|
HC ACB NEW PT LEVEL 5
|
Facility
|
OP
|
$1,042.88
|
|
|
Service Code
|
CPT 99205
|
| Hospital Charge Code |
51000104
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$385.87 |
| Max. Negotiated Rate |
$938.59 |
| Rate for Payer: Aetna American Axle |
$677.87
|
| Rate for Payer: Aetna Commercial |
$886.45
|
| Rate for Payer: Aetna Medicare |
$521.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$677.87
|
| Rate for Payer: BCBS Complete |
$417.15
|
| Rate for Payer: Cash Price |
$834.30
|
| Rate for Payer: Cofinity Commercial |
$730.02
|
| Rate for Payer: Cofinity Commercial |
$896.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$730.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$834.30
|
| Rate for Payer: Healthscope Commercial |
$938.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$730.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$782.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$886.45
|
| Rate for Payer: PHP Commercial |
$886.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$677.87
|
| Rate for Payer: Priority Health SBD |
$657.01
|
| Rate for Payer: UMR Bronson Commercial |
$385.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$782.16
|
|
|
HC ACCESS AORTA
|
Facility
|
IP
|
$3,920.31
|
|
|
Service Code
|
CPT 36200
|
| Hospital Charge Code |
36100105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,724.94 |
| Max. Negotiated Rate |
$3,528.28 |
| Rate for Payer: Aetna American Axle |
$2,548.20
|
| Rate for Payer: Aetna Commercial |
$3,332.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,548.20
|
| Rate for Payer: Cash Price |
$3,136.25
|
| Rate for Payer: Cofinity Commercial |
$2,744.22
|
| Rate for Payer: Cofinity Commercial |
$3,371.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,744.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,136.25
|
| Rate for Payer: Healthscope Commercial |
$3,528.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,744.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,940.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,332.26
|
| Rate for Payer: PHP Commercial |
$3,332.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,548.20
|
| Rate for Payer: Priority Health SBD |
$2,469.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,724.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,940.23
|
|
|
HC ACCESS AORTA
|
Facility
|
OP
|
$3,920.31
|
|
|
Service Code
|
CPT 36200
|
| Hospital Charge Code |
36100105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,450.51 |
| Max. Negotiated Rate |
$3,528.28 |
| Rate for Payer: Aetna American Axle |
$2,548.20
|
| Rate for Payer: Aetna Commercial |
$3,332.26
|
| Rate for Payer: Aetna Medicare |
$1,960.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,548.20
|
| Rate for Payer: BCBS Complete |
$1,568.12
|
| Rate for Payer: Cash Price |
$3,136.25
|
| Rate for Payer: Cofinity Commercial |
$2,744.22
|
| Rate for Payer: Cofinity Commercial |
$3,371.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,744.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,136.25
|
| Rate for Payer: Healthscope Commercial |
$3,528.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,744.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,940.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,332.26
|
| Rate for Payer: PHP Commercial |
$3,332.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,548.20
|
| Rate for Payer: Priority Health SBD |
$2,469.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,450.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,940.23
|
|
|
HC ACCESS EXTREMITY ARTERY
|
Facility
|
IP
|
$500.92
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
36100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$220.40 |
| Max. Negotiated Rate |
$450.83 |
| Rate for Payer: Aetna American Axle |
$325.60
|
| Rate for Payer: Aetna Commercial |
$425.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.60
|
| Rate for Payer: Cash Price |
$400.74
|
| Rate for Payer: Cofinity Commercial |
$350.64
|
| Rate for Payer: Cofinity Commercial |
$430.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$350.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.74
|
| Rate for Payer: Healthscope Commercial |
$450.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.78
|
| Rate for Payer: PHP Commercial |
$425.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.60
|
| Rate for Payer: Priority Health SBD |
$315.58
|
| Rate for Payer: UMR Bronson Commercial |
$220.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.69
|
|
|
HC ACCESS EXTREMITY ARTERY
|
Facility
|
OP
|
$500.92
|
|
|
Service Code
|
CPT 36140
|
| Hospital Charge Code |
36100102
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$185.34 |
| Max. Negotiated Rate |
$450.83 |
| Rate for Payer: Aetna American Axle |
$325.60
|
| Rate for Payer: Aetna Commercial |
$425.78
|
| Rate for Payer: Aetna Medicare |
$250.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.60
|
| Rate for Payer: BCBS Complete |
$200.37
|
| Rate for Payer: Cash Price |
$400.74
|
| Rate for Payer: Cofinity Commercial |
$350.64
|
| Rate for Payer: Cofinity Commercial |
$430.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$350.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.74
|
