|
HC BOOT STATIC AIR W/STAB Z-FLEX
|
Facility
|
IP
|
$49.78
|
|
| Hospital Charge Code |
27000631
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.90 |
| Max. Negotiated Rate |
$44.80 |
| Rate for Payer: Aetna American Axle |
$32.36
|
| Rate for Payer: Aetna Commercial |
$42.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.36
|
| Rate for Payer: Cash Price |
$39.82
|
| Rate for Payer: Cofinity Advantage |
$34.85
|
| Rate for Payer: Cofinity Commercial |
$42.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.82
|
| Rate for Payer: Healthscope Commercial |
$44.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.34
|
| Rate for Payer: PHP Commercial |
$42.31
|
| Rate for Payer: Priority Health SBD |
$31.36
|
| Rate for Payer: UMR Bronson Commercial |
$21.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.34
|
|
|
HC BOSTON SCI CRT ICD
|
Facility
|
OP
|
$26,848.56
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500003
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$24,163.70 |
| Rate for Payer: Aetna American Axle |
$17,451.56
|
| Rate for Payer: Aetna Commercial |
$22,821.28
|
| Rate for Payer: Aetna Medicare |
$13,424.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,451.56
|
| Rate for Payer: BCBS Complete |
$10,739.42
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$21,478.85
|
| Rate for Payer: Cash Price |
$21,478.85
|
| Rate for Payer: Cofinity Advantage |
$18,793.99
|
| Rate for Payer: Cofinity Commercial |
$23,089.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,478.85
|
| Rate for Payer: Healthscope Commercial |
$24,163.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18,793.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,136.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,478.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,821.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20,136.42
|
| Rate for Payer: PHP Commercial |
$22,821.28
|
| Rate for Payer: Priority Health SBD |
$16,914.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,451.56
|
| Rate for Payer: UHC Core |
$13,988.10
|
| Rate for Payer: UHC Exchange |
$10,551.48
|
| Rate for Payer: UMR Bronson Commercial |
$9,933.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,136.42
|
|
|
HC BOSTON SCI CRT ICD
|
Facility
|
IP
|
$26,848.56
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500003
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$11,813.37 |
| Max. Negotiated Rate |
$24,163.70 |
| Rate for Payer: Aetna American Axle |
$17,451.56
|
| Rate for Payer: Aetna Commercial |
$22,821.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,451.56
|
| Rate for Payer: Cash Price |
$21,478.85
|
| Rate for Payer: Cofinity Advantage |
$18,793.99
|
| Rate for Payer: Cofinity Commercial |
$23,089.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,478.85
|
| Rate for Payer: Healthscope Commercial |
$24,163.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18,793.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,136.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,821.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20,136.42
|
| Rate for Payer: PHP Commercial |
$22,821.28
|
| Rate for Payer: Priority Health SBD |
$16,914.59
|
| Rate for Payer: UMR Bronson Commercial |
$11,813.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,136.42
|
|
|
HC BOSTON SCI CRT LEAD
|
Facility
|
OP
|
$7,024.55
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$6,322.10 |
| Rate for Payer: Aetna American Axle |
$4,565.96
|
| Rate for Payer: Aetna Commercial |
$5,970.87
|
| Rate for Payer: Aetna Medicare |
$3,512.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,565.96
|
| Rate for Payer: BCBS Complete |
$2,809.82
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$5,619.64
|
| Rate for Payer: Cash Price |
$5,619.64
|
| Rate for Payer: Cofinity Advantage |
$4,917.19
|
| Rate for Payer: Cofinity Commercial |
$6,041.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,619.64
|
| Rate for Payer: Healthscope Commercial |
$6,322.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,917.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,268.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,619.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,970.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,268.41
|
| Rate for Payer: PHP Commercial |
$5,970.87
|
| Rate for Payer: Priority Health SBD |
$4,425.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,565.96
|
| Rate for Payer: UHC Core |
$3,659.79
|
| Rate for Payer: UHC Exchange |
$2,760.65
|
| Rate for Payer: UMR Bronson Commercial |
$2,599.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,268.41
|
|
|
HC BOSTON SCI CRT LEAD
|
Facility
|
IP
|
$7,024.55
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,090.80 |
| Max. Negotiated Rate |
$6,322.10 |
| Rate for Payer: Aetna American Axle |
$4,565.96
|
| Rate for Payer: Aetna Commercial |
$5,970.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,565.96
|
| Rate for Payer: Cash Price |
$5,619.64
|
| Rate for Payer: Cofinity Advantage |
$4,917.19
|
| Rate for Payer: Cofinity Commercial |
$6,041.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,619.64
|
| Rate for Payer: Healthscope Commercial |
