|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV KNEE 3 OR MORE NRVS
|
Facility
|
IP
|
$2,630.58
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,157.46 |
| Max. Negotiated Rate |
$2,367.52 |
| Rate for Payer: Aetna American Axle |
$1,709.88
|
| Rate for Payer: Aetna Commercial |
$2,235.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,709.88
|
| Rate for Payer: Cash Price |
$2,104.46
|
| Rate for Payer: Cofinity Commercial |
$1,841.41
|
| Rate for Payer: Cofinity Commercial |
$2,262.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.46
|
| Rate for Payer: Healthscope Commercial |
$2,367.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,841.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,972.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,235.99
|
| Rate for Payer: PHP Commercial |
$2,235.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.41
|
| Rate for Payer: Priority Health SBD |
$1,657.27
|
| Rate for Payer: UMR Bronson Commercial |
$1,157.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,972.94
|
|
|
HC ABLAT BY NEUROLYTIC AGENT GENICULAR NRV KNEE 3 OR MORE NRVS
|
Facility
|
OP
|
$2,630.58
|
|
|
Service Code
|
CPT 64624
|
| Hospital Charge Code |
36100601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$142.76 |
| Max. Negotiated Rate |
$5,402.75 |
| Rate for Payer: Aetna American Axle |
$1,709.88
|
| Rate for Payer: Aetna Commercial |
$2,235.99
|
| Rate for Payer: Aetna Medicare |
$1,784.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,709.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,145.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,145.29
|
| Rate for Payer: BCBS Complete |
$985.80
|
| Rate for Payer: BCBS MAPPO |
$1,716.23
|
| Rate for Payer: BCN Medicare Advantage |
$1,716.23
|
| Rate for Payer: Cash Price |
$2,104.46
|
| Rate for Payer: Cash Price |
$2,104.46
|
| Rate for Payer: Cofinity Commercial |
$1,841.41
|
| Rate for Payer: Cofinity Commercial |
$2,262.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,716.23
|
| Rate for Payer: Healthscope Commercial |
$2,367.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,841.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,972.94
|
| Rate for Payer: Mclaren Medicaid |
$938.78
|
| Rate for Payer: Mclaren Medicare |
$1,716.23
|
| Rate for Payer: Meridian Medicaid |
$985.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,802.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,973.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,235.99
|
| Rate for Payer: PACE Medicare |
$1,630.42
|
| Rate for Payer: PACE SWMI |
$1,716.23
|
| Rate for Payer: PHP Commercial |
$2,235.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,716.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$938.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,402.75
|
| Rate for Payer: Priority Health Medicare |
$1,716.23
|
| Rate for Payer: Priority Health Narrow Network |
$4,322.20
|
| Rate for Payer: Priority Health SBD |
$1,657.27
|
| Rate for Payer: Railroad Medicare Medicare |
$1,716.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$157.04
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,716.23
|
| Rate for Payer: UHC Exchange |
$142.76
|
| Rate for Payer: UHC Medicare Advantage |
$1,767.72
|
| Rate for Payer: UMR Bronson Commercial |
$973.31
|
| Rate for Payer: VA VA |
$1,716.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,972.94
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NR OR BRANCH SHOULDER EA ADDL NRV
|
Facility
|
OP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$109.56 |
| Max. Negotiated Rate |
$2,550.52 |
| Rate for Payer: Aetna American Axle |
$807.59
|
| Rate for Payer: Aetna Commercial |
$1,056.07
|
| Rate for Payer: Aetna Medicare |
$842.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$807.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$109.56
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$869.71
|
| Rate for Payer: Cofinity Commercial |
$1,068.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,118.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$869.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.83
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$1,056.07
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,550.52
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,040.42
|
| Rate for Payer: Priority Health SBD |
$782.74
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.23
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.19
|
| Rate for Payer: UHC Exchange |
$116.57
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$459.70
|
| Rate for Payer: VA VA |
$810.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.83
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NR OR BRANCH SHOULDER EA ADDL NRV
|
Facility
|
IP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$546.67 |
| Max. Negotiated Rate |
$1,118.20 |
| Rate for Payer: Aetna American Axle |
$807.59
|
| Rate for Payer: Aetna Commercial |
$1,056.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$807.59
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,068.50
|
| Rate for Payer: Cofinity Commercial |
$869.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Healthscope Commercial |
$1,118.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$869.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PHP Commercial |
$1,056.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health SBD |
$782.74
|
| Rate for Payer: UMR Bronson Commercial |
$546.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.83
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP EA ADDL NRV
|
Facility
|
OP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100598
