|
HC 2 PIECE WAFER
|
Facility
|
IP
|
$13.69
|
|
| Hospital Charge Code |
27100001
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$12.32 |
| Rate for Payer: Aetna American Axle |
$8.90
|
| Rate for Payer: Aetna Commercial |
$11.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.90
|
| Rate for Payer: Cash Price |
$10.95
|
| Rate for Payer: Cofinity Advantage |
$9.58
|
| Rate for Payer: Cofinity Commercial |
$11.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.95
|
| Rate for Payer: Healthscope Commercial |
$12.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.27
|
| Rate for Payer: PHP Commercial |
$11.64
|
| Rate for Payer: Priority Health SBD |
$8.62
|
| Rate for Payer: UMR Bronson Commercial |
$6.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.27
|
|
|
HC 3D ECHO RENDERING
|
Facility
|
OP
|
$682.57
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
32000282
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$40.23 |
| Max. Negotiated Rate |
$614.31 |
| Rate for Payer: Aetna American Axle |
$443.67
|
| Rate for Payer: Aetna Commercial |
$580.18
|
| Rate for Payer: Aetna Medicare |
$341.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.67
|
| Rate for Payer: BCBS Complete |
$273.03
|
| Rate for Payer: BCBS Trust/PPO |
$40.23
|
| Rate for Payer: BCN Commercial |
$40.23
|
| Rate for Payer: Cash Price |
$546.06
|
| Rate for Payer: Cash Price |
$546.06
|
| Rate for Payer: Cofinity Advantage |
$477.80
|
| Rate for Payer: Cofinity Commercial |
$587.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.06
|
| Rate for Payer: Healthscope Commercial |
$614.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$477.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$511.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$546.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$580.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$511.93
|
| Rate for Payer: PHP Commercial |
$580.18
|
| Rate for Payer: Priority Health SBD |
$430.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$443.67
|
| Rate for Payer: UHC Core |
$355.62
|
| Rate for Payer: UHC Exchange |
$268.25
|
| Rate for Payer: UMR Bronson Commercial |
$252.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$511.93
|
|
|
HC 3D ECHO RENDERING
|
Facility
|
IP
|
$682.57
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
32000282
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$300.33 |
| Max. Negotiated Rate |
$614.31 |
| Rate for Payer: Aetna American Axle |
$443.67
|
| Rate for Payer: Aetna Commercial |
$580.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$443.67
|
| Rate for Payer: Cash Price |
$546.06
|
| Rate for Payer: Cofinity Advantage |
$477.80
|
| Rate for Payer: Cofinity Commercial |
$587.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$546.06
|
| Rate for Payer: Healthscope Commercial |
$614.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$477.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$511.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$580.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$511.93
|
| Rate for Payer: PHP Commercial |
$580.18
|
| Rate for Payer: Priority Health SBD |
$430.02
|
| Rate for Payer: UMR Bronson Commercial |
$300.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$511.93
|
|
|
HC 3D ECHO REND W/WORKSTATION
|
Facility
|
IP
|
$650.63
|
|
|
Service Code
|
CPT 76377
|
| Hospital Charge Code |
32000283
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$286.28 |
| Max. Negotiated Rate |
$585.57 |
| Rate for Payer: Aetna American Axle |
$422.91
|
| Rate for Payer: Aetna Commercial |
$553.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.91
|
| Rate for Payer: Cash Price |
$520.50
|
| Rate for Payer: Cofinity Advantage |
$455.44
|
| Rate for Payer: Cofinity Commercial |
$559.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.50
|
| Rate for Payer: Healthscope Commercial |
$585.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$455.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$487.97
|
| Rate for Payer: PHP Commercial |
$553.04
|
| Rate for Payer: Priority Health SBD |
$409.90
|
| Rate for Payer: UMR Bronson Commercial |
$286.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.97
|
|
|
HC 3D ECHO REND W/WORKSTATION
|
Facility
|
OP
|
$650.63
|
|
|
Service Code
|
CPT 76377
|
| Hospital Charge Code |
32000283
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$103.44 |
| Max. Negotiated Rate |
$585.57 |
| Rate for Payer: Aetna American Axle |
$422.91
|
| Rate for Payer: Aetna Commercial |
$553.04
|
