|
HC CATH CORONARY DRUG-DELIVERY
|
Facility
|
IP
|
$11,166.37
|
|
|
Service Code
|
HCPCS C9610
|
| Hospital Charge Code |
27200405
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,913.20 |
| Max. Negotiated Rate |
$10,049.73 |
| Rate for Payer: Aetna American Axle |
$7,258.14
|
| Rate for Payer: Aetna Commercial |
$9,491.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,258.14
|
| Rate for Payer: Cash Price |
$8,933.10
|
| Rate for Payer: Cofinity Advantage |
$7,816.46
|
| Rate for Payer: Cofinity Commercial |
$9,603.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,933.10
|
| Rate for Payer: Healthscope Commercial |
$10,049.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,816.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,374.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,491.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,374.78
|
| Rate for Payer: PHP Commercial |
$9,491.41
|
| Rate for Payer: Priority Health SBD |
$7,034.81
|
| Rate for Payer: UMR Bronson Commercial |
$4,913.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,374.78
|
|
|
HC CATHETER BALLOON DILATATION NON VASCULAR
|
Facility
|
OP
|
$3,571.82
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$3,214.64 |
| Rate for Payer: Aetna American Axle |
$2,321.68
|
| Rate for Payer: Aetna Commercial |
$3,036.05
|
| Rate for Payer: Aetna Medicare |
$1,785.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,321.68
|
| Rate for Payer: BCBS Complete |
$1,428.73
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$2,857.46
|
| Rate for Payer: Cash Price |
$2,857.46
|
| Rate for Payer: Cofinity Advantage |
$2,500.27
|
| Rate for Payer: Cofinity Commercial |
$3,071.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,857.46
|
| Rate for Payer: Healthscope Commercial |
$3,214.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,500.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,678.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,857.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,036.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,678.86
|
| Rate for Payer: PHP Commercial |
$3,036.05
|
| Rate for Payer: Priority Health SBD |
$2,250.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,321.68
|
| Rate for Payer: UHC Core |
$1,860.92
|
| Rate for Payer: UHC Exchange |
$1,403.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,321.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,678.86
|
|
|
HC CATHETER BALLOON DILATATION NON VASCULAR
|
Facility
|
IP
|
$3,571.82
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,571.60 |
| Max. Negotiated Rate |
$3,214.64 |
| Rate for Payer: Aetna American Axle |
$2,321.68
|
| Rate for Payer: Aetna Commercial |
$3,036.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,321.68
|
| Rate for Payer: Cash Price |
$2,857.46
|
| Rate for Payer: Cofinity Advantage |
$2,500.27
|
| Rate for Payer: Cofinity Commercial |
$3,071.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,857.46
|
| Rate for Payer: Healthscope Commercial |
$3,214.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,500.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,678.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,036.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,678.86
|
| Rate for Payer: PHP Commercial |
$3,036.05
|
| Rate for Payer: Priority Health SBD |
$2,250.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,571.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,678.86
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 1
|
Facility
|
OP
|
$151.13
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$136.02 |
| Rate for Payer: Aetna American Axle |
$98.23
|
| Rate for Payer: Aetna Commercial |
$128.46
|
| Rate for Payer: Aetna Medicare |
$75.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.23
|
| Rate for Payer: BCBS Complete |
$60.45
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$120.90
|
| Rate for Payer: Cash Price |
$120.90
|
| Rate for Payer: Cofinity Advantage |
$105.79
|
| Rate for Payer: Cofinity Commercial |
$129.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.90
|
| Rate for Payer: Healthscope Commercial |
$136.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$120.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.35
|
| Rate for Payer: PHP Commercial |
$128.46
|
| Rate for Payer: Priority Health SBD |
$95.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.23
|
| Rate for Payer: UHC Core |
$78.74
|
| Rate for Payer: UHC Exchange |
$59.39
|
| Rate for Payer: UMR Bronson Commercial |
$55.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.35
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 1
|
Facility
|
IP
|
$151.13
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.50 |
| Max. Negotiated Rate |
$136.02 |
| Rate for Payer: Aetna American Axle |
