|
HC CROSSMATCH IMMED SPIN
|
Facility
|
IP
|
$90.07
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
30200351
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.63 |
| Max. Negotiated Rate |
$81.06 |
| Rate for Payer: Aetna American Axle |
$58.55
|
| Rate for Payer: Aetna Commercial |
$76.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.55
|
| Rate for Payer: Cash Price |
$72.06
|
| Rate for Payer: Cofinity Commercial |
$63.05
|
| Rate for Payer: Cofinity Commercial |
$77.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.06
|
| Rate for Payer: Healthscope Commercial |
$81.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.56
|
| Rate for Payer: PHP Commercial |
$76.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: Priority Health SBD |
$56.74
|
| Rate for Payer: UMR Bronson Commercial |
$39.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.55
|
|
|
HC CROSSMATCH IMMED SPIN
|
Facility
|
OP
|
$90.07
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
30200351
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$477.95 |
| Rate for Payer: Aetna American Axle |
$58.55
|
| Rate for Payer: Aetna Commercial |
$76.56
|
| Rate for Payer: Aetna Medicare |
$157.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.78
|
| Rate for Payer: BCBS Complete |
$87.21
|
| Rate for Payer: BCBS MAPPO |
$151.82
|
| Rate for Payer: BCBS Trust/PPO |
$5.40
|
| Rate for Payer: BCN Medicare Advantage |
$151.82
|
| Rate for Payer: Cash Price |
$72.06
|
| Rate for Payer: Cash Price |
$72.06
|
| Rate for Payer: Cofinity Commercial |
$77.46
|
| Rate for Payer: Cofinity Commercial |
$63.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.82
|
| Rate for Payer: Healthscope Commercial |
$81.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.55
|
| Rate for Payer: Mclaren Medicaid |
$83.05
|
| Rate for Payer: Mclaren Medicare |
$151.82
|
| Rate for Payer: Meridian Medicaid |
$87.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$159.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.56
|
| Rate for Payer: PACE Medicare |
$144.23
|
| Rate for Payer: PACE SWMI |
$151.82
|
| Rate for Payer: PHP Commercial |
$76.56
|
| Rate for Payer: PHP Medicare Advantage |
$151.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$477.95
|
| Rate for Payer: Priority Health Medicare |
$151.82
|
| Rate for Payer: Priority Health Narrow Network |
$382.36
|
| Rate for Payer: Priority Health SBD |
$56.74
|
| Rate for Payer: Railroad Medicare Medicare |
$151.82
|
| Rate for Payer: UHC Core |
$21.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.82
|
| Rate for Payer: UHC Medicare Advantage |
$156.37
|
| Rate for Payer: UMR Bronson Commercial |
$33.33
|
| Rate for Payer: VA VA |
$151.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.55
|
|
|
HC CROSSMATCH PREWARM
|
Facility
|
IP
|
$228.50
|
|
|
Service Code
|
CPT 86921
|
| Hospital Charge Code |
30200491
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$100.54 |
| Max. Negotiated Rate |
$205.65 |
| Rate for Payer: Aetna American Axle |
$148.52
|
| Rate for Payer: Aetna Commercial |
$194.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.52
|
| Rate for Payer: Cash Price |
$182.80
|
| Rate for Payer: Cofinity Commercial |
$196.51
|
| Rate for Payer: Cofinity Commercial |
$159.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.80
|
| Rate for Payer: Healthscope Commercial |
$205.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$159.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$194.22
|
| Rate for Payer: PHP Commercial |
$194.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.95
|
| Rate for Payer: Priority Health SBD |
$143.96
|
| Rate for Payer: UMR Bronson Commercial |
$100.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.38
|
|
|
HC CROSSMATCH PREWARM
|
Facility
|
OP
|
$228.50
|
|
|
Service Code
|
CPT 86921
|
| Hospital Charge Code |
30200491
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$477.95 |
| Rate for Payer: Aetna American Axle |
$148.52
|
| Rate for Payer: Aetna Commercial |
$194.22
|
| Rate for Payer: Aetna Medicare |
$157.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.78
|
| Rate for Payer: BCBS Complete |
$87.21
|
| Rate for Payer: BCBS MAPPO |
$151.82
|
| Rate for Payer: BCBS Trust/PPO |
$5.40
|
| Rate for Payer: BCN Medicare Advantage |
$151.82
|
| Rate for Payer: Cash Price |
$182.80
|
| Rate for Payer: Cash Price |
$182.80
|
| Rate for Payer: Cofinity Commercial |
$159.95
|
| Rate for Payer: Cofinity Commercial |
