|
HC 2 PIECE WAFER
|
Facility
|
OP
|
$13.42
|
|
| Hospital Charge Code |
27100001
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.97 |
| Max. Negotiated Rate |
$12.08 |
| Rate for Payer: Aetna American Axle |
$8.72
|
| Rate for Payer: Aetna Commercial |
$11.41
|
| Rate for Payer: Aetna Medicare |
$6.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.72
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: Cash Price |
$10.74
|
| Rate for Payer: Cofinity Commercial |
$11.54
|
| Rate for Payer: Cofinity Commercial |
$9.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.74
|
| Rate for Payer: Healthscope Commercial |
$12.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.41
|
| Rate for Payer: PHP Commercial |
$11.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.72
|
| Rate for Payer: Priority Health SBD |
$8.45
|
| Rate for Payer: UMR Bronson Commercial |
$4.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.06
|
|
|
HC 3D ECHO RENDERING
|
Facility
|
IP
|
$669.19
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
32000282
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$294.44 |
| Max. Negotiated Rate |
$602.27 |
| Rate for Payer: Aetna American Axle |
$434.97
|
| Rate for Payer: Aetna Commercial |
$568.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.97
|
| Rate for Payer: Cash Price |
$535.35
|
| Rate for Payer: Cofinity Commercial |
$468.43
|
| Rate for Payer: Cofinity Commercial |
$575.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$468.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$535.35
|
| Rate for Payer: Healthscope Commercial |
$602.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$468.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$501.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$568.81
|
| Rate for Payer: PHP Commercial |
$568.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$434.97
|
| Rate for Payer: Priority Health SBD |
$421.59
|
| Rate for Payer: UMR Bronson Commercial |
$294.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$501.89
|
|
|
HC 3D ECHO RENDERING
|
Facility
|
OP
|
$669.19
|
|
|
Service Code
|
CPT 76376
|
| Hospital Charge Code |
32000282
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$247.60 |
| Max. Negotiated Rate |
$602.27 |
| Rate for Payer: Aetna American Axle |
$434.97
|
| Rate for Payer: Aetna Commercial |
$568.81
|
| Rate for Payer: Aetna Medicare |
$334.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$434.97
|
| Rate for Payer: BCBS Complete |
$267.68
|
| Rate for Payer: Cash Price |
$535.35
|
| Rate for Payer: Cash Price |
$535.35
|
| Rate for Payer: Cofinity Commercial |
$575.50
|
| Rate for Payer: Cofinity Commercial |
$468.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$468.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$535.35
|
| Rate for Payer: Healthscope Commercial |
$602.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$468.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$501.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$568.81
|
| Rate for Payer: PHP Commercial |
$568.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$434.97
|
| Rate for Payer: Priority Health SBD |
$421.59
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UMR Bronson Commercial |
$247.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$501.89
|
|
|
HC 3D ECHO REND W/WORKSTATION
|
Facility
|
OP
|
$637.87
|
|
|
Service Code
|
CPT 76377
|
| Hospital Charge Code |
32000283
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$236.01 |
| Max. Negotiated Rate |
$574.08 |
| Rate for Payer: Aetna American Axle |
$414.62
|
| Rate for Payer: Aetna Commercial |
$542.19
|
| Rate for Payer: Aetna Medicare |
$318.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.62
|
| Rate for Payer: BCBS Complete |
$255.15
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cofinity Commercial |
$548.57
|
| Rate for Payer: Cofinity Commercial |
$446.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$446.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.30
|
| Rate for Payer: Healthscope Commercial |
$574.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$446.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$478.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$542.19
|
| Rate for Payer: PHP Commercial |
$542.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$414.62
|
| Rate for Payer: Priority Health SBD |
$401.86
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UMR Bronson Commercial |
$236.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$478.40
|
|
|
HC 3D ECHO REND W/WORKSTATION
|
Facility
|
IP
|
$637.87
|
|
|
Service Code
|
CPT 76377
|
| Hospital Charge Code |
32000283
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$280.66 |
| Max. Negotiated Rate |
$574.08 |
| Rate for Payer: Aetna American Axle |
$414.62
|
| Rate for Payer: Aetna Commercial |
$542.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.62
|
| Rate for Payer: Cash Price |
$510.30
|
| Rate for Payer: Cofinity Commercial |
$446.51
|
| Rate for Payer: Cofinity Commercial |
$548.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$446.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$510.30
|
| Rate for Payer: Healthscope Commercial |