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$109.56 |
| Max. Negotiated Rate |
$2,550.52 |
| Rate for Payer: Aetna American Axle |
$807.59
|
| Rate for Payer: Aetna Commercial |
$1,056.07
|
| Rate for Payer: Aetna Medicare |
$842.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$807.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$109.56
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,068.50
|
| Rate for Payer: Cofinity Commercial |
$869.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,118.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$869.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.83
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$1,056.07
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,550.52
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,040.42
|
| Rate for Payer: Priority Health SBD |
$782.74
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.23
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.19
|
| Rate for Payer: UHC Exchange |
$116.57
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$459.70
|
| Rate for Payer: VA VA |
$810.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.83
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP EA ADDL NRV
|
Facility
|
IP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100598
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$546.67 |
| Max. Negotiated Rate |
$1,118.20 |
| Rate for Payer: Aetna American Axle |
$807.59
|
| Rate for Payer: Aetna Commercial |
$1,056.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$807.59
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,068.50
|
| Rate for Payer: Cofinity Commercial |
$869.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Healthscope Commercial |
$1,118.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$869.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PHP Commercial |
$1,056.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health SBD |
$782.74
|
| Rate for Payer: UMR Bronson Commercial |
$546.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.83
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP SNG NRV
|
Facility
|
IP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$546.67 |
| Max. Negotiated Rate |
$1,118.20 |
| Rate for Payer: Aetna American Axle |
$807.59
|
| Rate for Payer: Aetna Commercial |
$1,056.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$807.59
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,068.50
|
| Rate for Payer: Cofinity Commercial |
$869.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Healthscope Commercial |
$1,118.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$869.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PHP Commercial |
$1,056.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health SBD |
$782.74
|
| Rate for Payer: UMR Bronson Commercial |
$546.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.83
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH HIP SNG NRV
|
Facility
|
OP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$109.56 |
| Max. Negotiated Rate |
$2,550.52 |
| Rate for Payer: Aetna American Axle |
$807.59
|
| Rate for Payer: Aetna Commercial |
$1,056.07
|
| Rate for Payer: Aetna Medicare |
$842.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$807.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$109.56
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,068.50
|
| Rate for Payer: Cofinity Commercial |
$869.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,118.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$869.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.83
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$1,056.07
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,550.52
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,040.42
|
| Rate for Payer: Priority Health SBD |
$782.74
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.23
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.19
|
| Rate for Payer: UHC Exchange |
$116.57
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$459.70
|
| Rate for Payer: VA VA |
$810.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.83
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH SHOULDER SNG NRV
|
Facility
|
IP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100595
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$546.67 |
| Max. Negotiated Rate |
$1,118.20 |
| Rate for Payer: Aetna American Axle |
$807.59
|
| Rate for Payer: Aetna Commercial |
$1,056.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$807.59
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,068.50
|
| Rate for Payer: Cofinity Commercial |
$869.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Healthscope Commercial |
$1,118.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$869.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PHP Commercial |
$1,056.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health SBD |
$782.74
|
| Rate for Payer: UMR Bronson Commercial |
$546.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.83
|
|
|
HC ABLAT BY NEUROLYTIC AGENT OTHER PERIPH NRV OR BRANCH SHOULDER SNG NRV
|
Facility
|
OP
|
$1,242.44
|
|
|
Service Code
|
CPT 64640
|
| Hospital Charge Code |
36100595
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$109.56 |
| Max. Negotiated Rate |
$2,550.52 |
| Rate for Payer: Aetna American Axle |
$807.59
|
| Rate for Payer: Aetna Commercial |
$1,056.07
|
| Rate for Payer: Aetna Medicare |
$842.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$807.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$109.56
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cash Price |
$993.95
|
| Rate for Payer: Cofinity Commercial |
$1,068.50
|