$6,322.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,917.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,268.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,970.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,268.41
|
| Rate for Payer: PHP Commercial |
$5,970.87
|
| Rate for Payer: Priority Health SBD |
$4,425.47
|
| Rate for Payer: UMR Bronson Commercial |
$3,090.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,268.41
|
|
|
HC BOSTON SCI DUAL PACEMAKER
|
Facility
|
OP
|
$8,744.36
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500004
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,235.41 |
| Max. Negotiated Rate |
$7,869.92 |
| Rate for Payer: Aetna American Axle |
$5,683.83
|
| Rate for Payer: Aetna Commercial |
$7,432.71
|
| Rate for Payer: Aetna Medicare |
$4,372.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,683.83
|
| Rate for Payer: BCBS Complete |
$3,497.74
|
| Rate for Payer: Cash Price |
$6,995.49
|
| Rate for Payer: Cofinity Advantage |
$6,121.05
|
| Rate for Payer: Cofinity Commercial |
$7,520.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,995.49
|
| Rate for Payer: Healthscope Commercial |
$7,869.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,121.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,558.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,995.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,432.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,558.27
|
| Rate for Payer: PHP Commercial |
$7,432.71
|
| Rate for Payer: Priority Health SBD |
$5,508.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,683.83
|
| Rate for Payer: UHC Core |
$4,555.81
|
| Rate for Payer: UHC Exchange |
$3,436.53
|
| Rate for Payer: UMR Bronson Commercial |
$3,235.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,558.27
|
|
|
HC BOSTON SCI DUAL PACEMAKER
|
Facility
|
IP
|
$8,744.36
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500004
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,847.52 |
| Max. Negotiated Rate |
$7,869.92 |
| Rate for Payer: Aetna American Axle |
$5,683.83
|
| Rate for Payer: Aetna Commercial |
$7,432.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,683.83
|
| Rate for Payer: Cash Price |
$6,995.49
|
| Rate for Payer: Cofinity Advantage |
$6,121.05
|
| Rate for Payer: Cofinity Commercial |
$7,520.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,995.49
|
| Rate for Payer: Healthscope Commercial |
$7,869.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,121.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,558.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,432.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,558.27
|
| Rate for Payer: PHP Commercial |
$7,432.71
|
| Rate for Payer: Priority Health SBD |
$5,508.95
|
| Rate for Payer: UMR Bronson Commercial |
$3,847.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,558.27
|
|
|
HC BOSTON SCI ICD DUAL
|
Facility
|
IP
|
$18,889.50
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800002
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,311.38 |
| Max. Negotiated Rate |
$17,000.55 |
| Rate for Payer: Aetna American Axle |
$12,278.17
|
| Rate for Payer: Aetna Commercial |
$16,056.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,278.17
|
| Rate for Payer: Cash Price |
$15,111.60
|
| Rate for Payer: Cofinity Advantage |
$13,222.65
|
| Rate for Payer: Cofinity Commercial |
$16,244.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,111.60
|
| Rate for Payer: Healthscope Commercial |
$17,000.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,222.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,167.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,056.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,167.12
|
| Rate for Payer: PHP Commercial |
$16,056.08
|
| Rate for Payer: Priority Health SBD |
$11,900.39
|
| Rate for Payer: UMR Bronson Commercial |
$8,311.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,167.12
|
|
|
HC BOSTON SCI ICD DUAL
|
Facility
|
OP
|
$18,889.50
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800002
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,989.11 |
| Max. Negotiated Rate |
$17,000.55 |
| Rate for Payer: Aetna American Axle |
$12,278.17
|
| Rate for Payer: Aetna Commercial |
$16,056.08
|
| Rate for Payer: Aetna Medicare |
$9,444.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,278.17
|
| Rate for Payer: BCBS Complete |
$7,555.80
|
| Rate for Payer: Cash Price |
$15,111.60
|
| Rate for Payer: Cofinity Advantage |
$13,222.65
|
| Rate for Payer: Cofinity Commercial |
$16,244.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,111.60
|
| Rate for Payer: Healthscope Commercial |
$17,000.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,222.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,167.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,111.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,056.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,167.12
|
| Rate for Payer: PHP Commercial |
$16,056.08
|
| Rate for Payer: Priority Health SBD |
$11,900.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,278.17
|
| Rate for Payer: UHC Core |
$9,841.43
|
| Rate for Payer: UHC Exchange |
