|
HC DEXAMETHASONE SODIUM PHOS, PER 1 MG
|
Facility
|
OP
|
$10.20
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
63600138
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$9.18 |
| Rate for Payer: Aetna American Axle |
$6.63
|
| Rate for Payer: Aetna Commercial |
$8.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.63
|
| Rate for Payer: BCBS Complete |
$4.08
|
| Rate for Payer: BCBS Trust/PPO |
$0.38
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cofinity Commercial |
$7.14
|
| Rate for Payer: Cofinity Commercial |
$8.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.16
|
| Rate for Payer: Healthscope Commercial |
$9.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.67
|
| Rate for Payer: PHP Commercial |
$8.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.14
|
| Rate for Payer: Priority Health SBD |
$6.43
|
| Rate for Payer: UMR Bronson Commercial |
$3.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.65
|
|
|
HC DEXAMETHASONE SODIUM PHOS, PER 1 MG
|
Facility
|
IP
|
$10.20
|
|
|
Service Code
|
HCPCS J1100
|
| Hospital Charge Code |
63600138
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.49 |
| Max. Negotiated Rate |
$9.18 |
| Rate for Payer: Aetna American Axle |
$6.63
|
| Rate for Payer: Aetna Commercial |
$8.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.63
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cofinity Commercial |
$7.14
|
| Rate for Payer: Cofinity Commercial |
$8.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.16
|
| Rate for Payer: Healthscope Commercial |
$9.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.67
|
| Rate for Payer: PHP Commercial |
$8.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.14
|
| Rate for Payer: Priority Health SBD |
$6.43
|
| Rate for Payer: UMR Bronson Commercial |
$4.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.65
|
|
|
HC DHEA
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 82626
|
| Hospital Charge Code |
30100187
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.82 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna American Axle |
$32.49
|
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna Medicare |
$26.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.59
|
| Rate for Payer: BCBS Complete |
$14.52
|
| Rate for Payer: BCBS MAPPO |
$25.27
|
| Rate for Payer: BCBS Trust/PPO |
$22.72
|
| Rate for Payer: BCN Medicare Advantage |
$25.27
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$34.99
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.27
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Mclaren Medicaid |
$13.82
|
| Rate for Payer: Mclaren Medicare |
$25.27
|
| Rate for Payer: Meridian Medicaid |
$14.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PACE Medicare |
$24.01
|
| Rate for Payer: PACE SWMI |
$25.27
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: PHP Medicare Advantage |
$25.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.67
|
| Rate for Payer: Priority Health Medicare |
$25.27
|
| Rate for Payer: Priority Health Narrow Network |
$27.74
|
| Rate for Payer: Priority Health SBD |
$31.49
|
| Rate for Payer: Railroad Medicare Medicare |
$25.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.32
|
| Rate for Payer: UHC Core |
$41.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.27
|
| Rate for Payer: UHC Exchange |
$25.27
|
| Rate for Payer: UHC Medicare Advantage |
$26.03
|
| Rate for Payer: UMR Bronson Commercial |
$18.49
|
| Rate for Payer: VA VA |
$25.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC DHEA
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 82626
|
| Hospital Charge Code |
30100187
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.99 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna American Axle |
$32.49
|
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.49
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$34.99
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health SBD |
$31.49
|
| Rate for Payer: UMR Bronson Commercial |
$21.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC DHEA-SULFATE
|
Facility
|
OP
|
$55.08
|
|
|
Service Code
|
CPT 82627
|
| Hospital Charge Code |
30100188
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.16 |
| Max. Negotiated Rate |
$49.57 |
| Rate for Payer: Aetna American Axle |
$35.80
|
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna Medicare |
$23.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.79
|
| Rate for Payer: BCBS Complete |
$12.77
|