$196.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.82
|
| Rate for Payer: Healthscope Commercial |
$205.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$159.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.38
|
| Rate for Payer: Mclaren Medicaid |
$83.05
|
| Rate for Payer: Mclaren Medicare |
$151.82
|
| Rate for Payer: Meridian Medicaid |
$87.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$159.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$194.22
|
| Rate for Payer: PACE Medicare |
$144.23
|
| Rate for Payer: PACE SWMI |
$151.82
|
| Rate for Payer: PHP Commercial |
$194.22
|
| Rate for Payer: PHP Medicare Advantage |
$151.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$477.95
|
| Rate for Payer: Priority Health Medicare |
$151.82
|
| Rate for Payer: Priority Health Narrow Network |
$382.36
|
| Rate for Payer: Priority Health SBD |
$143.96
|
| Rate for Payer: Railroad Medicare Medicare |
$151.82
|
| Rate for Payer: UHC Core |
$21.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.82
|
| Rate for Payer: UHC Medicare Advantage |
$156.37
|
| Rate for Payer: UMR Bronson Commercial |
$84.54
|
| Rate for Payer: VA VA |
$151.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.38
|
|
|
HC CRP HIGH SENSITIVITY CARDIAC RISK
|
Facility
|
IP
|
$90.40
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
30200138
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.78 |
| Max. Negotiated Rate |
$81.36 |
| Rate for Payer: Aetna American Axle |
$58.76
|
| Rate for Payer: Aetna Commercial |
$76.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.76
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cofinity Commercial |
$63.28
|
| Rate for Payer: Cofinity Commercial |
$77.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.32
|
| Rate for Payer: Healthscope Commercial |
$81.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.84
|
| Rate for Payer: PHP Commercial |
$76.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.28
|
| Rate for Payer: Priority Health SBD |
$56.95
|
| Rate for Payer: UMR Bronson Commercial |
$39.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.80
|
|
|
HC CRP HIGH SENSITIVITY CARDIAC RISK
|
Facility
|
OP
|
$90.40
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
30200138
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.08 |
| Max. Negotiated Rate |
$81.36 |
| Rate for Payer: Aetna American Axle |
$58.76
|
| Rate for Payer: Aetna Commercial |
$76.84
|
| Rate for Payer: Aetna Medicare |
$13.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.19
|
| Rate for Payer: BCBS Complete |
$7.44
|
| Rate for Payer: BCBS MAPPO |
$12.95
|
| Rate for Payer: BCBS Trust/PPO |
$11.64
|
| Rate for Payer: BCN Medicare Advantage |
$12.95
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cofinity Commercial |
$63.28
|
| Rate for Payer: Cofinity Commercial |
$77.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.95
|
| Rate for Payer: Healthscope Commercial |
$81.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.80
|
| Rate for Payer: Mclaren Medicaid |
$7.08
|
| Rate for Payer: Mclaren Medicare |
$12.95
|
| Rate for Payer: Meridian Medicaid |
$7.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.84
|
| Rate for Payer: PACE Medicare |
$12.30
|
| Rate for Payer: PACE SWMI |
$12.95
|
| Rate for Payer: PHP Commercial |
$76.84
|
| Rate for Payer: PHP Medicare Advantage |
$12.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.76
|
| Rate for Payer: Priority Health Medicare |
$12.95
|
| Rate for Payer: Priority Health Narrow Network |
$14.21
|
| Rate for Payer: Priority Health SBD |
$56.95
|
| Rate for Payer: Railroad Medicare Medicare |
$12.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.54
|
| Rate for Payer: UHC Core |
$21.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.95
|
| Rate for Payer: UHC Exchange |
$12.95
|
| Rate for Payer: UHC Medicare Advantage |
$13.34
|
| Rate for Payer: UMR Bronson Commercial |
$33.45
|
| Rate for Payer: VA VA |
$12.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.80
|
|
|
HC CRP-SF
|
Facility
|
IP
|
$29.38
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.93 |
| Max. Negotiated Rate |
$26.44 |
| Rate for Payer: Aetna American Axle |
$19.10
|
| Rate for Payer: Aetna Commercial |
$24.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.10
|
| Rate for Payer: Cash Price |
$23.50
|
| Rate for Payer: Cofinity Commercial |
$20.57
|
| Rate for Payer: Cofinity Commercial |
$25.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.50
|
