|
HC ANDROSTENEDIONE LEVEL
|
Facility
|
IP
|
$55.18
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.28 |
| Max. Negotiated Rate |
$49.66 |
| Rate for Payer: Aetna American Axle |
$35.87
|
| Rate for Payer: Aetna Commercial |
$46.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.87
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Advantage |
$38.63
|
| Rate for Payer: Cofinity Commercial |
$47.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Healthscope Commercial |
$49.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: PHP Commercial |
$46.90
|
| Rate for Payer: Priority Health SBD |
$34.76
|
| Rate for Payer: UMR Bronson Commercial |
$24.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.38
|
|
|
HC ANDROSTENEDIONE, SERUM
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100748
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.32 |
| Max. Negotiated Rate |
$92.70 |
| Rate for Payer: Aetna American Axle |
$66.95
|
| Rate for Payer: Aetna Commercial |
$87.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.95
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Advantage |
$72.10
|
| Rate for Payer: Cofinity Commercial |
$88.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.40
|
| Rate for Payer: Healthscope Commercial |
$92.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.25
|
| Rate for Payer: PHP Commercial |
$87.55
|
| Rate for Payer: Priority Health SBD |
$64.89
|
| Rate for Payer: UMR Bronson Commercial |
$45.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.25
|
|
|
HC ANDROSTENEDIONE, SERUM
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
30100748
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.31 |
| Max. Negotiated Rate |
$92.70 |
| Rate for Payer: Aetna American Axle |
$66.95
|
| Rate for Payer: Aetna Commercial |
$87.55
|
| Rate for Payer: Aetna Medicare |
$30.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.60
|
| Rate for Payer: BCBS Complete |
$16.08
|
| Rate for Payer: BCBS MAPPO |
$29.28
|
| Rate for Payer: BCBS Trust/PPO |
$33.85
|
| Rate for Payer: BCN Commercial |
$33.85
|
| Rate for Payer: BCN Medicare Advantage |
$29.28
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Advantage |
$72.10
|
| Rate for Payer: Cofinity Commercial |
$88.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.28
|
| Rate for Payer: Healthscope Commercial |
$92.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.25
|
| Rate for Payer: Mclaren Medicaid |
$29.28
|
| Rate for Payer: Mclaren Medicare |
$29.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.74
|
| Rate for Payer: Meridian Medicaid |
$30.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.55
|
| Rate for Payer: Nomi Health Commercial |
$43.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.25
|
| Rate for Payer: PACE Medicare |
$27.82
|
| Rate for Payer: PACE SWMI |
$29.28
|
| Rate for Payer: PHP Commercial |
$87.55
|
| Rate for Payer: PHP Medicare Advantage |
$29.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29.28
|
| Rate for Payer: Priority Health Medicare |
$29.28
|
| Rate for Payer: Priority Health SBD |
$64.89
|
| Rate for Payer: Priority Health Tiered Network |
$23.42
|
| Rate for Payer: Railroad Medicare Medicare |
$29.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.92
|
| Rate for Payer: UHC Core |
$43.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.28
|
| Rate for Payer: UHC Exchange |
$43.92
|
| Rate for Payer: UHC Medicaid |
$15.31
|
| Rate for Payer: UHCCP Medicaid |
$15.31
|
| Rate for Payer: UMR Bronson Commercial |
$38.11
|
| Rate for Payer: VA VA |
$29.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.25
|
|
|
HC ANESTHESIA BY ANESTHESIOLOGY
|
Facility
|
IP
|
$444.11
|
|
| Hospital Charge Code |
37100001
|
|
Hospital Revenue Code
|
371
|
| Min. Negotiated Rate |
$195.41 |
| Max. Negotiated Rate |
$399.70 |
| Rate for Payer: Aetna American Axle |
$288.67
|
| Rate for Payer: Aetna Commercial |
$377.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.67
|
| Rate for Payer: Cash Price |
$355.29
|
| Rate for Payer: Cofinity Advantage |
$310.88
|
| Rate for Payer: Cofinity Commercial |
$381.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$355.29
|
| Rate for Payer: Healthscope Commercial |
$399.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$310.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$333.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$377.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$333.08
|
| Rate for Payer: PHP Commercial |
$377.49
|
| Rate for Payer: Priority Health SBD |