| Rate for Payer: Cofinity Commercial |
$869.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$993.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,118.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$869.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$931.83
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.07
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$1,056.07
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$869.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,550.52
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,040.42
|
| Rate for Payer: Priority Health SBD |
$782.74
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.23
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.19
|
| Rate for Payer: UHC Exchange |
$116.57
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$459.70
|
| Rate for Payer: VA VA |
$810.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$931.83
|
|
|
HC ABLATION AV NODE
|
Facility
|
IP
|
$8,390.89
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
48100044
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,691.99 |
| Max. Negotiated Rate |
$7,551.80 |
| Rate for Payer: Aetna American Axle |
$5,454.08
|
| Rate for Payer: Aetna Commercial |
$7,132.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,454.08
|
| Rate for Payer: Cash Price |
$6,712.71
|
| Rate for Payer: Cofinity Commercial |
$5,873.62
|
| Rate for Payer: Cofinity Commercial |
$7,216.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,712.71
|
| Rate for Payer: Healthscope Commercial |
$7,551.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,873.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,293.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,132.26
|
| Rate for Payer: PHP Commercial |
$7,132.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,873.62
|
| Rate for Payer: Priority Health SBD |
$5,286.26
|
| Rate for Payer: UMR Bronson Commercial |
$3,691.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,293.17
|
|
|
HC ABLATION AV NODE
|
Facility
|
OP
|
$8,390.89
|
|
|
Service Code
|
CPT 93650
|
| Hospital Charge Code |
48100044
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$556.65 |
| Max. Negotiated Rate |
$20,897.69 |
| Rate for Payer: Aetna American Axle |
$5,454.08
|
| Rate for Payer: Aetna Commercial |
$7,132.26
|
| Rate for Payer: Aetna Medicare |
$6,903.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,454.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,297.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,297.88
|
| Rate for Payer: BCBS Complete |
$3,813.04
|
| Rate for Payer: BCBS MAPPO |
$6,638.30
|
| Rate for Payer: BCBS Trust/PPO |
$784.17
|
| Rate for Payer: BCN Medicare Advantage |
$6,638.30
|
| Rate for Payer: Cash Price |
$6,712.71
|
| Rate for Payer: Cash Price |
$6,712.71
|
| Rate for Payer: Cofinity Commercial |
$5,873.62
|
| Rate for Payer: Cofinity Commercial |
$7,216.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,712.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,638.30
|
| Rate for Payer: Healthscope Commercial |
$7,551.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,873.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,293.17
|
| Rate for Payer: Mclaren Medicaid |
$3,631.15
|
| Rate for Payer: Mclaren Medicare |
$6,638.30
|
| Rate for Payer: Meridian Medicaid |
$3,813.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,970.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,634.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,132.26
|
| Rate for Payer: PACE Medicare |
$6,306.38
|
| Rate for Payer: PACE SWMI |
$6,638.30
|
| Rate for Payer: PHP Commercial |
$7,132.26
|
| Rate for Payer: PHP Medicare Advantage |
$6,638.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,631.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,873.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,897.69
|
| Rate for Payer: Priority Health Medicare |
$6,638.30
|
| Rate for Payer: Priority Health Narrow Network |
$16,718.15
|
| Rate for Payer: Priority Health SBD |
$5,286.26
|
| Rate for Payer: Railroad Medicare Medicare |
$6,638.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$612.32
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,638.30
|
| Rate for Payer: UHC Exchange |
$556.65
|
| Rate for Payer: UHC Medicare Advantage |
$6,837.45
|
| Rate for Payer: UMR Bronson Commercial |
$3,104.63
|
| Rate for Payer: VA VA |
$6,638.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,293.17
|
|
|
HC ABLATION BONE
|
Facility
|
OP
|
$6,643.07
|
|
|
Service Code
|
CPT 20982
|
| Hospital Charge Code |
36100480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$354.29 |
| Max. Negotiated Rate |
$36,827.89 |
| Rate for Payer: Aetna American Axle |
$4,318.00
|
| Rate for Payer: Aetna Commercial |
$5,646.61
|
| Rate for Payer: Aetna Medicare |
$12,166.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,318.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,623.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,623.31
|
| Rate for Payer: BCBS Complete |
$6,719.70
|
| Rate for Payer: BCBS MAPPO |
$11,698.65
|
| Rate for Payer: BCBS Trust/PPO |
$3,934.75
|
| Rate for Payer: BCN Medicare Advantage |
$11,698.65
|
| Rate for Payer: Cash Price |
$5,314.46
|
| Rate for Payer: Cash Price |
$5,314.46
|
| Rate for Payer: Cofinity Commercial |
$4,650.15
|
| Rate for Payer: Cofinity Commercial |
$5,713.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,314.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,698.65
|
| Rate for Payer: Healthscope Commercial |
$5,978.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,650.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,982.30
|
| Rate for Payer: Mclaren Medicaid |