$574.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$446.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$478.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$542.19
|
| Rate for Payer: PHP Commercial |
$542.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$414.62
|
| Rate for Payer: Priority Health SBD |
$401.86
|
| Rate for Payer: UMR Bronson Commercial |
$280.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$478.40
|
|
|
HC 4X4 WAFER
|
Facility
|
OP
|
$24.51
|
|
| Hospital Charge Code |
27000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.07 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Aetna American Axle |
$15.93
|
| Rate for Payer: Aetna Commercial |
$20.83
|
| Rate for Payer: Aetna Medicare |
$12.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.93
|
| Rate for Payer: BCBS Complete |
$9.80
|
| Rate for Payer: Cash Price |
$19.61
|
| Rate for Payer: Cofinity Commercial |
$17.16
|
| Rate for Payer: Cofinity Commercial |
$21.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.61
|
| Rate for Payer: Healthscope Commercial |
$22.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.83
|
| Rate for Payer: PHP Commercial |
$20.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.93
|
| Rate for Payer: Priority Health SBD |
$15.44
|
| Rate for Payer: UMR Bronson Commercial |
$9.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.38
|
|
|
HC 4X4 WAFER
|
Facility
|
IP
|
$24.51
|
|
| Hospital Charge Code |
27000023
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.78 |
| Max. Negotiated Rate |
$22.06 |
| Rate for Payer: Aetna American Axle |
$15.93
|
| Rate for Payer: Aetna Commercial |
$20.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.93
|
| Rate for Payer: Cash Price |
$19.61
|
| Rate for Payer: Cofinity Commercial |
$17.16
|
| Rate for Payer: Cofinity Commercial |
$21.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.61
|
| Rate for Payer: Healthscope Commercial |
$22.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.83
|
| Rate for Payer: PHP Commercial |
$20.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.93
|
| Rate for Payer: Priority Health SBD |
$15.44
|
| Rate for Payer: UMR Bronson Commercial |
$10.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.38
|
|
|
HC 5 FR SOLO 3CG POWER PICC
|
Facility
|
OP
|
$1,126.57
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$416.83 |
| Max. Negotiated Rate |
$1,013.91 |
| Rate for Payer: Aetna American Axle |
$732.27
|
| Rate for Payer: Aetna Commercial |
$957.58
|
| Rate for Payer: Aetna Medicare |
$563.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$732.27
|
| Rate for Payer: BCBS Complete |
$450.63
|
| Rate for Payer: Cash Price |
$901.26
|
| Rate for Payer: Cofinity Commercial |
$788.60
|
| Rate for Payer: Cofinity Commercial |
$968.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$788.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$901.26
|
| Rate for Payer: Healthscope Commercial |
$1,013.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$788.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$844.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$957.58
|
| Rate for Payer: PHP Commercial |
$957.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$732.27
|
| Rate for Payer: Priority Health SBD |
$709.74
|
| Rate for Payer: UMR Bronson Commercial |
$416.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$844.93
|
|
|
HC 5 FR SOLO 3CG POWER PICC
|
Facility
|
IP
|
$1,126.57
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$495.69 |
| Max. Negotiated Rate |
$1,013.91 |
| Rate for Payer: Aetna American Axle |
$732.27
|
| Rate for Payer: Aetna Commercial |
$957.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$732.27
|
| Rate for Payer: Cash Price |
$901.26
|
| Rate for Payer: Cofinity Commercial |
$788.60
|
| Rate for Payer: Cofinity Commercial |
$968.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$788.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$901.26
|
| Rate for Payer: Healthscope Commercial |
$1,013.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$788.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$844.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$957.58
|
| Rate for Payer: PHP Commercial |
$957.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$732.27
|
| Rate for Payer: Priority Health SBD |
$709.74
|
| Rate for Payer: UMR Bronson Commercial |
$495.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$844.93
|
|
|
HC 5FR SOLO POWER PICC
|
Facility
|
IP
|
$976.26
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$429.55 |
| Max. Negotiated Rate |
$878.63 |
| Rate for Payer: Aetna American Axle |
$634.57
|
| Rate for Payer: Aetna Commercial |
$829.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.57
|
| Rate for Payer: Cash Price |
$781.01
|
| Rate for Payer: Cofinity Commercial |
$683.38
|
| Rate for Payer: Cofinity Commercial |
$839.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$683.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$781.01
|
| Rate for Payer: Healthscope Commercial |
$878.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$683.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$732.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.82
|
| Rate for Payer: PHP Commercial |
