercial |
$251.87
|
| Rate for Payer: PHP Medicare Advantage |
$179.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$465.40
|
| Rate for Payer: Priority Health Medicare |
$179.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.91
|
| Rate for Payer: UHC Medicare Advantage |
$179.91
|
| Rate for Payer: UMR Bronson Commercial |
$329.36
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$429.00
|
|
|
Service Code
|
HCPCS 36589
|
| Min. Negotiated Rate |
$129.08 |
| Max. Negotiated Rate |
$278.85 |
| Rate for Payer: Aetna Commercial |
$172.97
|
| Rate for Payer: Aetna Medicare |
$134.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.97
|
| Rate for Payer: BCBS Complete |
$171.60
|
| Rate for Payer: BCBS MAPPO |
$129.08
|
| Rate for Payer: BCN Medicare Advantage |
$129.08
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cofinity Commercial |
$185.88
|
| Rate for Payer: Cofinity Commercial |
$172.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.53
|
| Rate for Payer: Nomi Health Commercial |
$154.90
|
| Rate for Payer: PACE SWMI |
$129.08
|
| Rate for Payer: PHP Commercial |
$180.71
|
| Rate for Payer: PHP Medicare Advantage |
$129.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.85
|
| Rate for Payer: Priority Health Medicare |
$129.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.08
|
| Rate for Payer: UHC Medicare Advantage |
$129.08
|
| Rate for Payer: UMR Bronson Commercial |
$197.34
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Professional
|
Both
|
$429.00
|
|
|
Service Code
|
HCPCS 36589
|
| Hospital Charge Code |
36589
|
| Min. Negotiated Rate |
$129.08 |
| Max. Negotiated Rate |
$278.85 |
| Rate for Payer: Aetna Commercial |
$172.97
|
| Rate for Payer: Aetna Medicare |
$134.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.97
|
| Rate for Payer: BCBS Complete |
$171.60
|
| Rate for Payer: BCBS MAPPO |
$129.08
|
| Rate for Payer: BCN Medicare Advantage |
$129.08
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cofinity Commercial |
$172.97
|
| Rate for Payer: Cofinity Commercial |
$185.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.53
|
| Rate for Payer: Nomi Health Commercial |
$154.90
|
| Rate for Payer: PACE SWMI |
$129.08
|
| Rate for Payer: PHP Commercial |
$180.71
|
| Rate for Payer: PHP Medicare Advantage |
$129.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.85
|
| Rate for Payer: Priority Health Medicare |
$129.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.08
|
| Rate for Payer: UHC Medicare Advantage |
$129.08
|
| Rate for Payer: UMR Bronson Commercial |
$197.34
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Facility
|
OP
|
$429.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36589
|
| Min. Negotiated Rate |
$158.73 |
| Max. Negotiated Rate |
$1,697.33 |
| Rate for Payer: Aetna American Axle |
$278.85
|
| Rate for Payer: Aetna Commercial |
$364.65
|
| Rate for Payer: Aetna Medicare |
$627.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$753.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$753.73
|
| Rate for Payer: BCBS Complete |
$339.36
|
| Rate for Payer: BCBS MAPPO |
$602.98
|
| Rate for Payer: BCN Medicare Advantage |
$602.98
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cofinity Commercial |
$368.94
|
| Rate for Payer: Cofinity Commercial |
$300.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$300.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.98
|
| Rate for Payer: Healthscope Commercial |
$386.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.75
|
| Rate for Payer: Mclaren Medicaid |
$323.20
|
| Rate for Payer: Mclaren Medicare |
$602.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.13
|
| Rate for Payer: Meridian Medicaid |
$339.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$693.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.65
|
| Rate for Payer: PACE Medicare |
$572.83
|
| Rate for Payer: PACE SWMI |
$602.98
|
| Rate for Payer: PHP Commercial |
$364.65
|
| Rate for Payer: PHP Medicare Advantage |
$602.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.85
|
| Rate for Payer: Priority Health Medicare |
$602.98
|
| Rate for Payer: Priority Health SBD |
$270.27
|
| Rate for Payer: Railroad Medicare Medicare |
$602.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,697.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$602.98
