|
HC HEALTH & BEHAV ASSESS OR REASSESS
|
Facility
|
OP
|
$120.36
|
|
|
Service Code
|
CPT 96156
|
| Hospital Charge Code |
91400009
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$43.34 |
| Max. Negotiated Rate |
$249.42 |
| Rate for Payer: Aetna American Axle |
$78.23
|
| Rate for Payer: Aetna Commercial |
$102.31
|
| Rate for Payer: Aetna Medicare |
$82.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$99.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$99.04
|
| Rate for Payer: BCBS Complete |
$45.51
|
| Rate for Payer: BCBS MAPPO |
$79.23
|
| Rate for Payer: BCN Medicare Advantage |
$79.23
|
| Rate for Payer: Cash Price |
$96.29
|
| Rate for Payer: Cash Price |
$96.29
|
| Rate for Payer: Cofinity Commercial |
$103.51
|
| Rate for Payer: Cofinity Commercial |
$84.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.23
|
| Rate for Payer: Healthscope Commercial |
$108.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.27
|
| Rate for Payer: Mclaren Medicaid |
$43.34
|
| Rate for Payer: Mclaren Medicare |
$79.23
|
| Rate for Payer: Meridian Medicaid |
$45.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$83.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.31
|
| Rate for Payer: PACE Medicare |
$75.27
|
| Rate for Payer: PACE SWMI |
$79.23
|
| Rate for Payer: PHP Commercial |
$102.31
|
| Rate for Payer: PHP Medicare Advantage |
$79.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$249.42
|
| Rate for Payer: Priority Health Medicare |
$79.23
|
| Rate for Payer: Priority Health Narrow Network |
$199.54
|
| Rate for Payer: Priority Health SBD |
$75.83
|
| Rate for Payer: Railroad Medicare Medicare |
$79.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.23
|
| Rate for Payer: UHC Exchange |
$86.12
|
| Rate for Payer: UHC Medicare Advantage |
$81.61
|
| Rate for Payer: UMR Bronson Commercial |
$44.53
|
| Rate for Payer: VA VA |
$79.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.27
|
|
|
HC HEALTH & BEHAV INTERVENT INDIV EA ADD 15 MIN
|
Facility
|
IP
|
$60.18
|
|
|
Service Code
|
CPT 96159
|
| Hospital Charge Code |
91400011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$26.48 |
| Max. Negotiated Rate |
$54.16 |
| Rate for Payer: Aetna American Axle |
$39.12
|
| Rate for Payer: Aetna Commercial |
$51.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.12
|
| Rate for Payer: Cash Price |
$48.14
|
| Rate for Payer: Cofinity Commercial |
$42.13
|
| Rate for Payer: Cofinity Commercial |
$51.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.14
|
| Rate for Payer: Healthscope Commercial |
$54.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.15
|
| Rate for Payer: PHP Commercial |
$51.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.13
|
| Rate for Payer: Priority Health SBD |
$37.91
|
| Rate for Payer: UMR Bronson Commercial |
$26.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.14
|
|
|
HC HEALTH & BEHAV INTERVENT INDIV EA ADD 15 MIN
|
Facility
|
OP
|
$60.18
|
|
|
Service Code
|
CPT 96159
|
| Hospital Charge Code |
91400011
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$19.32 |
| Max. Negotiated Rate |
$54.16 |
| Rate for Payer: Aetna American Axle |
$39.12
|
| Rate for Payer: Aetna Commercial |
$51.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.12
|
| Rate for Payer: BCBS Complete |
$24.07
|
| Rate for Payer: Cash Price |
$48.14
|
| Rate for Payer: Cash Price |
$48.14
|
| Rate for Payer: Cofinity Commercial |
$51.75
|
| Rate for Payer: Cofinity Commercial |
$42.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.14
|
| Rate for Payer: Healthscope Commercial |
$54.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.15
|
| Rate for Payer: PHP Commercial |
$51.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.13
|
| Rate for Payer: Priority Health SBD |
$37.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.25
|
| Rate for Payer: UHC Exchange |
$19.32
|
| Rate for Payer: UMR Bronson Commercial |
$22.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.14
|
|
|
HC HEALTH & BEHAV INTERVENT INDIV INIT 30 MIN
|
Facility
|
OP
|
$120.36
|
|
|
Service Code
|
CPT 96158
|
| Hospital Charge Code |
91400010
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$44.53 |
| Max. Negotiated Rate |
$446.15 |
| Rate for Payer: Aetna American Axle |
$78.23
|
| Rate for Payer: Aetna Commercial |
$102.31
|
| Rate for Payer: Aetna Medicare |
$147.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$177.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$177.15
|
| Rate for Payer: BCBS Complete |
$81.40
|
| Rate for Payer: BCBS MAPPO |
$141.72
|
| Rate for Payer: BCN Medicare Advantage |
$141.72
|
| Rate for Payer: Cash Price |
$96.29
|
| Rate for Payer: Cash Price |
$96.29
|
| Rate for Payer: Cofinity Commercial |
$84.25
|
| Rate for Payer: Cofinity Commercial |