| Rate for Payer: Healthscope Commercial |
$450.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$425.78
|
| Rate for Payer: PHP Commercial |
$425.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$325.60
|
| Rate for Payer: Priority Health SBD |
$315.58
|
| Rate for Payer: UMR Bronson Commercial |
$185.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.69
|
|
|
HC ACCESS MAIN PULMONARY
|
Facility
|
OP
|
$427.58
|
|
|
Service Code
|
CPT 36013
|
| Hospital Charge Code |
36100099
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$158.20 |
| Max. Negotiated Rate |
$384.82 |
| Rate for Payer: Aetna American Axle |
$277.93
|
| Rate for Payer: Aetna Commercial |
$363.44
|
| Rate for Payer: Aetna Medicare |
$213.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.93
|
| Rate for Payer: BCBS Complete |
$171.03
|
| Rate for Payer: Cash Price |
$342.06
|
| Rate for Payer: Cofinity Commercial |
$299.31
|
| Rate for Payer: Cofinity Commercial |
$367.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$299.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.06
|
| Rate for Payer: Healthscope Commercial |
$384.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$299.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$320.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$363.44
|
| Rate for Payer: PHP Commercial |
$363.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.93
|
| Rate for Payer: Priority Health SBD |
$269.38
|
| Rate for Payer: UMR Bronson Commercial |
$158.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$320.69
|
|
|
HC ACCESS MAIN PULMONARY
|
Facility
|
IP
|
$427.58
|
|
|
Service Code
|
CPT 36013
|
| Hospital Charge Code |
36100099
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$188.14 |
| Max. Negotiated Rate |
$384.82 |
| Rate for Payer: Aetna American Axle |
$277.93
|
| Rate for Payer: Aetna Commercial |
$363.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.93
|
| Rate for Payer: Cash Price |
$342.06
|
| Rate for Payer: Cofinity Commercial |
$299.31
|
| Rate for Payer: Cofinity Commercial |
$367.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$299.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$342.06
|
| Rate for Payer: Healthscope Commercial |
$384.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$299.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$320.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$363.44
|
| Rate for Payer: PHP Commercial |
$363.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.93
|
| Rate for Payer: Priority Health SBD |
$269.38
|
| Rate for Payer: UMR Bronson Commercial |
$188.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$320.69
|
|
|
HC ACCESS VEIN
|
Facility
|
OP
|
$388.71
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
36100093
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$143.82 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna American Axle |
$252.66
|
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna Medicare |
$194.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| Rate for Payer: BCBS Complete |
$155.48
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$272.10
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$272.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health SBD |
$244.89
|
| Rate for Payer: UMR Bronson Commercial |
$143.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC ACCESS VEIN
|
Facility
|
IP
|
$388.71
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
36100093
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$171.03 |
| Max. Negotiated Rate |
$349.84 |
| Rate for Payer: Aetna American Axle |
$252.66
|
| Rate for Payer: Aetna Commercial |
$330.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.66
|
| Rate for Payer: Cash Price |
$310.97
|
| Rate for Payer: Cofinity Commercial |
$272.10
|
| Rate for Payer: Cofinity Commercial |
$334.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$272.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.97
|
| Rate for Payer: Healthscope Commercial |
$349.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$330.40
|
| Rate for Payer: PHP Commercial |
$330.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.66
|
| Rate for Payer: Priority Health SBD |
$244.89
|
| Rate for Payer: UMR Bronson Commercial |
$171.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.53
|
|
|
HC ACCESS VEIN ORGAN BLOOD SAMPLING
|
Facility
|
IP
|
$1,069.35
|
|
|
Service Code
|
CPT 36500
|
| Hospital Charge Code |
36100118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$470.51 |
| Max. Negotiated Rate |
$962.41 |
| Rate for Payer: Aetna American Axle |
$695.08
|
| Rate for Payer: Aetna Commercial |
$908.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$695.08
|
| Rate for Payer: Cash Price |
$855.48
|
| Rate for Payer: Cofinity Commercial |
$748.54
|
| Rate for Payer: Cofinity Commercial |
$919.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$748.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.48
|
| Rate for Payer: Healthscope Commercial |
$962.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$748.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$802.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.95
|
| Rate for Payer: PHP Commercial |
