|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
OP
|
$386.21
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$39.59 |
| Max. Negotiated Rate |
$909.03 |
| Rate for Payer: Aetna American Axle |
$251.04
|
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare |
$300.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.52
|
| Rate for Payer: BCBS Complete |
$162.77
|
| Rate for Payer: BCBS MAPPO |
$289.22
|
| Rate for Payer: BCBS Trust/PPO |
$44.17
|
| Rate for Payer: BCN Commercial |
$44.17
|
| Rate for Payer: BCN Medicare Advantage |
$289.22
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cofinity Commercial |
$332.14
|
| Rate for Payer: Cofinity Commercial |
$270.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$270.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.22
|
| Rate for Payer: Healthscope Commercial |
$347.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$270.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.66
|
| Rate for Payer: Mclaren Medicaid |
$155.02
|
| Rate for Payer: Mclaren Medicare |
$289.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.68
|
| Rate for Payer: Meridian Medicaid |
$162.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.28
|
| Rate for Payer: Nomi Health Commercial |
$607.36
|
| Rate for Payer: PACE Medicare |
$274.76
|
| Rate for Payer: PACE SWMI |
$289.22
|
| Rate for Payer: PHP Commercial |
$328.28
|
| Rate for Payer: PHP Medicare Advantage |
$289.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.03
|
| Rate for Payer: Priority Health Medicare |
$289.22
|
| Rate for Payer: Priority Health Narrow Network |
$727.22
|
| Rate for Payer: Priority Health SBD |
$243.31
|
| Rate for Payer: Railroad Medicare Medicare |
$289.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.55
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$289.22
|
| Rate for Payer: UHC Exchange |
$39.59
|
| Rate for Payer: UHC Medicare Advantage |
$289.22
|
| Rate for Payer: UHCCP Medicaid |
$155.02
|
| Rate for Payer: UMR Bronson Commercial |
$142.90
|
| Rate for Payer: VA VA |
$289.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.66
|
|
|
HC ASPIRATE/INJ GANGLION CYST
|
Facility
|
IP
|
$386.21
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
76100209
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$169.93 |
| Max. Negotiated Rate |
$347.59 |
| Rate for Payer: Aetna American Axle |
$251.04
|
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.04
|
| Rate for Payer: Cash Price |
$308.97
|
| Rate for Payer: Cofinity Commercial |
$270.35
|
| Rate for Payer: Cofinity Commercial |
$332.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$270.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.97
|
| Rate for Payer: Healthscope Commercial |
$347.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$270.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.28
|
| Rate for Payer: PHP Commercial |
$328.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$251.04
|
| Rate for Payer: Priority Health SBD |
$243.31
|
| Rate for Payer: UMR Bronson Commercial |
$169.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.66
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
IP
|
$3,128.23
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,376.42 |
| Max. Negotiated Rate |
$2,815.41 |
| Rate for Payer: Aetna American Axle |
$2,033.35
|
| Rate for Payer: Aetna Commercial |
$2,659.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,033.35
|
| Rate for Payer: Cash Price |
$2,502.58
|
| Rate for Payer: Cofinity Commercial |
$2,189.76
|
| Rate for Payer: Cofinity Commercial |
$2,690.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,189.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,502.58
|
| Rate for Payer: Healthscope Commercial |
$2,815.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,189.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,346.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,659.00
|
| Rate for Payer: PHP Commercial |
$2,659.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.35
|
| Rate for Payer: Priority Health SBD |
$1,970.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,376.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,346.17
|
|
|
HC ASPIRATION BLADDER WITH CATHETHER
|
Facility
|
OP
|
$3,128.23
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
36100250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$136.41 |
| Max. Negotiated Rate |
$6,308.24 |
| Rate for Payer: Aetna American Axle |
$2,033.35
|
| Rate for Payer: Aetna Commercial |
$2,659.00
|
| Rate for Payer: Aetna Medicare |
$2,087.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,033.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,439.79
|
| Rate for Payer: BCN Commercial |
$1,439.79
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$2,502.58
|
| Rate for Payer: Cash Price |
$2,502.58
|
| Rate for Payer: Cash Price |
$2,502.58
|
| Rate for Payer: Cofinity Commercial |
$2,690.28
|
| Rate for Payer: Cofinity Commercial |
$2,189.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,189.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,502.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$2,815.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,189.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,346.17
|
| Rate for Payer: Mclaren Medicaid |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,659.00