| Rate for Payer: Healthscope Commercial |
$26.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.97
|
| Rate for Payer: PHP Commercial |
$24.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.57
|
| Rate for Payer: Priority Health SBD |
$18.51
|
| Rate for Payer: UMR Bronson Commercial |
$12.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.04
|
|
|
HC CRP-SF
|
Facility
|
OP
|
$29.38
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.83 |
| Max. Negotiated Rate |
$26.44 |
| Rate for Payer: Aetna American Axle |
$19.10
|
| Rate for Payer: Aetna Commercial |
$24.97
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.48
|
| Rate for Payer: BCBS Complete |
$2.98
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$4.66
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$23.50
|
| Rate for Payer: Cash Price |
$23.50
|
| Rate for Payer: Cofinity Commercial |
$25.27
|
| Rate for Payer: Cofinity Commercial |
$20.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$26.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.04
|
| Rate for Payer: Mclaren Medicaid |
$2.83
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Medicaid |
$2.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.97
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$24.97
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.10
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$5.68
|
| Rate for Payer: Priority Health SBD |
$18.51
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.22
|
| Rate for Payer: UHC Core |
$8.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Exchange |
$5.18
|
| Rate for Payer: UHC Medicare Advantage |
$5.34
|
| Rate for Payer: UMR Bronson Commercial |
$10.87
|
| Rate for Payer: VA VA |
$5.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.04
|
|
|
HC CRRT INITIAL
|
Facility
|
IP
|
$700.00
|
|
| Hospital Charge Code |
27000607
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$308.00 |
| Max. Negotiated Rate |
$630.00 |
| Rate for Payer: Aetna American Axle |
$455.00
|
| Rate for Payer: Aetna Commercial |
$595.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cofinity Commercial |
$490.00
|
| Rate for Payer: Cofinity Commercial |
$602.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.00
|
| Rate for Payer: Healthscope Commercial |
$630.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$490.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$595.00
|
| Rate for Payer: PHP Commercial |
$595.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
| Rate for Payer: Priority Health SBD |
$441.00
|
| Rate for Payer: UMR Bronson Commercial |
$308.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.00
|
|
|
HC CRRT INITIAL
|
Facility
|
OP
|
$700.00
|
|
| Hospital Charge Code |
27000607
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$259.00 |
| Max. Negotiated Rate |
$630.00 |
| Rate for Payer: Aetna American Axle |
$455.00
|
| Rate for Payer: Aetna Commercial |
$595.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.00
|
| Rate for Payer: BCBS Complete |
$280.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cofinity Commercial |
$490.00
|
| Rate for Payer: Cofinity Commercial |
$602.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.00
|
| Rate for Payer: Healthscope Commercial |
$630.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$490.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$595.00
|
| Rate for Payer: PHP Commercial |
$595.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
| Rate for Payer: Priority Health SBD |
$441.00
|
| Rate for Payer: UMR Bronson Commercial |
$259.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.00
|
|
|
HC CRRT INITIATION/REINITIATION
|
Facility
|
OP
|
$1,112.82
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
88000001
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$83.17 |
| Max. Negotiated Rate |
$1,239.37 |
| Rate for Payer: Aetna American Axle |
$723.33
|
| Rate for Payer: Aetna Commercial |
$945.90
|
| Rate for Payer: Aetna Medicare |
$409.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$723.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.11
|
| Rate for Payer: BCBS Complete |
$226.14
|
| Rate for Payer: BCBS MAPPO |
$393.69
|
| Rate for Payer: BCN Medicare Advantage |
$393.69
|
| Rate for Payer: Cash Price |
$890.26
|
| Rate for Payer: Cash Price |
$890.26
|
| Rate for Payer: Cofinity Commercial |
$957.03
|
| Rate for Payer: Cofinity Commercial |
$778.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$890.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.69
