|
HC BIOTINIDASE
|
Facility
|
OP
|
$69.71
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
30100119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$62.74 |
| Rate for Payer: Aetna American Axle |
$45.31
|
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: Aetna Medicare |
$17.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.09
|
| Rate for Payer: BCBS Complete |
$9.27
|
| Rate for Payer: BCBS MAPPO |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$19.50
|
| Rate for Payer: BCN Commercial |
$19.50
|
| Rate for Payer: BCN Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Advantage |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$59.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.87
|
| Rate for Payer: Healthscope Commercial |
$62.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.28
|
| Rate for Payer: Mclaren Medicaid |
$16.87
|
| Rate for Payer: Mclaren Medicare |
$16.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.71
|
| Rate for Payer: Meridian Medicaid |
$17.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Nomi Health Commercial |
$25.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.28
|
| Rate for Payer: PACE Medicare |
$16.03
|
| Rate for Payer: PACE SWMI |
$16.87
|
| Rate for Payer: PHP Commercial |
$59.25
|
| Rate for Payer: PHP Medicare Advantage |
$16.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.87
|
| Rate for Payer: Priority Health Medicare |
$16.87
|
| Rate for Payer: Priority Health SBD |
$43.92
|
| Rate for Payer: Priority Health Tiered Network |
$13.50
|
| Rate for Payer: Railroad Medicare Medicare |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.31
|
| Rate for Payer: UHC Core |
$25.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.87
|
| Rate for Payer: UHC Exchange |
$25.31
|
| Rate for Payer: UHC Medicaid |
$8.82
|
| Rate for Payer: UHCCP Medicaid |
$8.82
|
| Rate for Payer: UMR Bronson Commercial |
$25.79
|
| Rate for Payer: VA VA |
$16.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.28
|
|
|
HC BIOTINIDASE
|
Facility
|
IP
|
$69.71
|
|
|
Service Code
|
CPT 82261
|
| Hospital Charge Code |
30100119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.67 |
| Max. Negotiated Rate |
$62.74 |
| Rate for Payer: Aetna American Axle |
$45.31
|
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.31
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Advantage |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$59.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Healthscope Commercial |
$62.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.28
|
| Rate for Payer: PHP Commercial |
$59.25
|
| Rate for Payer: Priority Health SBD |
$43.92
|
| Rate for Payer: UMR Bronson Commercial |
$30.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.28
|
|
|
HC BIOTRONIK DUAL PACEMAKER
|
Facility
|
IP
|
$9,824.34
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500002
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,322.71 |
| Max. Negotiated Rate |
$8,841.91 |
| Rate for Payer: Aetna American Axle |
$6,385.82
|
| Rate for Payer: Aetna Commercial |
$8,350.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,385.82
|
| Rate for Payer: Cash Price |
$7,859.47
|
| Rate for Payer: Cofinity Advantage |
$6,877.04
|
| Rate for Payer: Cofinity Commercial |
$8,448.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,859.47
|
| Rate for Payer: Healthscope Commercial |
$8,841.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,877.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,368.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,350.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,368.26
|
| Rate for Payer: PHP Commercial |
$8,350.69
|
| Rate for Payer: Priority Health SBD |
$6,189.33
|
| Rate for Payer: UMR Bronson Commercial |
$4,322.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,368.26
|
|
|
HC BIOTRONIK DUAL PACEMAKER
|
Facility
|
OP
|
$9,824.34
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500002
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,635.01 |
| Max. Negotiated Rate |
$8,841.91 |
| Rate for Payer: Aetna American Axle |
$6,385.82
|
| Rate for Payer: Aetna Commercial |
$8,350.69
|
| Rate for Payer: Aetna Medicare |
$4,912.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,385.82
|
| Rate for Payer: BCBS Complete |
$3,929.74
|
| Rate for Payer: Cash Price |
$7,859.47
|
| Rate for Payer: Cofinity Advantage |
$6,877.04
|
| Rate for Payer: Cofinity Commercial |
$8,448.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,859.47
|