| Rate for Payer: BCBS MAPPO |
$22.23
|
| Rate for Payer: BCBS Trust/PPO |
$19.99
|
| Rate for Payer: BCN Medicare Advantage |
$22.23
|
| Rate for Payer: Cash Price |
$44.06
|
| Rate for Payer: Cash Price |
$44.06
|
| Rate for Payer: Cofinity Commercial |
$38.56
|
| Rate for Payer: Cofinity Commercial |
$47.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.23
|
| Rate for Payer: Healthscope Commercial |
$49.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.31
|
| Rate for Payer: Mclaren Medicaid |
$12.16
|
| Rate for Payer: Mclaren Medicare |
$22.23
|
| Rate for Payer: Meridian Medicaid |
$12.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$23.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.82
|
| Rate for Payer: PACE Medicare |
$21.12
|
| Rate for Payer: PACE SWMI |
$22.23
|
| Rate for Payer: PHP Commercial |
$46.82
|
| Rate for Payer: PHP Medicare Advantage |
$22.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.50
|
| Rate for Payer: Priority Health Medicare |
$22.23
|
| Rate for Payer: Priority Health Narrow Network |
$24.40
|
| Rate for Payer: Priority Health SBD |
$34.70
|
| Rate for Payer: Railroad Medicare Medicare |
$22.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.68
|
| Rate for Payer: UHC Core |
$36.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.23
|
| Rate for Payer: UHC Exchange |
$22.23
|
| Rate for Payer: UHC Medicare Advantage |
$22.90
|
| Rate for Payer: UMR Bronson Commercial |
$20.38
|
| Rate for Payer: VA VA |
$22.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.31
|
|
|
HC DHEA-SULFATE
|
Facility
|
IP
|
$55.08
|
|
|
Service Code
|
CPT 82627
|
| Hospital Charge Code |
30100188
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.24 |
| Max. Negotiated Rate |
$49.57 |
| Rate for Payer: Aetna American Axle |
$35.80
|
| Rate for Payer: Aetna Commercial |
$46.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.80
|
| Rate for Payer: Cash Price |
$44.06
|
| Rate for Payer: Cofinity Commercial |
$38.56
|
| Rate for Payer: Cofinity Commercial |
$47.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.06
|
| Rate for Payer: Healthscope Commercial |
$49.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$46.82
|
| Rate for Payer: PHP Commercial |
$46.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.56
|
| Rate for Payer: Priority Health SBD |
$34.70
|
| Rate for Payer: UMR Bronson Commercial |
$24.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.31
|
|
|
HC DIABETES GROUP SESSION PER 30"
|
Facility
|
IP
|
$61.85
|
|
|
Service Code
|
HCPCS G0109
|
| Hospital Charge Code |
94200006
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$27.21 |
| Max. Negotiated Rate |
$55.66 |
| Rate for Payer: Aetna American Axle |
$40.20
|
| Rate for Payer: Aetna Commercial |
$52.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.20
|
| Rate for Payer: Cash Price |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$43.30
|
| Rate for Payer: Cofinity Commercial |
$53.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.48
|
| Rate for Payer: Healthscope Commercial |
$55.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.57
|
| Rate for Payer: PHP Commercial |
$52.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.30
|
| Rate for Payer: Priority Health SBD |
$38.97
|
| Rate for Payer: UMR Bronson Commercial |
$27.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.39
|
|
|
HC DIABETES GROUP SESSION PER 30"
|
Facility
|
OP
|
$61.85
|
|
|
Service Code
|
HCPCS G0109
|
| Hospital Charge Code |
94200006
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$40.20
|
| Rate for Payer: Aetna Commercial |
$52.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.20
|
| Rate for Payer: BCBS Complete |
$24.74
|
| Rate for Payer: BCBS Trust/PPO |
$33.52
|
| Rate for Payer: Cash Price |
$49.48
|
| Rate for Payer: Cash Price |
$49.48
|
| Rate for Payer: Cash Price |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$53.19
|
| Rate for Payer: Cofinity Commercial |
$43.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.48
|
| Rate for Payer: Healthscope Commercial |
$55.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.57
|
| Rate for Payer: PHP Commercial |
$52.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.00
|
| Rate for Payer: Priority Health Narrow Network |
$12.80
|
| Rate for Payer: Priority Health SBD |
$38.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.93
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$15.39
|
| Rate for Payer: UMR Bronson Commercial |