|
| Rate for Payer: Healthscope Commercial |
$1,001.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$778.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$834.62
|
| Rate for Payer: Mclaren Medicaid |
$215.35
|
| Rate for Payer: Mclaren Medicare |
$393.69
|
| Rate for Payer: Meridian Medicaid |
$226.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$413.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$945.90
|
| Rate for Payer: PACE Medicare |
$374.01
|
| Rate for Payer: PACE SWMI |
$393.69
|
| Rate for Payer: PHP Commercial |
$945.90
|
| Rate for Payer: PHP Medicare Advantage |
$393.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,239.37
|
| Rate for Payer: Priority Health Medicare |
$393.69
|
| Rate for Payer: Priority Health Narrow Network |
$991.50
|
| Rate for Payer: Priority Health SBD |
$701.08
|
| Rate for Payer: Railroad Medicare Medicare |
$393.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.69
|
| Rate for Payer: UHC Exchange |
$83.17
|
| Rate for Payer: UHC Medicare Advantage |
$405.50
|
| Rate for Payer: UMR Bronson Commercial |
$411.74
|
| Rate for Payer: VA VA |
$393.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$834.62
|
|
|
HC CRRT INITIATION/REINITIATION
|
Facility
|
IP
|
$1,112.82
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
88000001
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$489.64 |
| Max. Negotiated Rate |
$1,001.54 |
| Rate for Payer: Aetna American Axle |
$723.33
|
| Rate for Payer: Aetna Commercial |
$945.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$723.33
|
| Rate for Payer: Cash Price |
$890.26
|
| Rate for Payer: Cofinity Commercial |
$778.97
|
| Rate for Payer: Cofinity Commercial |
$957.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$890.26
|
| Rate for Payer: Healthscope Commercial |
$1,001.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$778.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$834.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$945.90
|
| Rate for Payer: PHP Commercial |
$945.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$778.97
|
| Rate for Payer: Priority Health SBD |
$701.08
|
| Rate for Payer: UMR Bronson Commercial |
$489.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$834.62
|
|
|
HC CRRT MONITOR FEE
|
Facility
|
OP
|
$125.00
|
|
| Hospital Charge Code |
27000609
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$46.25 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna American Axle |
$81.25
|
| Rate for Payer: Aetna Commercial |
$106.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.25
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$107.50
|
| Rate for Payer: Cofinity Commercial |
$87.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Healthscope Commercial |
$112.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$106.25
|
| Rate for Payer: PHP Commercial |
$106.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.50
|
| Rate for Payer: Priority Health SBD |
$78.75
|
| Rate for Payer: UMR Bronson Commercial |
$46.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.75
|
|
|
HC CRRT MONITOR FEE
|
Facility
|
IP
|
$125.00
|
|
| Hospital Charge Code |
27000609
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.00 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Aetna American Axle |
$81.25
|
| Rate for Payer: Aetna Commercial |
$106.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.25
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$87.50
|
| Rate for Payer: Cofinity Commercial |
$107.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.00
|
| Rate for Payer: Healthscope Commercial |
$112.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$106.25
|
| Rate for Payer: PHP Commercial |
$106.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.50
|
| Rate for Payer: Priority Health SBD |
$78.75
|
| Rate for Payer: UMR Bronson Commercial |
$55.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.75
|
|
|
HC CRRT MONITORING PER HOUR
|
Facility
|
OP
|
$408.67
|
|
| Hospital Charge Code |
88000002
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$151.21 |
| Max. Negotiated Rate |
$367.80 |
| Rate for Payer: Aetna American Axle |
$265.64
|
| Rate for Payer: Aetna Commercial |
$347.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.64
|
| Rate for Payer: BCBS Complete |
$163.47
|
| Rate for Payer: Cash Price |
$326.94
|
| Rate for Payer: Cofinity Commercial |
$286.07
|