$103.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.72
|
| Rate for Payer: Healthscope Commercial |
$108.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.27
|
| Rate for Payer: Mclaren Medicaid |
$77.52
|
| Rate for Payer: Mclaren Medicare |
$141.72
|
| Rate for Payer: Meridian Medicaid |
$81.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$148.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$162.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.31
|
| Rate for Payer: PACE Medicare |
$134.63
|
| Rate for Payer: PACE SWMI |
$141.72
|
| Rate for Payer: PHP Commercial |
$102.31
|
| Rate for Payer: PHP Medicare Advantage |
$141.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$446.15
|
| Rate for Payer: Priority Health Medicare |
$141.72
|
| Rate for Payer: Priority Health Narrow Network |
$356.92
|
| Rate for Payer: Priority Health SBD |
$75.83
|
| Rate for Payer: Railroad Medicare Medicare |
$141.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.72
|
| Rate for Payer: UHC Exchange |
$57.63
|
| Rate for Payer: UHC Medicare Advantage |
$145.97
|
| Rate for Payer: UMR Bronson Commercial |
$44.53
|
| Rate for Payer: VA VA |
$141.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.27
|
|
|
HC HEALTH & BEHAV INTERVENT INDIV INIT 30 MIN
|
Facility
|
IP
|
$120.36
|
|
|
Service Code
|
CPT 96158
|
| Hospital Charge Code |
91400010
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$52.96 |
| Max. Negotiated Rate |
$108.32 |
| Rate for Payer: Aetna American Axle |
$78.23
|
| Rate for Payer: Aetna Commercial |
$102.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.23
|
| Rate for Payer: Cash Price |
$96.29
|
| Rate for Payer: Cofinity Commercial |
$103.51
|
| Rate for Payer: Cofinity Commercial |
$84.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.29
|
| Rate for Payer: Healthscope Commercial |
$108.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.31
|
| Rate for Payer: PHP Commercial |
$102.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.25
|
| Rate for Payer: Priority Health SBD |
$75.83
|
| Rate for Payer: UMR Bronson Commercial |
$52.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.27
|
|
|
HC HEARING AID CHECK BINAURAL
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 92593
|
| Hospital Charge Code |
76100499
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Aetna American Axle |
$39.00
|
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$42.00
|
| Rate for Payer: Cofinity Commercial |
$51.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Healthscope Commercial |
$54.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: PHP Commercial |
$51.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health SBD |
$37.80
|
| Rate for Payer: UMR Bronson Commercial |
$26.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.00
|
|
|
HC HEARING AID CHECK BINAURAL
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 92593
|
| Hospital Charge Code |
76100499
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$22.20 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$39.00
|
| Rate for Payer: Aetna Commercial |
$51.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.00
|
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$51.60
|
| Rate for Payer: Cofinity Commercial |
$42.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.00
|
| Rate for Payer: Healthscope Commercial |
$54.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.00
|
| Rate for Payer: PHP Commercial |
$51.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health SBD |
$37.80
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$22.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.00
|
|
|
HC HEARING AID CHECK MONAURAL
|
Facility
|
OP
|
$53.00
|
|
|
Service Code
|
CPT 92592
|
| Hospital Charge Code |
47100402
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$19.61 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$34.45
|
| Rate for Payer: Aetna Commercial |
$45.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.45
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$45.58
|
| Rate for Payer: Cofinity Commercial |
$37.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.40
|
| Rate for Payer: Healthscope Commercial |
$47.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.05
|
| Rate for Payer: PHP Commercial |
$45.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.10
|
| Rate for Payer: Priority Health SBD |
$33.39
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$19.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.75
|
|
|
HC HEARING AID CHECK MONAURAL
|
Facility
|
IP
|
$53.00
|
|
|
Service Code
|
CPT 92592
|
| Hospital Charge Code |
47100402
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$23.32 |
| Max. Negotiated Rate |
$47.70 |
| Rate for Payer: Aetna American Axle |
