|
HC IMMUNOHISTOCHEMISTRY EA ADDL STAIN PER SPECIMEN
|
Facility
|
OP
|
$150.27
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
31000118
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$54.56 |
| Max. Negotiated Rate |
$135.24 |
| Rate for Payer: Aetna American Axle |
$97.68
|
| Rate for Payer: Aetna Commercial |
$127.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.68
|
| Rate for Payer: BCBS Complete |
$60.11
|
| Rate for Payer: BCBS Trust/PPO |
$83.15
|
| Rate for Payer: BCCCP Commercial |
$86.77
|
| Rate for Payer: Cash Price |
$120.22
|
| Rate for Payer: Cash Price |
$120.22
|
| Rate for Payer: Cofinity Commercial |
$129.23
|
| Rate for Payer: Cofinity Commercial |
$105.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.22
|
| Rate for Payer: Healthscope Commercial |
$135.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.73
|
| Rate for Payer: PHP Commercial |
$127.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.19
|
| Rate for Payer: Priority Health SBD |
$94.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.97
|
| Rate for Payer: UHC Core |
$54.56
|
| Rate for Payer: UHC Exchange |
$89.06
|
| Rate for Payer: UMR Bronson Commercial |
$55.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.70
|
|
|
HC IMMUNOHISTOCHEMISTRY STAIN
|
Facility
|
IP
|
$170.02
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
31000058
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$74.81 |
| Max. Negotiated Rate |
$153.02 |
| Rate for Payer: Aetna American Axle |
$110.51
|
| Rate for Payer: Aetna Commercial |
$144.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.51
|
| Rate for Payer: Cash Price |
$136.02
|
| Rate for Payer: Cofinity Commercial |
$119.01
|
| Rate for Payer: Cofinity Commercial |
$146.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.02
|
| Rate for Payer: Healthscope Commercial |
$153.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$119.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$144.52
|
| Rate for Payer: PHP Commercial |
$144.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.01
|
| Rate for Payer: Priority Health SBD |
$107.11
|
| Rate for Payer: UMR Bronson Commercial |
$74.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.52
|
|
|
HC IMMUNOHISTOCHEMISTRY STAIN
|
Facility
|
OP
|
$170.02
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
31000058
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$45.72 |
| Max. Negotiated Rate |
$477.95 |
| Rate for Payer: Aetna American Axle |
$110.51
|
| Rate for Payer: Aetna Commercial |
$144.52
|
| Rate for Payer: Aetna Medicare |
$157.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.78
|
| Rate for Payer: BCBS Complete |
$87.21
|
| Rate for Payer: BCBS MAPPO |
$151.82
|
| Rate for Payer: BCBS Trust/PPO |
$93.60
|
| Rate for Payer: BCCCP Commercial |
$100.83
|
| Rate for Payer: BCN Medicare Advantage |
$151.82
|
| Rate for Payer: Cash Price |
$136.02
|
| Rate for Payer: Cash Price |
$136.02
|
| Rate for Payer: Cofinity Commercial |
$146.22
|
| Rate for Payer: Cofinity Commercial |
$119.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.82
|
| Rate for Payer: Healthscope Commercial |
$153.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$119.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.52
|
| Rate for Payer: Mclaren Medicaid |
$83.05
|
| Rate for Payer: Mclaren Medicare |
$151.82
|
| Rate for Payer: Meridian Medicaid |
$87.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$159.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$144.52
|
| Rate for Payer: PACE Medicare |
$144.23
|
| Rate for Payer: PACE SWMI |
$151.82
|
| Rate for Payer: PHP Commercial |
$144.52
|
| Rate for Payer: PHP Medicare Advantage |
$151.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$477.95
|
| Rate for Payer: Priority Health Medicare |
$151.82
|
| Rate for Payer: Priority Health Narrow Network |
$382.36
|
| Rate for Payer: Priority Health SBD |
$107.11
|
| Rate for Payer: Railroad Medicare Medicare |
$151.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.54
|
| Rate for Payer: UHC Core |
$45.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.82
|
| Rate for Payer: UHC Exchange |
$104.13
|
| Rate for Payer: UHC Medicare Advantage |
$156.37
|
| Rate for Payer: UMR Bronson Commercial |
$62.91
|
| Rate for Payer: VA VA |
$151.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.52
|
|
|
HC IMMUNOHISTOCHEMISTY MULTIPLEX STAINS
|
Facility
|
IP
|
$333.42
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
31000117
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$146.70 |
| Max. Negotiated Rate |
$300.08 |