$98.23
|
| Rate for Payer: Aetna Commercial |
$128.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.23
|
| Rate for Payer: Cash Price |
$120.90
|
| Rate for Payer: Cofinity Advantage |
$105.79
|
| Rate for Payer: Cofinity Commercial |
$129.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.90
|
| Rate for Payer: Healthscope Commercial |
$136.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.35
|
| Rate for Payer: PHP Commercial |
$128.46
|
| Rate for Payer: Priority Health SBD |
$95.21
|
| Rate for Payer: UMR Bronson Commercial |
$66.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.35
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 7
|
Facility
|
IP
|
$792.81
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$348.84 |
| Max. Negotiated Rate |
$713.53 |
| Rate for Payer: Aetna American Axle |
$515.33
|
| Rate for Payer: Aetna Commercial |
$673.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.33
|
| Rate for Payer: Cash Price |
$634.25
|
| Rate for Payer: Cofinity Advantage |
$554.97
|
| Rate for Payer: Cofinity Commercial |
$681.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.25
|
| Rate for Payer: Healthscope Commercial |
$713.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$554.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$594.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$673.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.61
|
| Rate for Payer: PHP Commercial |
$673.89
|
| Rate for Payer: Priority Health SBD |
$499.47
|
| Rate for Payer: UMR Bronson Commercial |
$348.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$594.61
|
|
|
HC CATHETER BALLOON DILAT NON VASC LVL 7
|
Facility
|
OP
|
$792.81
|
|
|
Service Code
|
HCPCS C1726
|
| Hospital Charge Code |
27200295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$713.53 |
| Rate for Payer: Aetna American Axle |
$515.33
|
| Rate for Payer: Aetna Commercial |
$673.89
|
| Rate for Payer: Aetna Medicare |
$396.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$515.33
|
| Rate for Payer: BCBS Complete |
$317.12
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$634.25
|
| Rate for Payer: Cash Price |
$634.25
|
| Rate for Payer: Cofinity Advantage |
$554.97
|
| Rate for Payer: Cofinity Commercial |
$681.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$634.25
|
| Rate for Payer: Healthscope Commercial |
$713.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$554.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$594.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$634.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$673.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$594.61
|
| Rate for Payer: PHP Commercial |
$673.89
|
| Rate for Payer: Priority Health SBD |
$499.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$515.33
|
| Rate for Payer: UHC Core |
$413.05
|
| Rate for Payer: UHC Exchange |
$311.57
|
| Rate for Payer: UMR Bronson Commercial |
$293.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$594.61
|
|
|
HC CATHETER INTRADISCAL
|
Facility
|
IP
|
$1,562.73
|
|
|
Service Code
|
CPT C1754
|
| Hospital Charge Code |
27200357
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$687.60 |
| Max. Negotiated Rate |
$1,406.46 |
| Rate for Payer: Aetna American Axle |
$1,015.77
|
| Rate for Payer: Aetna Commercial |
$1,328.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,015.77
|
| Rate for Payer: Cash Price |
$1,250.18
|
| Rate for Payer: Cofinity Advantage |
$1,093.91
|
| Rate for Payer: Cofinity Commercial |
$1,343.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,250.18
|
| Rate for Payer: Healthscope Commercial |
$1,406.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,093.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,172.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,328.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,172.05
|
| Rate for Payer: PHP Commercial |
$1,328.32
|
| Rate for Payer: Priority Health SBD |
$984.52
|
| Rate for Payer: UMR Bronson Commercial |
$687.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,172.05
|
|
|
HC CATHETER INTRADISCAL
|
Facility
|
OP
|
$1,562.73
|
|
|
Service Code
|
CPT C1754
|
| Hospital Charge Code |
27200357
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$578.21 |
| Max. Negotiated Rate |
$1,406.46 |
| Rate for Payer: Aetna American Axle |
$1,015.77
|
| Rate for Payer: Aetna Commercial |
$1,328.32
|
| Rate for Payer: Aetna Medicare |
$781.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,015.77
|
| Rate for Payer: BCBS Complete |
$625.09
|
| Rate for Payer: Cash Price |
$1,250.18
|
| Rate for Payer: Cofinity Advantage |
$1,093.91
|
| Rate for Payer: Cofinity Commercial |
$1,343.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,250.18
|
| Rate for Payer: Healthscope Commercial |