| Rate for Payer: Aetna Medicare |
$325.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.91
|
| Rate for Payer: BCBS Complete |
$260.25
|
| Rate for Payer: BCBS Trust/PPO |
$103.44
|
| Rate for Payer: BCN Commercial |
$103.44
|
| Rate for Payer: Cash Price |
$520.50
|
| Rate for Payer: Cash Price |
$520.50
|
| Rate for Payer: Cofinity Advantage |
$455.44
|
| Rate for Payer: Cofinity Commercial |
$559.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$520.50
|
| Rate for Payer: Healthscope Commercial |
$585.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$455.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$487.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$520.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$553.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$487.97
|
| Rate for Payer: PHP Commercial |
$553.04
|
| Rate for Payer: Priority Health SBD |
$409.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$422.91
|
| Rate for Payer: UHC Core |
$338.98
|
| Rate for Payer: UHC Exchange |
$255.70
|
| Rate for Payer: UMR Bronson Commercial |
$240.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$487.97
|
|
|
HC 4X4 WAFER
|
Facility
|
IP
|
$25.00
|
|
| Hospital Charge Code |
27000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna American Axle |
$16.25
|
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.25
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Advantage |
$17.50
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: Priority Health SBD |
$15.75
|
| Rate for Payer: UMR Bronson Commercial |
$11.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.75
|
|
|
HC 4X4 WAFER
|
Facility
|
OP
|
$25.00
|
|
| Hospital Charge Code |
27000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.25 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna American Axle |
$16.25
|
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: Aetna Medicare |
$12.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.25
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Advantage |
$17.50
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: Priority Health SBD |
$15.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.25
|
| Rate for Payer: UHC Core |
$13.03
|
| Rate for Payer: UHC Exchange |
$9.82
|
| Rate for Payer: UMR Bronson Commercial |
$9.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.75
|
|
|
HC 5 FR SOLO 3CG POWER PICC
|
Facility
|
OP
|
$1,149.10
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$425.17 |
| Max. Negotiated Rate |
$1,034.19 |
| Rate for Payer: Aetna American Axle |
$746.91
|
| Rate for Payer: Aetna Commercial |
$976.74
|
| Rate for Payer: Aetna Medicare |
$574.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$746.91
|
| Rate for Payer: BCBS Complete |
$459.64
|
| Rate for Payer: Cash Price |
$919.28
|
| Rate for Payer: Cofinity Advantage |
$804.37
|
| Rate for Payer: Cofinity Commercial |
$988.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$919.28
|
| Rate for Payer: Healthscope Commercial |
$1,034.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$804.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$861.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$919.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$976.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$861.83
|
| Rate for Payer: PHP Commercial |
$976.74
|
| Rate for Payer: Priority Health SBD |
$723.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$746.91
|
| Rate for Payer: UHC Core |
$598.68
|
| Rate for Payer: UHC Exchange |
$451.60
|
| Rate for Payer: UMR Bronson Commercial |
$425.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$861.83
|
|
|
HC 5 FR SOLO 3CG POWER PICC
|
Facility
|
IP
|
$1,149.10
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$505.60 |
| Max. Negotiated Rate |
$1,034.19 |
| Rate for Payer: Aetna American Axle |
$746.91
|
| Rate for Payer: Aetna Commercial |
$976.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$746.91
|
| Rate for Payer: Cash Price |
$919.28
|
| Rate for Payer: Cofinity Advantage |
$804.37
|
| Rate for Payer: Cofinity Commercial |
$988.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$919.28
|
| Rate for Payer: Healthscope Commercial |
$1,034.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$804.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$861.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$976.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$861.83
|
| Rate for Payer: PHP Commercial |
$976.74
|
| Rate for Payer: Priority Health SBD |
$723.93