| Rate for Payer: Aetna American Axle |
$216.72
|
| Rate for Payer: Aetna Commercial |
$283.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.72
|
| Rate for Payer: Cash Price |
$266.74
|
| Rate for Payer: Cofinity Commercial |
$233.39
|
| Rate for Payer: Cofinity Commercial |
$286.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.74
|
| Rate for Payer: Healthscope Commercial |
$300.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$283.41
|
| Rate for Payer: PHP Commercial |
$283.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.39
|
| Rate for Payer: Priority Health SBD |
$210.05
|
| Rate for Payer: UMR Bronson Commercial |
$146.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.06
|
|
|
HC IMMUNOHISTOCHEMISTY MULTIPLEX STAINS
|
Facility
|
OP
|
$333.42
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
31000117
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$92.36 |
| Max. Negotiated Rate |
$1,005.81 |
| Rate for Payer: Aetna American Axle |
$216.72
|
| Rate for Payer: Aetna Commercial |
$283.41
|
| Rate for Payer: Aetna Medicare |
$332.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$399.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$399.39
|
| Rate for Payer: BCBS Complete |
$183.53
|
| Rate for Payer: BCBS MAPPO |
$319.51
|
| Rate for Payer: BCBS Trust/PPO |
$185.30
|
| Rate for Payer: BCN Medicare Advantage |
$319.51
|
| Rate for Payer: Cash Price |
$266.74
|
| Rate for Payer: Cash Price |
$266.74
|
| Rate for Payer: Cofinity Commercial |
$286.74
|
| Rate for Payer: Cofinity Commercial |
$233.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.51
|
| Rate for Payer: Healthscope Commercial |
$300.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.06
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$319.51
|
| Rate for Payer: Meridian Medicaid |
$183.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$335.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$367.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$283.41
|
| Rate for Payer: PACE Medicare |
$303.53
|
| Rate for Payer: PACE SWMI |
$319.51
|
| Rate for Payer: PHP Commercial |
$283.41
|
| Rate for Payer: PHP Medicare Advantage |
$319.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,005.81
|
| Rate for Payer: Priority Health Medicare |
$319.51
|
| Rate for Payer: Priority Health Narrow Network |
$804.65
|
| Rate for Payer: Priority Health SBD |
$210.05
|
| Rate for Payer: Railroad Medicare Medicare |
$319.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.93
|
| Rate for Payer: UHC Core |
$92.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$319.51
|
| Rate for Payer: UHC Exchange |
$169.94
|
| Rate for Payer: UHC Medicare Advantage |
$329.10
|
| Rate for Payer: UMR Bronson Commercial |
$123.37
|
| Rate for Payer: VA VA |
$319.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.06
|
|
|
HC IMPELLA LVAD
|
Facility
|
OP
|
$45,321.17
|
|
| Hospital Charge Code |
27200132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16,768.83 |
| Max. Negotiated Rate |
$40,789.05 |
| Rate for Payer: Aetna American Axle |
$29,458.76
|
| Rate for Payer: Aetna Commercial |
$38,522.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29,458.76
|
| Rate for Payer: BCBS Complete |
$18,128.47
|
| Rate for Payer: Cash Price |
$36,256.94
|
| Rate for Payer: Cofinity Commercial |
$31,724.82
|
| Rate for Payer: Cofinity Commercial |
$38,976.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36,256.94
|
| Rate for Payer: Healthscope Commercial |
$40,789.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31,724.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33,990.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38,522.99
|
| Rate for Payer: PHP Commercial |
$38,522.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31,724.82
|
| Rate for Payer: Priority Health SBD |
$28,552.34
|
| Rate for Payer: UMR Bronson Commercial |
$16,768.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33,990.88
|
|
|
HC IMPELLA LVAD
|
Facility
|
IP
|
$45,321.17
|
|
| Hospital Charge Code |
27200132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19,941.31 |
| Max. Negotiated Rate |
$40,789.05 |
| Rate for Payer: Aetna American Axle |
$29,458.76
|
| Rate for Payer: Aetna Commercial |
$38,522.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29,458.76
|
| Rate for Payer: Cash Price |
$36,256.94
|
| Rate for Payer: Cofinity Commercial |
$31,724.82
|
| Rate for Payer: Cofinity Commercial |
$38,976.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36,256.94
|
| Rate for Payer: Healthscope Commercial |