$1,406.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,093.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,172.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,250.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,328.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,172.05
|
| Rate for Payer: PHP Commercial |
$1,328.32
|
| Rate for Payer: Priority Health SBD |
$984.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,015.77
|
| Rate for Payer: UHC Core |
$814.18
|
| Rate for Payer: UHC Exchange |
$614.15
|
| Rate for Payer: UMR Bronson Commercial |
$578.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,172.05
|
|
|
HC CATHETERIZATION FOR COLLECTION OF SPECIMEN
|
Facility
|
IP
|
$30.77
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
30000114
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.54 |
| Max. Negotiated Rate |
$27.69 |
| Rate for Payer: Aetna American Axle |
$20.00
|
| Rate for Payer: Aetna Commercial |
$26.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.00
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cofinity Advantage |
$21.54
|
| Rate for Payer: Cofinity Commercial |
$26.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.62
|
| Rate for Payer: Healthscope Commercial |
$27.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.08
|
| Rate for Payer: PHP Commercial |
$26.15
|
| Rate for Payer: Priority Health SBD |
$19.39
|
| Rate for Payer: UMR Bronson Commercial |
$13.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.08
|
|
|
HC CATHETERIZATION FOR COLLECTION OF SPECIMEN
|
Facility
|
OP
|
$30.77
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
30000114
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.88 |
| Max. Negotiated Rate |
$28.02 |
| Rate for Payer: Aetna American Axle |
$20.00
|
| Rate for Payer: Aetna Commercial |
$26.15
|
| Rate for Payer: Aetna Medicare |
$9.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.68
|
| Rate for Payer: BCBS Complete |
$5.13
|
| Rate for Payer: BCBS MAPPO |
$9.34
|
| Rate for Payer: BCN Medicare Advantage |
$9.34
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cofinity Advantage |
$21.54
|
| Rate for Payer: Cofinity Commercial |
$26.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.34
|
| Rate for Payer: Healthscope Commercial |
$27.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.08
|
| Rate for Payer: Mclaren Medicaid |
$9.34
|
| Rate for Payer: Mclaren Medicare |
$9.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.81
|
| Rate for Payer: Meridian Medicaid |
$9.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.15
|
| Rate for Payer: Nomi Health Commercial |
$28.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.08
|
| Rate for Payer: PACE Medicare |
$8.87
|
| Rate for Payer: PACE SWMI |
$9.34
|
| Rate for Payer: PHP Commercial |
$26.15
|
| Rate for Payer: PHP Medicare Advantage |
$9.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.09
|
| Rate for Payer: Priority Health Medicare |
$9.34
|
| Rate for Payer: Priority Health SBD |
$19.39
|
| Rate for Payer: Priority Health Tiered Network |
$7.27
|
| Rate for Payer: Railroad Medicare Medicare |
$9.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.64
|
| Rate for Payer: UHC Core |
$13.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.34
|
| Rate for Payer: UHC Exchange |
$13.64
|
| Rate for Payer: UHC Medicaid |
$4.88
|
| Rate for Payer: UHCCP Medicaid |
$4.88
|
| Rate for Payer: UMR Bronson Commercial |
$11.38
|
| Rate for Payer: VA VA |
$9.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.08
|
|
|
HC CATHETER NOS LVL 1
|
Facility
|
OP
|
$67.32
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$60.59 |
| Rate for Payer: Aetna American Axle |
$43.76
|
| Rate for Payer: Aetna Commercial |
$57.22
|
| Rate for Payer: Aetna Medicare |
$33.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.76
|
| Rate for Payer: BCBS Complete |
$26.93
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Advantage |
$47.12
|
| Rate for Payer: Cofinity Commercial |
$57.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Healthscope Commercial |
$60.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.49
|
| Rate for Payer: PHP Commercial |
$57.22
|
| Rate for Payer: Priority Health SBD |
$42.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.76
|
| Rate for Payer: UHC Core |
$35.07
|
| Rate for Payer: UHC Exchange |
$26.46
|
| Rate for Payer: UMR Bronson Commercial |
$24.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.49
|
|
|
HC CATHETER NOS LVL 1
|
Facility
|
IP
|
$67.32
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800126
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$29.62 |
| Max. Negotiated Rate |
$60.59 |
| Rate for Payer: Aetna American Axle |
$43.76
|
| Rate for Payer: Aetna Commercial |
$57.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.76