$22.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.39
|
|
|
HC DIABETES MELLITUS TYPE 1 EVAL
|
Facility
|
OP
|
$47.73
|
|
|
Service Code
|
CPT 86337
|
| Hospital Charge Code |
30200504
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.71 |
| Max. Negotiated Rate |
$42.96 |
| Rate for Payer: Aetna American Axle |
$31.02
|
| Rate for Payer: Aetna Commercial |
$40.57
|
| Rate for Payer: Aetna Medicare |
$22.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.76
|
| Rate for Payer: BCBS Complete |
$12.30
|
| Rate for Payer: BCBS MAPPO |
$21.41
|
| Rate for Payer: BCBS Trust/PPO |
$19.26
|
| Rate for Payer: BCN Medicare Advantage |
$21.41
|
| Rate for Payer: Cash Price |
$38.18
|
| Rate for Payer: Cash Price |
$38.18
|
| Rate for Payer: Cofinity Commercial |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$33.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.41
|
| Rate for Payer: Healthscope Commercial |
$42.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.80
|
| Rate for Payer: Mclaren Medicaid |
$11.71
|
| Rate for Payer: Mclaren Medicare |
$21.41
|
| Rate for Payer: Meridian Medicaid |
$12.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.57
|
| Rate for Payer: PACE Medicare |
$20.34
|
| Rate for Payer: PACE SWMI |
$21.41
|
| Rate for Payer: PHP Commercial |
$40.57
|
| Rate for Payer: PHP Medicare Advantage |
$21.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.37
|
| Rate for Payer: Priority Health Medicare |
$21.41
|
| Rate for Payer: Priority Health Narrow Network |
$23.50
|
| Rate for Payer: Priority Health SBD |
$30.07
|
| Rate for Payer: Railroad Medicare Medicare |
$21.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.69
|
| Rate for Payer: UHC Core |
$35.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.41
|
| Rate for Payer: UHC Exchange |
$21.41
|
| Rate for Payer: UHC Medicare Advantage |
$22.05
|
| Rate for Payer: UMR Bronson Commercial |
$17.66
|
| Rate for Payer: VA VA |
$21.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.80
|
|
|
HC DIABETES MELLITUS TYPE 1 EVAL
|
Facility
|
IP
|
$47.73
|
|
|
Service Code
|
CPT 86337
|
| Hospital Charge Code |
30200504
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$42.96 |
| Rate for Payer: Aetna American Axle |
$31.02
|
| Rate for Payer: Aetna Commercial |
$40.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.02
|
| Rate for Payer: Cash Price |
$38.18
|
| Rate for Payer: Cofinity Commercial |
$33.41
|
| Rate for Payer: Cofinity Commercial |
$41.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.18
|
| Rate for Payer: Healthscope Commercial |
$42.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.57
|
| Rate for Payer: PHP Commercial |
$40.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.41
|
| Rate for Payer: Priority Health SBD |
$30.07
|
| Rate for Payer: UMR Bronson Commercial |
$21.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.80
|
|
|
HC DIABETES TRAINING PER 30 MIN
|
Facility
|
OP
|
$146.83
|
|
|
Service Code
|
HCPCS G0108
|
| Hospital Charge Code |
94200007
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$95.44
|
| Rate for Payer: Aetna Commercial |
$124.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.44
|
| Rate for Payer: BCBS Complete |
$58.73
|
| Rate for Payer: BCBS Trust/PPO |
$113.93
|
| Rate for Payer: Cash Price |
$117.46
|
| Rate for Payer: Cash Price |
$117.46
|
| Rate for Payer: Cash Price |
$117.46
|
| Rate for Payer: Cofinity Commercial |
$126.27
|
| Rate for Payer: Cofinity Commercial |
$102.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.46
|
| Rate for Payer: Healthscope Commercial |
$132.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.81
|
| Rate for Payer: PHP Commercial |
$124.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.00
|
| Rate for Payer: Priority Health Narrow Network |
$27.20
|
| Rate for Payer: Priority Health SBD |
$92.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.71
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$53.37
|
| Rate for Payer: UMR Bronson Commercial |
$54.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.12
|
|
|
HC DIABETES TRAINING PER 30 MIN
|
Facility
|
IP
|
$146.83
|
|
|
Service Code
|
HCPCS G0108
|
| Hospital Charge Code |
94200007
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$64.61 |
| Max. Negotiated Rate |
$132.15 |
| Rate for Payer: Aetna American Axle |
$95.44
|
| Rate for Payer: Aetna Commercial |
$124.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.44
|
| Rate for Payer: Cash Price |
$117.46
|
| Rate for Payer: Cofinity Commercial |