| Rate for Payer: Healthscope Commercial |
$8,841.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,877.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,368.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,859.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,350.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,368.26
|
| Rate for Payer: PHP Commercial |
$8,350.69
|
| Rate for Payer: Priority Health SBD |
$6,189.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,385.82
|
| Rate for Payer: UHC Core |
$5,118.48
|
| Rate for Payer: UHC Exchange |
$3,860.97
|
| Rate for Payer: UMR Bronson Commercial |
$3,635.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,368.26
|
|
|
HC BIPAL BIOPSY FORCEPS
|
Facility
|
OP
|
$1,792.06
|
|
| Hospital Charge Code |
27200113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$663.06 |
| Max. Negotiated Rate |
$1,612.85 |
| Rate for Payer: Aetna American Axle |
$1,164.84
|
| Rate for Payer: Aetna Commercial |
$1,523.25
|
| Rate for Payer: Aetna Medicare |
$896.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,164.84
|
| Rate for Payer: BCBS Complete |
$716.82
|
| Rate for Payer: Cash Price |
$1,433.65
|
| Rate for Payer: Cofinity Advantage |
$1,254.44
|
| Rate for Payer: Cofinity Commercial |
$1,541.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,433.65
|
| Rate for Payer: Healthscope Commercial |
$1,612.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,254.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,344.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,433.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,523.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,344.05
|
| Rate for Payer: PHP Commercial |
$1,523.25
|
| Rate for Payer: Priority Health SBD |
$1,129.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,164.84
|
| Rate for Payer: UHC Core |
$933.66
|
| Rate for Payer: UHC Exchange |
$704.28
|
| Rate for Payer: UMR Bronson Commercial |
$663.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,344.05
|
|
|
HC BIPAL BIOPSY FORCEPS
|
Facility
|
IP
|
$1,792.06
|
|
| Hospital Charge Code |
27200113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$788.51 |
| Max. Negotiated Rate |
$1,612.85 |
| Rate for Payer: Aetna American Axle |
$1,164.84
|
| Rate for Payer: Aetna Commercial |
$1,523.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,164.84
|
| Rate for Payer: Cash Price |
$1,433.65
|
| Rate for Payer: Cofinity Advantage |
$1,254.44
|
| Rate for Payer: Cofinity Commercial |
$1,541.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,433.65
|
| Rate for Payer: Healthscope Commercial |
$1,612.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,254.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,344.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,523.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,344.05
|
| Rate for Payer: PHP Commercial |
$1,523.25
|
| Rate for Payer: Priority Health SBD |
$1,129.00
|
| Rate for Payer: UMR Bronson Commercial |
$788.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,344.05
|
|
|
HC BIPAP / CPAP PER DAY
|
Facility
|
IP
|
$892.61
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
41000008
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$392.75 |
| Max. Negotiated Rate |
$803.35 |
| Rate for Payer: Aetna American Axle |
$580.20
|
| Rate for Payer: Aetna Commercial |
$758.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.20
|
| Rate for Payer: Cash Price |
$714.09
|
| Rate for Payer: Cofinity Advantage |
$624.83
|
| Rate for Payer: Cofinity Commercial |
$767.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$714.09
|
| Rate for Payer: Healthscope Commercial |
$803.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$624.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$669.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$758.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$669.46
|
| Rate for Payer: PHP Commercial |
$758.72
|
| Rate for Payer: Priority Health SBD |
$562.34
|
| Rate for Payer: UMR Bronson Commercial |
$392.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$669.46
|
|
|
HC BIPAP / CPAP PER DAY
|
Facility
|
OP
|
$892.61
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
41000008
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$114.11 |
| Max. Negotiated Rate |
$803.35 |
| Rate for Payer: Aetna American Axle |
$580.20
|
| Rate for Payer: Aetna Commercial |
$758.72
|
| Rate for Payer: Aetna Medicare |
$226.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.74
|
