|
HC INJ ANESTH AND/OR STEROID SCIATIC NERVE
|
Facility
|
IP
|
$2,549.64
|
|
|
Service Code
|
CPT 64445
|
| Hospital Charge Code |
37100008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,121.84 |
| Max. Negotiated Rate |
$2,294.68 |
| Rate for Payer: Aetna American Axle |
$1,657.27
|
| Rate for Payer: Aetna Commercial |
$2,167.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,657.27
|
| Rate for Payer: Cash Price |
$2,039.71
|
| Rate for Payer: Cofinity Commercial |
$1,784.75
|
| Rate for Payer: Cofinity Commercial |
$2,192.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,039.71
|
| Rate for Payer: Healthscope Commercial |
$2,294.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,784.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,912.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,167.19
|
| Rate for Payer: PHP Commercial |
$2,167.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,784.75
|
| Rate for Payer: Priority Health SBD |
$1,606.27
|
| Rate for Payer: UMR Bronson Commercial |
$1,121.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,912.23
|
|
|
HC INJ ANESTH AND/OR STEROID SUPRASCAPULAR NERVE
|
Facility
|
OP
|
$956.33
|
|
|
Service Code
|
CPT 64418
|
| Hospital Charge Code |
36100600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$54.03 |
| Max. Negotiated Rate |
$1,935.09 |
| Rate for Payer: Aetna American Axle |
$621.61
|
| Rate for Payer: Aetna Commercial |
$812.88
|
| Rate for Payer: Aetna Medicare |
$639.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$621.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$120.43
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cofinity Commercial |
$669.43
|
| Rate for Payer: Cofinity Commercial |
$822.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$860.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$669.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.25
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$812.88
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$812.88
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,935.09
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,548.07
|
| Rate for Payer: Priority Health SBD |
$602.49
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.43
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.70
|
| Rate for Payer: UHC Exchange |
$54.03
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: UMR Bronson Commercial |
$353.84
|
| Rate for Payer: VA VA |
$614.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.25
|
|
|
HC INJ ANESTH AND/OR STEROID SUPRASCAPULAR NERVE
|
Facility
|
IP
|
$956.33
|
|
|
Service Code
|
CPT 64418
|
| Hospital Charge Code |
36100600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$420.79 |
| Max. Negotiated Rate |
$860.70 |
| Rate for Payer: Aetna American Axle |
$621.61
|
| Rate for Payer: Aetna Commercial |
$812.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$621.61
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cofinity Commercial |
$669.43
|
| Rate for Payer: Cofinity Commercial |
$822.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.06
|
| Rate for Payer: Healthscope Commercial |
$860.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$669.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$812.88
|
| Rate for Payer: PHP Commercial |
$812.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.43
|
| Rate for Payer: Priority Health SBD |
$602.49
|
| Rate for Payer: UMR Bronson Commercial |
$420.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.25
|
|
|
HC INJ ANESTHETIC FEMORAL
|
Facility
|
IP
|
$1,504.19
|
|
|
Service Code
|
CPT 64447
|
| Hospital Charge Code |
36100391
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$661.84 |
| Max. Negotiated Rate |
$1,353.77 |
| Rate for Payer: Aetna American Axle |
$977.72
|
| Rate for Payer: Aetna Commercial |
$1,278.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$977.72
|
| Rate for Payer: Cash Price |
$1,203.35
|
| Rate for Payer: Cofinity Commercial |
$1,052.93
|
| Rate for Payer: Cofinity Commercial |
$1,293.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,203.35
|
| Rate for Payer: Healthscope Commercial |
$1,353.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,052.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,128.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,278.56
|
| Rate for Payer: PHP Commercial |
$1,278.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,052.93
|
| Rate for Payer: Priority Health SBD |
$947.64
|
| Rate for Payer: UMR Bronson Commercial |
$661.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,128.14
|
|
|
HC INJ ANESTHETIC FEMORAL
|
Facility
|
OP
|
$1,504.19
|
|
|
Service Code
|
CPT 64447
|
| Hospital Charge Code |
36100391
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$61.23 |
| Max. Negotiated Rate |
$1,935.09 |
| Rate for Payer: Aetna American Axle |
$977.72
|
| Rate for Payer: Aetna Commercial |
$1,278.56
|
| Rate for Payer: Aetna Medicare |
$639.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$977.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$79.67
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$1,203.35
|
| Rate for Payer: Cash Price |
$1,203.35
|
| Rate for Payer: Cofinity Commercial |