$34.45
|
| Rate for Payer: Aetna Commercial |
$45.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.45
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$37.10
|
| Rate for Payer: Cofinity Commercial |
$45.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.40
|
| Rate for Payer: Healthscope Commercial |
$47.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.05
|
| Rate for Payer: PHP Commercial |
$45.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.10
|
| Rate for Payer: Priority Health SBD |
$33.39
|
| Rate for Payer: UMR Bronson Commercial |
$23.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.75
|
|
|
HC HEARING AID EXAM BOTH EARS
|
Facility
|
IP
|
$119.00
|
|
|
Service Code
|
CPT 92591
|
| Hospital Charge Code |
76100504
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$52.36 |
| Max. Negotiated Rate |
$107.10 |
| Rate for Payer: Aetna American Axle |
$77.35
|
| Rate for Payer: Aetna Commercial |
$101.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.35
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$102.34
|
| Rate for Payer: Cofinity Commercial |
$83.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.20
|
| Rate for Payer: Healthscope Commercial |
$107.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$101.15
|
| Rate for Payer: PHP Commercial |
$101.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.30
|
| Rate for Payer: Priority Health SBD |
$74.97
|
| Rate for Payer: UMR Bronson Commercial |
$52.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.25
|
|
|
HC HEARING AID EXAM BOTH EARS
|
Facility
|
OP
|
$119.00
|
|
|
Service Code
|
CPT 92591
|
| Hospital Charge Code |
76100504
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$44.03 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$77.35
|
| Rate for Payer: Aetna Commercial |
$101.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.35
|
| Rate for Payer: BCBS Complete |
$47.60
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$83.30
|
| Rate for Payer: Cofinity Commercial |
$102.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.20
|
| Rate for Payer: Healthscope Commercial |
$107.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$101.15
|
| Rate for Payer: PHP Commercial |
$101.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.30
|
| Rate for Payer: Priority Health SBD |
$74.97
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$44.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.25
|
|
|
HC HEARING AID EXAM ONE EAR
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 92590
|
| Hospital Charge Code |
76100505
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$47.96 |
| Max. Negotiated Rate |
$98.10 |
| Rate for Payer: Aetna American Axle |
$70.85
|
| Rate for Payer: Aetna Commercial |
$92.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.85
|
| Rate for Payer: Cash Price |
$87.20
|
| Rate for Payer: Cofinity Commercial |
$76.30
|
| Rate for Payer: Cofinity Commercial |
$93.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.20
|
| Rate for Payer: Healthscope Commercial |
$98.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$92.65
|
| Rate for Payer: PHP Commercial |
$92.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.30
|
| Rate for Payer: Priority Health SBD |
$68.67
|
| Rate for Payer: UMR Bronson Commercial |
$47.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.75
|
|
|
HC HEARING AID EXAM ONE EAR
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
CPT 92590
|
| Hospital Charge Code |
76100505
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$40.33 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$70.85
|
| Rate for Payer: Aetna Commercial |
$92.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.85
|
| Rate for Payer: BCBS Complete |
$43.60
|
| Rate for Payer: Cash Price |
$87.20
|
| Rate for Payer: Cash Price |
$87.20
|
| Rate for Payer: Cofinity Commercial |
$93.74
|
| Rate for Payer: Cofinity Commercial |
$76.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.20
|
| Rate for Payer: Healthscope Commercial |
$98.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$92.65
|
| Rate for Payer: PHP Commercial |
$92.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.30
|
| Rate for Payer: Priority Health SBD |
$68.67
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$40.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.75
|
|
|
HC HEART CATH CORONARIES CABG'S
|
Facility
|
IP
|
$11,972.93
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100018
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,268.09 |
| Max. Negotiated Rate |
$10,775.64 |
| Rate for Payer: Aetna American Axle |
$7,782.40
|
| Rate for Payer: Aetna Commercial |
$10,176.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,782.40
|
| Rate for Payer: Cash Price |
$9,578.34