$102.78
|
| Rate for Payer: Cofinity Commercial |
$126.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.46
|
| Rate for Payer: Healthscope Commercial |
$132.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.81
|
| Rate for Payer: PHP Commercial |
$124.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.78
|
| Rate for Payer: Priority Health SBD |
$92.50
|
| Rate for Payer: UMR Bronson Commercial |
$64.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.12
|
|
|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W ANGIOPLASTY AND IMAGING
|
Facility
|
OP
|
$10,793.44
|
|
|
Service Code
|
CPT 36902
|
| Hospital Charge Code |
36100526
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$228.88 |
| Max. Negotiated Rate |
$15,993.75 |
| Rate for Payer: Aetna American Axle |
$7,015.74
|
| Rate for Payer: Aetna Commercial |
$9,174.42
|
| Rate for Payer: Aetna Medicare |
$5,283.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,015.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,350.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,350.66
|
| Rate for Payer: BCBS Complete |
$2,918.26
|
| Rate for Payer: BCBS MAPPO |
$5,080.53
|
| Rate for Payer: BCBS Trust/PPO |
$3,539.05
|
| Rate for Payer: BCN Medicare Advantage |
$5,080.53
|
| Rate for Payer: Cash Price |
$8,634.75
|
| Rate for Payer: Cash Price |
$8,634.75
|
| Rate for Payer: Cofinity Commercial |
$9,282.36
|
| Rate for Payer: Cofinity Commercial |
$7,555.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,634.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,080.53
|
| Rate for Payer: Healthscope Commercial |
$9,714.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,555.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,095.08
|
| Rate for Payer: Mclaren Medicaid |
$2,779.05
|
| Rate for Payer: Mclaren Medicare |
$5,080.53
|
| Rate for Payer: Meridian Medicaid |
$2,918.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,334.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,842.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,174.42
|
| Rate for Payer: PACE Medicare |
$4,826.50
|
| Rate for Payer: PACE SWMI |
$5,080.53
|
| Rate for Payer: PHP Commercial |
$9,174.42
|
| Rate for Payer: PHP Medicare Advantage |
$5,080.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,779.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,555.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,993.75
|
| Rate for Payer: Priority Health Medicare |
$5,080.53
|
| Rate for Payer: Priority Health Narrow Network |
$12,795.00
|
| Rate for Payer: Priority Health SBD |
$6,799.87
|
| Rate for Payer: Railroad Medicare Medicare |
$5,080.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.77
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,080.53
|
| Rate for Payer: UHC Exchange |
$228.88
|
| Rate for Payer: UHC Medicare Advantage |
$5,232.95
|
| Rate for Payer: UMR Bronson Commercial |
$3,993.57
|
| Rate for Payer: VA VA |
$5,080.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,095.08
|
|
|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W ANGIOPLASTY AND IMAGING
|
Facility
|
IP
|
$10,793.44
|
|
|
Service Code
|
CPT 36902
|
| Hospital Charge Code |
36100526
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,749.11 |
| Max. Negotiated Rate |
$9,714.10 |
| Rate for Payer: Aetna American Axle |
$7,015.74
|
| Rate for Payer: Aetna Commercial |
$9,174.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,015.74
|
| Rate for Payer: Cash Price |
$8,634.75
|
| Rate for Payer: Cofinity Commercial |
$7,555.41
|
| Rate for Payer: Cofinity Commercial |
$9,282.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,634.75
|
| Rate for Payer: Healthscope Commercial |
$9,714.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,555.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,095.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,174.42
|
| Rate for Payer: PHP Commercial |
$9,174.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,555.41
|
| Rate for Payer: Priority Health SBD |
$6,799.87
|
| Rate for Payer: UMR Bronson Commercial |
$4,749.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,095.08
|
|
|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W IMAGING
|
Facility
|
IP
|
$2,104.04
|
|
|
Service Code
|
CPT 36901
|
| Hospital Charge Code |
36100525
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$925.78 |
| Max. Negotiated Rate |
$1,893.64 |
| Rate for Payer: Aetna American Axle |
$1,367.63
|
| Rate for Payer: Aetna Commercial |