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Advantage |
$47.12
|
| Rate for Payer: Cofinity Commercial |
$57.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Healthscope Commercial |
$60.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.49
|
| Rate for Payer: PHP Commercial |
$57.22
|
| Rate for Payer: Priority Health SBD |
$42.41
|
| Rate for Payer: UMR Bronson Commercial |
$29.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.49
|
|
|
HC CATHETER NOS LVL 2
|
Facility
|
IP
|
$357.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$157.08 |
| Max. Negotiated Rate |
$321.30 |
| Rate for Payer: Aetna American Axle |
$232.05
|
| Rate for Payer: Aetna Commercial |
$303.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.05
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Advantage |
$249.90
|
| Rate for Payer: Cofinity Commercial |
$307.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.60
|
| Rate for Payer: Healthscope Commercial |
$321.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$249.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.75
|
| Rate for Payer: PHP Commercial |
$303.45
|
| Rate for Payer: Priority Health SBD |
$224.91
|
| Rate for Payer: UMR Bronson Commercial |
$157.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.75
|
|
|
HC CATHETER NOS LVL 2
|
Facility
|
OP
|
$357.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$321.30 |
| Rate for Payer: Aetna American Axle |
$232.05
|
| Rate for Payer: Aetna Commercial |
$303.45
|
| Rate for Payer: Aetna Medicare |
$178.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.05
|
| Rate for Payer: BCBS Complete |
$142.80
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cash Price |
$285.60
|
| Rate for Payer: Cofinity Advantage |
$249.90
|
| Rate for Payer: Cofinity Commercial |
$307.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.60
|
| Rate for Payer: Healthscope Commercial |
$321.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$249.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$285.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.75
|
| Rate for Payer: PHP Commercial |
$303.45
|
| Rate for Payer: Priority Health SBD |
$224.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.05
|
| Rate for Payer: UHC Core |
$186.00
|
| Rate for Payer: UHC Exchange |
$140.30
|
| Rate for Payer: UMR Bronson Commercial |
$132.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.75
|
|
|
HC CATHETER PRESSURE GENERATING ONE WAY INTERMED OCCLUSIVE
|
Facility
|
OP
|
$12,094.65
|
|
|
Service Code
|
CPT C1982
|
| Hospital Charge Code |
27800147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$10,885.18 |
| Rate for Payer: Aetna American Axle |
$7,861.52
|
| Rate for Payer: Aetna Commercial |
$10,280.45
|
| Rate for Payer: Aetna Medicare |
$6,047.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,861.52
|
| Rate for Payer: BCBS Complete |
$4,837.86
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$9,675.72
|
| Rate for Payer: Cash Price |
$9,675.72
|
| Rate for Payer: Cofinity Advantage |
$8,466.25
|
| Rate for Payer: Cofinity Commercial |
$10,401.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,675.72
|
| Rate for Payer: Healthscope Commercial |
$10,885.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,466.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,070.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,675.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,280.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,070.99
|
| Rate for Payer: PHP Commercial |
$10,280.45
|
| Rate for Payer: Priority Health SBD |
$7,619.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,861.52
|
| Rate for Payer: UHC Core |
$6,301.31
|
| Rate for Payer: UHC Exchange |
$4,753.20
|
| Rate for Payer: UMR Bronson Commercial |
$4,475.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,070.99
|
|
|
HC CATHETER PRESSURE GENERATING ONE WAY INTERMED OCCLUSIVE
|
Facility
|
IP
|
$12,094.65
|
|
|
Service Code
|
CPT C1982
|
| Hospital Charge Code |
27800147
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,321.65 |
| Max. Negotiated Rate |
$10,885.18 |
| Rate for Payer: Aetna American Axle |
$7,861.52
|
| Rate for Payer: Aetna Commercial |
$10,280.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,861.52
|
| Rate for Payer: Cash Price |
$9,675.72
|
| Rate for Payer: Cofinity Advantage |
$8,466.25
|
| Rate for Payer: Cofinity Commercial |
$10,401.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,675.72
|
| Rate for Payer: Healthscope Commercial |
$10,885.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,466.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,070.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,280.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,070.99
|
| Rate for Payer: PHP Commercial |
$10,280.45
|