$1,052.93
|
| Rate for Payer: Cofinity Commercial |
$1,293.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,203.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$1,353.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,052.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,128.14
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,278.56
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$1,278.56
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,052.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,935.09
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,548.07
|
| Rate for Payer: Priority Health SBD |
$947.64
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.70
|
| Rate for Payer: UHC Exchange |
$61.23
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: UMR Bronson Commercial |
$556.55
|
| Rate for Payer: VA VA |
$614.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,128.14
|
|
|
HC INJ ANESTH PERIPH NERVE
|
Facility
|
OP
|
$872.87
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
36100393
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$40.93 |
| Max. Negotiated Rate |
$1,935.09 |
| Rate for Payer: Aetna American Axle |
$567.37
|
| Rate for Payer: Aetna Commercial |
$741.94
|
| Rate for Payer: Aetna Medicare |
$639.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$567.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$689.06
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$698.30
|
| Rate for Payer: Cash Price |
$698.30
|
| Rate for Payer: Cofinity Commercial |
$611.01
|
| Rate for Payer: Cofinity Commercial |
$750.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$698.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$785.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$611.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$654.65
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$741.94
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$741.94
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,935.09
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,548.07
|
| Rate for Payer: Priority Health SBD |
$549.91
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.70
|
| Rate for Payer: UHC Exchange |
$40.93
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: UMR Bronson Commercial |
$322.96
|
| Rate for Payer: VA VA |
$614.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$654.65
|
|
|
HC INJ ANESTH PERIPH NERVE
|
Facility
|
IP
|
$872.87
|
|
|
Service Code
|
CPT 64450
|
| Hospital Charge Code |
36100393
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$384.06 |
| Max. Negotiated Rate |
$785.58 |
| Rate for Payer: Aetna American Axle |
$567.37
|
| Rate for Payer: Aetna Commercial |
$741.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$567.37
|
| Rate for Payer: Cash Price |
$698.30
|
| Rate for Payer: Cofinity Commercial |
$611.01
|
| Rate for Payer: Cofinity Commercial |
$750.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$698.30
|
| Rate for Payer: Healthscope Commercial |
$785.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$611.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$654.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$741.94
|
| Rate for Payer: PHP Commercial |
$741.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.01
|
| Rate for Payer: Priority Health SBD |
$549.91
|
| Rate for Payer: UMR Bronson Commercial |
$384.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$654.65
|
|
|
HC INJ ANESTH/STEROID BRACHIAL PLEXUS CONT
|
Facility
|
IP
|
$3,109.92
|
|
|
Service Code
|
CPT 64416
|
| Hospital Charge Code |
37100010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,368.36 |
| Max. Negotiated Rate |
$2,798.93 |
| Rate for Payer: Aetna American Axle |
$2,021.45
|
| Rate for Payer: Aetna Commercial |
$2,643.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,021.45
|
| Rate for Payer: Cash Price |
$2,487.94
|
| Rate for Payer: Cofinity Commercial |
$2,176.94
|
| Rate for Payer: Cofinity Commercial |
$2,674.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,487.94
|
| Rate for Payer: Healthscope Commercial |
$2,798.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,176.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,332.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,643.43
|
| Rate for Payer: PHP Commercial |
$2,643.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.94
|
| Rate for Payer: Priority Health SBD |
$1,959.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,368.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,332.44
|
|
|
HC INJ ANESTH/STEROID BRACHIAL PLEXUS CONT
|
Facility
|
OP
|
$3,109.92
|
|
|
Service Code
|
CPT 64416
|
| Hospital Charge Code |
37100010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$74.66 |
| Max. Negotiated Rate |
$2,798.93 |
| Rate for Payer: Aetna American Axle |
$2,021.45
|
| Rate for Payer: Aetna Commercial |
$2,643.43
|
| Rate for Payer: Aetna Medicare |
$842.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,021.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$662.27
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$2,487.94
|
| Rate for Payer: Cash Price |
$2,487.94
|
| Rate for Payer: Cofinity Commercial |