$829.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.57
|
| Rate for Payer: Priority Health SBD |
$615.04
|
| Rate for Payer: UMR Bronson Commercial |
$429.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$732.20
|
|
|
HC 5FR SOLO POWER PICC
|
Facility
|
OP
|
$976.26
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$361.22 |
| Max. Negotiated Rate |
$878.63 |
| Rate for Payer: Aetna American Axle |
$634.57
|
| Rate for Payer: Aetna Commercial |
$829.82
|
| Rate for Payer: Aetna Medicare |
$488.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.57
|
| Rate for Payer: BCBS Complete |
$390.50
|
| Rate for Payer: Cash Price |
$781.01
|
| Rate for Payer: Cofinity Commercial |
$683.38
|
| Rate for Payer: Cofinity Commercial |
$839.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$683.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$781.01
|
| Rate for Payer: Healthscope Commercial |
$878.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$683.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$732.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.82
|
| Rate for Payer: PHP Commercial |
$829.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.57
|
| Rate for Payer: Priority Health SBD |
$615.04
|
| Rate for Payer: UMR Bronson Commercial |
$361.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$732.20
|
|
|
HC 5 FR TL 3CG MAX POWER PICC
|
Facility
|
OP
|
$1,229.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$454.73 |
| Max. Negotiated Rate |
$1,106.10 |
| Rate for Payer: Aetna American Axle |
$798.85
|
| Rate for Payer: Aetna Commercial |
$1,044.65
|
| Rate for Payer: Aetna Medicare |
$614.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$798.85
|
| Rate for Payer: BCBS Complete |
$491.60
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cofinity Commercial |
$1,056.94
|
| Rate for Payer: Cofinity Commercial |
$860.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$860.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$983.20
|
| Rate for Payer: Healthscope Commercial |
$1,106.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$860.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$921.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.65
|
| Rate for Payer: PHP Commercial |
$1,044.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$798.85
|
| Rate for Payer: Priority Health SBD |
$774.27
|
| Rate for Payer: UMR Bronson Commercial |
$454.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$921.75
|
|
|
HC 5 FR TL 3CG MAX POWER PICC
|
Facility
|
IP
|
$1,229.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$540.76 |
| Max. Negotiated Rate |
$1,106.10 |
| Rate for Payer: Aetna American Axle |
$798.85
|
| Rate for Payer: Aetna Commercial |
$1,044.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$798.85
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cofinity Commercial |
$1,056.94
|
| Rate for Payer: Cofinity Commercial |
$860.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$860.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$983.20
|
| Rate for Payer: Healthscope Commercial |
$1,106.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$860.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$921.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.65
|
| Rate for Payer: PHP Commercial |
$1,044.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$798.85
|
| Rate for Payer: Priority Health SBD |
$774.27
|
| Rate for Payer: UMR Bronson Commercial |
$540.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$921.75
|
|
|
HC 5 FR TL SOLO MAX POWER PICC
|
Facility
|
OP
|
$1,065.01
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$394.05 |
| Max. Negotiated Rate |
$958.51 |
| Rate for Payer: Aetna American Axle |
$692.26
|
| Rate for Payer: Aetna Commercial |
$905.26
|
| Rate for Payer: Aetna Medicare |
$532.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$692.26
|
| Rate for Payer: BCBS Complete |
$426.00
|
| Rate for Payer: Cash Price |
$852.01
|
| Rate for Payer: Cofinity Commercial |
$745.51
|
| Rate for Payer: Cofinity Commercial |
$915.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$745.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.01
|
| Rate for Payer: Healthscope Commercial |
$958.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$745.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.26
|
| Rate for Payer: PHP Commercial |
$905.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.26
|
| Rate for Payer: Priority Health SBD |
$670.96
|
| Rate for Payer: UMR Bronson Commercial |
$394.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.76
|
|
|
HC 5 FR TL SOLO MAX POWER PICC
|
Facility
|
IP
|
$1,065.01
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$468.60 |
| Max. Negotiated Rate |
$958.51 |
| Rate for Payer: Aetna American Axle |
$692.26
|
| Rate for Payer: Aetna Commercial |
$905.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$692.26
|
| Rate for Payer: Cash Price |
$852.01
|
| Rate for Payer: Cofinity Commercial |
$745.51
|
| Rate for Payer: Cofinity Commercial |
$915.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$745.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.01
|
| Rate for Payer: Healthscope Commercial |