$279.79
|
| Rate for Payer: UMR Bronson Commercial |
$195.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$333.08
|
|
|
HC ANESTHESIA BY ANESTHESIOLOGY
|
Facility
|
OP
|
$444.11
|
|
| Hospital Charge Code |
37100001
|
|
Hospital Revenue Code
|
371
|
| Min. Negotiated Rate |
$164.32 |
| Max. Negotiated Rate |
$399.70 |
| Rate for Payer: Aetna American Axle |
$288.67
|
| Rate for Payer: Aetna Commercial |
$377.49
|
| Rate for Payer: Aetna Medicare |
$222.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.67
|
| Rate for Payer: BCBS Complete |
$177.64
|
| Rate for Payer: Cash Price |
$355.29
|
| Rate for Payer: Cofinity Advantage |
$310.88
|
| Rate for Payer: Cofinity Commercial |
$381.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$355.29
|
| Rate for Payer: Healthscope Commercial |
$399.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$310.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$333.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$355.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$377.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$333.08
|
| Rate for Payer: PHP Commercial |
$377.49
|
| Rate for Payer: Priority Health SBD |
$279.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.67
|
| Rate for Payer: UHC Core |
$231.38
|
| Rate for Payer: UHC Exchange |
$174.54
|
| Rate for Payer: UMR Bronson Commercial |
$164.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$333.08
|
|
|
HC ANEUPLOIDY DETECTION CMPT
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000028
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$22.88 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna American Axle |
$33.80
|
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.80
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Advantage |
$36.40
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: Priority Health SBD |
$32.76
|
| Rate for Payer: UMR Bronson Commercial |
$22.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC ANEUPLOIDY DETECTION CMPT
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000028
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna American Axle |
$33.80
|
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$24.77
|
| Rate for Payer: BCN Commercial |
$24.77
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Advantage |
$36.40
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Mclaren Medicaid |
$21.42
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$32.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.42
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$32.76
|
| Rate for Payer: Priority Health Tiered Network |
$17.14
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.13
|
| Rate for Payer: UHC Core |
$32.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.42
|
| Rate for Payer: UHC Exchange |
$32.13
|
| Rate for Payer: UHC Medicaid |
$11.20
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: UMR Bronson Commercial |
$19.24
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC ANEUPLOIDY DETECTION POC FISH
|
Facility
|
IP
|
$141.14
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000038
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$62.10 |
| Max. Negotiated Rate |
$127.03 |
| Rate for Payer: Aetna American Axle |
$91.74
|
| Rate for Payer: Aetna Commercial |
$119.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.74
|
| Rate for Payer: Cash Price |
$112.91
|
| Rate for Payer: Cofinity Advantage |
$98.80
|
| Rate for Payer: Cofinity Commercial |
$121.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.91
|
| Rate for Payer: Healthscope Commercial |
$127.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.86
|
| Rate for Payer: PHP Commercial |
$119.97
|
| Rate for Payer: Priority Health SBD |
$88.92
|
| Rate for Payer: UMR Bronson Commercial |
$62.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.86
|
|
|
HC ANEUPLOIDY DETECTION POC FISH
|
Facility
|
OP
|
$141.14
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000038
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.77 |
| Max. Negotiated Rate |
$127.03 |
| Rate for Payer: Aetna American Axle |
$91.74
|
| Rate for Payer: Aetna Commercial |
$119.97
|
| Rate for Payer: Aetna Medicare |
$53.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: BCBS Complete |
$28.11
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$59.17
|
| Rate for Payer: BCN Commercial |
$59.17
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$112.91
|
| Rate for Payer: Cash Price |
$112.91
|
| Rate for Payer: Cofinity Advantage |