$2,176.94
|
| Rate for Payer: Cofinity Commercial |
$2,674.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,487.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$2,798.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,176.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,332.44
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,643.43
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$2,643.43
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,550.52
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,040.42
|
| Rate for Payer: Priority Health SBD |
$1,959.25
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.19
|
| Rate for Payer: UHC Exchange |
$74.66
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,150.67
|
| Rate for Payer: VA VA |
$810.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,332.44
|
|
|
HC INJ ANESTH/STEROID SCIATIC NERVE CONT
|
Facility
|
OP
|
$3,118.20
|
|
|
Service Code
|
CPT 64446
|
| Hospital Charge Code |
37000020
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$73.02 |
| Max. Negotiated Rate |
$2,806.38 |
| Rate for Payer: Aetna American Axle |
$2,026.83
|
| Rate for Payer: Aetna Commercial |
$2,650.47
|
| Rate for Payer: Aetna Medicare |
$842.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,026.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$702.20
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$2,494.56
|
| Rate for Payer: Cash Price |
$2,494.56
|
| Rate for Payer: Cofinity Commercial |
$2,182.74
|
| Rate for Payer: Cofinity Commercial |
$2,681.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,494.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$2,806.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,182.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,338.65
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,650.47
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$2,650.47
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,182.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,550.52
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,040.42
|
| Rate for Payer: Priority Health SBD |
$1,964.47
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.19
|
| Rate for Payer: UHC Exchange |
$73.02
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,153.73
|
| Rate for Payer: VA VA |
$810.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,338.65
|
|
|
HC INJ ANESTH/STEROID SCIATIC NERVE CONT
|
Facility
|
IP
|
$3,118.20
|
|
|
Service Code
|
CPT 64446
|
| Hospital Charge Code |
37000020
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,372.01 |
| Max. Negotiated Rate |
$2,806.38 |
| Rate for Payer: Aetna American Axle |
$2,026.83
|
| Rate for Payer: Aetna Commercial |
$2,650.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,026.83
|
| Rate for Payer: Cash Price |
$2,494.56
|
| Rate for Payer: Cofinity Commercial |
$2,182.74
|
| Rate for Payer: Cofinity Commercial |
$2,681.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,494.56
|
| Rate for Payer: Healthscope Commercial |
$2,806.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,182.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,338.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,650.47
|
| Rate for Payer: PHP Commercial |
$2,650.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,182.74
|
| Rate for Payer: Priority Health SBD |
$1,964.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,372.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,338.65
|
|
|
HC INJ ANEST/STEROID ILIOING ILIOHYPOGAST NRV
|
Facility
|
IP
|
$956.33
|
|
|
Service Code
|
CPT 64425
|
| Hospital Charge Code |
76100270
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$420.79 |
| Max. Negotiated Rate |
$860.70 |
| Rate for Payer: Aetna American Axle |
$621.61
|
| Rate for Payer: Aetna Commercial |
$812.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$621.61
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cofinity Commercial |
$669.43
|
| Rate for Payer: Cofinity Commercial |
$822.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.06
|
| Rate for Payer: Healthscope Commercial |
$860.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$669.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$812.88
|
| Rate for Payer: PHP Commercial |
$812.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.43
|
| Rate for Payer: Priority Health SBD |
$602.49
|
| Rate for Payer: UMR Bronson Commercial |
$420.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.25
|
|
|
HC INJ ANEST/STEROID ILIOING ILIOHYPOGAST NRV
|
Facility
|
OP
|
$956.33
|
|
|
Service Code
|
CPT 64425
|
| Hospital Charge Code |
76100270
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$53.05 |
| Max. Negotiated Rate |
$1,935.09 |
| Rate for Payer: Aetna American Axle |
$621.61
|
| Rate for Payer: Aetna Commercial |
$812.88
|
| Rate for Payer: Aetna Medicare |
$639.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$621.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$689.06
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cash Price |
$765.06
|
| Rate for Payer: Cofinity Commercial |
$822.44
|
| Rate for Payer: Cofinity Commercial |