$7,423.57
|
| Rate for Payer: UMR Bronson Commercial |
$6,989.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,167.12
|
|
|
HC BOSTON SCI ICD SINGLE
|
Facility
|
OP
|
$22,497.61
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,324.12 |
| Max. Negotiated Rate |
$20,247.85 |
| Rate for Payer: Aetna American Axle |
$14,623.45
|
| Rate for Payer: Aetna Commercial |
$19,122.97
|
| Rate for Payer: Aetna Medicare |
$11,248.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,623.45
|
| Rate for Payer: BCBS Complete |
$8,999.04
|
| Rate for Payer: Cash Price |
$17,998.09
|
| Rate for Payer: Cofinity Advantage |
$15,748.33
|
| Rate for Payer: Cofinity Commercial |
$19,347.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,998.09
|
| Rate for Payer: Healthscope Commercial |
$20,247.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15,748.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,873.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,998.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,122.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,873.21
|
| Rate for Payer: PHP Commercial |
$19,122.97
|
| Rate for Payer: Priority Health SBD |
$14,173.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,623.45
|
| Rate for Payer: UHC Core |
$11,721.25
|
| Rate for Payer: UHC Exchange |
$8,841.56
|
| Rate for Payer: UMR Bronson Commercial |
$8,324.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,873.21
|
|
|
HC BOSTON SCI ICD SINGLE
|
Facility
|
IP
|
$22,497.61
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,898.95 |
| Max. Negotiated Rate |
$20,247.85 |
| Rate for Payer: Aetna American Axle |
$14,623.45
|
| Rate for Payer: Aetna Commercial |
$19,122.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,623.45
|
| Rate for Payer: Cash Price |
$17,998.09
|
| Rate for Payer: Cofinity Advantage |
$15,748.33
|
| Rate for Payer: Cofinity Commercial |
$19,347.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,998.09
|
| Rate for Payer: Healthscope Commercial |
$20,247.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15,748.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,873.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,122.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16,873.21
|
| Rate for Payer: PHP Commercial |
$19,122.97
|
| Rate for Payer: Priority Health SBD |
$14,173.49
|
| Rate for Payer: UMR Bronson Commercial |
$9,898.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,873.21
|
|
|
HC BOSTON SCI PACEMAKER LEAD
|
Facility
|
OP
|
$2,302.92
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$852.08 |
| Max. Negotiated Rate |
$2,072.63 |
| Rate for Payer: Aetna American Axle |
$1,496.90
|
| Rate for Payer: Aetna Commercial |
$1,957.48
|
| Rate for Payer: Aetna Medicare |
$1,151.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,496.90
|
| Rate for Payer: BCBS Complete |
$921.17
|
| Rate for Payer: Cash Price |
$1,842.34
|
| Rate for Payer: Cofinity Advantage |
$1,612.04
|
| Rate for Payer: Cofinity Commercial |
$1,980.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,842.34
|
| Rate for Payer: Healthscope Commercial |
$2,072.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,612.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,727.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,842.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,957.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,727.19
|
| Rate for Payer: PHP Commercial |
$1,957.48
|
| Rate for Payer: Priority Health SBD |
$1,450.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,496.90
|
| Rate for Payer: UHC Core |
$1,199.82
|
| Rate for Payer: UHC Exchange |
$905.05
|
| Rate for Payer: UMR Bronson Commercial |
$852.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,727.19
|
|
|
HC BOSTON SCI PACEMAKER LEAD
|
Facility
|
IP
|
$2,302.92
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,013.28 |
| Max. Negotiated Rate |
$2,072.63 |
| Rate for Payer: Aetna American Axle |
$1,496.90
|
| Rate for Payer: Aetna Commercial |
$1,957.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,496.90
|
| Rate for Payer: Cash Price |
$1,842.34
|
| Rate for Payer: Cofinity Advantage |
$1,612.04
|
| Rate for Payer: Cofinity Commercial |
$1,980.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,842.34
|
| Rate for Payer: Healthscope Commercial |
$2,072.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,612.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,727.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,957.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,727.19
|
| Rate for Payer: PHP Commercial |
$1,957.48
|
| Rate for Payer: Priority Health SBD |
$1,450.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,013.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,727.19
|
|
|
HC BOSTON SCI SINGLE PACEMAKER
|
Facility
|
OP
|
$14,510.97
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500005
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,369.06 |
| Max. Negotiated Rate |
$13,059.87 |
| Rate for Payer: Aetna American Axle |
$9,432.13
|
| Rate for Payer: Aetna Commercial |
$12,334.32
|
| Rate for Payer: Aetna Medicare |
$7,255.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,432.13