|
| Rate for Payer: Nomi Health Commercial |
$4,214.89
|
| Rate for Payer: PACE Medicare |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Commercial |
$2,659.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,308.24
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$5,046.59
|
| Rate for Payer: Priority Health SBD |
$1,970.78
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.05
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$136.41
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,157.45
|
| Rate for Payer: VA VA |
$2,007.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,346.17
|
|
|
HC ASPIRATION CYST OVARIAN ABDOMINAL APPROACH UNI OR BIL
|
Facility
|
OP
|
$4,334.38
|
|
|
Service Code
|
CPT 58805
|
| Hospital Charge Code |
36100258
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$415.34 |
| Max. Negotiated Rate |
$9,791.14 |
| Rate for Payer: Aetna American Axle |
$2,817.35
|
| Rate for Payer: Aetna Commercial |
$3,684.22
|
| Rate for Payer: Aetna Medicare |
$3,239.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,817.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,937.53
|
| Rate for Payer: BCN Commercial |
$1,937.53
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$3,467.50
|
| Rate for Payer: Cash Price |
$3,467.50
|
| Rate for Payer: Cash Price |
$3,467.50
|
| Rate for Payer: Cofinity Commercial |
$3,727.57
|
| Rate for Payer: Cofinity Commercial |
$3,034.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,034.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,467.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$3,900.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,034.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,250.78
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,684.22
|
| Rate for Payer: Nomi Health Commercial |
$6,542.00
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$3,684.22
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,817.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,791.14
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$7,832.91
|
| Rate for Payer: Priority Health SBD |
$2,730.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$456.87
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$415.34
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,603.72
|
| Rate for Payer: VA VA |
$3,115.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,250.78
|
|
|
HC ASPIRATION CYST OVARIAN ABDOMINAL APPROACH UNI OR BIL
|
Facility
|
IP
|
$4,334.38
|
|
|
Service Code
|
CPT 58805
|
| Hospital Charge Code |
36100258
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,907.13 |
| Max. Negotiated Rate |
$3,900.94 |
| Rate for Payer: Aetna American Axle |
$2,817.35
|
| Rate for Payer: Aetna Commercial |
$3,684.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,817.35
|
| Rate for Payer: Cash Price |
$3,467.50
|
| Rate for Payer: Cofinity Commercial |
$3,034.07
|
| Rate for Payer: Cofinity Commercial |
$3,727.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,034.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,467.50
|
| Rate for Payer: Healthscope Commercial |
$3,900.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,034.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,250.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,684.22
|
| Rate for Payer: PHP Commercial |
$3,684.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,817.35
|
| Rate for Payer: Priority Health SBD |
$2,730.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,907.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,250.78
|
|
|
HC ASPIRATION CYST OVARIAN VAGINAL APPROACH UNI OR BIL
|
Facility
|
IP
|
$2,544.30
|
|
|
Service Code
|
CPT 58800
|
| Hospital Charge Code |
36100257
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,119.49 |
| Max. Negotiated Rate |
$2,289.87 |
| Rate for Payer: Aetna American Axle |
$1,653.80
|
| Rate for Payer: Aetna Commercial |
$2,162.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,653.80
|
| Rate for Payer: Cash Price |
$2,035.44
|
| Rate for Payer: Cofinity Commercial |
$1,781.01
|
| Rate for Payer: Cofinity Commercial |
$2,188.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,781.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,035.44
|
| Rate for Payer: Healthscope Commercial |
$2,289.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,781.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,908.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,162.66
|
| Rate for Payer: PHP Commercial |
$2,162.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,653.80
|
| Rate for Payer: Priority Health SBD |
$1,602.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,119.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,908.22
|
|
|
HC ASPIRATION CYST OVARIAN VAGINAL APPROACH UNI OR BIL
|
Facility
|
OP
|
$2,544.30
|
|
|
Service Code
|
CPT 58800
|
| Hospital Charge Code |
36100257
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$305.63 |
| Max. Negotiated Rate |
$9,791.14 |
| Rate for Payer: Aetna American Axle |
$1,653.80
|
| Rate for Payer: Aetna Commercial |
$2,162.66
|
| Rate for Payer: Aetna Medicare |
$3,239.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,653.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,660.74
|
| Rate for Payer: BCN Commercial |