| Rate for Payer: Priority Health SBD |
$7,619.63
|
| Rate for Payer: UMR Bronson Commercial |
$5,321.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,070.99
|
|
|
HC CATHETER SINGLE
|
Facility
|
IP
|
$194.37
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200018
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$85.52 |
| Max. Negotiated Rate |
$174.93 |
| Rate for Payer: Aetna American Axle |
$126.34
|
| Rate for Payer: Aetna Commercial |
$165.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.34
|
| Rate for Payer: Cash Price |
$155.50
|
| Rate for Payer: Cofinity Advantage |
$136.06
|
| Rate for Payer: Cofinity Commercial |
$167.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.50
|
| Rate for Payer: Healthscope Commercial |
$174.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.78
|
| Rate for Payer: PHP Commercial |
$165.21
|
| Rate for Payer: Priority Health SBD |
$122.45
|
| Rate for Payer: UMR Bronson Commercial |
$85.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.78
|
|
|
HC CATHETER SINGLE
|
Facility
|
OP
|
$194.37
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200018
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$71.92 |
| Max. Negotiated Rate |
$174.93 |
| Rate for Payer: Aetna American Axle |
$126.34
|
| Rate for Payer: Aetna Commercial |
$165.21
|
| Rate for Payer: Aetna Medicare |
$97.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.34
|
| Rate for Payer: BCBS Complete |
$77.75
|
| Rate for Payer: Cash Price |
$155.50
|
| Rate for Payer: Cofinity Advantage |
$136.06
|
| Rate for Payer: Cofinity Commercial |
$167.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.50
|
| Rate for Payer: Healthscope Commercial |
$174.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$155.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.78
|
| Rate for Payer: PHP Commercial |
$165.21
|
| Rate for Payer: Priority Health SBD |
$122.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.34
|
| Rate for Payer: UHC Core |
$101.27
|
| Rate for Payer: UHC Exchange |
$76.39
|
| Rate for Payer: UMR Bronson Commercial |
$71.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.78
|
|
|
HC CATHETER TLA DRUG COATED NON LASER
|
Facility
|
IP
|
$1,671.40
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27200302
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$735.42 |
| Max. Negotiated Rate |
$1,504.26 |
| Rate for Payer: Aetna American Axle |
$1,086.41
|
| Rate for Payer: Aetna Commercial |
$1,420.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,086.41
|
| Rate for Payer: Cash Price |
$1,337.12
|
| Rate for Payer: Cofinity Advantage |
$1,169.98
|
| Rate for Payer: Cofinity Commercial |
$1,437.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,337.12
|
| Rate for Payer: Healthscope Commercial |
$1,504.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,169.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,253.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,420.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,253.55
|
| Rate for Payer: PHP Commercial |
$1,420.69
|
| Rate for Payer: Priority Health SBD |
$1,052.98
|
| Rate for Payer: UMR Bronson Commercial |
$735.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,253.55
|
|
|
HC CATHETER TLA DRUG COATED NON LASER
|
Facility
|
OP
|
$1,671.40
|
|
|
Service Code
|
HCPCS C2623
|
| Hospital Charge Code |
27200302
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$618.42 |
| Max. Negotiated Rate |
$1,504.26 |
| Rate for Payer: Aetna American Axle |
$1,086.41
|
| Rate for Payer: Aetna Commercial |
$1,420.69
|
| Rate for Payer: Aetna Medicare |
$835.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,086.41
|
| Rate for Payer: BCBS Complete |
$668.56
|
| Rate for Payer: Cash Price |
$1,337.12
|
| Rate for Payer: Cofinity Advantage |
$1,169.98
|
| Rate for Payer: Cofinity Commercial |
$1,437.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,337.12
|
| Rate for Payer: Healthscope Commercial |
$1,504.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,169.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,253.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,337.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,420.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,253.55
|
| Rate for Payer: PHP Commercial |
$1,420.69
|
| Rate for Payer: Priority Health SBD |
$1,052.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,086.41
|
| Rate for Payer: UHC Core |
$870.80
|
| Rate for Payer: UHC Exchange |
$656.86
|
| Rate for Payer: UMR Bronson Commercial |
$618.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,253.55
|
|
|
HC CATHETER TRANSLUM ATHERECT DIRECTIONAL
|
Facility
|
OP
|
$7,849.99
|
|
|
Service Code
|
HCPCS C1714
|
| Hospital Charge Code |
27200294
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$7,064.99 |
