|
HC INJECTION MYELOGRAM
|
Facility
|
IP
|
$1,046.41
|
|
|
Service Code
|
CPT 62284
|
| Hospital Charge Code |
36100281
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.42 |
| Max. Negotiated Rate |
$941.77 |
| Rate for Payer: Aetna American Axle |
$680.17
|
| Rate for Payer: Aetna Commercial |
$889.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$680.17
|
| Rate for Payer: Cash Price |
$837.13
|
| Rate for Payer: Cofinity Commercial |
$732.49
|
| Rate for Payer: Cofinity Commercial |
$899.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$837.13
|
| Rate for Payer: Healthscope Commercial |
$941.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$732.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$784.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$889.45
|
| Rate for Payer: PHP Commercial |
$889.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$732.49
|
| Rate for Payer: Priority Health SBD |
$659.24
|
| Rate for Payer: UMR Bronson Commercial |
$460.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$784.81
|
|
|
HC INJECTION PLANTAR DIGIT
|
Facility
|
IP
|
$344.76
|
|
|
Service Code
|
CPT 64455
|
| Hospital Charge Code |
76100263
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$151.69 |
| Max. Negotiated Rate |
$310.28 |
| Rate for Payer: Aetna American Axle |
$224.09
|
| Rate for Payer: Aetna Commercial |
$293.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.09
|
| Rate for Payer: Cash Price |
$275.81
|
| Rate for Payer: Cofinity Commercial |
$241.33
|
| Rate for Payer: Cofinity Commercial |
$296.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.81
|
| Rate for Payer: Healthscope Commercial |
$310.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$293.05
|
| Rate for Payer: PHP Commercial |
$293.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.33
|
| Rate for Payer: Priority Health SBD |
$217.20
|
| Rate for Payer: UMR Bronson Commercial |
$151.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.57
|
|
|
HC INJECTION PLANTAR DIGIT
|
Facility
|
OP
|
$344.76
|
|
|
Service Code
|
CPT 64455
|
| Hospital Charge Code |
76100263
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$32.42 |
| Max. Negotiated Rate |
$828.79 |
| Rate for Payer: Aetna American Axle |
$224.09
|
| Rate for Payer: Aetna Commercial |
$293.05
|
| Rate for Payer: Aetna Medicare |
$273.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$290.76
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$275.81
|
| Rate for Payer: Cash Price |
$275.81
|
| Rate for Payer: Cofinity Commercial |
$241.33
|
| Rate for Payer: Cofinity Commercial |
$296.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$310.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.57
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$293.05
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$293.05
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$241.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$828.79
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$663.03
|
| Rate for Payer: Priority Health SBD |
$217.20
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.27
|
| Rate for Payer: UHC Exchange |
$32.42
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: UMR Bronson Commercial |
$127.56
|
| Rate for Payer: VA VA |
$263.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.57
|
|
|
HC INJECTION PLANTAR DIGIT BILATERAL
|
Facility
|
IP
|
$517.14
|
|
|
Service Code
|
CPT 64455
|
| Hospital Charge Code |
76100510
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$227.54 |
| Max. Negotiated Rate |
$465.43 |
| Rate for Payer: Aetna American Axle |
$336.14
|
| Rate for Payer: Aetna Commercial |
$439.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.14
|
| Rate for Payer: Cash Price |
$413.71
|
| Rate for Payer: Cofinity Commercial |
$362.00
|
| Rate for Payer: Cofinity Commercial |
$444.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.71
|
| Rate for Payer: Healthscope Commercial |
$465.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$362.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$387.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$439.57
|
| Rate for Payer: PHP Commercial |
$439.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$362.00
|
| Rate for Payer: Priority Health SBD |
$325.80
|
| Rate for Payer: UMR Bronson Commercial |
$227.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$387.86
|
|
|
HC INJECTION PLANTAR DIGIT BILATERAL
|
Facility
|
OP
|
$517.14
|
|
|
Service Code
|
CPT 64455
|
| Hospital Charge Code |
76100510
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$32.42 |
| Max. Negotiated Rate |
$828.79 |
| Rate for Payer: Aetna American Axle |
$336.14
|
| Rate for Payer: Aetna Commercial |
$439.57
|
| Rate for Payer: Aetna Medicare |
$273.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$290.76