|
| Rate for Payer: Cofinity Commercial |
$10,296.72
|
| Rate for Payer: Cofinity Commercial |
$8,381.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,578.34
|
| Rate for Payer: Healthscope Commercial |
$10,775.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,381.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,979.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,176.99
|
| Rate for Payer: PHP Commercial |
$10,176.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,381.05
|
| Rate for Payer: Priority Health SBD |
$7,542.95
|
| Rate for Payer: UMR Bronson Commercial |
$5,268.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,979.70
|
|
|
HC HEART CATH CORONARIES CABG'S
|
Facility
|
OP
|
$11,972.93
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100018
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,083.51 |
| Max. Negotiated Rate |
$10,775.64 |
| Rate for Payer: Aetna American Axle |
$7,782.40
|
| Rate for Payer: Aetna Commercial |
$10,176.99
|
| Rate for Payer: Aetna Medicare |
$3,012.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,782.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,620.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,620.58
|
| Rate for Payer: BCBS Complete |
$1,663.73
|
| Rate for Payer: BCBS MAPPO |
$2,896.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,989.62
|
| Rate for Payer: BCN Medicare Advantage |
$2,896.46
|
| Rate for Payer: Cash Price |
$9,578.34
|
| Rate for Payer: Cash Price |
$9,578.34
|
| Rate for Payer: Cofinity Commercial |
$8,381.05
|
| Rate for Payer: Cofinity Commercial |
$10,296.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,578.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,896.46
|
| Rate for Payer: Healthscope Commercial |
$10,775.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,381.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,979.70
|
| Rate for Payer: Mclaren Medicaid |
$1,584.36
|
| Rate for Payer: Mclaren Medicare |
$2,896.46
|
| Rate for Payer: Meridian Medicaid |
$1,663.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,041.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,330.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,176.99
|
| Rate for Payer: PACE Medicare |
$2,751.64
|
| Rate for Payer: PACE SWMI |
$2,896.46
|
| Rate for Payer: PHP Commercial |
$10,176.99
|
| Rate for Payer: PHP Medicare Advantage |
$2,896.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,584.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,381.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,118.19
|
| Rate for Payer: Priority Health Medicare |
$2,896.46
|
| Rate for Payer: Priority Health Narrow Network |
$7,294.55
|
| Rate for Payer: Priority Health SBD |
$7,542.95
|
| Rate for Payer: Railroad Medicare Medicare |
$2,896.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,191.86
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,896.46
|
| Rate for Payer: UHC Exchange |
$1,083.51
|
| Rate for Payer: UHC Medicare Advantage |
$2,983.35
|
| Rate for Payer: UMR Bronson Commercial |
$4,429.98
|
| Rate for Payer: VA VA |
$2,896.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,979.70
|
|
|
HC HEART CATH EXCHANGE WIRE
|
Facility
|
OP
|
$53.51
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$48.16 |
| Rate for Payer: Aetna American Axle |
$34.78
|
| Rate for Payer: Aetna Commercial |
$45.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.78
|
| Rate for Payer: BCBS Complete |
$21.40
|
| Rate for Payer: Cash Price |
$42.81
|
| Rate for Payer: Cofinity Commercial |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$46.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.81
|
| Rate for Payer: Healthscope Commercial |
$48.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.48
|
| Rate for Payer: PHP Commercial |
$45.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.46
|
| Rate for Payer: Priority Health SBD |
$33.71
|
| Rate for Payer: UMR Bronson Commercial |
$19.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.13
|
|
|
HC HEART CATH EXCHANGE WIRE
|
Facility
|
IP
|
$53.51
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.54 |
| Max. Negotiated Rate |
$48.16 |
| Rate for Payer: Aetna American Axle |
$34.78
|
| Rate for Payer: Aetna Commercial |
$45.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.78
|
| Rate for Payer: Cash Price |
$42.81
|
| Rate for Payer: Cofinity Commercial |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$46.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.81
|
| Rate for Payer: Healthscope Commercial |
$48.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.48
|
| Rate for Payer: PHP Commercial |
$45.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.46
|
| Rate for Payer: Priority Health SBD |
$33.71
|
| Rate for Payer: UMR Bronson Commercial |