|
| Rate for Payer: UHC Exchange |
$1,152.36
|
| Rate for Payer: UHC Medicare Advantage |
$602.98
|
| Rate for Payer: UHCCP Medicaid |
$323.20
|
| Rate for Payer: UMR Bronson Commercial |
$158.73
|
| Rate for Payer: VA VA |
$602.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.75
|
|
|
PR RMVL TUN CVC W/O SUBQ PORT/PMP
|
Facility
|
IP
|
$429.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
36589
|
| Min. Negotiated Rate |
$188.76 |
| Max. Negotiated Rate |
$386.10 |
| Rate for Payer: Aetna American Axle |
$278.85
|
| Rate for Payer: Aetna Commercial |
$364.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.85
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cofinity Commercial |
$300.30
|
| Rate for Payer: Cofinity Commercial |
$368.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$300.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.20
|
| Rate for Payer: Healthscope Commercial |
$386.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.65
|
| Rate for Payer: PHP Commercial |
$364.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.85
|
| Rate for Payer: Priority Health SBD |
$270.27
|
| Rate for Payer: UMR Bronson Commercial |
$188.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.75
|
|
|
PR RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT
|
Professional
|
Both
|
$402.00
|
|
|
Service Code
|
HCPCS 11983
|
| Min. Negotiated Rate |
$99.73 |
| Max. Negotiated Rate |
$261.30 |
| Rate for Payer: Aetna Commercial |
$133.64
|
| Rate for Payer: Aetna Medicare |
$103.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.64
|
| Rate for Payer: BCBS Complete |
$160.80
|
| Rate for Payer: BCBS MAPPO |
$99.73
|
| Rate for Payer: BCN Medicare Advantage |
$99.73
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cash Price |
$321.60
|
| Rate for Payer: Cofinity Commercial |
$143.61
|
| Rate for Payer: Cofinity Commercial |
$133.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.72
|
| Rate for Payer: Nomi Health Commercial |
$119.68
|
| Rate for Payer: PACE SWMI |
$99.73
|
| Rate for Payer: PHP Commercial |
$139.62
|
| Rate for Payer: PHP Medicare Advantage |
$99.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.30
|
| Rate for Payer: Priority Health Medicare |
$99.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$99.73
|
| Rate for Payer: UHC Medicare Advantage |
$99.73
|
| Rate for Payer: UMR Bronson Commercial |
$184.92
|
|
|
PR RNL NDSC NFROT/PLOT W/ENDOPYELOTOMY
|
Professional
|
Both
|
$1,386.00
|
|
|
Service Code
|
HCPCS 50575
|
| Min. Negotiated Rate |
$554.40 |
| Max. Negotiated Rate |
$974.39 |
| Rate for Payer: Aetna Commercial |
$906.72
|
| Rate for Payer: Aetna Medicare |
$703.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$906.72
|
| Rate for Payer: BCBS Complete |
$554.40
|
| Rate for Payer: BCBS MAPPO |
$676.66
|
| Rate for Payer: BCN Medicare Advantage |
$676.66
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cash Price |
$1,108.80
|
| Rate for Payer: Cofinity Commercial |
$974.39
|
| Rate for Payer: Cofinity Commercial |
$906.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$676.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$710.49
|
| Rate for Payer: Nomi Health Commercial |
$811.99
|
| Rate for Payer: PACE SWMI |
$676.66
|
| Rate for Payer: PHP Commercial |
$947.32
|
| Rate for Payer: PHP Medicare Advantage |
$676.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.90
|
| Rate for Payer: Priority Health Medicare |
$676.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$676.66
|
| Rate for Payer: UHC Medicare Advantage |
$676.66
|
| Rate for Payer: UMR Bronson Commercial |
$637.56
|
|
|
PR ROBOTIC SURGICAL SYSTEM
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS S2900
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$39.65 |
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
| Rate for Payer: UMR Bronson Commercial |
$28.06
|
|
|
PR ROM MEAS&REPRT HAND W/WO COMPARISON NORMAL SID
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 95852
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$52.00 |
| Rate for Payer: Aetna Commercial |
$7.25
|
| Rate for Payer: Aetna Medicare |
$5.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.79
|
| Rate for Payer: BCBS Complete |
$32.00
|