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$413.71
|
| Rate for Payer: Cash Price |
$413.71
|
| Rate for Payer: Cofinity Commercial |
$444.74
|
| Rate for Payer: Cofinity Commercial |
$362.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$413.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$465.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$362.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$387.86
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$439.57
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$439.57
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$362.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$828.79
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$663.03
|
| Rate for Payer: Priority Health SBD |
$325.80
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.27
|
| Rate for Payer: UHC Exchange |
$32.42
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: UMR Bronson Commercial |
$191.34
|
| Rate for Payer: VA VA |
$263.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$387.86
|
|
|
HC INJECTION PLATELET PLASMA W/IMG HARVEST/PREP
|
Facility
|
IP
|
$790.00
|
|
|
Service Code
|
CPT 0232T
|
| Hospital Charge Code |
76100473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$347.60 |
| Max. Negotiated Rate |
$711.00 |
| Rate for Payer: Aetna American Axle |
$513.50
|
| Rate for Payer: Aetna Commercial |
$671.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.50
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cofinity Commercial |
$553.00
|
| Rate for Payer: Cofinity Commercial |
$679.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.00
|
| Rate for Payer: Healthscope Commercial |
$711.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$553.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$592.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$671.50
|
| Rate for Payer: PHP Commercial |
$671.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$553.00
|
| Rate for Payer: Priority Health SBD |
$497.70
|
| Rate for Payer: UMR Bronson Commercial |
$347.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$592.50
|
|
|
HC INJECTION PLATELET PLASMA W/IMG HARVEST/PREP
|
Facility
|
OP
|
$790.00
|
|
|
Service Code
|
CPT 0232T
|
| Hospital Charge Code |
76100473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.73 |
| Max. Negotiated Rate |
$1,114.93 |
| Rate for Payer: Aetna American Axle |
$513.50
|
| Rate for Payer: Aetna Commercial |
$671.50
|
| Rate for Payer: Aetna Medicare |
$368.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.50
|
| 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: BCN Medicare Advantage |
$354.16
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cash Price |
$632.00
|
| Rate for Payer: Cofinity Commercial |
$553.00
|
| Rate for Payer: Cofinity Commercial |
$679.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$632.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.16
|
| Rate for Payer: Healthscope Commercial |
$711.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$553.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$592.50
|
| 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 |
$671.50
|
| Rate for Payer: PACE Medicare |
$336.45
|
| Rate for Payer: PACE SWMI |
$354.16
|
| Rate for Payer: PHP Commercial |
$671.50
|
| 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 |
$553.00
|
| 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 |
$497.70
|
| Rate for Payer: Railroad Medicare Medicare |
$354.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.16
|
| Rate for Payer: UHC Medicare Advantage |
$364.78
|
| Rate for Payer: UMR Bronson Commercial |
$292.30
|
| Rate for Payer: VA VA |
$354.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$592.50
|
|
|
HC INJECTION PROC CYSTOGRAPHY VOIDING
|
Facility
|
OP
|
$1,284.65
|
|
|
Service Code
|
CPT 51600
|
| Hospital Charge Code |
36100251
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$41.91 |
| Max. Negotiated Rate |
$1,156.18 |
| Rate for Payer: Aetna American Axle |
$835.02
|
| Rate for Payer: Aetna Commercial |
$1,091.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$835.02
|
| Rate for Payer: BCBS Complete |
$513.86
|
| Rate for Payer: BCBS Trust/PPO |
$522.64
|
| Rate for Payer: Cash Price |
$1,027.72
|
| Rate for Payer: Cash Price |
$1,027.72
|
| Rate for Payer: Cofinity Commercial |
$1,104.80
|
| Rate for Payer: Cofinity Commercial |
$899.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,027.72
|
| Rate for Payer: Healthscope Commercial |
$1,156.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$899.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$963.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,091.95
|
| Rate for Payer: PHP Commercial |
$1,091.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.26