$669.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$860.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$669.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.25
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$812.88
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$812.88
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,935.09
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,548.07
|
| Rate for Payer: Priority Health SBD |
$602.49
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.70
|
| Rate for Payer: UHC Exchange |
$53.05
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: UMR Bronson Commercial |
$353.84
|
| Rate for Payer: VA VA |
$614.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.25
|
|
|
HC INJ BEBTELOVIMAB
|
Facility
|
OP
|
$475.49
|
|
|
Service Code
|
HCPCS M0222
|
| Hospital Charge Code |
77100034
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$47.00 |
| Max. Negotiated Rate |
$427.94 |
| Rate for Payer: Aetna American Axle |
$309.07
|
| Rate for Payer: Aetna Commercial |
$404.17
|
| Rate for Payer: Aetna Medicare |
$340.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$309.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$408.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$408.74
|
| Rate for Payer: BCBS Complete |
$187.82
|
| Rate for Payer: BCBS MAPPO |
$326.99
|
| Rate for Payer: BCN Medicare Advantage |
$326.99
|
| Rate for Payer: Cash Price |
$380.39
|
| Rate for Payer: Cash Price |
$380.39
|
| Rate for Payer: Cash Price |
$380.39
|
| Rate for Payer: Cofinity Commercial |
$408.92
|
| Rate for Payer: Cofinity Commercial |
$332.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$380.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$326.99
|
| Rate for Payer: Healthscope Commercial |
$427.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$332.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$356.62
|
| Rate for Payer: Mclaren Medicaid |
$178.86
|
| Rate for Payer: Mclaren Medicare |
$326.99
|
| Rate for Payer: Meridian Medicaid |
$187.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$343.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$376.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$404.17
|
| Rate for Payer: PACE Medicare |
$310.64
|
| Rate for Payer: PACE SWMI |
$326.99
|
| Rate for Payer: PHP Commercial |
$404.17
|
| Rate for Payer: PHP Medicare Advantage |
$326.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$178.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$350.50
|
| Rate for Payer: Priority Health Medicare |
$326.99
|
| Rate for Payer: Priority Health Narrow Network |
$280.40
|
| Rate for Payer: Priority Health SBD |
$299.56
|
| Rate for Payer: Railroad Medicare Medicare |
$326.99
|
| Rate for Payer: UHC Core |
$47.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$326.99
|
| Rate for Payer: UHC Medicare Advantage |
$336.80
|
| Rate for Payer: UMR Bronson Commercial |
$175.93
|
| Rate for Payer: VA VA |
$326.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$356.62
|
|
|
HC INJ BEBTELOVIMAB
|
Facility
|
IP
|
$475.49
|
|
|
Service Code
|
HCPCS M0222
|
| Hospital Charge Code |
77100034
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$209.22 |
| Max. Negotiated Rate |
$427.94 |
| Rate for Payer: Aetna American Axle |
$309.07
|
| Rate for Payer: Aetna Commercial |
$404.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$309.07
|
| Rate for Payer: Cash Price |
$380.39
|
| Rate for Payer: Cofinity Commercial |
$408.92
|
| Rate for Payer: Cofinity Commercial |
$332.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$380.39
|
| Rate for Payer: Healthscope Commercial |
$427.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$332.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$356.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$404.17
|
| Rate for Payer: PHP Commercial |
$404.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.84
|
| Rate for Payer: Priority Health SBD |
$299.56
|
| Rate for Payer: UMR Bronson Commercial |
$209.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$356.62
|
|
|
HC INJ,BETAMETHASONE ACT 3MG AND BETAMETASONE NA PHOS 3 MG
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT J0702
|
| Hospital Charge Code |
63600089
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.55 |
| Max. Negotiated Rate |
$22.01 |
| Rate for Payer: Aetna American Axle |
$13.26
|
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
| Rate for Payer: BCBS Complete |
$8.16
|
| Rate for Payer: BCBS Trust/PPO |
$22.01
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$14.28
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health SBD |
$12.85
|
| Rate for Payer: UMR Bronson Commercial |
$7.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC INJ,BETAMETHASONE ACT 3MG AND BETAMETASONE NA PHOS 3 MG
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT J0702
|
| Hospital Charge Code |
63600089
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna American Axle |
$13.26
|
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$14.28
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health SBD |
$12.85
|
| Rate for Payer: UMR Bronson Commercial |
$8.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC INJ CATH PLACE CON INF OR BOLUS CERV OR THORACIC W IMAGIG GUID