$1,660.74
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$2,035.44
|
| Rate for Payer: Cash Price |
$2,035.44
|
| Rate for Payer: Cash Price |
$2,035.44
|
| Rate for Payer: Cofinity Commercial |
$2,188.10
|
| Rate for Payer: Cofinity Commercial |
$1,781.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,781.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,035.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$2,289.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,781.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,908.22
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,162.66
|
| Rate for Payer: Nomi Health Commercial |
$6,542.00
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$2,162.66
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,653.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,791.14
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$7,832.91
|
| Rate for Payer: Priority Health SBD |
$1,602.91
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.19
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$305.63
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: UMR Bronson Commercial |
$941.39
|
| Rate for Payer: VA VA |
$3,115.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,908.22
|
|
|
HC ASPIRATION DISK
|
Facility
|
IP
|
$4,614.21
|
|
|
Service Code
|
CPT 62287
|
| Hospital Charge Code |
32000003
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,030.25 |
| Max. Negotiated Rate |
$4,152.79 |
| Rate for Payer: Aetna American Axle |
$2,999.24
|
| Rate for Payer: Aetna Commercial |
$3,922.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,999.24
|
| Rate for Payer: Cash Price |
$3,691.37
|
| Rate for Payer: Cofinity Commercial |
$3,229.95
|
| Rate for Payer: Cofinity Commercial |
$3,968.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,229.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,691.37
|
| Rate for Payer: Healthscope Commercial |
$4,152.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,229.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,460.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,922.08
|
| Rate for Payer: PHP Commercial |
$3,922.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,999.24
|
| Rate for Payer: Priority Health SBD |
$2,906.95
|
| Rate for Payer: UMR Bronson Commercial |
$2,030.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,460.66
|
|
|
HC ASPIRATION DISK
|
Facility
|
OP
|
$4,614.21
|
|
|
Service Code
|
CPT 62287
|
| Hospital Charge Code |
32000003
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$574.18 |
| Max. Negotiated Rate |
$6,013.44 |
| Rate for Payer: Aetna American Axle |
$2,999.24
|
| Rate for Payer: Aetna Commercial |
$3,922.08
|
| Rate for Payer: Aetna Medicare |
$1,989.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,999.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,391.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,391.60
|
| Rate for Payer: BCBS Complete |
$1,076.79
|
| Rate for Payer: BCBS MAPPO |
$1,913.28
|
| Rate for Payer: BCBS Trust/PPO |
$2,938.56
|
| Rate for Payer: BCN Commercial |
$2,938.56
|
| Rate for Payer: BCN Medicare Advantage |
$1,913.28
|
| Rate for Payer: Cash Price |
$3,691.37
|
| Rate for Payer: Cash Price |
$3,691.37
|
| Rate for Payer: Cash Price |
$3,691.37
|
| Rate for Payer: Cofinity Commercial |
$3,968.22
|
| Rate for Payer: Cofinity Commercial |
$3,229.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,229.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,691.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,913.28
|
| Rate for Payer: Healthscope Commercial |
$4,152.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,229.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,460.66
|
| Rate for Payer: Mclaren Medicaid |
$1,025.52
|
| Rate for Payer: Mclaren Medicare |
$1,913.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,008.94
|
| Rate for Payer: Meridian Medicaid |
$1,076.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,200.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,922.08
|
| Rate for Payer: Nomi Health Commercial |
$4,017.89
|
| Rate for Payer: PACE Medicare |
$1,817.62
|
| Rate for Payer: PACE SWMI |
$1,913.28
|
| Rate for Payer: PHP Commercial |
$3,922.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,913.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,999.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,013.44
|
| Rate for Payer: Priority Health Medicare |
$1,913.28
|
| Rate for Payer: Priority Health Narrow Network |
$4,810.75
|
| Rate for Payer: Priority Health SBD |
$2,906.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,913.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$631.60
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,913.28
|
| Rate for Payer: UHC Exchange |
$574.18
|
| Rate for Payer: UHC Medicare Advantage |
$1,913.28
|
| Rate for Payer: UHCCP Medicaid |
$1,025.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,707.26
|
| Rate for Payer: VA VA |
$1,913.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,460.66
|
|
|
HC ASPIRATION SIMPLE
|
Facility
|
IP
|
$414.53
|
|
| Hospital Charge Code |
45000031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$182.39 |
| Max. Negotiated Rate |
$373.08 |
| Rate for Payer: Aetna American Axle |
$269.44
|
| Rate for Payer: Aetna Commercial |