$23.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.13
|
|
|
HC HEART CATH LT ONLY
|
Facility
|
IP
|
$8,314.74
|
|
|
Service Code
|
CPT 93452
|
| Hospital Charge Code |
48100011
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,658.49 |
| Max. Negotiated Rate |
$7,483.27 |
| Rate for Payer: Aetna American Axle |
$5,404.58
|
| Rate for Payer: Aetna Commercial |
$7,067.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,404.58
|
| Rate for Payer: Cash Price |
$6,651.79
|
| Rate for Payer: Cofinity Commercial |
$7,150.68
|
| Rate for Payer: Cofinity Commercial |
$5,820.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,651.79
|
| Rate for Payer: Healthscope Commercial |
$7,483.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,820.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,236.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,067.53
|
| Rate for Payer: PHP Commercial |
$7,067.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,820.32
|
| Rate for Payer: Priority Health SBD |
$5,238.29
|
| Rate for Payer: UMR Bronson Commercial |
$3,658.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,236.06
|
|
|
HC HEART CATH LT ONLY
|
Facility
|
OP
|
$8,314.74
|
|
|
Service Code
|
CPT 93452
|
| Hospital Charge Code |
48100011
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$868.38 |
| Max. Negotiated Rate |
$9,118.19 |
| Rate for Payer: Aetna American Axle |
$5,404.58
|
| Rate for Payer: Aetna Commercial |
$7,067.53
|
| Rate for Payer: Aetna Medicare |
$3,012.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,404.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,620.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,620.58
|
| Rate for Payer: BCBS Complete |
$1,663.73
|
| Rate for Payer: BCBS MAPPO |
$2,896.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,374.69
|
| Rate for Payer: BCN Medicare Advantage |
$2,896.46
|
| Rate for Payer: Cash Price |
$6,651.79
|
| Rate for Payer: Cash Price |
$6,651.79
|
| Rate for Payer: Cofinity Commercial |
$5,820.32
|
| Rate for Payer: Cofinity Commercial |
$7,150.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,651.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,896.46
|
| Rate for Payer: Healthscope Commercial |
$7,483.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,820.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,236.06
|
| Rate for Payer: Mclaren Medicaid |
$1,584.36
|
| Rate for Payer: Mclaren Medicare |
$2,896.46
|
| Rate for Payer: Meridian Medicaid |
$1,663.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,041.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,330.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,067.53
|
| Rate for Payer: PACE Medicare |
$2,751.64
|
| Rate for Payer: PACE SWMI |
$2,896.46
|
| Rate for Payer: PHP Commercial |
$7,067.53
|
| Rate for Payer: PHP Medicare Advantage |
$2,896.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,584.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,820.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,118.19
|
| Rate for Payer: Priority Health Medicare |
$2,896.46
|
| Rate for Payer: Priority Health Narrow Network |
$7,294.55
|
| Rate for Payer: Priority Health SBD |
$5,238.29
|
| Rate for Payer: Railroad Medicare Medicare |
$2,896.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$955.22
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,896.46
|
| Rate for Payer: UHC Exchange |
$868.38
|
| Rate for Payer: UHC Medicare Advantage |
$2,983.35
|
| Rate for Payer: UMR Bronson Commercial |
$3,076.45
|
| Rate for Payer: VA VA |
$2,896.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,236.06
|
|
|
HC HEART CATH LT/RT/C/CABGS
|
Facility
|
IP
|
$14,804.56
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100052
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,514.01 |
| Max. Negotiated Rate |
$13,324.10 |
| Rate for Payer: Aetna American Axle |
$9,622.96
|
| Rate for Payer: Aetna Commercial |
$12,583.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,622.96
|
| Rate for Payer: Cash Price |
$11,843.65
|
| Rate for Payer: Cofinity Commercial |
$10,363.19
|
| Rate for Payer: Cofinity Commercial |
$12,731.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,843.65
|
| Rate for Payer: Healthscope Commercial |
$13,324.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,363.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,103.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,583.88
|
| Rate for Payer: PHP Commercial |
$12,583.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,363.19
|
| Rate for Payer: Priority Health SBD |
$9,326.87
|
| Rate for Payer: UMR Bronson Commercial |
$6,514.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,103.42
|
|
|
HC HEART CATH LT/RT/C/CABGS
|
Facility
|
OP
|