$1,788.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.63
|
| Rate for Payer: Cash Price |
$1,683.23
|
| Rate for Payer: Cofinity Commercial |
$1,472.83
|
| Rate for Payer: Cofinity Commercial |
$1,809.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.23
|
| Rate for Payer: Healthscope Commercial |
$1,893.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,472.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.43
|
| Rate for Payer: PHP Commercial |
$1,788.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.83
|
| Rate for Payer: Priority Health SBD |
$1,325.55
|
| Rate for Payer: UMR Bronson Commercial |
$925.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.03
|
|
|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W IMAGING
|
Facility
|
OP
|
$2,104.04
|
|
|
Service Code
|
CPT 36901
|
| Hospital Charge Code |
36100525
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$160.45 |
| Max. Negotiated Rate |
$4,481.48 |
| Rate for Payer: Aetna American Axle |
$1,367.63
|
| Rate for Payer: Aetna Commercial |
$1,788.43
|
| Rate for Payer: Aetna Medicare |
$1,480.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,367.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,591.11
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,683.23
|
| Rate for Payer: Cash Price |
$1,683.23
|
| Rate for Payer: Cofinity Commercial |
$1,472.83
|
| Rate for Payer: Cofinity Commercial |
$1,809.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,683.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$1,893.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,472.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,578.03
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,788.43
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$1,788.43
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,472.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,481.48
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$3,585.18
|
| Rate for Payer: Priority Health SBD |
$1,325.55
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.50
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,423.57
|
| Rate for Payer: UHC Exchange |
$160.45
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: UMR Bronson Commercial |
$778.49
|
| Rate for Payer: VA VA |
$1,423.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,578.03
|
|
|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W STENT AND IMAGING
|
Facility
|
OP
|
$18,171.61
|
|
|
Service Code
|
CPT 36903
|
| Hospital Charge Code |
36100527
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$300.92 |
| Max. Negotiated Rate |
$30,783.77 |
| Rate for Payer: Aetna American Axle |
$11,811.55
|
| Rate for Payer: Aetna Commercial |
$15,445.87
|
| Rate for Payer: Aetna Medicare |
$10,169.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,811.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,223.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,223.36
|
| Rate for Payer: BCBS Complete |
$5,616.88
|
| Rate for Payer: BCBS MAPPO |
$9,778.69
|
| Rate for Payer: BCBS Trust/PPO |
$9,788.60
|
| Rate for Payer: BCN Medicare Advantage |
$9,778.69
|
| Rate for Payer: Cash Price |
$14,537.29
|
| Rate for Payer: Cash Price |
$14,537.29
|
| Rate for Payer: Cofinity Commercial |
$12,720.13
|
| Rate for Payer: Cofinity Commercial |
$15,627.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,537.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,778.69
|
| Rate for Payer: Healthscope Commercial |
$16,354.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,720.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,628.71
|
| Rate for Payer: Mclaren Medicaid |
$5,348.94
|
| Rate for Payer: Mclaren Medicare |
$9,778.69
|
| Rate for Payer: Meridian Medicaid |
$5,616.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,267.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,245.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,445.87
|
| Rate for Payer: PACE Medicare |
$9,289.76
|
| Rate for Payer: PACE SWMI |
$9,778.69
|
| Rate for Payer: PHP Commercial |
$15,445.87
|
| Rate for Payer: PHP Medicare Advantage |
$9,778.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,348.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,720.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30,783.77
|
| Rate for Payer: Priority Health Medicare |
$9,778.69
|
| Rate for Payer: Priority Health Narrow Network |
$24,627.02
|
| Rate for Payer: Priority Health SBD |
$11,448.11
|
| Rate for Payer: Railroad Medicare Medicare |