$958.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$745.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.26
|
| Rate for Payer: PHP Commercial |
$905.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.26
|
| Rate for Payer: Priority Health SBD |
$670.96
|
| Rate for Payer: UMR Bronson Commercial |
$468.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.76
|
|
|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
IP
|
$1,229.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$540.76 |
| Max. Negotiated Rate |
$1,106.10 |
| Rate for Payer: Aetna American Axle |
$798.85
|
| Rate for Payer: Aetna Commercial |
$1,044.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$798.85
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cofinity Commercial |
$1,056.94
|
| Rate for Payer: Cofinity Commercial |
$860.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$860.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$983.20
|
| Rate for Payer: Healthscope Commercial |
$1,106.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$860.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$921.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.65
|
| Rate for Payer: PHP Commercial |
$1,044.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$798.85
|
| Rate for Payer: Priority Health SBD |
$774.27
|
| Rate for Payer: UMR Bronson Commercial |
$540.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$921.75
|
|
|
HC 6 FR SOLO 3CG POWER PICC
|
Facility
|
OP
|
$1,229.00
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200168
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$454.73 |
| Max. Negotiated Rate |
$1,106.10 |
| Rate for Payer: Aetna American Axle |
$798.85
|
| Rate for Payer: Aetna Commercial |
$1,044.65
|
| Rate for Payer: Aetna Medicare |
$614.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$798.85
|
| Rate for Payer: BCBS Complete |
$491.60
|
| Rate for Payer: Cash Price |
$983.20
|
| Rate for Payer: Cofinity Commercial |
$1,056.94
|
| Rate for Payer: Cofinity Commercial |
$860.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$860.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$983.20
|
| Rate for Payer: Healthscope Commercial |
$1,106.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$860.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$921.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,044.65
|
| Rate for Payer: PHP Commercial |
$1,044.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$798.85
|
| Rate for Payer: Priority Health SBD |
$774.27
|
| Rate for Payer: UMR Bronson Commercial |
$454.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$921.75
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
OP
|
$1,065.01
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$394.05 |
| Max. Negotiated Rate |
$958.51 |
| Rate for Payer: Aetna American Axle |
$692.26
|
| Rate for Payer: Aetna Commercial |
$905.26
|
| Rate for Payer: Aetna Medicare |
$532.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$692.26
|
| Rate for Payer: BCBS Complete |
$426.00
|
| Rate for Payer: Cash Price |
$852.01
|
| Rate for Payer: Cofinity Commercial |
$745.51
|
| Rate for Payer: Cofinity Commercial |
$915.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$745.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.01
|
| Rate for Payer: Healthscope Commercial |
$958.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$745.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.26
|
| Rate for Payer: PHP Commercial |
$905.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.26
|
| Rate for Payer: Priority Health SBD |
$670.96
|
| Rate for Payer: UMR Bronson Commercial |
$394.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.76
|
|
|
HC 6FR SOLO POWER PICC
|
Facility
|
IP
|
$1,065.01
|
|
| Hospital Charge Code |
27200109
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$468.60 |
| Max. Negotiated Rate |
$958.51 |
| Rate for Payer: Aetna American Axle |
$692.26
|
| Rate for Payer: Aetna Commercial |
$905.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$692.26
|
| Rate for Payer: Cash Price |
$852.01
|
| Rate for Payer: Cofinity Commercial |
$745.51
|
| Rate for Payer: Cofinity Commercial |
$915.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$745.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$852.01
|
| Rate for Payer: Healthscope Commercial |
$958.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$745.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$905.26
|
| Rate for Payer: PHP Commercial |
$905.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$692.26
|
| Rate for Payer: Priority Health SBD |
$670.96
|
| Rate for Payer: UMR Bronson Commercial |
$468.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.76
|
|
|
HC 8X8 WAFER
|
Facility
|
IP
|
$74.04
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$32.58 |
| Max. Negotiated Rate |
$66.64 |
| Rate for Payer: Aetna American Axle |
$48.13
|
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.13
|
| Rate for Payer: Cash Price |
$59.23
|
| Rate for Payer: Cofinity Commercial |
$51.83
|
| Rate for Payer: Cofinity Commercial |
$63.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.23
|
| Rate for Payer: Healthscope Commercial |
$66.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.93