$352.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.44
|
| Rate for Payer: Cash Price |
$331.62
|
| Rate for Payer: Cofinity Commercial |
$290.17
|
| Rate for Payer: Cofinity Commercial |
$356.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$290.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.62
|
| Rate for Payer: Healthscope Commercial |
$373.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$290.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.35
|
| Rate for Payer: PHP Commercial |
$352.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.44
|
| Rate for Payer: Priority Health SBD |
$261.15
|
| Rate for Payer: UMR Bronson Commercial |
$182.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.90
|
|
|
HC ASPIRATION SIMPLE
|
Facility
|
OP
|
$414.53
|
|
| Hospital Charge Code |
45000031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$153.38 |
| Max. Negotiated Rate |
$373.08 |
| Rate for Payer: Aetna American Axle |
$269.44
|
| Rate for Payer: Aetna Commercial |
$352.35
|
| Rate for Payer: Aetna Medicare |
$207.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.44
|
| Rate for Payer: BCBS Complete |
$165.81
|
| Rate for Payer: Cash Price |
$331.62
|
| Rate for Payer: Cofinity Commercial |
$290.17
|
| Rate for Payer: Cofinity Commercial |
$356.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$290.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.62
|
| Rate for Payer: Healthscope Commercial |
$373.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$290.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.35
|
| Rate for Payer: PHP Commercial |
$352.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.44
|
| Rate for Payer: Priority Health SBD |
$261.15
|
| Rate for Payer: UMR Bronson Commercial |
$153.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.90
|
|
|
HC ASPIRATION THYROID CYST
|
Facility
|
IP
|
$493.85
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
36100266
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$217.29 |
| Max. Negotiated Rate |
$444.46 |
| Rate for Payer: Aetna American Axle |
$321.00
|
| Rate for Payer: Aetna Commercial |
$419.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.00
|
| Rate for Payer: Cash Price |
$395.08
|
| Rate for Payer: Cofinity Commercial |
$345.70
|
| Rate for Payer: Cofinity Commercial |
$424.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$345.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.08
|
| Rate for Payer: Healthscope Commercial |
$444.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$345.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.77
|
| Rate for Payer: PHP Commercial |
$419.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.00
|
| Rate for Payer: Priority Health SBD |
$311.13
|
| Rate for Payer: UMR Bronson Commercial |
$217.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.39
|
|
|
HC ASPIRATION THYROID CYST
|
Facility
|
OP
|
$493.85
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
36100266
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$46.34 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna American Axle |
$321.00
|
| Rate for Payer: Aetna Commercial |
$419.77
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$108.28
|
| Rate for Payer: BCN Commercial |
$108.28
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$395.08
|
| Rate for Payer: Cash Price |
$395.08
|
| Rate for Payer: Cash Price |
$395.08
|
| Rate for Payer: Cofinity Commercial |
$424.71
|
| Rate for Payer: Cofinity Commercial |
$345.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$345.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$444.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$345.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.39
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.77
|
| Rate for Payer: Nomi Health Commercial |
$1,447.66
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$419.77
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$321.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$311.13
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.97
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$46.34
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: UMR Bronson Commercial |
$182.72
|
| Rate for Payer: VA VA |
$689.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.39
|
|
|
HC ASSMT & CARE PLN PT COG IMP
|
Facility
|
OP
|
$233.68
|
|
|
Service Code
|
CPT 99483
|
| Hospital Charge Code |
51000106
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.58 |
| Max. Negotiated Rate |
$420.51 |
| Rate for Payer: Aetna American Axle |
$151.89
|
| Rate for Payer: Aetna Commercial |
$198.63
|
| Rate for Payer: Aetna Medicare |
$94.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.29
|
| Rate for Payer: BCBS Complete |
$51.01
|
| Rate for Payer: BCBS MAPPO |
$90.63
|
| Rate for Payer: BCBS Trust/PPO |
$420.51
|
| Rate for Payer: BCN Commercial |
$420.51
|
| Rate for Payer: BCN Medicare Advantage |
$90.63
|
| Rate for Payer: Cash Price |
$186.94
|
| Rate for Payer: Cash Price |
$186.94
|
| Rate for Payer: Cofinity Commercial |
$200.96
|
| Rate for Payer: Cofinity Commercial |
$163.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$163.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.63
|
| Rate for Payer: Healthscope Commercial |