|
| Rate for Payer: Priority Health SBD |
$809.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.10
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$41.91
|
| Rate for Payer: UMR Bronson Commercial |
$475.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$963.49
|
|
|
HC INJECTION PROC CYSTOGRAPHY VOIDING
|
Facility
|
IP
|
$1,284.65
|
|
|
Service Code
|
CPT 51600
|
| Hospital Charge Code |
36100251
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$565.25 |
| Max. Negotiated Rate |
$1,156.18 |
| Rate for Payer: Aetna American Axle |
$835.02
|
| Rate for Payer: Aetna Commercial |
$1,091.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$835.02
|
| Rate for Payer: Cash Price |
$1,027.72
|
| Rate for Payer: Cofinity Commercial |
$1,104.80
|
| Rate for Payer: Cofinity Commercial |
$899.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,027.72
|
| Rate for Payer: Healthscope Commercial |
$1,156.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$899.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$963.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,091.95
|
| Rate for Payer: PHP Commercial |
$1,091.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$899.26
|
| Rate for Payer: Priority Health SBD |
$809.33
|
| Rate for Payer: UMR Bronson Commercial |
$565.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$963.49
|
|
|
HC INJECTION PROCEDURE
|
Facility
|
OP
|
$591.65
|
|
| Hospital Charge Code |
36000085
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$218.91 |
| Max. Negotiated Rate |
$532.48 |
| Rate for Payer: Aetna American Axle |
$384.57
|
| Rate for Payer: Aetna Commercial |
$502.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$384.57
|
| Rate for Payer: BCBS Complete |
$236.66
|
| Rate for Payer: Cash Price |
$473.32
|
| Rate for Payer: Cofinity Commercial |
$414.16
|
| Rate for Payer: Cofinity Commercial |
$508.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$473.32
|
| Rate for Payer: Healthscope Commercial |
$532.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$414.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$443.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$502.90
|
| Rate for Payer: PHP Commercial |
$502.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$414.16
|
| Rate for Payer: Priority Health SBD |
$372.74
|
| Rate for Payer: UMR Bronson Commercial |
$218.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$443.74
|
|
|
HC INJECTION PROCEDURE
|
Facility
|
IP
|
$591.65
|
|
| Hospital Charge Code |
36000085
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$260.33 |
| Max. Negotiated Rate |
$532.48 |
| Rate for Payer: Aetna American Axle |
$384.57
|
| Rate for Payer: Aetna Commercial |
$502.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$384.57
|
| Rate for Payer: Cash Price |
$473.32
|
| Rate for Payer: Cofinity Commercial |
$414.16
|
| Rate for Payer: Cofinity Commercial |
$508.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$473.32
|
| Rate for Payer: Healthscope Commercial |
$532.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$414.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$443.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$502.90
|
| Rate for Payer: PHP Commercial |
$502.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$414.16
|
| Rate for Payer: Priority Health SBD |
$372.74
|
| Rate for Payer: UMR Bronson Commercial |
$260.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$443.74
|
|
|
HC INJECTION PROCEDURE ILEAL CONDUIT
|
Facility
|
OP
|
$630.91
|
|
|
Service Code
|
CPT 50690
|
| Hospital Charge Code |
36100249
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$67.78 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$410.09
|
| Rate for Payer: Aetna Commercial |
$536.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.09
|
| Rate for Payer: BCBS Complete |
$252.36
|
| Rate for Payer: BCBS Trust/PPO |
$339.72
|
| Rate for Payer: Cash Price |
$504.73
|
| Rate for Payer: Cash Price |
$504.73
|
| Rate for Payer: Cofinity Commercial |
$441.64
|
| Rate for Payer: Cofinity Commercial |
$542.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$504.73
|
| Rate for Payer: Healthscope Commercial |
$567.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$441.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$473.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$536.27
|
| Rate for Payer: PHP Commercial |
$536.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$441.64
|
| Rate for Payer: Priority Health SBD |
$397.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.56
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$67.78
|
| Rate for Payer: UMR Bronson Commercial |
$233.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$473.18
|
|
|
HC INJECTION PROCEDURE ILEAL CONDUIT