$908.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.08
|
| Rate for Payer: Priority Health SBD |
$673.69
|
| Rate for Payer: UMR Bronson Commercial |
$470.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$802.01
|
|
|
HC ACCESS VEIN ORGAN BLOOD SAMPLING
|
Facility
|
OP
|
$1,069.35
|
|
|
Service Code
|
CPT 36500
|
| Hospital Charge Code |
36100118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$395.66 |
| Max. Negotiated Rate |
$962.41 |
| Rate for Payer: Aetna American Axle |
$695.08
|
| Rate for Payer: Aetna Commercial |
$908.95
|
| Rate for Payer: Aetna Medicare |
$534.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$695.08
|
| Rate for Payer: BCBS Complete |
$427.74
|
| Rate for Payer: Cash Price |
$855.48
|
| Rate for Payer: Cofinity Commercial |
$748.54
|
| Rate for Payer: Cofinity Commercial |
$919.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$748.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.48
|
| Rate for Payer: Healthscope Commercial |
$962.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$748.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$802.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.95
|
| Rate for Payer: PHP Commercial |
$908.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.08
|
| Rate for Payer: Priority Health SBD |
$673.69
|
| Rate for Payer: UMR Bronson Commercial |
$395.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$802.01
|
|
|
HC ACCESS VENA CAVA
|
Facility
|
OP
|
$3,128.58
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
36100096
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,157.57 |
| Max. Negotiated Rate |
$2,815.72 |
| Rate for Payer: Aetna American Axle |
$2,033.58
|
| Rate for Payer: Aetna Commercial |
$2,659.29
|
| Rate for Payer: Aetna Medicare |
$1,564.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,033.58
|
| Rate for Payer: BCBS Complete |
$1,251.43
|
| Rate for Payer: Cash Price |
$2,502.86
|
| Rate for Payer: Cofinity Commercial |
$2,190.01
|
| Rate for Payer: Cofinity Commercial |
$2,690.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,190.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,502.86
|
| Rate for Payer: Healthscope Commercial |
$2,815.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,190.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,346.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,659.29
|
| Rate for Payer: PHP Commercial |
$2,659.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.58
|
| Rate for Payer: Priority Health SBD |
$1,971.01
|
| Rate for Payer: UMR Bronson Commercial |
$1,157.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,346.43
|
|
|
HC ACCESS VENA CAVA
|
Facility
|
IP
|
$3,128.58
|
|
|
Service Code
|
CPT 36010
|
| Hospital Charge Code |
36100096
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,376.58 |
| Max. Negotiated Rate |
$2,815.72 |
| Rate for Payer: Aetna American Axle |
$2,033.58
|
| Rate for Payer: Aetna Commercial |
$2,659.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,033.58
|
| Rate for Payer: Cash Price |
$2,502.86
|
| Rate for Payer: Cofinity Commercial |
$2,190.01
|
| Rate for Payer: Cofinity Commercial |
$2,690.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,190.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,502.86
|
| Rate for Payer: Healthscope Commercial |
$2,815.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,190.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,346.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,659.29
|
| Rate for Payer: PHP Commercial |
$2,659.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.58
|
| Rate for Payer: Priority Health SBD |
$1,971.01
|
| Rate for Payer: UMR Bronson Commercial |
$1,376.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,346.43
|
|
|
HC ACCESS WINDOW
|
Facility
|
OP
|
$38.93
|
|
| Hospital Charge Code |
27000624
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$35.04 |
| Rate for Payer: Aetna American Axle |
$25.30
|
| Rate for Payer: Aetna Commercial |
$33.09
|
| Rate for Payer: Aetna Medicare |
$19.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.30
|
| Rate for Payer: BCBS Complete |
$15.57
|
| Rate for Payer: Cash Price |
$31.14
|
| Rate for Payer: Cofinity Commercial |
$27.25
|
| Rate for Payer: Cofinity Commercial |
$33.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.14
|
| Rate for Payer: Healthscope Commercial |
$35.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.09
|
| Rate for Payer: PHP Commercial |
$33.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.30
|
| Rate for Payer: Priority Health SBD |
$24.53
|
| Rate for Payer: UMR Bronson Commercial |
$14.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.20
|
|
|
HC ACCESS WINDOW
|
Facility
|
IP
|
$38.93
|
|
| Hospital Charge Code |
27000624
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.13 |
| Max. Negotiated Rate |
$35.04 |
| Rate for Payer: Aetna American Axle |
$25.30
|
| Rate for Payer: Aetna Commercial |
$33.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.30
|
| Rate for Payer: Cash Price |
$31.14
|
| Rate for Payer: Cofinity Commercial |
$27.25
|
| Rate for Payer: Cofinity Commercial |
$33.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.14
|
| Rate for Payer: Healthscope Commercial |