$40,789.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31,724.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33,990.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38,522.99
|
| Rate for Payer: PHP Commercial |
$38,522.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31,724.82
|
| Rate for Payer: Priority Health SBD |
$28,552.34
|
| Rate for Payer: UMR Bronson Commercial |
$19,941.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33,990.88
|
|
|
HC IMPELLA MONITORING KIT
|
Facility
|
OP
|
$332.79
|
|
| Hospital Charge Code |
27200133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.13 |
| Max. Negotiated Rate |
$299.51 |
| Rate for Payer: Aetna American Axle |
$216.31
|
| Rate for Payer: Aetna Commercial |
$282.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.31
|
| Rate for Payer: BCBS Complete |
$133.12
|
| Rate for Payer: Cash Price |
$266.23
|
| Rate for Payer: Cofinity Commercial |
$232.95
|
| Rate for Payer: Cofinity Commercial |
$286.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.23
|
| Rate for Payer: Healthscope Commercial |
$299.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$232.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$282.87
|
| Rate for Payer: PHP Commercial |
$282.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.95
|
| Rate for Payer: Priority Health SBD |
$209.66
|
| Rate for Payer: UMR Bronson Commercial |
$123.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.59
|
|
|
HC IMPELLA MONITORING KIT
|
Facility
|
IP
|
$332.79
|
|
| Hospital Charge Code |
27200133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.43 |
| Max. Negotiated Rate |
$299.51 |
| Rate for Payer: Aetna American Axle |
$216.31
|
| Rate for Payer: Aetna Commercial |
$282.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.31
|
| Rate for Payer: Cash Price |
$266.23
|
| Rate for Payer: Cofinity Commercial |
$232.95
|
| Rate for Payer: Cofinity Commercial |
$286.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.23
|
| Rate for Payer: Healthscope Commercial |
$299.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$232.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$282.87
|
| Rate for Payer: PHP Commercial |
$282.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.95
|
| Rate for Payer: Priority Health SBD |
$209.66
|
| Rate for Payer: UMR Bronson Commercial |
$146.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.59
|
|
|
HC IMPELLA REMOVAL
|
Facility
|
IP
|
$2,873.12
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
48100114
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,264.17 |
| Max. Negotiated Rate |
$2,585.81 |
| Rate for Payer: Aetna American Axle |
$1,867.53
|
| Rate for Payer: Aetna Commercial |
$2,442.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,867.53
|
| Rate for Payer: Cash Price |
$2,298.50
|
| Rate for Payer: Cofinity Commercial |
$2,470.88
|
| Rate for Payer: Cofinity Commercial |
$2,011.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,298.50
|
| Rate for Payer: Healthscope Commercial |
$2,585.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,011.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,154.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,442.15
|
| Rate for Payer: PHP Commercial |
$2,442.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,011.18
|
| Rate for Payer: Priority Health SBD |
$1,810.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,264.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,154.84
|
|
|
HC IMPELLA REMOVAL
|
Facility
|
OP
|
$2,873.12
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
48100114
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$180.09 |
| Max. Negotiated Rate |
$2,585.81 |
| Rate for Payer: Aetna American Axle |
$1,867.53
|
| Rate for Payer: Aetna Commercial |
$2,442.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,867.53
|
| Rate for Payer: BCBS Complete |
$1,149.25
|
| Rate for Payer: BCBS Trust/PPO |
$703.54
|
| Rate for Payer: Cash Price |
$2,298.50
|
| Rate for Payer: Cash Price |
$2,298.50
|
| Rate for Payer: Cofinity Commercial |
$2,470.88
|
| Rate for Payer: Cofinity Commercial |
$2,011.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,298.50
|
| Rate for Payer: Healthscope Commercial |
$2,585.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,011.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,154.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,442.15
|
| Rate for Payer: PHP Commercial |
$2,442.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,011.18
|
| Rate for Payer: Priority Health SBD |
$1,810.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.10