$6,399.16
|
| Rate for Payer: Mclaren Medicare |
$11,698.65
|
| Rate for Payer: Meridian Medicaid |
$6,719.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12,283.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,453.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,646.61
|
| Rate for Payer: PACE Medicare |
$11,113.72
|
| Rate for Payer: PACE SWMI |
$11,698.65
|
| Rate for Payer: PHP Commercial |
$5,646.61
|
| Rate for Payer: PHP Medicare Advantage |
$11,698.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,399.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,650.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36,827.89
|
| Rate for Payer: Priority Health Medicare |
$11,698.65
|
| Rate for Payer: Priority Health Narrow Network |
$29,462.31
|
| Rate for Payer: Priority Health SBD |
$4,185.13
|
| Rate for Payer: Railroad Medicare Medicare |
$11,698.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$389.72
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,698.65
|
| Rate for Payer: UHC Exchange |
$354.29
|
| Rate for Payer: UHC Medicare Advantage |
$12,049.61
|
| Rate for Payer: UMR Bronson Commercial |
$2,457.94
|
| Rate for Payer: VA VA |
$11,698.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,982.30
|
|
|
HC ABLATION BONE
|
Facility
|
IP
|
$6,643.07
|
|
|
Service Code
|
CPT 20982
|
| Hospital Charge Code |
36100480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,922.95 |
| Max. Negotiated Rate |
$5,978.76 |
| Rate for Payer: Aetna American Axle |
$4,318.00
|
| Rate for Payer: Aetna Commercial |
$5,646.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,318.00
|
| Rate for Payer: Cash Price |
$5,314.46
|
| Rate for Payer: Cofinity Commercial |
$4,650.15
|
| Rate for Payer: Cofinity Commercial |
$5,713.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,314.46
|
| Rate for Payer: Healthscope Commercial |
$5,978.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,650.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,982.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,646.61
|
| Rate for Payer: PHP Commercial |
$5,646.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,650.15
|
| Rate for Payer: Priority Health SBD |
$4,185.13
|
| Rate for Payer: UMR Bronson Commercial |
$2,922.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,982.30
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T EA ADDL JOINT
|
Facility
|
OP
|
$1,071.00
|
|
|
Service Code
|
CPT 64634
|
| Hospital Charge Code |
36100591
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$65.16 |
| Max. Negotiated Rate |
$963.90 |
| Rate for Payer: Aetna American Axle |
$696.15
|
| Rate for Payer: Aetna Commercial |
$910.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.15
|
| Rate for Payer: BCBS Complete |
$428.40
|
| Rate for Payer: BCBS Trust/PPO |
$640.89
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$921.06
|
| Rate for Payer: Cofinity Commercial |
$749.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Healthscope Commercial |
$963.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$749.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$803.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$910.35
|
| Rate for Payer: PHP Commercial |
$910.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.70
|
| Rate for Payer: Priority Health SBD |
$674.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.68
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$65.16
|
| Rate for Payer: UMR Bronson Commercial |
$396.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$803.25
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T EA ADDL JOINT
|
Facility
|
IP
|
$1,071.00
|
|
|
Service Code
|
CPT 64634
|
| Hospital Charge Code |
36100591
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$471.24 |
| Max. Negotiated Rate |
$963.90 |
| Rate for Payer: Aetna American Axle |
$696.15
|
| Rate for Payer: Aetna Commercial |
$910.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.15
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$921.06
|
| Rate for Payer: Cofinity Commercial |
$749.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Healthscope Commercial |
$963.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$749.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$803.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$910.35
|
| Rate for Payer: PHP Commercial |
$910.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.70
|
| Rate for Payer: Priority Health SBD |
$674.73
|
| Rate for Payer: UMR Bronson Commercial |
$471.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$803.25
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T SNG LVL
|
Facility
|
IP
|
$2,630.61
|
|
|
Service Code
|
CPT 64633
|
| Hospital Charge Code |
36100590
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,157.47 |
| Max. Negotiated Rate |
$2,367.55 |
| Rate for Payer: Aetna American Axle |
$1,709.90
|
| Rate for Payer: Aetna Commercial |
$2,236.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,709.90
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cofinity Commercial |
$1,841.43
|
| Rate for Payer: Cofinity Commercial |
$2,262.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.49
|
| Rate for Payer: Healthscope Commercial |
$2,367.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,841.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,972.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,236.02
|
| Rate for Payer: PHP Commercial |
$2,236.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.43
|
| Rate for Payer: Priority Health SBD |
$1,657.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,157.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,972.96