| Rate for Payer: BCBS MAPPO |
$5.41
|
| Rate for Payer: BCN Medicare Advantage |
$5.41
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$7.25
|
| Rate for Payer: Cofinity Commercial |
$7.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.68
|
| Rate for Payer: Nomi Health Commercial |
$6.49
|
| Rate for Payer: PACE SWMI |
$5.41
|
| Rate for Payer: PHP Commercial |
$7.57
|
| Rate for Payer: PHP Medicare Advantage |
$5.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.00
|
| Rate for Payer: Priority Health Medicare |
$5.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.41
|
| Rate for Payer: UHC Medicare Advantage |
$5.41
|
| Rate for Payer: UMR Bronson Commercial |
$36.80
|
|
|
PR ROPRTJ > 1 MO AFTER ORIGINAL OPRATION
|
Professional
|
Both
|
$578.00
|
|
|
Service Code
|
HCPCS 35700
|
| Min. Negotiated Rate |
$145.85 |
| Max. Negotiated Rate |
$375.70 |
| Rate for Payer: Aetna Commercial |
$195.44
|
| Rate for Payer: Aetna Medicare |
$151.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.44
|
| Rate for Payer: BCBS Complete |
$231.20
|
| Rate for Payer: BCBS MAPPO |
$145.85
|
| Rate for Payer: BCN Medicare Advantage |
$145.85
|
| Rate for Payer: Cash Price |
$462.40
|
| Rate for Payer: Cash Price |
$462.40
|
| Rate for Payer: Cofinity Commercial |
$210.02
|
| Rate for Payer: Cofinity Commercial |
$195.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.14
|
| Rate for Payer: Nomi Health Commercial |
$175.02
|
| Rate for Payer: PACE SWMI |
$145.85
|
| Rate for Payer: PHP Commercial |
$204.19
|
| Rate for Payer: PHP Medicare Advantage |
$145.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$375.70
|
| Rate for Payer: Priority Health Medicare |
$145.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.85
|
| Rate for Payer: UHC Medicare Advantage |
$145.85
|
| Rate for Payer: UMR Bronson Commercial |
$265.88
|
|
|
PR ROPRTJ CAB/VALVE PX > 1 MO AFTER ORIGINAL OPERJ
|
Professional
|
Both
|
$1,703.00
|
|
|
Service Code
|
HCPCS 33530
|
| Min. Negotiated Rate |
$502.04 |
| Max. Negotiated Rate |
$1,106.95 |
| Rate for Payer: Aetna Commercial |
$672.73
|
| Rate for Payer: Aetna Medicare |
$522.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$722.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$672.73
|
| Rate for Payer: BCBS Complete |
$681.20
|
| Rate for Payer: BCBS MAPPO |
$502.04
|
| Rate for Payer: BCN Medicare Advantage |
$502.04
|
| Rate for Payer: Cash Price |
$1,362.40
|
| Rate for Payer: Cash Price |
$1,362.40
|
| Rate for Payer: Cofinity Commercial |
$722.94
|
| Rate for Payer: Cofinity Commercial |
$672.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$502.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$527.14
|
| Rate for Payer: Nomi Health Commercial |
$602.45
|
| Rate for Payer: PACE SWMI |
$502.04
|
| Rate for Payer: PHP Commercial |
$702.86
|
| Rate for Payer: PHP Medicare Advantage |
$502.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,106.95
|
| Rate for Payer: Priority Health Medicare |
$502.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$502.04
|
| Rate for Payer: UHC Medicare Advantage |
$502.04
|
| Rate for Payer: UMR Bronson Commercial |
$783.38
|
|
|
PR ROPRTJ CRTD TEAEC > 1 MO AFTER ORIGINAL OPRATIO
|
Professional
|
Both
|
$316.00
|
|
|
Service Code
|
HCPCS 35390
|
| Min. Negotiated Rate |
$126.40 |
| Max. Negotiated Rate |
$220.61 |
| Rate for Payer: Aetna Commercial |
$205.29
|
| Rate for Payer: Aetna Medicare |
$159.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.29
|
| Rate for Payer: BCBS Complete |
$126.40
|
| Rate for Payer: BCBS MAPPO |
$153.20
|
| Rate for Payer: BCN Medicare Advantage |
$153.20
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cofinity Commercial |
$220.61
|
| Rate for Payer: Cofinity Commercial |
$205.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.86
|
| Rate for Payer: Nomi Health Commercial |
$183.84
|
| Rate for Payer: PACE SWMI |
$153.20
|
| Rate for Payer: PHP Commercial |
$214.48
|
| Rate for Payer: PHP Medicare Advantage |
$153.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.40
|
| Rate for Payer: Priority Health Medicare |
$153.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.20
|
| Rate for Payer: UHC Medicare Advantage |
$153.20
|
| Rate for Payer: UMR Bronson Commercial |
$145.36
|
|
|