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UHC Exchange |
$180.09
|
| Rate for Payer: UMR Bronson Commercial |
$1,063.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,154.84
|
|
|
HC IMPLANTABLE PRESSURE SENSOR W ANGIO
|
Facility
|
OP
|
$6,081.01
|
|
|
Service Code
|
CPT 33289
|
| Hospital Charge Code |
48100105
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$320.57 |
| Max. Negotiated Rate |
$81,329.31 |
| Rate for Payer: Aetna American Axle |
$3,952.66
|
| Rate for Payer: Aetna Commercial |
$5,168.86
|
| Rate for Payer: Aetna Medicare |
$26,868.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,952.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32,293.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32,293.58
|
| Rate for Payer: BCBS Complete |
$14,839.54
|
| Rate for Payer: BCBS MAPPO |
$25,834.86
|
| Rate for Payer: BCN Medicare Advantage |
$25,834.86
|
| Rate for Payer: Cash Price |
$4,864.81
|
| Rate for Payer: Cash Price |
$4,864.81
|
| Rate for Payer: Cofinity Commercial |
$4,256.71
|
| Rate for Payer: Cofinity Commercial |
$5,229.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,864.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25,834.86
|
| Rate for Payer: Healthscope Commercial |
$5,472.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,256.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,560.76
|
| Rate for Payer: Mclaren Medicaid |
$14,131.67
|
| Rate for Payer: Mclaren Medicare |
$25,834.86
|
| Rate for Payer: Meridian Medicaid |
$14,839.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27,126.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29,710.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,168.86
|
| Rate for Payer: PACE Medicare |
$24,543.12
|
| Rate for Payer: PACE SWMI |
$25,834.86
|
| Rate for Payer: PHP Commercial |
$5,168.86
|
| Rate for Payer: PHP Medicare Advantage |
$25,834.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,131.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,256.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81,329.31
|
| Rate for Payer: Priority Health Medicare |
$25,834.86
|
| Rate for Payer: Priority Health Narrow Network |
$65,063.45
|
| Rate for Payer: Priority Health SBD |
$3,831.04
|
| Rate for Payer: Railroad Medicare Medicare |
$25,834.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.63
|
| Rate for Payer: UHC Core |
$52,490.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$25,834.86
|
| Rate for Payer: UHC Exchange |
$320.57
|
| Rate for Payer: UHC Medicare Advantage |
$26,609.91
|
| Rate for Payer: UMR Bronson Commercial |
$2,249.97
|
| Rate for Payer: VA VA |
$25,834.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,560.76
|
|
|
HC IMPLANTABLE PRESSURE SENSOR W ANGIO
|
Facility
|
IP
|
$6,081.01
|
|
|
Service Code
|
CPT 33289
|
| Hospital Charge Code |
48100105
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,675.64 |
| Max. Negotiated Rate |
$5,472.91 |
| Rate for Payer: Aetna American Axle |
$3,952.66
|
| Rate for Payer: Aetna Commercial |
$5,168.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,952.66
|
| Rate for Payer: Cash Price |
$4,864.81
|
| Rate for Payer: Cofinity Commercial |
$4,256.71
|
| Rate for Payer: Cofinity Commercial |
$5,229.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,864.81
|
| Rate for Payer: Healthscope Commercial |
$5,472.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,256.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,560.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,168.86
|
| Rate for Payer: PHP Commercial |
$5,168.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,256.71
|
| Rate for Payer: Priority Health SBD |
$3,831.04
|
| Rate for Payer: UMR Bronson Commercial |
$2,675.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,560.76
|
|
|
HC IMPLANTABLE PRESSURE SENSOR WO LEAD
|
Facility
|
OP
|
$70,725.38
|
|
|
Service Code
|
HCPCS C2624
|
| Hospital Charge Code |
27800103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$63,652.84 |
| Rate for Payer: Aetna American Axle |
$45,971.50
|
| Rate for Payer: Aetna Commercial |
$60,116.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45,971.50
|
| Rate for Payer: BCBS Complete |
$28,290.15
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: Cash Price |
$56,580.30
|
| Rate for Payer: Cash Price |
$56,580.30
|
| Rate for Payer: Cofinity Commercial |
$49,507.77
|
| Rate for Payer: Cofinity Commercial |
$60,823.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56,580.30
|
| Rate for Payer: Healthscope Commercial |