| Rate for Payer: BCBS Complete |
$119.83
|
| Rate for Payer: BCBS MAPPO |
$218.19
|
| Rate for Payer: BCBS Trust/PPO |
$162.02
|
| Rate for Payer: BCN Commercial |
$162.02
|
| Rate for Payer: BCN Medicare Advantage |
$218.19
|
| Rate for Payer: Cash Price |
$714.09
|
| Rate for Payer: Cash Price |
$714.09
|
| Rate for Payer: Cofinity Advantage |
$624.83
|
| Rate for Payer: Cofinity Commercial |
$767.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$714.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.19
|
| Rate for Payer: Healthscope Commercial |
$803.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$624.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$669.46
|
| Rate for Payer: Mclaren Medicaid |
$218.19
|
| Rate for Payer: Mclaren Medicare |
$218.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.10
|
| Rate for Payer: Meridian Medicaid |
$229.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$240.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$758.72
|
| Rate for Payer: Nomi Health Commercial |
$654.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$669.46
|
| Rate for Payer: PACE Medicare |
$207.28
|
| Rate for Payer: PACE SWMI |
$218.19
|
| Rate for Payer: PHP Commercial |
$758.72
|
| Rate for Payer: PHP Medicare Advantage |
$218.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$705.61
|
| Rate for Payer: Priority Health Medicare |
$218.19
|
| Rate for Payer: Priority Health SBD |
$562.34
|
| Rate for Payer: Priority Health Tiered Network |
$564.49
|
| Rate for Payer: Railroad Medicare Medicare |
$218.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$580.20
|
| Rate for Payer: UHC Core |
$465.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$218.19
|
| Rate for Payer: UHC Exchange |
$350.80
|
| Rate for Payer: UHC Medicaid |
$114.11
|
| Rate for Payer: UHCCP Medicaid |
$114.11
|
| Rate for Payer: UMR Bronson Commercial |
$330.27
|
| Rate for Payer: VA VA |
$218.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$669.46
|
|
|
HC BIRCH IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200029
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC BIRCH IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200029
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC BIVENTRICULAR DELIVERY SYSTEM
|
Facility
|
OP
|
$2,079.46
|
|
| Hospital Charge Code |
27200114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$769.40 |
| Max. Negotiated Rate |
$1,871.51 |
| Rate for Payer: Aetna American Axle |
$1,351.65
|
| Rate for Payer: Aetna Commercial |
$1,767.54
|
| Rate for Payer: Aetna Medicare |
$1,039.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,351.65
|
| Rate for Payer: BCBS Complete |
$831.78
|
| Rate for Payer: Cash Price |
$1,663.57
|
| Rate for Payer: Cofinity Advantage |
$1,455.62
|
| Rate for Payer: Cofinity Commercial |
$1,788.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,663.57
|
| Rate for Payer: Healthscope Commercial |
$1,871.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,455.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,559.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,663.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,767.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,559.60
|
| Rate for Payer: PHP Commercial |
$1,767.54
|
| Rate for Payer: Priority Health SBD |
$1,310.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,351.65
|
| Rate for Payer: UHC Core |
$1,083.40
|
| Rate for Payer: UHC Exchange |
$817.23
|
| Rate for Payer: UMR Bronson Commercial |
$769.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,559.60
|
|
|
HC BIVENTRICULAR DELIVERY SYSTEM
|
Facility
|
IP
|
$2,079.46
|
|
| Hospital Charge Code |
27200114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$914.96 |
| Max. Negotiated Rate |
$1,871.51 |
| Rate for Payer: Aetna American Axle |
$1,351.65
|
| Rate for Payer: Aetna Commercial |
$1,767.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,351.65
|
| Rate for Payer: Cash Price |
$1,663.57
|
| Rate for Payer: Cofinity Advantage |
$1,455.62
|
| Rate for Payer: Cofinity Commercial |
$1,788.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,663.57
|
| Rate for Payer: Healthscope Commercial |
$1,871.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,455.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,559.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,767.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,559.60
|
| Rate for Payer: PHP Commercial |
$1,767.54
|
| Rate for Payer: Priority Health SBD |
$1,310.06
|