$98.80
|
| Rate for Payer: Cofinity Commercial |
$121.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$127.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.86
|
| Rate for Payer: Mclaren Medicaid |
$51.19
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$53.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.97
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.86
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$119.97
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.19
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health SBD |
$88.92
|
| Rate for Payer: Priority Health Tiered Network |
$40.95
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.79
|
| Rate for Payer: UHC Core |
$76.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.19
|
| Rate for Payer: UHC Exchange |
$76.79
|
| Rate for Payer: UHC Medicaid |
$26.77
|
| Rate for Payer: UHCCP Medicaid |
$26.77
|
| Rate for Payer: UMR Bronson Commercial |
$52.22
|
| Rate for Payer: VA VA |
$51.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.86
|
|
|
HC ANGIOPLASTY CENTRAL DIALYSIS W IMAGING
|
Facility
|
OP
|
$2,407.94
|
|
|
Service Code
|
CPT 36907
|
| Hospital Charge Code |
36100531
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$890.94 |
| Max. Negotiated Rate |
$3,142.85 |
| Rate for Payer: Aetna American Axle |
$1,565.16
|
| Rate for Payer: Aetna Commercial |
$2,046.75
|
| Rate for Payer: Aetna Medicare |
$1,203.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,565.16
|
| Rate for Payer: BCBS Complete |
$963.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,142.85
|
| Rate for Payer: BCN Commercial |
$3,142.85
|
| Rate for Payer: Cash Price |
$1,926.35
|
| Rate for Payer: Cash Price |
$1,926.35
|
| Rate for Payer: Cash Price |
$1,926.35
|
| Rate for Payer: Cofinity Advantage |
$1,685.56
|
| Rate for Payer: Cofinity Commercial |
$2,070.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,926.35
|
| Rate for Payer: Healthscope Commercial |
$2,167.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,685.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,805.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,926.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,046.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,805.95
|
| Rate for Payer: PHP Commercial |
$2,046.75
|
| Rate for Payer: Priority Health SBD |
$1,517.00
|
| Rate for Payer: UMR Bronson Commercial |
$890.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,805.95
|
|
|
HC ANGIOPLASTY CENTRAL DIALYSIS W IMAGING
|
Facility
|
IP
|
$2,407.94
|
|
|
Service Code
|
CPT 36907
|
| Hospital Charge Code |
36100531
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,059.49 |
| Max. Negotiated Rate |
$2,167.15 |
| Rate for Payer: Aetna American Axle |
$1,565.16
|
| Rate for Payer: Aetna Commercial |
$2,046.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,565.16
|
| Rate for Payer: Cash Price |
$1,926.35
|
| Rate for Payer: Cofinity Advantage |
$1,685.56
|
| Rate for Payer: Cofinity Commercial |
$2,070.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,926.35
|
| Rate for Payer: Healthscope Commercial |
$2,167.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,685.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,805.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,046.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,805.95
|
| Rate for Payer: PHP Commercial |
$2,046.75
|
| Rate for Payer: Priority Health SBD |
$1,517.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,059.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,805.95
|
|
|
HC ANGIOPLASTY EACH ADDL ARTERY WITH IMAGING
|
Facility
|
OP
|
$512.46
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
36100535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$189.61 |
| Max. Negotiated Rate |
$3,742.73 |
| Rate for Payer: Aetna American Axle |
$333.10
|
| Rate for Payer: Aetna Commercial |
$435.59
|
| Rate for Payer: Aetna Medicare |
$256.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.10
|
| Rate for Payer: BCBS Complete |
$204.98
|
| Rate for Payer: BCBS Trust/PPO |
$3,742.73
|
| Rate for Payer: BCN Commercial |
$3,742.73
|
| Rate for Payer: Cash Price |
$409.97
|
| Rate for Payer: Cash Price |
$409.97
|
| Rate for Payer: Cash Price |
$409.97
|
| Rate for Payer: Cofinity Advantage |
$358.72
|
| Rate for Payer: Cofinity Commercial |
$440.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$409.97
|
| Rate for Payer: Healthscope Commercial |