$63,652.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49,507.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53,044.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60,116.57
|
| Rate for Payer: PHP Commercial |
$60,116.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49,507.77
|
| Rate for Payer: Priority Health SBD |
$44,556.99
|
| Rate for Payer: UMR Bronson Commercial |
$26,168.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53,044.04
|
|
|
HC IMPLANTABLE PRESSURE SENSOR WO LEAD
|
Facility
|
IP
|
$70,725.38
|
|
|
Service Code
|
HCPCS C2624
|
| Hospital Charge Code |
27800103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31,119.17 |
| Max. Negotiated Rate |
$63,652.84 |
| Rate for Payer: Aetna American Axle |
$45,971.50
|
| Rate for Payer: Aetna Commercial |
$60,116.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45,971.50
|
| Rate for Payer: Cash Price |
$56,580.30
|
| Rate for Payer: Cofinity Commercial |
$49,507.77
|
| Rate for Payer: Cofinity Commercial |
$60,823.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56,580.30
|
| Rate for Payer: Healthscope Commercial |
$63,652.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49,507.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53,044.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60,116.57
|
| Rate for Payer: PHP Commercial |
$60,116.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49,507.77
|
| Rate for Payer: Priority Health SBD |
$44,556.99
|
| Rate for Payer: UMR Bronson Commercial |
$31,119.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53,044.04
|
|
|
HC IMPLANT HORMONE SUBCUTANEOUS
|
Facility
|
OP
|
$532.68
|
|
|
Service Code
|
CPT 11980
|
| Hospital Charge Code |
76100178
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$54.03 |
| Max. Negotiated Rate |
$1,114.93 |
| Rate for Payer: Aetna American Axle |
$346.24
|
| Rate for Payer: Aetna Commercial |
$452.78
|
| Rate for Payer: Aetna Medicare |
$368.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$442.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$442.70
|
| Rate for Payer: BCBS Complete |
$203.43
|
| Rate for Payer: BCBS MAPPO |
$354.16
|
| Rate for Payer: BCBS Trust/PPO |
$403.77
|
| Rate for Payer: BCN Medicare Advantage |
$354.16
|
| Rate for Payer: Cash Price |
$426.14
|
| Rate for Payer: Cash Price |
$426.14
|
| Rate for Payer: Cofinity Commercial |
$458.10
|
| Rate for Payer: Cofinity Commercial |
$372.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.16
|
| Rate for Payer: Healthscope Commercial |
$479.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$372.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$399.51
|
| Rate for Payer: Mclaren Medicaid |
$193.73
|
| Rate for Payer: Mclaren Medicare |
$354.16
|
| Rate for Payer: Meridian Medicaid |
$203.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$371.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$452.78
|
| Rate for Payer: PACE Medicare |
$336.45
|
| Rate for Payer: PACE SWMI |
$354.16
|
| Rate for Payer: PHP Commercial |
$452.78
|
| Rate for Payer: PHP Medicare Advantage |
$354.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,114.93
|
| Rate for Payer: Priority Health Medicare |
$354.16
|
| Rate for Payer: Priority Health Narrow Network |
$891.94
|
| Rate for Payer: Priority Health SBD |
$335.59
|
| Rate for Payer: Railroad Medicare Medicare |
$354.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.16
|
| Rate for Payer: UHC Exchange |
$54.03
|
| Rate for Payer: UHC Medicare Advantage |
$364.78
|
| Rate for Payer: UMR Bronson Commercial |
$197.09
|
| Rate for Payer: VA VA |
$354.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$399.51
|
|
|
HC IMPLANT HORMONE SUBCUTANEOUS
|
Facility
|
IP
|
$532.68
|
|
|
Service Code
|
CPT 11980
|
| Hospital Charge Code |
76100178
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$234.38 |
| Max. Negotiated Rate |
$479.41 |
| Rate for Payer: Aetna American Axle |
$346.24
|
| Rate for Payer: Aetna Commercial |
$452.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$346.24
|
| Rate for Payer: Cash Price |
$426.14
|
| Rate for Payer: Cofinity Commercial |
$372.88
|
| Rate for Payer: Cofinity Commercial |
$458.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$426.14
|
| Rate for Payer: Healthscope Commercial |
$479.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$372.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$399.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$452.78
|
| Rate for Payer: PHP Commercial |
$452.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.88
|
| Rate for Payer: Priority Health SBD |
$335.59
|
| Rate for Payer: UMR Bronson Commercial |