| Rate for Payer: UMR Bronson Commercial |
$914.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,559.60
|
|
|
HC BI V PACEMAKER
|
Facility
|
IP
|
$28,495.15
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$12,537.87 |
| Max. Negotiated Rate |
$25,645.63 |
| Rate for Payer: Aetna American Axle |
$18,521.85
|
| Rate for Payer: Aetna Commercial |
$24,220.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,521.85
|
| Rate for Payer: Cash Price |
$22,796.12
|
| Rate for Payer: Cofinity Advantage |
$19,946.60
|
| Rate for Payer: Cofinity Commercial |
$24,505.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,796.12
|
| Rate for Payer: Healthscope Commercial |
$25,645.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19,946.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,371.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,220.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,371.36
|
| Rate for Payer: PHP Commercial |
$24,220.88
|
| Rate for Payer: Priority Health SBD |
$17,951.94
|
| Rate for Payer: UMR Bronson Commercial |
$12,537.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,371.36
|
|
|
HC BI V PACEMAKER
|
Facility
|
OP
|
$28,495.15
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500001
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$10,543.21 |
| Max. Negotiated Rate |
$25,645.63 |
| Rate for Payer: Aetna American Axle |
$18,521.85
|
| Rate for Payer: Aetna Commercial |
$24,220.88
|
| Rate for Payer: Aetna Medicare |
$14,247.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,521.85
|
| Rate for Payer: BCBS Complete |
$11,398.06
|
| Rate for Payer: Cash Price |
$22,796.12
|
| Rate for Payer: Cofinity Advantage |
$19,946.60
|
| Rate for Payer: Cofinity Commercial |
$24,505.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,796.12
|
| Rate for Payer: Healthscope Commercial |
$25,645.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19,946.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,371.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,796.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,220.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,371.36
|
| Rate for Payer: PHP Commercial |
$24,220.88
|
| Rate for Payer: Priority Health SBD |
$17,951.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,521.85
|
| Rate for Payer: UHC Core |
$14,845.97
|
| Rate for Payer: UHC Exchange |
$11,198.59
|
| Rate for Payer: UMR Bronson Commercial |
$10,543.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,371.36
|
|
|
HC BK VIRUS PCR, QUANT
|
Facility
|
OP
|
$115.67
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.41 |
| Max. Negotiated Rate |
$104.10 |
| Rate for Payer: Aetna American Axle |
$75.19
|
| Rate for Payer: Aetna Commercial |
$98.32
|
| Rate for Payer: Aetna Medicare |
$44.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: BCBS Complete |
$23.53
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$49.52
|
| Rate for Payer: BCN Commercial |
$49.52
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$92.54
|
| Rate for Payer: Cash Price |
$92.54
|
| Rate for Payer: Cofinity Advantage |
$80.97
|
| Rate for Payer: Cofinity Commercial |
$99.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$104.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.75
|
| Rate for Payer: Mclaren Medicaid |
$42.84
|
| Rate for Payer: Mclaren Medicare |
$42.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: Meridian Medicaid |
$44.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.32
|
| Rate for Payer: Nomi Health Commercial |
$64.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.75
|
| Rate for Payer: PACE Medicare |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$98.32
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.41
|
| Rate for Payer: Priority Health Medicare |
$42.84
|
| Rate for Payer: Priority Health SBD |
$72.87
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.26
|
| Rate for Payer: UHC Core |
$64.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.84
|
| Rate for Payer: UHC Exchange |
$64.26
|
| Rate for Payer: UHC Medicaid |
$22.41
|
| Rate for Payer: UHCCP Medicaid |
$22.41
|
| Rate for Payer: UMR Bronson Commercial |
$42.80
|
| Rate for Payer: VA VA |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.75
|
|
|
HC BK VIRUS PCR, QUANT
|
Facility
|
IP
|
$115.67
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600289
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$50.89 |
| Max. Negotiated Rate |
$104.10 |
| Rate for Payer: Aetna American Axle |
$75.19
|