$461.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$358.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$384.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$409.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$435.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$384.35
|
| Rate for Payer: PHP Commercial |
$435.59
|
| Rate for Payer: Priority Health SBD |
$322.85
|
| Rate for Payer: UMR Bronson Commercial |
$189.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$384.35
|
|
|
HC ANGIOPLASTY EACH ADDL ARTERY WITH IMAGING
|
Facility
|
IP
|
$512.46
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
36100535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$225.48 |
| Max. Negotiated Rate |
$461.21 |
| Rate for Payer: Aetna American Axle |
$333.10
|
| Rate for Payer: Aetna Commercial |
$435.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.10
|
| Rate for Payer: Cash Price |
$409.97
|
| Rate for Payer: Cofinity Advantage |
$358.72
|
| Rate for Payer: Cofinity Commercial |
$440.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$409.97
|
| Rate for Payer: Healthscope Commercial |
$461.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$358.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$384.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$435.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$384.35
|
| Rate for Payer: PHP Commercial |
$435.59
|
| Rate for Payer: Priority Health SBD |
$322.85
|
| Rate for Payer: UMR Bronson Commercial |
$225.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$384.35
|
|
|
HC ANGIOPLASTY EACH ADDL VEIN WITH IMAGING
|
Facility
|
IP
|
$580.28
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
36100537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$255.32 |
| Max. Negotiated Rate |
$522.25 |
| Rate for Payer: Aetna American Axle |
$377.18
|
| Rate for Payer: Aetna Commercial |
$493.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$377.18
|
| Rate for Payer: Cash Price |
$464.22
|
| Rate for Payer: Cofinity Advantage |
$406.20
|
| Rate for Payer: Cofinity Commercial |
$499.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$464.22
|
| Rate for Payer: Healthscope Commercial |
$522.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$406.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$435.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$493.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$435.21
|
| Rate for Payer: PHP Commercial |
$493.24
|
| Rate for Payer: Priority Health SBD |
$365.58
|
| Rate for Payer: UMR Bronson Commercial |
$255.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$435.21
|
|
|
HC ANGIOPLASTY EACH ADDL VEIN WITH IMAGING
|
Facility
|
OP
|
$580.28
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
36100537
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$214.70 |
| Max. Negotiated Rate |
$2,745.99 |
| Rate for Payer: Aetna American Axle |
$377.18
|
| Rate for Payer: Aetna Commercial |
$493.24
|
| Rate for Payer: Aetna Medicare |
$290.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$377.18
|
| Rate for Payer: BCBS Complete |
$232.11
|
| Rate for Payer: BCBS Trust/PPO |
$2,745.99
|
| Rate for Payer: BCN Commercial |
$2,745.99
|
| Rate for Payer: Cash Price |
$464.22
|
| Rate for Payer: Cash Price |
$464.22
|
| Rate for Payer: Cash Price |
$464.22
|
| Rate for Payer: Cofinity Advantage |
$406.20
|
| Rate for Payer: Cofinity Commercial |
$499.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$464.22
|
| Rate for Payer: Healthscope Commercial |
$522.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$406.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$435.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$464.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$493.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$435.21
|
| Rate for Payer: PHP Commercial |
$493.24
|
| Rate for Payer: Priority Health SBD |
$365.58
|
| Rate for Payer: UMR Bronson Commercial |
$214.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$435.21
|
|
|
HC ANGIOPLASTY INITIAL ARTERY WITH IMAGING
|
Facility
|
IP
|
$6,639.53
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
36100534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,921.39 |
| Max. Negotiated Rate |
$5,975.58 |
| Rate for Payer: Aetna American Axle |
$4,315.69
|
| Rate for Payer: Aetna Commercial |
$5,643.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,315.69
|
| Rate for Payer: Cash Price |
$5,311.62
|
| Rate for Payer: Cofinity Advantage |
$4,647.67
|
| Rate for Payer: Cofinity Commercial |