$14,804.56
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100052
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,326.14 |
| Max. Negotiated Rate |
$13,324.10 |
| Rate for Payer: Aetna American Axle |
$9,622.96
|
| Rate for Payer: Aetna Commercial |
$12,583.88
|
| Rate for Payer: Aetna Medicare |
$3,012.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,622.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,620.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,620.58
|
| Rate for Payer: BCBS Complete |
$1,663.73
|
| Rate for Payer: BCBS MAPPO |
$2,896.46
|
| Rate for Payer: BCBS Trust/PPO |
$4,867.64
|
| Rate for Payer: BCN Medicare Advantage |
$2,896.46
|
| Rate for Payer: Cash Price |
$11,843.65
|
| Rate for Payer: Cash Price |
$11,843.65
|
| Rate for Payer: Cofinity Commercial |
$10,363.19
|
| Rate for Payer: Cofinity Commercial |
$12,731.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,843.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,896.46
|
| Rate for Payer: Healthscope Commercial |
$13,324.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,363.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,103.42
|
| Rate for Payer: Mclaren Medicaid |
$1,584.36
|
| Rate for Payer: Mclaren Medicare |
$2,896.46
|
| Rate for Payer: Meridian Medicaid |
$1,663.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,041.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,330.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,583.88
|
| Rate for Payer: PACE Medicare |
$2,751.64
|
| Rate for Payer: PACE SWMI |
$2,896.46
|
| Rate for Payer: PHP Commercial |
$12,583.88
|
| Rate for Payer: PHP Medicare Advantage |
$2,896.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,584.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,363.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,118.19
|
| Rate for Payer: Priority Health Medicare |
$2,896.46
|
| Rate for Payer: Priority Health Narrow Network |
$7,294.55
|
| Rate for Payer: Priority Health SBD |
$9,326.87
|
| Rate for Payer: Railroad Medicare Medicare |
$2,896.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,458.75
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,896.46
|
| Rate for Payer: UHC Exchange |
$1,326.14
|
| Rate for Payer: UHC Medicare Advantage |
$2,983.35
|
| Rate for Payer: UMR Bronson Commercial |
$5,477.69
|
| Rate for Payer: VA VA |
$2,896.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,103.42
|
|
|
HC HEART CATH LT/RT CORONARIES
|
Facility
|
IP
|
$12,514.29
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
48100019
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,506.29 |
| Max. Negotiated Rate |
$11,262.86 |
| Rate for Payer: Aetna American Axle |
$8,134.29
|
| Rate for Payer: Aetna Commercial |
$10,637.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,134.29
|
| Rate for Payer: Cash Price |
$10,011.43
|
| Rate for Payer: Cofinity Commercial |
$10,762.29
|
| Rate for Payer: Cofinity Commercial |
$8,760.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,011.43
|
| Rate for Payer: Healthscope Commercial |
$11,262.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,760.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,385.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,637.15
|
| Rate for Payer: PHP Commercial |
$10,637.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,760.00
|
| Rate for Payer: Priority Health SBD |
$7,884.00
|
| Rate for Payer: UMR Bronson Commercial |
$5,506.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,385.72
|
|
|
HC HEART CATH LT/RT CORONARIES
|
Facility
|
OP
|
$12,514.29
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
48100019
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,202.04 |
| Max. Negotiated Rate |
$11,262.86 |
| Rate for Payer: Aetna American Axle |
$8,134.29
|
| Rate for Payer: Aetna Commercial |
$10,637.15
|
| Rate for Payer: Aetna Medicare |
$3,012.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,134.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,620.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,620.58
|
| Rate for Payer: BCBS Complete |
$1,663.73
|
| Rate for Payer: BCBS MAPPO |
$2,896.46
|
| Rate for Payer: BCBS Trust/PPO |
$4,416.91
|
| Rate for Payer: BCN Medicare Advantage |
$2,896.46
|
| Rate for Payer: Cash Price |
$10,011.43
|
| Rate for Payer: Cash Price |
$10,011.43
|
| Rate for Payer: Cofinity Commercial |
$10,762.29
|
| Rate for Payer: Cofinity Commercial |
$8,760.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,011.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,896.46
|
| Rate for Payer: Healthscope Commercial |
$11,262.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,760.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,385.72
|
| Rate for Payer: Mclaren Medicaid |
$1,584.36
|