|
Facility
|
IP
|
$1,081.82
|
|
|
Service Code
|
CPT 62325
|
| Hospital Charge Code |
36100540
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$476.00 |
| Max. Negotiated Rate |
$973.64 |
| Rate for Payer: Aetna American Axle |
$703.18
|
| Rate for Payer: Aetna Commercial |
$919.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$703.18
|
| Rate for Payer: Cash Price |
$865.46
|
| Rate for Payer: Cofinity Commercial |
$757.27
|
| Rate for Payer: Cofinity Commercial |
$930.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$865.46
|
| Rate for Payer: Healthscope Commercial |
$973.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$757.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$811.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$919.55
|
| Rate for Payer: PHP Commercial |
$919.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.27
|
| Rate for Payer: Priority Health SBD |
$681.55
|
| Rate for Payer: UMR Bronson Commercial |
$476.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$811.36
|
|
|
HC INJ CATH PLACE CON INF OR BOLUS CERV OR THORACIC W IMAGIG GUID
|
Facility
|
OP
|
$1,081.82
|
|
|
Service Code
|
CPT 62325
|
| Hospital Charge Code |
36100540
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$107.40 |
| Max. Negotiated Rate |
$2,550.52 |
| Rate for Payer: Aetna American Axle |
$703.18
|
| Rate for Payer: Aetna Commercial |
$919.55
|
| Rate for Payer: Aetna Medicare |
$842.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$703.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$670.74
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$865.46
|
| Rate for Payer: Cash Price |
$865.46
|
| Rate for Payer: Cofinity Commercial |
$757.27
|
| Rate for Payer: Cofinity Commercial |
$930.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$865.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$973.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$757.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$811.36
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$919.55
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$919.55
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,550.52
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,040.42
|
| Rate for Payer: Priority Health SBD |
$681.55
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.14
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.19
|
| Rate for Payer: UHC Exchange |
$107.40
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$400.27
|
| Rate for Payer: VA VA |
$810.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$811.36
|
|
|
HC INJ CATH PLACE CON INF OR BOLUS CERV OR THORACIC WO IMAGING
|
Facility
|
IP
|
$1,081.82
|
|
|
Service Code
|
CPT 62324
|
| Hospital Charge Code |
36100542
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$476.00 |
| Max. Negotiated Rate |
$973.64 |
| Rate for Payer: Aetna American Axle |
$703.18
|
| Rate for Payer: Aetna Commercial |
$919.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$703.18
|
| Rate for Payer: Cash Price |
$865.46
|
| Rate for Payer: Cofinity Commercial |
$757.27
|
| Rate for Payer: Cofinity Commercial |
$930.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$865.46
|
| Rate for Payer: Healthscope Commercial |
$973.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$757.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$811.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$919.55
|
| Rate for Payer: PHP Commercial |
$919.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.27
|
| Rate for Payer: Priority Health SBD |
$681.55
|
| Rate for Payer: UMR Bronson Commercial |
$476.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$811.36
|
|
|
HC INJ CATH PLACE CON INF OR BOLUS CERV OR THORACIC WO IMAGING
|
Facility
|
OP
|
$1,081.82
|
|
|
Service Code
|
CPT 62324
|
| Hospital Charge Code |
36100542
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$86.44 |
| Max. Negotiated Rate |
$2,550.52 |
| Rate for Payer: Aetna American Axle |
$703.18
|
| Rate for Payer: Aetna Commercial |
$919.55
|
| Rate for Payer: Aetna Medicare |
$842.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$703.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$670.74
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$865.46
|
| Rate for Payer: Cash Price |
$865.46
|
| Rate for Payer: Cofinity Commercial |
$757.27
|
| Rate for Payer: Cofinity Commercial |
$930.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$865.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$973.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$757.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$811.36
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$919.55
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$919.55
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,550.52
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,040.42
|
| Rate for Payer: Priority Health SBD |
$681.55
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.08
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.19
|
| Rate for Payer: UHC Exchange |
$86.44
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$400.27
|
| Rate for Payer: VA VA |