|
| Rate for Payer: PHP Commercial |
$62.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.13
|
| Rate for Payer: Priority Health SBD |
$46.65
|
| Rate for Payer: UMR Bronson Commercial |
$32.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.53
|
|
|
HC 8X8 WAFER
|
Facility
|
OP
|
$74.04
|
|
| Hospital Charge Code |
27000024
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$27.39 |
| Max. Negotiated Rate |
$66.64 |
| Rate for Payer: Aetna American Axle |
$48.13
|
| Rate for Payer: Aetna Commercial |
$62.93
|
| Rate for Payer: Aetna Medicare |
$37.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.13
|
| Rate for Payer: BCBS Complete |
$29.62
|
| Rate for Payer: Cash Price |
$59.23
|
| Rate for Payer: Cofinity Commercial |
$51.83
|
| Rate for Payer: Cofinity Commercial |
$63.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.23
|
| Rate for Payer: Healthscope Commercial |
$66.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.93
|
| Rate for Payer: PHP Commercial |
$62.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.13
|
| Rate for Payer: Priority Health SBD |
$46.65
|
| Rate for Payer: UMR Bronson Commercial |
$27.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.53
|
|
|
HC A1AT PROTEOTYPE
|
Facility
|
IP
|
$48.90
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100610
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.52 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna American Axle |
$31.79
|
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.79
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.79
|
| Rate for Payer: Priority Health SBD |
$30.81
|
| Rate for Payer: UMR Bronson Commercial |
$21.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.67
|
|
|
HC A1AT PROTEOTYPE
|
Facility
|
OP
|
$48.90
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100610
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$67.81 |
| Rate for Payer: Aetna American Axle |
$31.79
|
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: Aetna Medicare |
$25.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.79
|
| 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 |
$13.56
|
| Rate for Payer: BCBS MAPPO |
$24.09
|
| Rate for Payer: BCN Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.67
|
| Rate for Payer: Mclaren Medicaid |
$12.91
|
| 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 |
$13.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: PACE Medicare |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.09
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: PHP Medicare Advantage |
$24.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.79
|
| Rate for Payer: Priority Health Medicare |
$24.09
|
| Rate for Payer: Priority Health SBD |
$30.81
|
| Rate for Payer: Railroad Medicare Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.09
|
| Rate for Payer: UHC Exchange |
$46.04
|
| Rate for Payer: UHC Medicare Advantage |
$24.09
|
| Rate for Payer: UHCCP Medicaid |
$12.91
|
| Rate for Payer: UMR Bronson Commercial |
$18.09
|
| Rate for Payer: VA VA |
$24.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.67
|
|
|
HC A1AT PROTEOTYPE CMPT
|
Facility
|
OP
|
$21.42
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$37.83 |
| Rate for Payer: Aetna American Axle |
$13.92
|
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna Medicare |
$13.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.92
|
| 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 |
$7.56
|
| Rate for Payer: BCBS MAPPO |
$13.44
|
| Rate for Payer: BCN Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Cofinity Commercial |
$14.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.44
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.07
|
| Rate for Payer: Mclaren Medicaid |
$7.20
|
| 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 |
$7.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.21
|
| Rate for Payer: PACE Medicare |
$12.77
|
| Rate for Payer: PACE SWMI |
$13.44
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: PHP Medicare Advantage |
$13.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.92
|
| Rate for Payer: Priority Health Medicare |
$13.44
|
| Rate for Payer: Priority Health SBD |
$13.49
|
| Rate for Payer: Railroad Medicare Medicare |
$13.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.44
|
| Rate for Payer: UHC Exchange |
$25.69
|
| Rate for Payer: UHC Medicare Advantage |
$13.44
|
| Rate for Payer: UHCCP Medicaid |
$7.20
|
| Rate for Payer: UMR Bronson Commercial |
$7.93
|
| Rate for Payer: VA VA |
$13.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.07
|
|
|
HC A1AT PROTEOTYPE CMPT
|
Facility
|
IP
|
$21.42
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
30100611
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.42 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna American Axle |
$13.92
|
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.92
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$14.99
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.21
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.92
|
| Rate for Payer: Priority Health SBD |
$13.49
|
| Rate for Payer: UMR Bronson Commercial |
$9.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.07
|
|