|
| Rate for Payer: UMR Bronson Commercial |
$505.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$861.83
|
|
|
HC 5FR SOLO POWER PICC
|
Facility
|
OP
|
$995.79
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$368.44 |
| Max. Negotiated Rate |
$896.21 |
| Rate for Payer: Aetna American Axle |
$647.26
|
| Rate for Payer: Aetna Commercial |
$846.42
|
| Rate for Payer: Aetna Medicare |
$497.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$647.26
|
| Rate for Payer: BCBS Complete |
$398.32
|
| Rate for Payer: Cash Price |
$796.63
|
| Rate for Payer: Cofinity Advantage |
$697.05
|
| Rate for Payer: Cofinity Commercial |
$856.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$796.63
|
| Rate for Payer: Healthscope Commercial |
$896.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$697.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$796.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$846.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.84
|
| Rate for Payer: PHP Commercial |
$846.42
|
| Rate for Payer: Priority Health SBD |
$627.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$647.26
|
| Rate for Payer: UHC Core |
$518.81
|
| Rate for Payer: UHC Exchange |
$391.35
|
| Rate for Payer: UMR Bronson Commercial |
$368.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.84
|
|
|
HC 5FR SOLO POWER PICC
|
Facility
|
IP
|
$995.79
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$438.15 |
| Max. Negotiated Rate |
$896.21 |
| Rate for Payer: Aetna American Axle |
$647.26
|
| Rate for Payer: Aetna Commercial |
$846.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$647.26
|
| Rate for Payer: Cash Price |
$796.63
|
| Rate for Payer: Cofinity Advantage |
$697.05
|
| Rate for Payer: Cofinity Commercial |
$856.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$796.63
|
| Rate for Payer: Healthscope Commercial |
$896.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$697.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$846.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.84
|
| Rate for Payer: PHP Commercial |
$846.42
|
| Rate for Payer: Priority Health SBD |
$627.35
|
| Rate for Payer: UMR Bronson Commercial |
$438.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.84
|
|
|
HC 5 FR TL 3CG MAX POWER PICC
|
Facility
|
IP
|
$1,253.58
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$551.58 |
| Max. Negotiated Rate |
$1,128.22 |
| Rate for Payer: Aetna American Axle |
$814.83
|
| Rate for Payer: Aetna Commercial |
$1,065.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.83
|
| Rate for Payer: Cash Price |
$1,002.86
|
| Rate for Payer: Cofinity Advantage |
$877.51
|
| Rate for Payer: Cofinity Commercial |
$1,078.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.86
|
| Rate for Payer: Healthscope Commercial |
$1,128.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$877.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$940.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$940.18
|
| Rate for Payer: PHP Commercial |
$1,065.54
|
| Rate for Payer: Priority Health SBD |
$789.76
|
| Rate for Payer: UMR Bronson Commercial |
$551.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$940.18
|
|
|
HC 5 FR TL 3CG MAX POWER PICC
|
Facility
|
OP
|
$1,253.58
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$463.82 |
| Max. Negotiated Rate |
$1,128.22 |
| Rate for Payer: Aetna American Axle |
$814.83
|
| Rate for Payer: Aetna Commercial |
$1,065.54
|
| Rate for Payer: Aetna Medicare |
$626.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.83
|
| Rate for Payer: BCBS Complete |
$501.43
|
| Rate for Payer: Cash Price |
$1,002.86
|
| Rate for Payer: Cofinity Advantage |
$877.51
|
| Rate for Payer: Cofinity Commercial |
$1,078.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.86
|
| Rate for Payer: Healthscope Commercial |
$1,128.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$877.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$940.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,002.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$940.18
|
| Rate for Payer: PHP Commercial |
$1,065.54
|
| Rate for Payer: Priority Health SBD |
$789.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$814.83
|
| Rate for Payer: UHC Core |
$653.12
|
| Rate for Payer: UHC Exchange |
$492.66
|
| Rate for Payer: UMR Bronson Commercial |
$463.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$940.18
|
|
|
HC 5 FR TL SOLO MAX POWER PICC
|
Facility
|
OP
|
$1,086.31
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$401.93 |