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT C OR T SNG LVL
|
Facility
|
OP
|
$2,630.61
|
|
|
Service Code
|
CPT 64633
|
| Hospital Charge Code |
36100590
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$187.95 |
| Max. Negotiated Rate |
$5,402.75 |
| Rate for Payer: Aetna American Axle |
$1,709.90
|
| Rate for Payer: Aetna Commercial |
$2,236.02
|
| Rate for Payer: Aetna Medicare |
$1,784.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,709.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,145.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,145.29
|
| Rate for Payer: BCBS Complete |
$985.80
|
| Rate for Payer: BCBS MAPPO |
$1,716.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,313.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,716.23
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cofinity Commercial |
$1,841.43
|
| Rate for Payer: Cofinity Commercial |
$2,262.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,716.23
|
| Rate for Payer: Healthscope Commercial |
$2,367.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,841.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,972.96
|
| Rate for Payer: Mclaren Medicaid |
$938.78
|
| Rate for Payer: Mclaren Medicare |
$1,716.23
|
| Rate for Payer: Meridian Medicaid |
$985.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,802.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,973.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,236.02
|
| Rate for Payer: PACE Medicare |
$1,630.42
|
| Rate for Payer: PACE SWMI |
$1,716.23
|
| Rate for Payer: PHP Commercial |
$2,236.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,716.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$938.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,402.75
|
| Rate for Payer: Priority Health Medicare |
$1,716.23
|
| Rate for Payer: Priority Health Narrow Network |
$4,322.20
|
| Rate for Payer: Priority Health SBD |
$1,657.28
|
| Rate for Payer: Railroad Medicare Medicare |
$1,716.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.74
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,716.23
|
| Rate for Payer: UHC Exchange |
$187.95
|
| Rate for Payer: UHC Medicare Advantage |
$1,767.72
|
| Rate for Payer: UMR Bronson Commercial |
$973.33
|
| Rate for Payer: VA VA |
$1,716.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,972.96
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S EA ADDL JOINT
|
Facility
|
OP
|
$1,071.00
|
|
|
Service Code
|
CPT 64636
|
| Hospital Charge Code |
36100593
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$56.97 |
| Max. Negotiated Rate |
$963.90 |
| Rate for Payer: Aetna American Axle |
$696.15
|
| Rate for Payer: Aetna Commercial |
$910.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.15
|
| Rate for Payer: BCBS Complete |
$428.40
|
| Rate for Payer: BCBS Trust/PPO |
$583.06
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$921.06
|
| Rate for Payer: Cofinity Commercial |
$749.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Healthscope Commercial |
$963.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$749.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$803.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$910.35
|
| Rate for Payer: PHP Commercial |
$910.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.70
|
| Rate for Payer: Priority Health SBD |
$674.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.67
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$56.97
|
| Rate for Payer: UMR Bronson Commercial |
$396.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$803.25
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S EA ADDL JOINT
|
Facility
|
IP
|
$1,071.00
|
|
|
Service Code
|
CPT 64636
|
| Hospital Charge Code |
36100593
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$471.24 |
| Max. Negotiated Rate |
$963.90 |
| Rate for Payer: Aetna American Axle |
$696.15
|
| Rate for Payer: Aetna Commercial |
$910.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.15
|
| Rate for Payer: Cash Price |
$856.80
|
| Rate for Payer: Cofinity Commercial |
$749.70
|
| Rate for Payer: Cofinity Commercial |
$921.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$856.80
|
| Rate for Payer: Healthscope Commercial |
$963.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$749.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$803.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$910.35
|
| Rate for Payer: PHP Commercial |
$910.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$749.70
|
| Rate for Payer: Priority Health SBD |
$674.73
|
| Rate for Payer: UMR Bronson Commercial |
$471.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$803.25
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S SNG LVL
|
Facility
|
IP
|
$2,630.61
|
|
|
Service Code
|
CPT 64635
|
| Hospital Charge Code |
36100592
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,157.47 |
| Max. Negotiated Rate |
$2,367.55 |
| Rate for Payer: Aetna American Axle |
$1,709.90
|
| Rate for Payer: Aetna Commercial |
$2,236.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,709.90
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cofinity Commercial |
$1,841.43
|
| Rate for Payer: Cofinity Commercial |
$2,262.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.49
|
| Rate for Payer: Healthscope Commercial |
$2,367.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,841.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,972.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,236.02
|
| Rate for Payer: PHP Commercial |
$2,236.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.43
|
| Rate for Payer: Priority Health SBD |