$5,710.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,311.62
|
| Rate for Payer: Healthscope Commercial |
$5,975.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,647.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,979.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,643.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,979.65
|
| Rate for Payer: PHP Commercial |
$5,643.60
|
| Rate for Payer: Priority Health SBD |
$4,182.90
|
| Rate for Payer: UMR Bronson Commercial |
$2,921.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,979.65
|
|
|
HC ANGIOPLASTY INITIAL ARTERY WITH IMAGING
|
Facility
|
OP
|
$6,639.53
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
36100534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,456.63 |
| Max. Negotiated Rate |
$18,339.80 |
| Rate for Payer: Aetna American Axle |
$4,315.69
|
| Rate for Payer: Aetna Commercial |
$5,643.60
|
| Rate for Payer: Aetna Medicare |
$5,897.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,315.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,088.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,088.88
|
| Rate for Payer: BCBS Complete |
$3,114.57
|
| Rate for Payer: BCBS MAPPO |
$5,671.10
|
| Rate for Payer: BCBS Trust/PPO |
$6,545.53
|
| Rate for Payer: BCN Commercial |
$6,545.53
|
| Rate for Payer: BCN Medicare Advantage |
$5,671.10
|
| Rate for Payer: Cash Price |
$5,311.62
|
| Rate for Payer: Cash Price |
$5,311.62
|
| Rate for Payer: Cash Price |
$5,311.62
|
| Rate for Payer: Cofinity Advantage |
$4,647.67
|
| Rate for Payer: Cofinity Commercial |
$5,710.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,311.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,671.10
|
| Rate for Payer: Healthscope Commercial |
$5,975.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,647.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,979.65
|
| Rate for Payer: Mclaren Medicaid |
$5,671.10
|
| Rate for Payer: Mclaren Medicare |
$5,671.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,954.65
|
| Rate for Payer: Meridian Medicaid |
$5,954.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,521.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,238.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,643.60
|
| Rate for Payer: Nomi Health Commercial |
$17,013.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,979.65
|
| Rate for Payer: PACE Medicare |
$5,387.55
|
| Rate for Payer: PACE SWMI |
$5,671.10
|
| Rate for Payer: PHP Commercial |
$5,643.60
|
| Rate for Payer: PHP Medicare Advantage |
$5,671.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,965.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18,339.80
|
| Rate for Payer: Priority Health Medicare |
$5,671.10
|
| Rate for Payer: Priority Health SBD |
$4,182.90
|
| Rate for Payer: Priority Health Tiered Network |
$14,671.84
|
| Rate for Payer: Railroad Medicare Medicare |
$5,671.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,671.10
|
| Rate for Payer: UHC Medicaid |
$2,965.99
|
| Rate for Payer: UHCCP Medicaid |
$2,965.99
|
| Rate for Payer: UMR Bronson Commercial |
$2,456.63
|
| Rate for Payer: VA VA |
$5,671.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,979.65
|
|
|
HC ANGIOPLASTY INITIAL VEIN WITH IMAGING
|
Facility
|
OP
|
$6,834.81
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
36100536
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,528.88 |
| Max. Negotiated Rate |
$18,339.80 |
| Rate for Payer: Aetna American Axle |
$4,442.63
|
| Rate for Payer: Aetna Commercial |
$5,809.59
|
| Rate for Payer: Aetna Medicare |
$5,897.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,442.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,088.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,088.88
|
| Rate for Payer: BCBS Complete |
$3,114.57
|
| Rate for Payer: BCBS MAPPO |
$5,671.10
|
| Rate for Payer: BCBS Trust/PPO |
$9,691.75
|
| Rate for Payer: BCN Commercial |
$9,691.75
|
| Rate for Payer: BCN Medicare Advantage |
$5,671.10
|
| Rate for Payer: Cash Price |
$5,467.85
|
| Rate for Payer: Cash Price |
$5,467.85
|
| Rate for Payer: Cash Price |
$5,467.85
|
| Rate for Payer: Cofinity Advantage |
$4,784.37
|
| Rate for Payer: Cofinity Commercial |
$5,877.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,467.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,671.10
|
| Rate for Payer: Healthscope Commercial |
$6,151.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,784.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,126.11
|
| Rate for Payer: Mclaren Medicaid |