$210.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$163.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.26
|
| Rate for Payer: Mclaren Medicaid |
$48.58
|
| Rate for Payer: Mclaren Medicare |
$90.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.16
|
| Rate for Payer: Meridian Medicaid |
$51.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.63
|
| Rate for Payer: Nomi Health Commercial |
$271.89
|
| Rate for Payer: PACE Medicare |
$86.10
|
| Rate for Payer: PACE SWMI |
$90.63
|
| Rate for Payer: PHP Commercial |
$198.63
|
| Rate for Payer: PHP Medicare Advantage |
$90.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$284.86
|
| Rate for Payer: Priority Health Medicare |
$90.63
|
| Rate for Payer: Priority Health Narrow Network |
$227.89
|
| Rate for Payer: Priority Health SBD |
$147.22
|
| Rate for Payer: Railroad Medicare Medicare |
$90.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.63
|
| Rate for Payer: UHC Exchange |
$184.65
|
| Rate for Payer: UHC Medicare Advantage |
$90.63
|
| Rate for Payer: UHCCP Medicaid |
$48.58
|
| Rate for Payer: UMR Bronson Commercial |
$86.46
|
| Rate for Payer: VA VA |
$90.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.26
|
|
|
HC ASSMT & CARE PLN PT COG IMP
|
Facility
|
IP
|
$233.68
|
|
|
Service Code
|
CPT 99483
|
| Hospital Charge Code |
51000106
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$102.82 |
| Max. Negotiated Rate |
$210.31 |
| Rate for Payer: Aetna American Axle |
$151.89
|
| Rate for Payer: Aetna Commercial |
$198.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.89
|
| Rate for Payer: Cash Price |
$186.94
|
| Rate for Payer: Cofinity Commercial |
$163.58
|
| Rate for Payer: Cofinity Commercial |
$200.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$163.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.94
|
| Rate for Payer: Healthscope Commercial |
$210.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$163.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.63
|
| Rate for Payer: PHP Commercial |
$198.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.89
|
| Rate for Payer: Priority Health SBD |
$147.22
|
| Rate for Payer: UMR Bronson Commercial |
$102.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.26
|
|
|
HC ASTIGMATISM CORRECT FXN IOL
|
Facility
|
IP
|
$1,605.35
|
|
|
Service Code
|
HCPCS V2787
|
| Hospital Charge Code |
27600002
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$706.35 |
| Max. Negotiated Rate |
$1,444.82 |
| Rate for Payer: Aetna American Axle |
$1,043.48
|
| Rate for Payer: Aetna Commercial |
$1,364.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,043.48
|
| Rate for Payer: Cash Price |
$1,284.28
|
| Rate for Payer: Cofinity Commercial |
$1,123.74
|
| Rate for Payer: Cofinity Commercial |
$1,380.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,123.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,284.28
|
| Rate for Payer: Healthscope Commercial |
$1,444.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,123.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,204.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,364.55
|
| Rate for Payer: PHP Commercial |
$1,364.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,043.48
|
| Rate for Payer: Priority Health SBD |
$1,011.37
|
| Rate for Payer: UMR Bronson Commercial |
$706.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,204.01
|
|
|
HC ASTIGMATISM CORRECT FXN IOL
|
Facility
|
OP
|
$1,605.35
|
|
|
Service Code
|
HCPCS V2787
|
| Hospital Charge Code |
27600002
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$593.98 |
| Max. Negotiated Rate |
$1,444.82 |
| Rate for Payer: Aetna American Axle |
$1,043.48
|
| Rate for Payer: Aetna Commercial |
$1,364.55
|
| Rate for Payer: Aetna Medicare |
$802.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,043.48
|
| Rate for Payer: BCBS Complete |
$642.14
|
| Rate for Payer: Cash Price |
$1,284.28
|
| Rate for Payer: Cofinity Commercial |
$1,123.74
|
| Rate for Payer: Cofinity Commercial |
$1,380.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,123.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,284.28
|
| Rate for Payer: Healthscope Commercial |
$1,444.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,123.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,204.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,364.55
|
| Rate for Payer: PHP Commercial |
$1,364.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,043.48
|
| Rate for Payer: Priority Health SBD |
$1,011.37
|
| Rate for Payer: UMR Bronson Commercial |
$593.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,204.01
|
|
|
HC ATHERECT ABDOMINAL AORTA
|
Facility
|
OP
|
$14,889.58
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
36100300
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,509.14 |
| Max. Negotiated Rate |
$34,922.52 |
| Rate for Payer: Aetna American Axle |
$9,678.23
|
| Rate for Payer: Aetna Commercial |
$12,656.14
|
| Rate for Payer: Aetna Medicare |
$11,555.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,678.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$9,108.64
|
| Rate for Payer: BCN Commercial |
$9,108.64
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cofinity Commercial |
$12,805.04
|
| Rate for Payer: Cofinity Commercial |