| Max. Negotiated Rate |
$977.68 |
| Rate for Payer: Aetna American Axle |
$706.10
|
| Rate for Payer: Aetna Commercial |
$923.36
|
| Rate for Payer: Aetna Medicare |
$543.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$706.10
|
| Rate for Payer: BCBS Complete |
$434.52
|
| Rate for Payer: Cash Price |
$869.05
|
| Rate for Payer: Cofinity Advantage |
$760.42
|
| Rate for Payer: Cofinity Commercial |
$934.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$869.05
|
| Rate for Payer: Healthscope Commercial |
$977.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$760.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$814.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$869.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$923.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$814.73
|
| Rate for Payer: PHP Commercial |
$923.36
|
| Rate for Payer: Priority Health SBD |
$684.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$706.10
|
| Rate for Payer: UHC Core |
$565.97
|
| Rate for Payer: UHC Exchange |
$426.92
|
| Rate for Payer: UMR Bronson Commercial |
$401.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$814.73
|
|
|
HC 5 FR TL SOLO MAX POWER PICC
|
Facility
|
IP
|
$1,086.31
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$477.98 |
| Max. Negotiated Rate |
$977.68 |
| Rate for Payer: Aetna American Axle |
$706.10
|
| Rate for Payer: Aetna Commercial |
$923.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$706.10
|
| Rate for Payer: Cash Price |
$869.05
|
| Rate for Payer: Cofinity Advantage |
$760.42
|
| Rate for Payer: Cofinity Commercial |
$934.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$869.05
|
| Rate for Payer: Healthscope Commercial |
$977.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$760.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$814.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$923.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$814.73
|
| Rate for Payer: PHP Commercial |
$923.36
|
| Rate for Payer: Priority Health SBD |
$684.38
|
| Rate for Payer: UMR Bronson Commercial |
$477.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$814.73
|
|
|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
OP
|
$1,253.58
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$463.82 |
| Max. Negotiated Rate |
$1,128.22 |
| Rate for Payer: Aetna American Axle |
$814.83
|
| Rate for Payer: Aetna Commercial |
$1,065.54
|
| Rate for Payer: Aetna Medicare |
$626.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.83
|
| Rate for Payer: BCBS Complete |
$501.43
|
| Rate for Payer: Cash Price |
$1,002.86
|
| Rate for Payer: Cofinity Advantage |
$877.51
|
| Rate for Payer: Cofinity Commercial |
$1,078.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.86
|
| Rate for Payer: Healthscope Commercial |
$1,128.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$877.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$940.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,002.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$940.18
|
| Rate for Payer: PHP Commercial |
$1,065.54
|
| Rate for Payer: Priority Health SBD |
$789.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$814.83
|
| Rate for Payer: UHC Core |
$653.12
|
| Rate for Payer: UHC Exchange |
$492.66
|
| Rate for Payer: UMR Bronson Commercial |
$463.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$940.18
|
|
|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
IP
|
$1,253.58
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$551.58 |
| Max. Negotiated Rate |
$1,128.22 |
| Rate for Payer: Aetna American Axle |
$814.83
|
| Rate for Payer: Aetna Commercial |
$1,065.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$814.83
|
| Rate for Payer: Cash Price |
$1,002.86
|
| Rate for Payer: Cofinity Advantage |
$877.51
|
| Rate for Payer: Cofinity Commercial |
$1,078.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,002.86
|
| Rate for Payer: Healthscope Commercial |
$1,128.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$877.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$940.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,065.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$940.18
|
| Rate for Payer: PHP Commercial |
$1,065.54
|
| Rate for Payer: Priority Health SBD |
$789.76
|
| Rate for Payer: UMR Bronson Commercial |
$551.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$940.18
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
IP
|
$1,086.31
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$477.98 |