$5,671.10
|
| Rate for Payer: Mclaren Medicare |
$5,671.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,954.65
|
| Rate for Payer: Meridian Medicaid |
$5,954.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,521.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,238.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,809.59
|
| Rate for Payer: Nomi Health Commercial |
$17,013.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,126.11
|
| Rate for Payer: PACE Medicare |
$5,387.55
|
| Rate for Payer: PACE SWMI |
$5,671.10
|
| Rate for Payer: PHP Commercial |
$5,809.59
|
| Rate for Payer: PHP Medicare Advantage |
$5,671.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,965.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18,339.80
|
| Rate for Payer: Priority Health Medicare |
$5,671.10
|
| Rate for Payer: Priority Health SBD |
$4,305.93
|
| Rate for Payer: Priority Health Tiered Network |
$14,671.84
|
| Rate for Payer: Railroad Medicare Medicare |
$5,671.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,671.10
|
| Rate for Payer: UHC Medicaid |
$2,965.99
|
| Rate for Payer: UHCCP Medicaid |
$2,965.99
|
| Rate for Payer: UMR Bronson Commercial |
$2,528.88
|
| Rate for Payer: VA VA |
$5,671.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,126.11
|
|
|
HC ANGIOPLASTY INITIAL VEIN WITH IMAGING
|
Facility
|
IP
|
$6,834.81
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
36100536
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,007.32 |
| Max. Negotiated Rate |
$6,151.33 |
| Rate for Payer: Aetna American Axle |
$4,442.63
|
| Rate for Payer: Aetna Commercial |
$5,809.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,442.63
|
| Rate for Payer: Cash Price |
$5,467.85
|
| Rate for Payer: Cofinity Advantage |
$4,784.37
|
| Rate for Payer: Cofinity Commercial |
$5,877.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,467.85
|
| Rate for Payer: Healthscope Commercial |
$6,151.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,784.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,126.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,809.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,126.11
|
| Rate for Payer: PHP Commercial |
$5,809.59
|
| Rate for Payer: Priority Health SBD |
$4,305.93
|
| Rate for Payer: UMR Bronson Commercial |
$3,007.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,126.11
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL DIFF FAM
|
Facility
|
IP
|
$1,031.59
|
|
|
Service Code
|
CPT 61642
|
| Hospital Charge Code |
36100277
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$453.90 |
| Max. Negotiated Rate |
$928.43 |
| Rate for Payer: Aetna American Axle |
$670.53
|
| Rate for Payer: Aetna Commercial |
$876.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.53
|
| Rate for Payer: Cash Price |
$825.27
|
| Rate for Payer: Cofinity Advantage |
$722.11
|
| Rate for Payer: Cofinity Commercial |
$887.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.27
|
| Rate for Payer: Healthscope Commercial |
$928.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$722.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.69
|
| Rate for Payer: PHP Commercial |
$876.85
|
| Rate for Payer: Priority Health SBD |
$649.90
|
| Rate for Payer: UMR Bronson Commercial |
$453.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.69
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL DIFF FAM
|
Facility
|
OP
|
$1,031.59
|
|
|
Service Code
|
CPT 61642
|
| Hospital Charge Code |
36100277
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$381.69 |
| Max. Negotiated Rate |
$928.43 |
| Rate for Payer: Aetna American Axle |
$670.53
|
| Rate for Payer: Aetna Commercial |
$876.85
|
| Rate for Payer: Aetna Medicare |
$515.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.53
|
| Rate for Payer: BCBS Complete |
$412.64
|
| Rate for Payer: Cash Price |
$825.27
|
| Rate for Payer: Cofinity Advantage |
$722.11
|
| Rate for Payer: Cofinity Commercial |
$887.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.27
|
| Rate for Payer: Healthscope Commercial |
$928.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$722.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$825.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.69
|
| Rate for Payer: PHP Commercial |
$876.85
|
| Rate for Payer: Priority Health SBD |
$649.90
|
| Rate for Payer: UMR Bronson Commercial |
$381.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.69
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL SAME FAM
|
Facility
|
IP
|