| Rate for Payer: Mclaren Medicare |
$2,896.46
|
| Rate for Payer: Meridian Medicaid |
$1,663.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,041.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,330.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,637.15
|
| Rate for Payer: PACE Medicare |
$2,751.64
|
| Rate for Payer: PACE SWMI |
$2,896.46
|
| Rate for Payer: PHP Commercial |
$10,637.15
|
| Rate for Payer: PHP Medicare Advantage |
$2,896.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,584.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,760.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,118.19
|
| Rate for Payer: Priority Health Medicare |
$2,896.46
|
| Rate for Payer: Priority Health Narrow Network |
$7,294.55
|
| Rate for Payer: Priority Health SBD |
$7,884.00
|
| Rate for Payer: Railroad Medicare Medicare |
$2,896.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,322.24
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,896.46
|
| Rate for Payer: UHC Exchange |
$1,202.04
|
| Rate for Payer: UHC Medicare Advantage |
$2,983.35
|
| Rate for Payer: UMR Bronson Commercial |
$4,630.29
|
| Rate for Payer: VA VA |
$2,896.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,385.72
|
|
|
HC HEART CATH LT/RT ONLY
|
Facility
|
OP
|
$8,785.89
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
48100012
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,108.06 |
| Max. Negotiated Rate |
$9,118.19 |
| Rate for Payer: Aetna American Axle |
$5,710.83
|
| Rate for Payer: Aetna Commercial |
$7,468.01
|
| Rate for Payer: Aetna Medicare |
$3,012.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,710.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,620.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,620.58
|
| Rate for Payer: BCBS Complete |
$1,663.73
|
| Rate for Payer: BCBS MAPPO |
$2,896.46
|
| Rate for Payer: BCBS Trust/PPO |
$4,215.82
|
| Rate for Payer: BCN Medicare Advantage |
$2,896.46
|
| Rate for Payer: Cash Price |
$7,028.71
|
| Rate for Payer: Cash Price |
$7,028.71
|
| Rate for Payer: Cofinity Commercial |
$7,555.87
|
| Rate for Payer: Cofinity Commercial |
$6,150.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,028.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,896.46
|
| Rate for Payer: Healthscope Commercial |
$7,907.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,150.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,589.42
|
| Rate for Payer: Mclaren Medicaid |
$1,584.36
|
| Rate for Payer: Mclaren Medicare |
$2,896.46
|
| Rate for Payer: Meridian Medicaid |
$1,663.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,041.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,330.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,468.01
|
| Rate for Payer: PACE Medicare |
$2,751.64
|
| Rate for Payer: PACE SWMI |
$2,896.46
|
| Rate for Payer: PHP Commercial |
$7,468.01
|
| Rate for Payer: PHP Medicare Advantage |
$2,896.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,584.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,150.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,118.19
|
| Rate for Payer: Priority Health Medicare |
$2,896.46
|
| Rate for Payer: Priority Health Narrow Network |
$7,294.55
|
| Rate for Payer: Priority Health SBD |
$5,535.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2,896.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,218.87
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,896.46
|
| Rate for Payer: UHC Exchange |
$1,108.06
|
| Rate for Payer: UHC Medicare Advantage |
$2,983.35
|
| Rate for Payer: UMR Bronson Commercial |
$3,250.78
|
| Rate for Payer: VA VA |
$2,896.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,589.42
|
|
|
HC HEART CATH LT/RT ONLY
|
Facility
|
IP
|
$8,785.89
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
48100012
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,865.79 |
| Max. Negotiated Rate |
$7,907.30 |
| Rate for Payer: Aetna American Axle |
$5,710.83
|
| Rate for Payer: Aetna Commercial |
$7,468.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,710.83
|
| Rate for Payer: Cash Price |
$7,028.71
|
| Rate for Payer: Cofinity Commercial |
$6,150.12
|
| Rate for Payer: Cofinity Commercial |
$7,555.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,028.71
|
| Rate for Payer: Healthscope Commercial |
$7,907.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,150.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,589.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,468.01
|
| Rate for Payer: PHP Commercial |
$7,468.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,150.12
|
| Rate for Payer: Priority Health SBD |
$5,535.11
|
| Rate for Payer: UMR Bronson Commercial |
$3,865.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,589.42
|
|