| Rate for Payer: Aetna American Axle |
$5,102.49
|
| Rate for Payer: Aetna Commercial |
$6,672.49
|
| Rate for Payer: Aetna Medicare |
$3,924.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,102.49
|
| Rate for Payer: BCBS Complete |
$3,140.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$6,279.99
|
| Rate for Payer: Cash Price |
$6,279.99
|
| Rate for Payer: Cofinity Advantage |
$5,494.99
|
| Rate for Payer: Cofinity Commercial |
$6,750.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,279.99
|
| Rate for Payer: Healthscope Commercial |
$7,064.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,494.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,887.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,279.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,672.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,887.49
|
| Rate for Payer: PHP Commercial |
$6,672.49
|
| Rate for Payer: Priority Health SBD |
$4,945.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,102.49
|
| Rate for Payer: UHC Core |
$4,089.84
|
| Rate for Payer: UHC Exchange |
$3,085.05
|
| Rate for Payer: UMR Bronson Commercial |
$2,904.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,887.49
|
|
|
HC CATHETER TRANSLUM ATHERECT DIRECTIONAL
|
Facility
|
IP
|
$7,849.99
|
|
|
Service Code
|
HCPCS C1714
|
| Hospital Charge Code |
27200294
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,454.00 |
| Max. Negotiated Rate |
$7,064.99 |
| Rate for Payer: Aetna American Axle |
$5,102.49
|
| Rate for Payer: Aetna Commercial |
$6,672.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,102.49
|
| Rate for Payer: Cash Price |
$6,279.99
|
| Rate for Payer: Cofinity Advantage |
$5,494.99
|
| Rate for Payer: Cofinity Commercial |
$6,750.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,279.99
|
| Rate for Payer: Healthscope Commercial |
$7,064.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,494.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,887.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,672.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,887.49
|
| Rate for Payer: PHP Commercial |
$6,672.49
|
| Rate for Payer: Priority Health SBD |
$4,945.49
|
| Rate for Payer: UMR Bronson Commercial |
$3,454.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,887.49
|
|
|
HC CATHETER TRANSLUM INTRAVAS LITHOTRIPSY CORONARY
|
Facility
|
OP
|
$9,904.61
|
|
|
Service Code
|
CPT C1761
|
| Hospital Charge Code |
27200350
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,664.71 |
| Max. Negotiated Rate |
$8,914.15 |
| Rate for Payer: Aetna American Axle |
$6,438.00
|
| Rate for Payer: Aetna Commercial |
$8,418.92
|
| Rate for Payer: Aetna Medicare |
$4,952.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,438.00
|
| Rate for Payer: BCBS Complete |
$3,961.84
|
| Rate for Payer: Cash Price |
$7,923.69
|
| Rate for Payer: Cofinity Advantage |
$6,933.23
|
| Rate for Payer: Cofinity Commercial |
$8,517.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,923.69
|
| Rate for Payer: Healthscope Commercial |
$8,914.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,933.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,428.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,923.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,418.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,428.46
|
| Rate for Payer: PHP Commercial |
$8,418.92
|
| Rate for Payer: Priority Health SBD |
$6,239.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,438.00
|
| Rate for Payer: UHC Core |
$5,160.30
|
| Rate for Payer: UHC Exchange |
$3,892.51
|
| Rate for Payer: UMR Bronson Commercial |
$3,664.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,428.46
|
|
|
HC CATHETER TRANSLUM INTRAVAS LITHOTRIPSY CORONARY
|
Facility
|
IP
|
$9,904.61
|
|
|
Service Code
|
CPT C1761
|
| Hospital Charge Code |
27200350
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,358.03 |
| Max. Negotiated Rate |
$8,914.15 |
| Rate for Payer: Aetna American Axle |
$6,438.00
|
| Rate for Payer: Aetna Commercial |
$8,418.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,438.00
|
| Rate for Payer: Cash Price |
$7,923.69
|
| Rate for Payer: Cofinity Advantage |
$6,933.23
|
| Rate for Payer: Cofinity Commercial |
$8,517.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,923.69
|
| Rate for Payer: Healthscope Commercial |
$8,914.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,933.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,428.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,418.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,428.46
|
| Rate for Payer: PHP Commercial |
$8,418.92
|
| Rate for Payer: Priority Health SBD |
$6,239.90
|
| Rate for Payer: UMR Bronson Commercial |
$4,358.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,428.46
|
|