$1,031.59
|
|
|
Service Code
|
CPT 61641
|
| Hospital Charge Code |
36100276
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$453.90 |
| Max. Negotiated Rate |
$928.43 |
| Rate for Payer: Aetna American Axle |
$670.53
|
| Rate for Payer: Aetna Commercial |
$876.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.53
|
| Rate for Payer: Cash Price |
$825.27
|
| Rate for Payer: Cofinity Advantage |
$722.11
|
| Rate for Payer: Cofinity Commercial |
$887.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.27
|
| Rate for Payer: Healthscope Commercial |
$928.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$722.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.69
|
| Rate for Payer: PHP Commercial |
$876.85
|
| Rate for Payer: Priority Health SBD |
$649.90
|
| Rate for Payer: UMR Bronson Commercial |
$453.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.69
|
|
|
HC ANGIOPLASTY INTRACR VASOSPASM EACH ADDL SAME FAM
|
Facility
|
OP
|
$1,031.59
|
|
|
Service Code
|
CPT 61641
|
| Hospital Charge Code |
36100276
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$381.69 |
| Max. Negotiated Rate |
$928.43 |
| Rate for Payer: Aetna American Axle |
$670.53
|
| Rate for Payer: Aetna Commercial |
$876.85
|
| Rate for Payer: Aetna Medicare |
$515.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$670.53
|
| Rate for Payer: BCBS Complete |
$412.64
|
| Rate for Payer: Cash Price |
$825.27
|
| Rate for Payer: Cofinity Advantage |
$722.11
|
| Rate for Payer: Cofinity Commercial |
$887.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$825.27
|
| Rate for Payer: Healthscope Commercial |
$928.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$722.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$825.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$876.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$773.69
|
| Rate for Payer: PHP Commercial |
$876.85
|
| Rate for Payer: Priority Health SBD |
$649.90
|
| Rate for Payer: UMR Bronson Commercial |
$381.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.69
|
|
|
HC ANGIO ROOM TIME W/FLUORO 1 HOU
|
Facility
|
OP
|
$1,902.94
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000232
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$68.96 |
| Max. Negotiated Rate |
$1,712.65 |
| Rate for Payer: Aetna American Axle |
$1,236.91
|
| Rate for Payer: Aetna Commercial |
$1,617.50
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$68.96
|
| Rate for Payer: BCN Commercial |
$68.96
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$1,522.35
|
| Rate for Payer: Cash Price |
$1,522.35
|
| Rate for Payer: Cofinity Advantage |
$1,332.06
|
| Rate for Payer: Cofinity Commercial |
$1,636.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$1,712.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,332.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,427.20
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,617.50
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,427.20
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$1,617.50
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$1,198.85
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,236.91
|
| Rate for Payer: UHC Core |
$991.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$747.86
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: UMR Bronson Commercial |
$704.09
|
| Rate for Payer: VA VA |
$237.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,427.20
|
|
|
HC ANGIO ROOM TIME W/FLUORO 1 HOU
|
Facility
|
IP
|
$1,902.94
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
32000232
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$837.29 |
| Max. Negotiated Rate |
$1,712.65 |
| Rate for Payer: Aetna American Axle |
$1,236.91
|
| Rate for Payer: Aetna Commercial |
$1,617.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,236.91
|
| Rate for Payer: Cash Price |
$1,522.35
|
| Rate for Payer: Cofinity Advantage |
$1,332.06
|
| Rate for Payer: Cofinity Commercial |
$1,636.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,522.35
|
| Rate for Payer: Healthscope Commercial |
$1,712.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,332.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,427.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,617.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,427.20
|
| Rate for Payer: PHP Commercial |
$1,617.50
|
| Rate for Payer: Priority Health SBD |
$1,198.85
|
| Rate for Payer: UMR Bronson Commercial |
$837.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,427.20
|
|