| Max. Negotiated Rate |
$977.68 |
| Rate for Payer: Aetna American Axle |
$706.10
|
| Rate for Payer: Aetna Commercial |
$923.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$706.10
|
| Rate for Payer: Cash Price |
$869.05
|
| Rate for Payer: Cofinity Advantage |
$760.42
|
| Rate for Payer: Cofinity Commercial |
$934.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$869.05
|
| Rate for Payer: Healthscope Commercial |
$977.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$760.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$814.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$923.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$814.73
|
| Rate for Payer: PHP Commercial |
$923.36
|
| Rate for Payer: Priority Health SBD |
$684.38
|
| Rate for Payer: UMR Bronson Commercial |
$477.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$814.73
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
OP
|
$1,086.31
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$401.93 |
| Max. Negotiated Rate |
$977.68 |
| Rate for Payer: Aetna American Axle |
$706.10
|
| Rate for Payer: Aetna Commercial |
$923.36
|
| Rate for Payer: Aetna Medicare |
$543.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$706.10
|
| Rate for Payer: BCBS Complete |
$434.52
|
| Rate for Payer: Cash Price |
$869.05
|
| Rate for Payer: Cofinity Advantage |
$760.42
|
| Rate for Payer: Cofinity Commercial |
$934.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$869.05
|
| Rate for Payer: Healthscope Commercial |
$977.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$760.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$814.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$869.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$923.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$814.73
|
| Rate for Payer: PHP Commercial |
$923.36
|
| Rate for Payer: Priority Health SBD |
$684.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$706.10
|
| Rate for Payer: UHC Core |
$565.97
|
| Rate for Payer: UHC Exchange |
$426.92
|
| Rate for Payer: UMR Bronson Commercial |
$401.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$814.73
|
|
|
HC 8X8 WAFER
|
Facility
|
IP
|
$75.52
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$33.23 |
| Max. Negotiated Rate |
$67.97 |
| Rate for Payer: Aetna American Axle |
$49.09
|
| Rate for Payer: Aetna Commercial |
$64.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.09
|
| Rate for Payer: Cash Price |
$60.42
|
| Rate for Payer: Cofinity Advantage |
$52.86
|
| Rate for Payer: Cofinity Commercial |
$64.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.42
|
| Rate for Payer: Healthscope Commercial |
$67.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.64
|
| Rate for Payer: PHP Commercial |
$64.19
|
| Rate for Payer: Priority Health SBD |
$47.58
|
| Rate for Payer: UMR Bronson Commercial |
$33.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.64
|
|
|
HC 8X8 WAFER
|
Facility
|
OP
|
$75.52
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.94 |
| Max. Negotiated Rate |
$67.97 |
| Rate for Payer: Aetna American Axle |
$49.09
|
| Rate for Payer: Aetna Commercial |
$64.19
|
| Rate for Payer: Aetna Medicare |
$37.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.09
|
| Rate for Payer: BCBS Complete |
$30.21
|
| Rate for Payer: Cash Price |
$60.42
|
| Rate for Payer: Cofinity Advantage |
$52.86
|
| Rate for Payer: Cofinity Commercial |
$64.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.42
|
| Rate for Payer: Healthscope Commercial |
$67.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.64
|
| Rate for Payer: PHP Commercial |
$64.19
|
| Rate for Payer: Priority Health SBD |
$47.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.09
|
| Rate for Payer: UHC Core |
$39.35
|
| Rate for Payer: UHC Exchange |
$29.68
|
| Rate for Payer: UMR Bronson Commercial |
$27.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.64
|
|
|
HC A1AT PROTEOTYPE
|
Facility
|
IP
|
$49.88
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100610
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.95 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna American Axle |
$32.42
|
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.42
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Advantage |
$34.92
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: Priority Health SBD |
$31.42
|
| Rate for Payer: UMR Bronson Commercial |
$21.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
HC A1AT PROTEOTYPE
|
Facility
|
OP