$35.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.09
|
| Rate for Payer: PHP Commercial |
$33.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.30
|
| Rate for Payer: Priority Health SBD |
$24.53
|
| Rate for Payer: UMR Bronson Commercial |
$17.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.20
|
|
|
HC ACCUNET EMBOLIC PROTECTION
|
Facility
|
IP
|
$4,011.59
|
|
| Hospital Charge Code |
27200110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,765.10 |
| Max. Negotiated Rate |
$3,610.43 |
| Rate for Payer: Aetna American Axle |
$2,607.53
|
| Rate for Payer: Aetna Commercial |
$3,409.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,607.53
|
| Rate for Payer: Cash Price |
$3,209.27
|
| Rate for Payer: Cofinity Commercial |
$2,808.11
|
| Rate for Payer: Cofinity Commercial |
$3,449.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,808.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,209.27
|
| Rate for Payer: Healthscope Commercial |
$3,610.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,808.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,008.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,409.85
|
| Rate for Payer: PHP Commercial |
$3,409.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,607.53
|
| Rate for Payer: Priority Health SBD |
$2,527.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,765.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,008.69
|
|
|
HC ACCUNET EMBOLIC PROTECTION
|
Facility
|
OP
|
$4,011.59
|
|
| Hospital Charge Code |
27200110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,484.29 |
| Max. Negotiated Rate |
$3,610.43 |
| Rate for Payer: Aetna American Axle |
$2,607.53
|
| Rate for Payer: Aetna Commercial |
$3,409.85
|
| Rate for Payer: Aetna Medicare |
$2,005.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,607.53
|
| Rate for Payer: BCBS Complete |
$1,604.64
|
| Rate for Payer: Cash Price |
$3,209.27
|
| Rate for Payer: Cofinity Commercial |
$2,808.11
|
| Rate for Payer: Cofinity Commercial |
$3,449.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,808.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,209.27
|
| Rate for Payer: Healthscope Commercial |
$3,610.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,808.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,008.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,409.85
|
| Rate for Payer: PHP Commercial |
$3,409.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,607.53
|
| Rate for Payer: Priority Health SBD |
$2,527.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,484.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,008.69
|
|
|
HC ACETAMINOPHEN LVL.
|
Facility
|
OP
|
$129.11
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100648
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$174.92 |
| Rate for Payer: Aetna American Axle |
$83.92
|
| Rate for Payer: Aetna Commercial |
$109.74
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$103.29
|
| Rate for Payer: Cash Price |
$103.29
|
| Rate for Payer: Cofinity Commercial |
$90.38
|
| Rate for Payer: Cofinity Commercial |
$111.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$90.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$116.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.83
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.74
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$109.74
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.92
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health SBD |
$81.34
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$118.76
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: UMR Bronson Commercial |
$47.77
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.83
|
|
|
HC ACETAMINOPHEN LVL.
|
Facility
|
IP
|
$129.11
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100648
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.81 |
| Max. Negotiated Rate |
$116.20 |
| Rate for Payer: Aetna American Axle |
$83.92
|
| Rate for Payer: Aetna Commercial |
$109.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.92
|
| Rate for Payer: Cash Price |
$103.29
|
| Rate for Payer: Cofinity Commercial |
$111.03
|
| Rate for Payer: Cofinity Commercial |
$90.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$90.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.29
|
| Rate for Payer: Healthscope Commercial |
$116.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.74
|
| Rate for Payer: PHP Commercial |
$109.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.92
|
| Rate for Payer: Priority Health SBD |
$81.34
|
| Rate for Payer: UMR Bronson Commercial |
$56.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.83
|
|
|
HC ACETOMINOPHEN THERAPEUTIC DRUG ASSAY
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 80143
|
| Hospital Charge Code |
30100729
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$52.47 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.49
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$9.99
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$10.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.64
|
| Rate for Payer: UHC Exchange |
$35.62
|
| Rate for Payer: UHC Medicare Advantage |
$18.64
|
| Rate for Payer: UHCCP Medicaid |
$9.99
|