$234.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$399.51
|
|
|
HC IMRT PLAN
|
Facility
|
IP
|
$6,985.98
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
33300006
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$3,073.83 |
| Max. Negotiated Rate |
$6,287.38 |
| Rate for Payer: Aetna American Axle |
$4,540.89
|
| Rate for Payer: Aetna American Axle |
$4,762.55
|
| Rate for Payer: Aetna Commercial |
$5,938.08
|
| Rate for Payer: Aetna Commercial |
$6,227.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,762.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,540.89
|
| Rate for Payer: Cash Price |
$5,861.60
|
| Rate for Payer: Cash Price |
$5,588.78
|
| Rate for Payer: Cofinity Commercial |
$6,301.22
|
| Rate for Payer: Cofinity Commercial |
$5,128.90
|
| Rate for Payer: Cofinity Commercial |
$6,007.94
|
| Rate for Payer: Cofinity Commercial |
$4,890.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,588.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,861.60
|
| Rate for Payer: Healthscope Commercial |
$6,594.30
|
| Rate for Payer: Healthscope Commercial |
$6,287.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,890.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,128.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,239.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,495.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,227.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,938.08
|
| Rate for Payer: PHP Commercial |
$5,938.08
|
| Rate for Payer: PHP Commercial |
$6,227.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,890.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,128.90
|
| Rate for Payer: Priority Health SBD |
$4,616.01
|
| Rate for Payer: Priority Health SBD |
$4,401.17
|
| Rate for Payer: UMR Bronson Commercial |
$3,223.88
|
| Rate for Payer: UMR Bronson Commercial |
$3,073.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,239.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,495.25
|
|
|
HC IMRT PLAN
|
Facility
|
OP
|
$6,985.98
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
33300006
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$673.71 |
| Max. Negotiated Rate |
$6,287.38 |
| Rate for Payer: Aetna American Axle |
$4,540.89
|
| Rate for Payer: Aetna American Axle |
$4,762.55
|
| Rate for Payer: Aetna Commercial |
$5,938.08
|
| Rate for Payer: Aetna Commercial |
$6,227.95
|
| Rate for Payer: Aetna Medicare |
$1,280.92
|
| Rate for Payer: Aetna Medicare |
$1,280.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,762.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,540.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,539.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,539.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,539.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,539.56
|
| Rate for Payer: BCBS Complete |
$707.46
|
| Rate for Payer: BCBS Complete |
$707.46
|
| Rate for Payer: BCBS MAPPO |
$1,231.65
|
| Rate for Payer: BCBS MAPPO |
$1,231.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,849.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,849.31
|
| Rate for Payer: BCN Medicare Advantage |
$1,231.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,231.65
|
| Rate for Payer: Cash Price |
$5,861.60
|
| Rate for Payer: Cash Price |
$5,861.60
|
| Rate for Payer: Cash Price |
$5,588.78
|
| Rate for Payer: Cash Price |
$5,588.78
|
| Rate for Payer: Cash Price |
$5,861.60
|
| Rate for Payer: Cash Price |
$5,588.78
|
| Rate for Payer: Cofinity Commercial |
$6,007.94
|
| Rate for Payer: Cofinity Commercial |
$5,128.90
|
| Rate for Payer: Cofinity Commercial |
$6,301.22
|
| Rate for Payer: Cofinity Commercial |
$4,890.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,588.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,861.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,231.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,231.65
|
| Rate for Payer: Healthscope Commercial |
$6,287.38
|
| Rate for Payer: Healthscope Commercial |
$6,594.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,128.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,890.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,495.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,239.48
|
| Rate for Payer: Mclaren Medicaid |
$673.71
|
| Rate for Payer: Mclaren Medicaid |
$673.71
|
| Rate for Payer: Mclaren Medicare |
$1,231.65
|
| Rate for Payer: Mclaren Medicare |
$1,231.65
|
| Rate for Payer: Meridian Medicaid |
$707.46
|
| Rate for Payer: Meridian Medicaid |