$10,422.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$10,422.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,911.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$13,400.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,422.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,167.18
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,656.14
|
| Rate for Payer: Nomi Health Commercial |
$23,333.65
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$12,656.14
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,678.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34,922.52
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$27,938.02
|
| Rate for Payer: Priority Health SBD |
$9,380.44
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,277.09
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$21,234.73
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: UMR Bronson Commercial |
$5,509.14
|
| Rate for Payer: VA VA |
$11,111.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,167.18
|
|
|
HC ATHERECT ABDOMINAL AORTA
|
Facility
|
IP
|
$14,889.58
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
36100300
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,551.42 |
| Max. Negotiated Rate |
$13,400.62 |
| Rate for Payer: Aetna American Axle |
$9,678.23
|
| Rate for Payer: Aetna Commercial |
$12,656.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,678.23
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cofinity Commercial |
$10,422.71
|
| Rate for Payer: Cofinity Commercial |
$12,805.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$10,422.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,911.66
|
| Rate for Payer: Healthscope Commercial |
$13,400.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,422.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,167.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,656.14
|
| Rate for Payer: PHP Commercial |
$12,656.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,678.23
|
| Rate for Payer: Priority Health SBD |
$9,380.44
|
| Rate for Payer: UMR Bronson Commercial |
$6,551.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,167.18
|
|
|
HC ATHERECT BRACHIOCEPHAL EA V
|
Facility
|
OP
|
$14,889.58
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
36100301
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,509.14 |
| Max. Negotiated Rate |
$34,922.52 |
| Rate for Payer: Aetna American Axle |
$9,678.23
|
| Rate for Payer: Aetna Commercial |
$12,656.14
|
| Rate for Payer: Aetna Medicare |
$11,555.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,678.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$9,108.64
|
| Rate for Payer: BCN Commercial |
$9,108.64
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cofinity Commercial |
$12,805.04
|
| Rate for Payer: Cofinity Commercial |
$10,422.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$10,422.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,911.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$13,400.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,422.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,167.18
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,656.14
|
| Rate for Payer: Nomi Health Commercial |
$23,333.65
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$12,656.14
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,678.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34,922.52
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$27,938.02
|
| Rate for Payer: Priority Health SBD |
$9,380.44
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,277.09
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$21,234.73
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: UMR Bronson Commercial |
$5,509.14
|
| Rate for Payer: VA VA |
$11,111.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,167.18
|
|
|
HC ATHERECT BRACHIOCEPHAL EA V
|
Facility
|
IP
|
$14,889.58
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
36100301
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,551.42 |
| Max. Negotiated Rate |
$13,400.62 |
| Rate for Payer: Aetna American Axle |
$9,678.23
|
| Rate for Payer: Aetna Commercial |
$12,656.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,678.23
|
| Rate for Payer: Cash Price |
$11,911.66
|
| Rate for Payer: Cofinity Commercial |
$10,422.71
|
| Rate for Payer: Cofinity Commercial |
$12,805.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$10,422.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,911.66
|
| Rate for Payer: Healthscope Commercial |
$13,400.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,422.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,167.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,656.14
|
| Rate for Payer: PHP Commercial |
$12,656.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,678.23
|
| Rate for Payer: Priority Health SBD |
$9,380.44
|
| Rate for Payer: UMR Bronson Commercial |
$6,551.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,167.18
|
|
|
HC ATHERECT ILIAC ARTERY EA VE
|
Facility
|
OP
|
$12,085.44
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
36100302
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,471.61 |
| Max. Negotiated Rate |
$55,296.52 |
| Rate for Payer: Aetna American Axle |
$7,855.54
|
| Rate for Payer: Aetna Commercial |
$10,272.62
|
| Rate for Payer: Aetna Medicare |