|
| Rate for Payer: BCBS Complete |
$5,804.39
|
| Rate for Payer: Cash Price |
$11,608.78
|
| Rate for Payer: Cofinity Advantage |
$10,157.68
|
| Rate for Payer: Cofinity Commercial |
$12,479.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,608.78
|
| Rate for Payer: Healthscope Commercial |
$13,059.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,157.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,883.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,608.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,334.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,883.23
|
| Rate for Payer: PHP Commercial |
$12,334.32
|
| Rate for Payer: Priority Health SBD |
$9,141.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,432.13
|
| Rate for Payer: UHC Core |
$7,560.22
|
| Rate for Payer: UHC Exchange |
$5,702.81
|
| Rate for Payer: UMR Bronson Commercial |
$5,369.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,883.23
|
|
|
HC BOSTON SCI SINGLE PACEMAKER
|
Facility
|
IP
|
$14,510.97
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500005
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,384.83 |
| Max. Negotiated Rate |
$13,059.87 |
| Rate for Payer: Aetna American Axle |
$9,432.13
|
| Rate for Payer: Aetna Commercial |
$12,334.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,432.13
|
| Rate for Payer: Cash Price |
$11,608.78
|
| Rate for Payer: Cofinity Advantage |
$10,157.68
|
| Rate for Payer: Cofinity Commercial |
$12,479.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,608.78
|
| Rate for Payer: Healthscope Commercial |
$13,059.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,157.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,883.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,334.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,883.23
|
| Rate for Payer: PHP Commercial |
$12,334.32
|
| Rate for Payer: Priority Health SBD |
$9,141.91
|
| Rate for Payer: UMR Bronson Commercial |
$6,384.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,883.23
|
|
|
HC BOSTON SCI TACHY (ICD) LEAD
|
Facility
|
OP
|
$8,948.46
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,310.93 |
| Max. Negotiated Rate |
$8,053.61 |
| Rate for Payer: Aetna American Axle |
$5,816.50
|
| Rate for Payer: Aetna Commercial |
$7,606.19
|
| Rate for Payer: Aetna Medicare |
$4,474.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,816.50
|
| Rate for Payer: BCBS Complete |
$3,579.38
|
| Rate for Payer: Cash Price |
$7,158.77
|
| Rate for Payer: Cofinity Advantage |
$6,263.92
|
| Rate for Payer: Cofinity Commercial |
$7,695.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,158.77
|
| Rate for Payer: Healthscope Commercial |
$8,053.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,263.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,711.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,158.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,606.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,711.35
|
| Rate for Payer: PHP Commercial |
$7,606.19
|
| Rate for Payer: Priority Health SBD |
$5,637.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,816.50
|
| Rate for Payer: UHC Core |
$4,662.15
|
| Rate for Payer: UHC Exchange |
$3,516.74
|
| Rate for Payer: UMR Bronson Commercial |
$3,310.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,711.35
|
|
|
HC BOSTON SCI TACHY (ICD) LEAD
|
Facility
|
IP
|
$8,948.46
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,937.32 |
| Max. Negotiated Rate |
$8,053.61 |
| Rate for Payer: Aetna American Axle |
$5,816.50
|
| Rate for Payer: Aetna Commercial |
$7,606.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,816.50
|
| Rate for Payer: Cash Price |
$7,158.77
|
| Rate for Payer: Cofinity Advantage |
$6,263.92
|
| Rate for Payer: Cofinity Commercial |
$7,695.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,158.77
|
| Rate for Payer: Healthscope Commercial |
$8,053.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,263.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,711.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,606.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,711.35
|
| Rate for Payer: PHP Commercial |
$7,606.19
|
| Rate for Payer: Priority Health SBD |
$5,637.53
|
| Rate for Payer: UMR Bronson Commercial |
$3,937.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,711.35
|
|
|
HC BOTRYTIS CINEREA IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200075
|
|
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 BOTRYTIS CINEREA IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200075
|
|
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 BOTTLE A/B CDI 500
|
Facility
|
OP
|
$206.00
|
|
| Hospital Charge Code |
27000684
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$76.22 |
| Max. Negotiated Rate |
$185.40 |
| Rate for Payer: Aetna American Axle |
$133.90
|
| Rate for Payer: Aetna Commercial |
$175.10
|
| Rate for Payer: Aetna Medicare |
$103.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.90
|
| Rate for Payer: BCBS Complete |
$82.40
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Advantage |
$144.20
|
| Rate for Payer: Cofinity Commercial |