PR ROUT FOOT CARE PER VISIT
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS S0390
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$17.55 |
| Rate for Payer: Aetna Medicare |
$13.50
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: UMR Bronson Commercial |
$12.42
|
|
|
PR ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB
|
Professional
|
Both
|
$4,028.00
|
|
|
Service Code
|
HCPCS 59610
|
| Min. Negotiated Rate |
$1,611.20 |
| Max. Negotiated Rate |
$3,540.57 |
| Rate for Payer: Aetna Commercial |
$3,294.70
|
| Rate for Payer: Aetna Medicare |
$2,557.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,294.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,540.57
|
| Rate for Payer: BCBS Complete |
$1,611.20
|
| Rate for Payer: BCBS MAPPO |
$2,458.73
|
| Rate for Payer: BCN Medicare Advantage |
$2,458.73
|
| Rate for Payer: Cash Price |
$3,222.40
|
| Rate for Payer: Cash Price |
$3,222.40
|
| Rate for Payer: Cofinity Commercial |
$3,294.70
|
| Rate for Payer: Cofinity Commercial |
$3,540.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,458.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,581.67
|
| Rate for Payer: Nomi Health Commercial |
$2,950.48
|
| Rate for Payer: PACE SWMI |
$2,458.73
|
| Rate for Payer: PHP Commercial |
$3,442.22
|
| Rate for Payer: PHP Medicare Advantage |
$2,458.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,618.20
|
| Rate for Payer: Priority Health Medicare |
$2,458.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,458.73
|
| Rate for Payer: UHC Medicare Advantage |
$2,458.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,852.88
|
|
|
PR ROUTINE OBSTETRICAL CARE ATTEMPTED VBAC
|
Professional
|
Both
|
$4,323.00
|
|
|
Service Code
|
HCPCS 59618
|
| Min. Negotiated Rate |
$1,729.20 |
| Max. Negotiated Rate |
$3,794.90 |
| Rate for Payer: Aetna Commercial |
$3,531.37
|
| Rate for Payer: Aetna Medicare |
$2,740.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,794.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,531.37
|
| Rate for Payer: BCBS Complete |
$1,729.20
|
| Rate for Payer: BCBS MAPPO |
$2,635.35
|
| Rate for Payer: BCN Medicare Advantage |
$2,635.35
|
| Rate for Payer: Cash Price |
$3,458.40
|
| Rate for Payer: Cash Price |
$3,458.40
|
| Rate for Payer: Cofinity Commercial |
$3,794.90
|
| Rate for Payer: Cofinity Commercial |
$3,531.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,635.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,767.12
|
| Rate for Payer: Nomi Health Commercial |
$3,162.42
|
| Rate for Payer: PACE SWMI |
$2,635.35
|
| Rate for Payer: PHP Commercial |
$3,689.49
|
| Rate for Payer: PHP Medicare Advantage |
$2,635.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,809.95
|
| Rate for Payer: Priority Health Medicare |
$2,635.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,635.35
|
| Rate for Payer: UHC Medicare Advantage |
$2,635.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,988.58
|
|
|
PR RPLCMT ALL/PART URETER INTESTINE SGM W/ANAST
|
Professional
|
Both
|
$2,539.00
|
|
|
Service Code
|
HCPCS 50840
|
| Min. Negotiated Rate |
$1,015.60 |
| Max. Negotiated Rate |
$1,691.38 |
| Rate for Payer: Aetna Commercial |
$1,573.92
|
| Rate for Payer: Aetna Medicare |
$1,221.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,691.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,573.92
|
| Rate for Payer: BCBS Complete |
$1,015.60
|
| Rate for Payer: BCBS MAPPO |
$1,174.57
|
| Rate for Payer: BCN Medicare Advantage |
$1,174.57
|
| Rate for Payer: Cash Price |
$2,031.20
|
| Rate for Payer: Cash Price |
$2,031.20
|
| Rate for Payer: Cofinity Commercial |
$1,691.38
|
| Rate for Payer: Cofinity Commercial |
$1,573.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,174.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,233.30
|
| Rate for Payer: Nomi Health Commercial |
$1,409.48
|
| Rate for Payer: PACE SWMI |
$1,174.57
|
| Rate for Payer: PHP Commercial |
$1,644.40
|
| Rate for Payer: PHP Medicare Advantage |
$1,174.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,650.35
|
| Rate for Payer: Priority Health Medicare |
$1,174.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,174.57
|
| Rate for Payer: UHC Medicare Advantage |
$1,174.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,167.94
|
|