$9,778.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$331.01
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,778.69
|
| Rate for Payer: UHC Exchange |
$300.92
|
| Rate for Payer: UHC Medicare Advantage |
$10,072.05
|
| Rate for Payer: UMR Bronson Commercial |
$6,723.50
|
| Rate for Payer: VA VA |
$9,778.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,628.71
|
|
|
HC DIAG ANGIO OF DIALYSIS CIRCUIT W STENT AND IMAGING
|
Facility
|
IP
|
$18,171.61
|
|
|
Service Code
|
CPT 36903
|
| Hospital Charge Code |
36100527
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,995.51 |
| Max. Negotiated Rate |
$16,354.45 |
| Rate for Payer: Aetna American Axle |
$11,811.55
|
| Rate for Payer: Aetna Commercial |
$15,445.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,811.55
|
| Rate for Payer: Cash Price |
$14,537.29
|
| Rate for Payer: Cofinity Commercial |
$12,720.13
|
| Rate for Payer: Cofinity Commercial |
$15,627.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,537.29
|
| Rate for Payer: Healthscope Commercial |
$16,354.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,720.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,628.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,445.87
|
| Rate for Payer: PHP Commercial |
$15,445.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,720.13
|
| Rate for Payer: Priority Health SBD |
$11,448.11
|
| Rate for Payer: UMR Bronson Commercial |
$7,995.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,628.71
|
|
|
HC DIALYSIS CATH LVL 10 LONG TERM
|
Facility
|
IP
|
$1,026.90
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200268
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$451.84 |
| Max. Negotiated Rate |
$924.21 |
| Rate for Payer: Aetna American Axle |
$667.48
|
| Rate for Payer: Aetna Commercial |
$872.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$667.48
|
| Rate for Payer: Cash Price |
$821.52
|
| Rate for Payer: Cofinity Commercial |
$718.83
|
| Rate for Payer: Cofinity Commercial |
$883.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$821.52
|
| Rate for Payer: Healthscope Commercial |
$924.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$718.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$770.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$872.86
|
| Rate for Payer: PHP Commercial |
$872.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$718.83
|
| Rate for Payer: Priority Health SBD |
$646.95
|
| Rate for Payer: UMR Bronson Commercial |
$451.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$770.18
|
|
|
HC DIALYSIS CATH LVL 10 LONG TERM
|
Facility
|
OP
|
$1,026.90
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200268
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$379.95 |
| Max. Negotiated Rate |
$924.21 |
| Rate for Payer: Aetna American Axle |
$667.48
|
| Rate for Payer: Aetna Commercial |
$872.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$667.48
|
| Rate for Payer: BCBS Complete |
$410.76
|
| Rate for Payer: Cash Price |
$821.52
|
| Rate for Payer: Cofinity Commercial |
$718.83
|
| Rate for Payer: Cofinity Commercial |
$883.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$821.52
|
| Rate for Payer: Healthscope Commercial |
$924.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$718.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$770.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$872.86
|
| Rate for Payer: PHP Commercial |
$872.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$718.83
|
| Rate for Payer: Priority Health SBD |
$646.95
|
| Rate for Payer: UMR Bronson Commercial |
$379.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$770.18
|
|
|
HC DIALYSIS CATH LVL 11 LONG TERM
|
Facility
|
OP
|
$1,148.99
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200269
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$425.13 |
| Max. Negotiated Rate |
$1,034.09 |
| Rate for Payer: Aetna American Axle |
$746.84
|
| Rate for Payer: Aetna Commercial |
$976.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$746.84
|
| Rate for Payer: BCBS Complete |
$459.60
|
| Rate for Payer: Cash Price |
$919.19
|
| Rate for Payer: Cofinity Commercial |
$804.29
|
| Rate for Payer: Cofinity Commercial |
$988.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$919.19
|
| Rate for Payer: Healthscope Commercial |
$1,034.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$804.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$861.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$976.64