$177.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Healthscope Commercial |
$185.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$144.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$154.50
|
| Rate for Payer: PHP Commercial |
$175.10
|
| Rate for Payer: Priority Health SBD |
$129.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.90
|
| Rate for Payer: UHC Core |
$107.33
|
| Rate for Payer: UHC Exchange |
$80.96
|
| Rate for Payer: UMR Bronson Commercial |
$76.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.50
|
|
|
HC BOTTLE A/B CDI 500
|
Facility
|
IP
|
$206.00
|
|
| Hospital Charge Code |
27000684
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$90.64 |
| Max. Negotiated Rate |
$185.40 |
| Rate for Payer: Aetna American Axle |
$133.90
|
| Rate for Payer: Aetna Commercial |
$175.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.90
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Advantage |
$144.20
|
| Rate for Payer: Cofinity Commercial |
$177.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Healthscope Commercial |
$185.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$144.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$154.50
|
| Rate for Payer: PHP Commercial |
$175.10
|
| Rate for Payer: Priority Health SBD |
$129.78
|
| Rate for Payer: UMR Bronson Commercial |
$90.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.50
|
|
|
HC BOWL
|
Facility
|
OP
|
$234.09
|
|
| Hospital Charge Code |
27000091
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$86.61 |
| Max. Negotiated Rate |
$210.68 |
| Rate for Payer: Aetna American Axle |
$152.16
|
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: Aetna Medicare |
$117.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.16
|
| Rate for Payer: BCBS Complete |
$93.64
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Advantage |
$163.86
|
| Rate for Payer: Cofinity Commercial |
$201.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Healthscope Commercial |
$210.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$163.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$187.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$175.57
|
| Rate for Payer: PHP Commercial |
$198.98
|
| Rate for Payer: Priority Health SBD |
$147.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.16
|
| Rate for Payer: UHC Core |
$121.96
|
| Rate for Payer: UHC Exchange |
$92.00
|
| Rate for Payer: UMR Bronson Commercial |
$86.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.57
|
|
|
HC BOWL
|
Facility
|
IP
|
$234.09
|
|
| Hospital Charge Code |
27000091
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$103.00 |
| Max. Negotiated Rate |
$210.68 |
| Rate for Payer: Aetna American Axle |
$152.16
|
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.16
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Advantage |
$163.86
|
| Rate for Payer: Cofinity Commercial |
$201.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Healthscope Commercial |
$210.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$163.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$175.57
|
| Rate for Payer: PHP Commercial |
$198.98
|
| Rate for Payer: Priority Health SBD |
$147.48
|
| Rate for Payer: UMR Bronson Commercial |
$103.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.57
|
|
|
HC BOWL ATS 55 ML
|
Facility
|
OP
|
$258.54
|
|
| Hospital Charge Code |
27000283
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$95.66 |
| Max. Negotiated Rate |
$232.69 |
| Rate for Payer: Aetna American Axle |
$168.05
|
| Rate for Payer: Aetna Commercial |
$219.76
|
| Rate for Payer: Aetna Medicare |
$129.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.05
|
| Rate for Payer: BCBS Complete |
$103.42
|
| Rate for Payer: Cash Price |
$206.83
|
| Rate for Payer: Cofinity Advantage |
$180.98
|
| Rate for Payer: Cofinity Commercial |
$222.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.83
|
| Rate for Payer: Healthscope Commercial |
$232.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$206.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.91
|
| Rate for Payer: PHP Commercial |
$219.76
|
| Rate for Payer: Priority Health SBD |
$162.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.05
|
| Rate for Payer: UHC Core |
$134.70
|
| Rate for Payer: UHC Exchange |
$101.61
|
| Rate for Payer: UMR Bronson Commercial |
$95.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.91
|
|
|
HC BOWL ATS 55 ML
|
Facility
|
IP
|
$258.54
|
|
| Hospital Charge Code |
27000283
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$113.76 |
| Max. Negotiated Rate |
$232.69 |
| Rate for Payer: Aetna American Axle |
$168.05
|
| Rate for Payer: Aetna Commercial |
$219.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.05
|
| Rate for Payer: Cash Price |
$206.83
|
| Rate for Payer: Cofinity Advantage |
$180.98
|
| Rate for Payer: Cofinity Commercial |
$222.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.83
|
| Rate for Payer: Healthscope Commercial |
$232.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.91
|
| Rate for Payer: PHP Commercial |
$219.76
|
| Rate for Payer: Priority Health SBD |
$162.88
|
| Rate for Payer: UMR Bronson Commercial |
$113.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.91
|
|