$18,297.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,855.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,992.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,992.05
|
| Rate for Payer: BCBS Complete |
$9,901.70
|
| Rate for Payer: BCBS MAPPO |
$17,593.64
|
| Rate for Payer: BCBS Trust/PPO |
$14,011.12
|
| Rate for Payer: BCN Commercial |
$14,011.12
|
| Rate for Payer: BCN Medicare Advantage |
$17,593.64
|
| Rate for Payer: Cash Price |
$9,668.35
|
| Rate for Payer: Cash Price |
$9,668.35
|
| Rate for Payer: Cash Price |
$9,668.35
|
| Rate for Payer: Cofinity Commercial |
$8,459.81
|
| Rate for Payer: Cofinity Commercial |
$10,393.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,459.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,668.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,593.64
|
| Rate for Payer: Healthscope Commercial |
$10,876.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,459.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,064.08
|
| Rate for Payer: Mclaren Medicaid |
$9,430.19
|
| Rate for Payer: Mclaren Medicare |
$17,593.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,473.32
|
| Rate for Payer: Meridian Medicaid |
$9,901.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,232.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,272.62
|
| Rate for Payer: Nomi Health Commercial |
$36,946.64
|
| Rate for Payer: PACE Medicare |
$16,713.96
|
| Rate for Payer: PACE SWMI |
$17,593.64
|
| Rate for Payer: PHP Commercial |
$10,272.62
|
| Rate for Payer: PHP Medicare Advantage |
$17,593.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,430.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,855.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55,296.52
|
| Rate for Payer: Priority Health Medicare |
$17,593.64
|
| Rate for Payer: Priority Health Narrow Network |
$44,237.22
|
| Rate for Payer: Priority Health SBD |
$7,613.83
|
| Rate for Payer: Railroad Medicare Medicare |
$17,593.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,524.34
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,593.64
|
| Rate for Payer: UHC Exchange |
$33,623.21
|
| Rate for Payer: UHC Medicare Advantage |
$17,593.64
|
| Rate for Payer: UHCCP Medicaid |
$9,430.19
|
| Rate for Payer: UMR Bronson Commercial |
$4,471.61
|
| Rate for Payer: VA VA |
$17,593.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,064.08
|
|
|
HC ATHERECT ILIAC ARTERY EA VE
|
Facility
|
IP
|
$12,085.44
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
36100302
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,317.59 |
| Max. Negotiated Rate |
$10,876.90 |
| Rate for Payer: Aetna American Axle |
$7,855.54
|
| Rate for Payer: Aetna Commercial |
$10,272.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,855.54
|
| Rate for Payer: Cash Price |
$9,668.35
|
| Rate for Payer: Cofinity Commercial |
$10,393.48
|
| Rate for Payer: Cofinity Commercial |
$8,459.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,459.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,668.35
|
| Rate for Payer: Healthscope Commercial |
$10,876.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,459.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,064.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,272.62
|
| Rate for Payer: PHP Commercial |
$10,272.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,855.54
|
| Rate for Payer: Priority Health SBD |
$7,613.83
|
| Rate for Payer: UMR Bronson Commercial |
$5,317.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,064.08
|
|
|
HC ATHERECTOMY RENAL ARTERY
|
Facility
|
OP
|
$12,970.49
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
36100304
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,799.08 |
| Max. Negotiated Rate |
$34,922.52 |
| Rate for Payer: Aetna American Axle |
$8,430.82
|
| Rate for Payer: Aetna Commercial |
$11,024.92
|
| Rate for Payer: Aetna Medicare |
$11,555.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,430.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$9,108.64
|
| Rate for Payer: BCN Commercial |
$9,108.64
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$10,376.39
|
| Rate for Payer: Cash Price |
$10,376.39
|
| Rate for Payer: Cash Price |
$10,376.39
|
| Rate for Payer: Cofinity Commercial |
$9,079.34
|
| Rate for Payer: Cofinity Commercial |
$11,154.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,079.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,376.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$11,673.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,079.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,727.87
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,024.92
|
| Rate for Payer: Nomi Health Commercial |
$23,333.65
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$11,024.92
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,430.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34,922.52
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$27,938.02
|
| Rate for Payer: Priority Health SBD |
$8,171.41
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,277.09
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$21,234.73
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: UMR Bronson Commercial |
$4,799.08
|
| Rate for Payer: VA VA |
$11,111.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,727.87
|
|