| Rate for Payer: UMR Bronson Commercial |
$15.40
|
| Rate for Payer: VA VA |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC ACETOMINOPHEN THERAPEUTIC DRUG ASSAY
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 80143
|
| Hospital Charge Code |
30100729
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: UMR Bronson Commercial |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC ACETYLCHOLINE RECEPTOR AB
|
Facility
|
IP
|
$76.99
|
|
|
Service Code
|
CPT 86041
|
| Hospital Charge Code |
30100254
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.88 |
| Max. Negotiated Rate |
$69.29 |
| Rate for Payer: Aetna American Axle |
$50.04
|
| Rate for Payer: Aetna Commercial |
$65.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.04
|
| Rate for Payer: Cash Price |
$61.59
|
| Rate for Payer: Cofinity Commercial |
$53.89
|
| Rate for Payer: Cofinity Commercial |
$66.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.59
|
| Rate for Payer: Healthscope Commercial |
$69.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.44
|
| Rate for Payer: PHP Commercial |
$65.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.04
|
| Rate for Payer: Priority Health SBD |
$48.50
|
| Rate for Payer: UMR Bronson Commercial |
$33.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.74
|
|
|
HC ACETYLCHOLINE RECEPTOR AB
|
Facility
|
OP
|
$76.99
|
|
|
Service Code
|
CPT 86041
|
| Hospital Charge Code |
30100254
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$69.29 |
| Rate for Payer: Aetna American Axle |
$50.04
|
| Rate for Payer: Aetna Commercial |
$65.44
|
| Rate for Payer: Aetna Medicare |
$19.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: BCBS Complete |
$10.36
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$61.59
|
| Rate for Payer: Cash Price |
$61.59
|
| Rate for Payer: Cofinity Commercial |
$66.21
|
| Rate for Payer: Cofinity Commercial |
$53.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$69.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.74
|
| Rate for Payer: Mclaren Medicaid |
$9.86
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$10.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.44
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$65.44
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.04
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health SBD |
$48.50
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.40
|
| Rate for Payer: UHC Exchange |
$35.16
|
| Rate for Payer: UHC Medicare Advantage |
$18.40
|
| Rate for Payer: UHCCP Medicaid |
$9.86
|
| Rate for Payer: UMR Bronson Commercial |
$28.49
|
| Rate for Payer: VA VA |
$18.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.74
|
|
|
HC ACETYLCHOLINESTERASE AMNIOTIC
|
Facility
|
IP
|
$108.61
|
|
|
Service Code
|
CPT 82013
|
| Hospital Charge Code |
30100069
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.79 |
| Max. Negotiated Rate |
$97.75 |
| Rate for Payer: Aetna American Axle |
$70.60
|
| Rate for Payer: Aetna Commercial |
$92.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.60
|
| Rate for Payer: Cash Price |
$86.89
|
| Rate for Payer: Cofinity Commercial |
$76.03
|
| Rate for Payer: Cofinity Commercial |
$93.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.89
|
| Rate for Payer: Healthscope Commercial |
$97.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.32
|
| Rate for Payer: PHP Commercial |
$92.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.60
|
| Rate for Payer: Priority Health SBD |
$68.42
|
| Rate for Payer: UMR Bronson Commercial |
$47.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.46
|
|
|
HC ACETYLCHOLINESTERASE AMNIOTIC
|
Facility
|
OP
|
$108.61
|
|
|
Service Code
|
CPT 82013
|
| Hospital Charge Code |
30100069
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$97.75 |
| Rate for Payer: Aetna American Axle |
$70.60
|
| Rate for Payer: Aetna Commercial |
$92.32
|
| Rate for Payer: Aetna Medicare |
$12.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.36
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.29
|
| Rate for Payer: BCN Medicare Advantage |
$12.29
|
| Rate for Payer: Cash Price |
$86.89
|
| Rate for Payer: Cash Price |
$86.89
|
| Rate for Payer: Cofinity Commercial |
$93.40
|
| Rate for Payer: Cofinity Commercial |
$76.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.29
|
| Rate for Payer: Healthscope Commercial |
$97.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.46
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.90
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.32
|
| Rate for Payer: PACE Medicare |
$11.68
|
| Rate for Payer: PACE SWMI |
$12.29
|
| Rate for Payer: PHP Commercial |
$92.32
|
| Rate for Payer: PHP Medicare Advantage |
$12.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.60
|
| Rate for Payer: Priority Health Medicare |
$12.29
|
| Rate for Payer: Priority Health SBD |
$68.42
|
| Rate for Payer: Railroad Medicare Medicare |
$12.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.29
|
| Rate for Payer: UHC Exchange |
$23.49
|
| Rate for Payer: UHC Medicare Advantage |
$12.29
|
| Rate for Payer: UHCCP Medicaid |
$6.59
|
| Rate for Payer: UMR Bronson Commercial |
$40.19
|
| Rate for Payer: VA VA |
$12.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.46
|
|