$1,657.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,157.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,972.96
|
|
|
HC ABLATION BY NEUROLYTIC AGENT FACET JT L OR S SNG LVL
|
Facility
|
OP
|
$2,630.61
|
|
|
Service Code
|
CPT 64635
|
| Hospital Charge Code |
36100592
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$188.28 |
| Max. Negotiated Rate |
$5,402.75 |
| Rate for Payer: Aetna American Axle |
$1,709.90
|
| Rate for Payer: Aetna Commercial |
$2,236.02
|
| Rate for Payer: Aetna Medicare |
$1,784.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,709.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,145.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,145.29
|
| Rate for Payer: BCBS Complete |
$985.80
|
| Rate for Payer: BCBS MAPPO |
$1,716.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,471.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,716.23
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cash Price |
$2,104.49
|
| Rate for Payer: Cofinity Commercial |
$2,262.32
|
| Rate for Payer: Cofinity Commercial |
$1,841.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,104.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,716.23
|
| Rate for Payer: Healthscope Commercial |
$2,367.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,841.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,972.96
|
| Rate for Payer: Mclaren Medicaid |
$938.78
|
| Rate for Payer: Mclaren Medicare |
$1,716.23
|
| Rate for Payer: Meridian Medicaid |
$985.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,802.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,973.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,236.02
|
| Rate for Payer: PACE Medicare |
$1,630.42
|
| Rate for Payer: PACE SWMI |
$1,716.23
|
| Rate for Payer: PHP Commercial |
$2,236.02
|
| Rate for Payer: PHP Medicare Advantage |
$1,716.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$938.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,841.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,402.75
|
| Rate for Payer: Priority Health Medicare |
$1,716.23
|
| Rate for Payer: Priority Health Narrow Network |
$4,322.20
|
| Rate for Payer: Priority Health SBD |
$1,657.28
|
| Rate for Payer: Railroad Medicare Medicare |
$1,716.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.11
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,716.23
|
| Rate for Payer: UHC Exchange |
$188.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,767.72
|
| Rate for Payer: UMR Bronson Commercial |
$973.33
|
| Rate for Payer: VA VA |
$1,716.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,972.96
|
|
|
HC ABLATION CATHETER
|
Facility
|
IP
|
$4,261.53
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,875.07 |
| Max. Negotiated Rate |
$3,835.38 |
| Rate for Payer: Aetna American Axle |
$2,769.99
|
| Rate for Payer: Aetna Commercial |
$3,622.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,769.99
|
| Rate for Payer: Cash Price |
$3,409.22
|
| Rate for Payer: Cofinity Commercial |
$2,983.07
|
| Rate for Payer: Cofinity Commercial |
$3,664.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,409.22
|
| Rate for Payer: Healthscope Commercial |
$3,835.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,983.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,196.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,622.30
|
| Rate for Payer: PHP Commercial |
$3,622.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.07
|
| Rate for Payer: Priority Health SBD |
$2,684.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,875.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,196.15
|
|
|
HC ABLATION CATHETER
|
Facility
|
OP
|
$4,261.53
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$3,835.38 |
| Rate for Payer: Aetna American Axle |
$2,769.99
|
| Rate for Payer: Aetna Commercial |
$3,622.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,769.99
|
| Rate for Payer: BCBS Complete |
$1,704.61
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: Cash Price |
$3,409.22
|
| Rate for Payer: Cash Price |
$3,409.22
|
| Rate for Payer: Cofinity Commercial |
$2,983.07
|
| Rate for Payer: Cofinity Commercial |
$3,664.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,409.22
|
| Rate for Payer: Healthscope Commercial |
$3,835.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,983.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,196.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,622.30
|
| Rate for Payer: PHP Commercial |
$3,622.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.07
|
| Rate for Payer: Priority Health SBD |
$2,684.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,576.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,196.15
|
|
|
HC ABLATION CATHETER (8/10 MM TIP
|
Facility
|
IP
|
$5,796.29
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,550.37 |
| Max. Negotiated Rate |
$5,216.66 |
| Rate for Payer: Aetna American Axle |
$3,767.59
|
| Rate for Payer: Aetna Commercial |
$4,926.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,767.59
|
| Rate for Payer: Cash Price |
$4,637.03
|
| Rate for Payer: Cofinity Commercial |
$4,057.40
|
| Rate for Payer: Cofinity Commercial |
$4,984.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,637.03
|
| Rate for Payer: Healthscope Commercial |
$5,216.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,057.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,347.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,926.85
|
| Rate for Payer: PHP Commercial |
$4,926.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,057.40
|
| Rate for Payer: Priority Health SBD |
$3,651.66
|
| Rate for Payer: UMR Bronson Commercial |
$2,550.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,347.22
|
|