| Rate for Payer: Cofinity Commercial |
$351.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.94
|
| Rate for Payer: Healthscope Commercial |
$367.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$286.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$347.37
|
| Rate for Payer: PHP Commercial |
$347.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.07
|
| Rate for Payer: Priority Health SBD |
$257.46
|
| Rate for Payer: UMR Bronson Commercial |
$151.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.50
|
|
|
HC CRRT MONITORING PER HOUR
|
Facility
|
IP
|
$408.67
|
|
| Hospital Charge Code |
88000002
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$179.81 |
| Max. Negotiated Rate |
$367.80 |
| Rate for Payer: Aetna American Axle |
$265.64
|
| Rate for Payer: Aetna Commercial |
$347.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.64
|
| Rate for Payer: Cash Price |
$326.94
|
| Rate for Payer: Cofinity Commercial |
$286.07
|
| Rate for Payer: Cofinity Commercial |
$351.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.94
|
| Rate for Payer: Healthscope Commercial |
$367.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$286.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$347.37
|
| Rate for Payer: PHP Commercial |
$347.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.07
|
| Rate for Payer: Priority Health SBD |
$257.46
|
| Rate for Payer: UMR Bronson Commercial |
$179.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.50
|
|
|
HC CRRT SUBSEQUENT CARTRIDGE
|
Facility
|
OP
|
$275.00
|
|
| Hospital Charge Code |
27000608
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$101.75 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Aetna American Axle |
$178.75
|
| Rate for Payer: Aetna Commercial |
$233.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.75
|
| Rate for Payer: BCBS Complete |
$110.00
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cofinity Commercial |
$192.50
|
| Rate for Payer: Cofinity Commercial |
$236.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.00
|
| Rate for Payer: Healthscope Commercial |
$247.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$192.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.75
|
| Rate for Payer: PHP Commercial |
$233.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.50
|
| Rate for Payer: Priority Health SBD |
$173.25
|
| Rate for Payer: UMR Bronson Commercial |
$101.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.25
|
|
|
HC CRRT SUBSEQUENT CARTRIDGE
|
Facility
|
IP
|
$275.00
|
|
| Hospital Charge Code |
27000608
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$121.00 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Aetna American Axle |
$178.75
|
| Rate for Payer: Aetna Commercial |
$233.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.75
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cofinity Commercial |
$192.50
|
| Rate for Payer: Cofinity Commercial |
$236.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.00
|
| Rate for Payer: Healthscope Commercial |
$247.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$192.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.75
|
| Rate for Payer: PHP Commercial |
$233.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.50
|
| Rate for Payer: Priority Health SBD |
$173.25
|
| Rate for Payer: UMR Bronson Commercial |
$121.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.25
|
|
|
HC CRUTCHES
|
Facility
|
IP
|
$124.22
|
|
| Hospital Charge Code |
96000002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.66 |
| Max. Negotiated Rate |
$111.80 |
| Rate for Payer: Aetna American Axle |
$80.74
|
| Rate for Payer: Aetna Commercial |
$105.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.74
|
| Rate for Payer: Cash Price |
$99.38
|
| Rate for Payer: Cofinity Commercial |
$106.83
|
| Rate for Payer: Cofinity Commercial |
$86.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.38
|
| Rate for Payer: Healthscope Commercial |
$111.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$105.59
|
| Rate for Payer: PHP Commercial |
$105.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.95
|
| Rate for Payer: Priority Health SBD |
$78.26
|
| Rate for Payer: UMR Bronson Commercial |
$54.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.16
|
|
|
HC CRUTCHES
|
Facility
|
OP
|
$124.22
|
|
| Hospital Charge Code |
96000002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.96 |
| Max. Negotiated Rate |
$111.80 |
| Rate for Payer: Aetna American Axle |