|
| Rate for Payer: PHP Commercial |
$976.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$804.29
|
| Rate for Payer: Priority Health SBD |
$723.86
|
| Rate for Payer: UMR Bronson Commercial |
$425.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$861.74
|
|
|
HC DIALYSIS CATH LVL 11 LONG TERM
|
Facility
|
IP
|
$1,148.99
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200269
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$505.56 |
| Max. Negotiated Rate |
$1,034.09 |
| Rate for Payer: Aetna American Axle |
$746.84
|
| Rate for Payer: Aetna Commercial |
$976.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$746.84
|
| Rate for Payer: Cash Price |
$919.19
|
| Rate for Payer: Cofinity Commercial |
$804.29
|
| Rate for Payer: Cofinity Commercial |
$988.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$919.19
|
| Rate for Payer: Healthscope Commercial |
$1,034.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$804.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$861.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$976.64
|
| Rate for Payer: PHP Commercial |
$976.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$804.29
|
| Rate for Payer: Priority Health SBD |
$723.86
|
| Rate for Payer: UMR Bronson Commercial |
$505.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$861.74
|
|
|
HC DIALYSIS CATH LVL 13 LONG TERM
|
Facility
|
IP
|
$1,353.00
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200266
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$595.32 |
| Max. Negotiated Rate |
$1,217.70 |
| Rate for Payer: Aetna American Axle |
$879.45
|
| Rate for Payer: Aetna Commercial |
$1,150.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$879.45
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cofinity Commercial |
$1,163.58
|
| Rate for Payer: Cofinity Commercial |
$947.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,082.40
|
| Rate for Payer: Healthscope Commercial |
$1,217.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$947.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,014.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,150.05
|
| Rate for Payer: PHP Commercial |
$1,150.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$947.10
|
| Rate for Payer: Priority Health SBD |
$852.39
|
| Rate for Payer: UMR Bronson Commercial |
$595.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,014.75
|
|
|
HC DIALYSIS CATH LVL 13 LONG TERM
|
Facility
|
OP
|
$1,353.00
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
27200266
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$500.61 |
| Max. Negotiated Rate |
$1,217.70 |
| Rate for Payer: Aetna American Axle |
$879.45
|
| Rate for Payer: Aetna Commercial |
$1,150.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$879.45
|
| Rate for Payer: BCBS Complete |
$541.20
|
| Rate for Payer: Cash Price |
$1,082.40
|
| Rate for Payer: Cofinity Commercial |
$1,163.58
|
| Rate for Payer: Cofinity Commercial |
$947.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,082.40
|
| Rate for Payer: Healthscope Commercial |
$1,217.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$947.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,014.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,150.05
|
| Rate for Payer: PHP Commercial |
$1,150.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$947.10
|
| Rate for Payer: Priority Health SBD |
$852.39
|
| Rate for Payer: UMR Bronson Commercial |
$500.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,014.75
|
|
|
HC DIALYSIS CATH LVL 2 SHORT TERM
|
Facility
|
IP
|
$203.99
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200002
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$89.76 |
| Max. Negotiated Rate |
$183.59 |
| Rate for Payer: Aetna American Axle |
$132.59
|
| Rate for Payer: Aetna Commercial |
$173.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.59
|
| Rate for Payer: Cash Price |
$163.19
|
| Rate for Payer: Cofinity Commercial |
$142.79
|
| Rate for Payer: Cofinity Commercial |
$175.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.19
|
| Rate for Payer: Healthscope Commercial |
$183.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$142.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$173.39
|
| Rate for Payer: PHP Commercial |
$173.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$142.79
|
| Rate for Payer: Priority Health SBD |
$128.51
|
| Rate for Payer: UMR Bronson Commercial |
$89.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.99
|
|