$707.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,293.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,293.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,416.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,416.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,227.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,938.08
|
| Rate for Payer: PACE Medicare |
$1,170.07
|
| Rate for Payer: PACE Medicare |
$1,170.07
|
| Rate for Payer: PACE SWMI |
$1,231.65
|
| Rate for Payer: PACE SWMI |
$1,231.65
|
| Rate for Payer: PHP Commercial |
$5,938.08
|
| Rate for Payer: PHP Commercial |
$6,227.95
|
| Rate for Payer: PHP Medicare Advantage |
$1,231.65
|
| Rate for Payer: PHP Medicare Advantage |
$1,231.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,128.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,890.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,877.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,877.29
|
| Rate for Payer: Priority Health Medicare |
$1,231.65
|
| Rate for Payer: Priority Health Medicare |
$1,231.65
|
| Rate for Payer: Priority Health Narrow Network |
$3,101.83
|
| Rate for Payer: Priority Health Narrow Network |
$3,101.83
|
| Rate for Payer: Priority Health SBD |
$4,401.17
|
| Rate for Payer: Priority Health SBD |
$4,616.01
|
| Rate for Payer: Railroad Medicare Medicare |
$1,231.65
|
| Rate for Payer: Railroad Medicare Medicare |
$1,231.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,993.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,993.99
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,231.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,231.65
|
| Rate for Payer: UHC Exchange |
$1,812.72
|
| Rate for Payer: UHC Exchange |
$1,812.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,268.60
|
| Rate for Payer: UHC Medicare Advantage |
$1,268.60
|
| Rate for Payer: UMR Bronson Commercial |
$2,710.99
|
| Rate for Payer: UMR Bronson Commercial |
$2,584.81
|
| Rate for Payer: VA VA |
$1,231.65
|
| Rate for Payer: VA VA |
$1,231.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,495.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,239.48
|
|
|
HC IN 111 AUTOLOG WBC PER STUDY
|
Facility
|
OP
|
$768.66
|
|
|
Service Code
|
HCPCS A9570
|
| Hospital Charge Code |
34300013
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$284.40 |
| Max. Negotiated Rate |
$691.79 |
| Rate for Payer: Aetna American Axle |
$499.63
|
| Rate for Payer: Aetna Commercial |
$653.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.63
|
| Rate for Payer: BCBS Complete |
$307.46
|
| Rate for Payer: BCBS Trust/PPO |
$381.06
|
| Rate for Payer: Cash Price |
$614.93
|
| Rate for Payer: Cash Price |
$614.93
|
| Rate for Payer: Cofinity Commercial |
$538.06
|
| Rate for Payer: Cofinity Commercial |
$661.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$614.93
|
| Rate for Payer: Healthscope Commercial |
$691.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$538.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$576.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$653.36
|
| Rate for Payer: PHP Commercial |
$653.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$538.06
|
| Rate for Payer: Priority Health SBD |
$484.26
|
| Rate for Payer: UMR Bronson Commercial |
$284.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$576.50
|
|
|
HC IN 111 AUTOLOG WBC PER STUDY
|
Facility
|
IP
|
$768.66
|
|
|
Service Code
|
HCPCS A9570
|
| Hospital Charge Code |
34300013
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$338.21 |
| Max. Negotiated Rate |
$691.79 |
| Rate for Payer: Aetna American Axle |
$499.63
|
| Rate for Payer: Aetna Commercial |
$653.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$499.63
|
| Rate for Payer: Cash Price |
$614.93
|
| Rate for Payer: Cofinity Commercial |
$661.05
|
| Rate for Payer: Cofinity Commercial |
$538.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$614.93
|
| Rate for Payer: Healthscope Commercial |
$691.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$538.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$576.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$653.36
|
| Rate for Payer: PHP Commercial |
$653.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$538.06
|
| Rate for Payer: Priority Health SBD |
$484.26
|
| Rate for Payer: UMR Bronson Commercial |
$338.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$576.50
|
|
|
HC IN 111 OCTEO PER STUDY UP TO 6 MCI
|
Facility
|
IP
|
$5,305.42
|
|
|
Service Code
|
HCPCS A9572
|
| Hospital Charge Code |
34300014
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$2,334.38 |
| Max. Negotiated Rate |
$4,774.88 |
| Rate for Payer: Aetna American Axle |