$80.74
|
| Rate for Payer: Aetna Commercial |
$105.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.74
|
| Rate for Payer: BCBS Complete |
$49.69
|
| Rate for Payer: Cash Price |
$99.38
|
| Rate for Payer: Cofinity Commercial |
$106.83
|
| Rate for Payer: Cofinity Commercial |
$86.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.38
|
| Rate for Payer: Healthscope Commercial |
$111.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$105.59
|
| Rate for Payer: PHP Commercial |
$105.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.95
|
| Rate for Payer: Priority Health SBD |
$78.26
|
| Rate for Payer: UMR Bronson Commercial |
$45.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.16
|
|
|
HC CRYOABLATION KIDNEY UNILATERAL
|
Facility
|
OP
|
$11,844.24
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
36100572
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$438.44 |
| Max. Negotiated Rate |
$28,804.18 |
| Rate for Payer: Aetna American Axle |
$7,698.76
|
| Rate for Payer: Aetna Commercial |
$10,067.60
|
| Rate for Payer: Aetna Medicare |
$9,515.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,698.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,437.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,437.32
|
| Rate for Payer: BCBS Complete |
$5,255.68
|
| Rate for Payer: BCBS MAPPO |
$9,149.86
|
| Rate for Payer: BCBS Trust/PPO |
$5,982.15
|
| Rate for Payer: BCN Medicare Advantage |
$9,149.86
|
| Rate for Payer: Cash Price |
$9,475.39
|
| Rate for Payer: Cash Price |
$9,475.39
|
| Rate for Payer: Cofinity Commercial |
$8,290.97
|
| Rate for Payer: Cofinity Commercial |
$10,186.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,475.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,149.86
|
| Rate for Payer: Healthscope Commercial |
$10,659.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,290.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,883.18
|
| Rate for Payer: Mclaren Medicaid |
$5,004.97
|
| Rate for Payer: Mclaren Medicare |
$9,149.86
|
| Rate for Payer: Meridian Medicaid |
$5,255.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,607.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,522.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,067.60
|
| Rate for Payer: PACE Medicare |
$8,692.37
|
| Rate for Payer: PACE SWMI |
$9,149.86
|
| Rate for Payer: PHP Commercial |
$10,067.60
|
| Rate for Payer: PHP Medicare Advantage |
$9,149.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,004.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,290.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28,804.18
|
| Rate for Payer: Priority Health Medicare |
$9,149.86
|
| Rate for Payer: Priority Health Narrow Network |
$23,043.34
|
| Rate for Payer: Priority Health SBD |
$7,461.87
|
| Rate for Payer: Railroad Medicare Medicare |
$9,149.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$482.28
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,149.86
|
| Rate for Payer: UHC Exchange |
$438.44
|
| Rate for Payer: UHC Medicare Advantage |
$9,424.36
|
| Rate for Payer: UMR Bronson Commercial |
$4,382.37
|
| Rate for Payer: VA VA |
$9,149.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,883.18
|
|
|
HC CRYOABLATION KIDNEY UNILATERAL
|
Facility
|
IP
|
$11,844.24
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
36100572
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,211.47 |
| Max. Negotiated Rate |
$10,659.82 |
| Rate for Payer: Aetna American Axle |
$7,698.76
|
| Rate for Payer: Aetna Commercial |
$10,067.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,698.76
|
| Rate for Payer: Cash Price |
$9,475.39
|
| Rate for Payer: Cofinity Commercial |
$10,186.05
|
| Rate for Payer: Cofinity Commercial |
$8,290.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,475.39
|
| Rate for Payer: Healthscope Commercial |
$10,659.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,290.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,883.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,067.60
|
| Rate for Payer: PHP Commercial |
$10,067.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,290.97
|
| Rate for Payer: Priority Health SBD |
$7,461.87
|
| Rate for Payer: UMR Bronson Commercial |
$5,211.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,883.18
|
|
|
HC CRYOABLATION LIVER TUMOR
|
Facility
|
IP
|
$10,323.30
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
36100613
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,542.25 |