$810.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$811.36
|
|
|
HC INJ CATH PLACE CON INF OR BOLUS LUMBAR OR SACRAL W IMAGING GUID
|
Facility
|
OP
|
$1,081.82
|
|
|
Service Code
|
CPT 62327
|
| Hospital Charge Code |
36100541
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$104.78 |
| Max. Negotiated Rate |
$2,550.52 |
| Rate for Payer: Aetna American Axle |
$703.18
|
| Rate for Payer: Aetna Commercial |
$919.55
|
| Rate for Payer: Aetna Medicare |
$842.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$703.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$670.74
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$865.46
|
| Rate for Payer: Cash Price |
$865.46
|
| Rate for Payer: Cofinity Commercial |
$930.37
|
| Rate for Payer: Cofinity Commercial |
$757.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$865.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$973.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$757.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$811.36
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$919.55
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$919.55
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,550.52
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,040.42
|
| Rate for Payer: Priority Health SBD |
$681.55
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.26
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.19
|
| Rate for Payer: UHC Exchange |
$104.78
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$400.27
|
| Rate for Payer: VA VA |
$810.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$811.36
|
|
|
HC INJ CATH PLACE CON INF OR BOLUS LUMBAR OR SACRAL W IMAGING GUID
|
Facility
|
IP
|
$1,081.82
|
|
|
Service Code
|
CPT 62327
|
| Hospital Charge Code |
36100541
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$476.00 |
| Max. Negotiated Rate |
$973.64 |
| Rate for Payer: Aetna American Axle |
$703.18
|
| Rate for Payer: Aetna Commercial |
$919.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$703.18
|
| Rate for Payer: Cash Price |
$865.46
|
| Rate for Payer: Cofinity Commercial |
$757.27
|
| Rate for Payer: Cofinity Commercial |
$930.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$865.46
|
| Rate for Payer: Healthscope Commercial |
$973.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$757.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$811.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$919.55
|
| Rate for Payer: PHP Commercial |
$919.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$757.27
|
| Rate for Payer: Priority Health SBD |
$681.55
|
| Rate for Payer: UMR Bronson Commercial |
$476.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$811.36
|
|
|
HC INJ COLLAGENASE, CLOSTRIDIUM HISTOLYTICUM, 0.01MG
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
HCPCS J0775
|
| Hospital Charge Code |
63600164
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.05 |
| Max. Negotiated Rate |
$214.12 |
| Rate for Payer: Aetna American Axle |
$42.25
|
| Rate for Payer: Aetna Commercial |
$55.25
|
| Rate for Payer: Aetna Medicare |
$68.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.84
|
| Rate for Payer: BCBS Complete |
$38.06
|
| Rate for Payer: BCBS MAPPO |
$66.27
|
| Rate for Payer: BCBS Trust/PPO |
$214.12
|
| Rate for Payer: BCN Medicare Advantage |
$66.27
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$45.50
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.27
|
| Rate for Payer: Healthscope Commercial |
$58.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.75
|
| Rate for Payer: Mclaren Medicaid |
$36.25
|
| Rate for Payer: Mclaren Medicare |
$66.27
|
| Rate for Payer: Meridian Medicaid |
$38.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PACE Medicare |
$62.96
|
| Rate for Payer: PACE SWMI |
$66.27
|
| Rate for Payer: PHP Commercial |
$55.25
|
| Rate for Payer: PHP Medicare Advantage |
$66.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$198.97
|
| Rate for Payer: Priority Health Medicare |
$66.27
|
| Rate for Payer: Priority Health Narrow Network |
$159.18
|
| Rate for Payer: Priority Health SBD |
$40.95
|
| Rate for Payer: Railroad Medicare Medicare |
$66.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.27
|
| Rate for Payer: UHC Medicare Advantage |
$68.26
|
| Rate for Payer: UMR Bronson Commercial |
$24.05
|
| Rate for Payer: VA VA |
$66.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.75
|
|
|
HC INJ COLLAGENASE, CLOSTRIDIUM HISTOLYTICUM, 0.01MG
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
HCPCS J0775
|
| Hospital Charge Code |
63600164
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.60 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Aetna American Axle |
$42.25
|
| Rate for Payer: Aetna Commercial |
$55.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.25
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$45.50
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Healthscope Commercial |
$58.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PHP Commercial |
$55.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health SBD |
$40.95
|
| Rate for Payer: UMR Bronson Commercial |
$28.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.75
|
|