| Rate for Payer: Aetna Commercial |
$98.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.19
|
| Rate for Payer: Cash Price |
$92.54
|
| Rate for Payer: Cofinity Advantage |
$80.97
|
| Rate for Payer: Cofinity Commercial |
$99.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.54
|
| Rate for Payer: Healthscope Commercial |
$104.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.75
|
| Rate for Payer: PHP Commercial |
$98.32
|
| Rate for Payer: Priority Health SBD |
$72.87
|
| Rate for Payer: UMR Bronson Commercial |
$50.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.75
|
|
|
HC BLADDER IRRIGATION
|
Facility
|
IP
|
$285.45
|
|
| Hospital Charge Code |
45000032
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.60 |
| Max. Negotiated Rate |
$256.90 |
| Rate for Payer: Aetna American Axle |
$185.54
|
| Rate for Payer: Aetna Commercial |
$242.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.54
|
| Rate for Payer: Cash Price |
$228.36
|
| Rate for Payer: Cofinity Advantage |
$199.81
|
| Rate for Payer: Cofinity Commercial |
$245.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.36
|
| Rate for Payer: Healthscope Commercial |
$256.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.09
|
| Rate for Payer: PHP Commercial |
$242.63
|
| Rate for Payer: Priority Health SBD |
$179.83
|
| Rate for Payer: UMR Bronson Commercial |
$125.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.09
|
|
|
HC BLADDER IRRIGATION
|
Facility
|
OP
|
$285.45
|
|
| Hospital Charge Code |
45000032
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$105.62 |
| Max. Negotiated Rate |
$256.90 |
| Rate for Payer: Aetna American Axle |
$185.54
|
| Rate for Payer: Aetna Commercial |
$242.63
|
| Rate for Payer: Aetna Medicare |
$142.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.54
|
| Rate for Payer: BCBS Complete |
$114.18
|
| Rate for Payer: Cash Price |
$228.36
|
| Rate for Payer: Cash Price |
$228.36
|
| Rate for Payer: Cofinity Advantage |
$199.81
|
| Rate for Payer: Cofinity Commercial |
$245.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.36
|
| Rate for Payer: Healthscope Commercial |
$256.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.09
|
| Rate for Payer: PHP Commercial |
$242.63
|
| Rate for Payer: Priority Health SBD |
$179.83
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: UMR Bronson Commercial |
$105.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.09
|
|
|
HC BLADDER SCAN
|
Facility
|
IP
|
$156.20
|
|
|
Service Code
|
CPT 51798
|
| Hospital Charge Code |
45000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$68.73 |
| Max. Negotiated Rate |
$140.58 |
| Rate for Payer: Aetna American Axle |
$101.53
|
| Rate for Payer: Aetna Commercial |
$132.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.53
|
| Rate for Payer: Cash Price |
$124.96
|
| Rate for Payer: Cofinity Advantage |
$109.34
|
| Rate for Payer: Cofinity Commercial |
$134.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.96
|
| Rate for Payer: Healthscope Commercial |
$140.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.15
|
| Rate for Payer: PHP Commercial |
$132.77
|
| Rate for Payer: Priority Health SBD |
$98.41
|
| Rate for Payer: UMR Bronson Commercial |
$68.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.15
|
|
|
HC BLADDER SCAN
|
Facility
|
OP
|
$156.20
|
|
|
Service Code
|
CPT 51798
|
| Hospital Charge Code |
45000006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$190.09 |
| Rate for Payer: Aetna American Axle |
$101.53
|
| Rate for Payer: Aetna Commercial |
$132.77
|
| Rate for Payer: Aetna Medicare |
$61.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCBS Trust/PPO |
$150.74
|
| Rate for Payer: BCN Commercial |
$150.74
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$124.96
|
| Rate for Payer: Cash Price |
$124.96
|
| Rate for Payer: Cash Price |
$124.96
|
| Rate for Payer: Cofinity Advantage |
$109.34
|
| Rate for Payer: Cofinity Commercial |
$134.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$140.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.15
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$61.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.77
|
| Rate for Payer: Nomi Health Commercial |
$176.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.15
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$132.77
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.09
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health SBD |
$98.41
|
| Rate for Payer: Priority Health Tiered Network |
$152.07