| Max. Negotiated Rate |
$9,290.97 |
| Rate for Payer: Aetna American Axle |
$6,710.14
|
| Rate for Payer: Aetna Commercial |
$8,774.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,710.14
|
| Rate for Payer: Cash Price |
$8,258.64
|
| Rate for Payer: Cofinity Commercial |
$7,226.31
|
| Rate for Payer: Cofinity Commercial |
$8,878.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,258.64
|
| Rate for Payer: Healthscope Commercial |
$9,290.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,226.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,742.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,774.80
|
| Rate for Payer: PHP Commercial |
$8,774.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,226.31
|
| Rate for Payer: Priority Health SBD |
$6,503.68
|
| Rate for Payer: UMR Bronson Commercial |
$4,542.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,742.48
|
|
|
HC CRYOABLATION LIVER TUMOR
|
Facility
|
OP
|
$10,323.30
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
36100613
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$429.28 |
| Max. Negotiated Rate |
$28,804.18 |
| Rate for Payer: Aetna American Axle |
$6,710.14
|
| Rate for Payer: Aetna Commercial |
$8,774.80
|
| Rate for Payer: Aetna Medicare |
$9,515.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,710.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,437.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,437.32
|
| Rate for Payer: BCBS Complete |
$5,255.68
|
| Rate for Payer: BCBS MAPPO |
$9,149.86
|
| Rate for Payer: BCBS Trust/PPO |
$4,385.26
|
| Rate for Payer: BCN Medicare Advantage |
$9,149.86
|
| Rate for Payer: Cash Price |
$8,258.64
|
| Rate for Payer: Cash Price |
$8,258.64
|
| Rate for Payer: Cofinity Commercial |
$7,226.31
|
| Rate for Payer: Cofinity Commercial |
$8,878.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,258.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,149.86
|
| Rate for Payer: Healthscope Commercial |
$9,290.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,226.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,742.48
|
| Rate for Payer: Mclaren Medicaid |
$5,004.97
|
| Rate for Payer: Mclaren Medicare |
$9,149.86
|
| Rate for Payer: Meridian Medicaid |
$5,255.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,607.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,522.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,774.80
|
| Rate for Payer: PACE Medicare |
$8,692.37
|
| Rate for Payer: PACE SWMI |
$9,149.86
|
| Rate for Payer: PHP Commercial |
$8,774.80
|
| Rate for Payer: PHP Medicare Advantage |
$9,149.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,004.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,226.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28,804.18
|
| Rate for Payer: Priority Health Medicare |
$9,149.86
|
| Rate for Payer: Priority Health Narrow Network |
$23,043.34
|
| Rate for Payer: Priority Health SBD |
$6,503.68
|
| Rate for Payer: Railroad Medicare Medicare |
$9,149.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$472.21
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,149.86
|
| Rate for Payer: UHC Exchange |
$429.28
|
| Rate for Payer: UHC Medicare Advantage |
$9,424.36
|
| Rate for Payer: UMR Bronson Commercial |
$3,819.62
|
| Rate for Payer: VA VA |
$9,149.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,742.48
|
|
|
HC CRYOABLATION NASAL TISSUE OR NERVES UNI OR BIL
|
Facility
|
IP
|
$10,678.00
|
|
|
Service Code
|
CPT 31243
|
| Hospital Charge Code |
76100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,698.32 |
| Max. Negotiated Rate |
$9,610.20 |
| Rate for Payer: Aetna American Axle |
$6,940.70
|
| Rate for Payer: Aetna Commercial |
$9,076.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,940.70
|
| Rate for Payer: Cash Price |
$8,542.40
|
| Rate for Payer: Cofinity Commercial |
$7,474.60
|
| Rate for Payer: Cofinity Commercial |
$9,183.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,542.40
|
| Rate for Payer: Healthscope Commercial |
$9,610.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,474.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,008.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,076.30
|
| Rate for Payer: PHP Commercial |
$9,076.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,474.60
|
| Rate for Payer: Priority Health SBD |
$6,727.14
|
| Rate for Payer: UMR Bronson Commercial |
$4,698.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,008.50
|
|