$3,448.52
|
| Rate for Payer: Aetna Commercial |
$4,509.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,448.52
|
| Rate for Payer: Cash Price |
$4,244.34
|
| Rate for Payer: Cofinity Commercial |
$4,562.66
|
| Rate for Payer: Cofinity Commercial |
$3,713.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,244.34
|
| Rate for Payer: Healthscope Commercial |
$4,774.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,713.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,979.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,509.61
|
| Rate for Payer: PHP Commercial |
$4,509.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,713.79
|
| Rate for Payer: Priority Health SBD |
$3,342.41
|
| Rate for Payer: UMR Bronson Commercial |
$2,334.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,979.06
|
|
|
HC IN 111 OCTEO PER STUDY UP TO 6 MCI
|
Facility
|
OP
|
$5,305.42
|
|
|
Service Code
|
HCPCS A9572
|
| Hospital Charge Code |
34300014
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,963.01 |
| Max. Negotiated Rate |
$4,774.88 |
| Rate for Payer: Aetna American Axle |
$3,448.52
|
| Rate for Payer: Aetna Commercial |
$4,509.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,448.52
|
| Rate for Payer: BCBS Complete |
$2,122.17
|
| Rate for Payer: BCBS Trust/PPO |
$3,538.92
|
| Rate for Payer: Cash Price |
$4,244.34
|
| Rate for Payer: Cash Price |
$4,244.34
|
| Rate for Payer: Cofinity Commercial |
$3,713.79
|
| Rate for Payer: Cofinity Commercial |
$4,562.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,244.34
|
| Rate for Payer: Healthscope Commercial |
$4,774.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,713.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,979.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,509.61
|
| Rate for Payer: PHP Commercial |
$4,509.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,713.79
|
| Rate for Payer: Priority Health SBD |
$3,342.41
|
| Rate for Payer: UMR Bronson Commercial |
$1,963.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,979.06
|
|
|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
OP
|
$5,409.15
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$209.89 |
| Max. Negotiated Rate |
$5,699.47 |
| Rate for Payer: Aetna American Axle |
$3,515.95
|
| Rate for Payer: Aetna Commercial |
$4,597.78
|
| Rate for Payer: Aetna Medicare |
$1,882.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,515.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,421.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$4,327.32
|
| Rate for Payer: Cash Price |
$4,327.32
|
| Rate for Payer: Cofinity Commercial |
$4,651.87
|
| Rate for Payer: Cofinity Commercial |
$3,786.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,327.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$4,868.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,786.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,056.86
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,597.78
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$4,597.78
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,786.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,699.47
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$4,559.58
|
| Rate for Payer: Priority Health SBD |
$3,407.76
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,810.48
|
| Rate for Payer: UHC Exchange |
$209.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: UMR Bronson Commercial |
$2,001.39
|
| Rate for Payer: VA VA |
$1,810.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,056.86
|
|
|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
IP
|
$5,409.15
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,380.03 |
| Max. Negotiated Rate |
$4,868.24 |
| Rate for Payer: Aetna American Axle |
$3,515.95
|
| Rate for Payer: Aetna Commercial |
$4,597.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,515.95
|
| Rate for Payer: Cash Price |
$4,327.32
|
| Rate for Payer: Cofinity Commercial |
$3,786.40
|
| Rate for Payer: Cofinity Commercial |
$4,651.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,327.32
|
| Rate for Payer: Healthscope Commercial |
$4,868.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,786.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,056.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,597.78
|
| Rate for Payer: PHP Commercial |
$4,597.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,786.40
|
| Rate for Payer: Priority Health SBD |
$3,407.76
|
| Rate for Payer: UMR Bronson Commercial |
$2,380.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,056.86
|
|