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.53
|
| Rate for Payer: UHC Core |
$81.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$61.39
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: UMR Bronson Commercial |
$57.79
|
| Rate for Payer: VA VA |
$58.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.15
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$13.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.12
|
| Rate for Payer: BCBS Complete |
$7.08
|
| Rate for Payer: BCBS MAPPO |
$12.90
|
| Rate for Payer: BCBS Trust/PPO |
$14.92
|
| Rate for Payer: BCN Commercial |
$14.92
|
| Rate for Payer: BCN Medicare Advantage |
$12.90
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$12.90
|
| Rate for Payer: Mclaren Medicare |
$12.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.54
|
| Rate for Payer: Meridian Medicaid |
$13.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$19.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PACE Medicare |
$12.26
|
| Rate for Payer: PACE SWMI |
$12.90
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$12.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.90
|
| Rate for Payer: Priority Health Medicare |
$12.90
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: Priority Health Tiered Network |
$10.32
|
| Rate for Payer: Railroad Medicare Medicare |
$12.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.35
|
| Rate for Payer: UHC Core |
$19.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.90
|
| Rate for Payer: UHC Exchange |
$19.35
|
| Rate for Payer: UHC Medicaid |
$6.75
|
| Rate for Payer: UHCCP Medicaid |
$6.75
|
| Rate for Payer: UMR Bronson Commercial |
$28.87
|
| Rate for Payer: VA VA |
$12.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC BLASTOMYCES ABS BY COMP FIX
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200230
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.33 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: UMR Bronson Commercial |
$34.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
OP
|
$127.01
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$46.99 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna American Axle |
$82.56
|
| Rate for Payer: Aetna Commercial |
$107.96
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$54.79
|
| Rate for Payer: BCN Commercial |
$54.79
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$101.61
|
| Rate for Payer: Cash Price |
$101.61
|
| Rate for Payer: Cofinity Advantage |
$88.91
|
| Rate for Payer: Cofinity Commercial |
$109.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$114.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.26
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.96
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.26
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$107.96
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$80.02
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.56
|
| Rate for Payer: UHC Core |
$66.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$49.91
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$46.99
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.26
|
|
|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
IP
|
$127.01
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.88 |
| Max. Negotiated Rate |
$114.31 |
| Rate for Payer: Aetna American Axle |
$82.56
|
| Rate for Payer: Aetna Commercial |
$107.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.56
|
| Rate for Payer: Cash Price |
$101.61
|
| Rate for Payer: Cofinity Advantage |
$88.91
|
| Rate for Payer: Cofinity Commercial |
$109.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.61
|
| Rate for Payer: Healthscope Commercial |
$114.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.26
|
| Rate for Payer: PHP Commercial |
$107.96
|
| Rate for Payer: Priority Health SBD |
$80.02
|
| Rate for Payer: UMR Bronson Commercial |
$55.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.26
|
|
|
HC BLEEDING TIME
|
Facility
|
IP
|
$78.45
|
|
|
Service Code
|
CPT 85002
|
| Hospital Charge Code |
30500001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$34.52 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna American Axle |
$50.99
|
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.99
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Advantage |
$54.91
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: Priority Health SBD |
$49.42
|
| Rate for Payer: UMR Bronson Commercial |
$34.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.84
|
|