|
$49.88
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100610
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna American Axle |
$32.42
|
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna Medicare |
$25.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.11
|
| Rate for Payer: BCBS Complete |
$13.23
|
| Rate for Payer: BCBS MAPPO |
$24.09
|
| Rate for Payer: BCBS Trust/PPO |
$27.85
|
| Rate for Payer: BCN Commercial |
$27.85
|
| Rate for Payer: BCN Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Advantage |
$34.92
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Mclaren Medicaid |
$24.09
|
| Rate for Payer: Mclaren Medicare |
$24.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.29
|
| Rate for Payer: Meridian Medicaid |
$25.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$36.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PACE Medicare |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.09
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: PHP Medicare Advantage |
$24.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24.09
|
| Rate for Payer: Priority Health Medicare |
$24.09
|
| Rate for Payer: Priority Health SBD |
$31.42
|
| Rate for Payer: Priority Health Tiered Network |
$19.27
|
| Rate for Payer: Railroad Medicare Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.14
|
| Rate for Payer: UHC Core |
$36.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.09
|
| Rate for Payer: UHC Exchange |
$36.14
|
| Rate for Payer: UHC Medicaid |
$12.60
|
| Rate for Payer: UHCCP Medicaid |
$12.60
|
| Rate for Payer: UMR Bronson Commercial |
$18.46
|
| Rate for Payer: VA VA |
$24.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
HC A1AT PROTEOTYPE CMPT
|
Facility
|
OP
|
$24.06
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$21.65 |
| Rate for Payer: Aetna American Axle |
$15.64
|
| Rate for Payer: Aetna Commercial |
$20.45
|
| Rate for Payer: Aetna Medicare |
$13.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.80
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS MAPPO |
$13.44
|
| Rate for Payer: BCBS Trust/PPO |
$15.54
|
| Rate for Payer: BCN Commercial |
$15.54
|
| Rate for Payer: BCN Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$19.25
|
| Rate for Payer: Cash Price |
$19.25
|
| Rate for Payer: Cofinity Advantage |
$16.84
|
| Rate for Payer: Cofinity Commercial |
$20.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.44
|
| Rate for Payer: Healthscope Commercial |
$21.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.05
|
| Rate for Payer: Mclaren Medicaid |
$13.44
|
| Rate for Payer: Mclaren Medicare |
$13.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.11
|
| Rate for Payer: Meridian Medicaid |
$14.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.45
|
| Rate for Payer: Nomi Health Commercial |
$20.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.05
|
| Rate for Payer: PACE Medicare |
$12.77
|
| Rate for Payer: PACE SWMI |
$13.44
|
| Rate for Payer: PHP Commercial |
$20.45
|
| Rate for Payer: PHP Medicare Advantage |
$13.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.44
|
| Rate for Payer: Priority Health Medicare |
$13.44
|
| Rate for Payer: Priority Health SBD |
$15.16
|
| Rate for Payer: Priority Health Tiered Network |
$10.75
|
| Rate for Payer: Railroad Medicare Medicare |
$13.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.16
|
| Rate for Payer: UHC Core |
$20.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.44
|
| Rate for Payer: UHC Exchange |
$20.16
|
| Rate for Payer: UHC Medicaid |
$7.03
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
| Rate for Payer: UMR Bronson Commercial |
$8.90
|
| Rate for Payer: VA VA |
$13.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.05
|
|
|
HC A1AT PROTEOTYPE CMPT
|
Facility
|
IP
|
$24.06
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.59 |
| Max. Negotiated Rate |
$21.65 |
| Rate for Payer: Aetna American Axle |
$15.64
|
| Rate for Payer: Aetna Commercial |
$20.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.64
|
| Rate for Payer: Cash Price |
$19.25
|
| Rate for Payer: Cofinity Advantage |
$16.84
|
| Rate for Payer: Cofinity Commercial |
$20.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.25
|
| Rate for Payer: Healthscope Commercial |
$21.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.05
|
| Rate for Payer: PHP Commercial |
$20.45
|
| Rate for Payer: Priority Health SBD |
$15.16
|
| Rate for Payer: UMR Bronson Commercial |
$10.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.05
|
|