|
Facility
|
IP
|
$630.91
|
|
|
Service Code
|
CPT 50690
|
| Hospital Charge Code |
36100249
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$277.60 |
| Max. Negotiated Rate |
$567.82 |
| Rate for Payer: Aetna American Axle |
$410.09
|
| Rate for Payer: Aetna Commercial |
$536.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.09
|
| Rate for Payer: Cash Price |
$504.73
|
| Rate for Payer: Cofinity Commercial |
$542.58
|
| Rate for Payer: Cofinity Commercial |
$441.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$504.73
|
| Rate for Payer: Healthscope Commercial |
$567.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$441.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$473.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$536.27
|
| Rate for Payer: PHP Commercial |
$536.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$441.64
|
| Rate for Payer: Priority Health SBD |
$397.47
|
| Rate for Payer: UMR Bronson Commercial |
$277.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$473.18
|
|
|
HC INJECTION PROC RETROGRAD CYSTOGRAPHY
|
Facility
|
IP
|
$816.16
|
|
|
Service Code
|
CPT 51610
|
| Hospital Charge Code |
36100252
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$359.11 |
| Max. Negotiated Rate |
$734.54 |
| Rate for Payer: Aetna American Axle |
$530.50
|
| Rate for Payer: Aetna Commercial |
$693.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.50
|
| Rate for Payer: Cash Price |
$652.93
|
| Rate for Payer: Cofinity Commercial |
$571.31
|
| Rate for Payer: Cofinity Commercial |
$701.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$652.93
|
| Rate for Payer: Healthscope Commercial |
$734.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$571.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$693.74
|
| Rate for Payer: PHP Commercial |
$693.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$571.31
|
| Rate for Payer: Priority Health SBD |
$514.18
|
| Rate for Payer: UMR Bronson Commercial |
$359.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.12
|
|
|
HC INJECTION PROC RETROGRAD CYSTOGRAPHY
|
Facility
|
OP
|
$816.16
|
|
|
Service Code
|
CPT 51610
|
| Hospital Charge Code |
36100252
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.54 |
| Max. Negotiated Rate |
$734.54 |
| Rate for Payer: Aetna American Axle |
$530.50
|
| Rate for Payer: Aetna Commercial |
$693.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$530.50
|
| Rate for Payer: BCBS Complete |
$326.46
|
| Rate for Payer: BCBS Trust/PPO |
$473.31
|
| Rate for Payer: Cash Price |
$652.93
|
| Rate for Payer: Cash Price |
$652.93
|
| Rate for Payer: Cofinity Commercial |
$701.90
|
| Rate for Payer: Cofinity Commercial |
$571.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$652.93
|
| Rate for Payer: Healthscope Commercial |
$734.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$571.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$612.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$693.74
|
| Rate for Payer: PHP Commercial |
$693.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$571.31
|
| Rate for Payer: Priority Health SBD |
$514.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.79
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$62.54
|
| Rate for Payer: UMR Bronson Commercial |
$301.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$612.12
|
|
|
HC INJECTION, PROMETHAZINE HCL, UP TO 50 MG
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
CPT J2550
|
| Hospital Charge Code |
63600100
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna American Axle |
$9.94
|
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.94
|
| Rate for Payer: BCBS Complete |
$6.12
|
| Rate for Payer: BCBS Trust/PPO |
$11.58
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: UMR Bronson Commercial |
$5.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC INJECTION, PROMETHAZINE HCL, UP TO 50 MG
|
Facility
|
IP
|
$15.30
|
|
|
Service Code
|
CPT J2550
|
| Hospital Charge Code |
63600100
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna American Axle |
$9.94
|
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.94
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: UMR Bronson Commercial |
$6.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC INJECTION PUDENDAL NERVE
|
Facility
|
OP
|
$1,170.21
|
|
|
Service Code
|
CPT 64430
|
| Hospital Charge Code |
36100570
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$53.37 |
| Max. Negotiated Rate |
$2,550.52 |
| Rate for Payer: Aetna American Axle |
$760.64
|
| Rate for Payer: Aetna Commercial |
$994.68
|
| Rate for Payer: Aetna Medicare |
$842.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$760.64
|
| 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 |
$841.86
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$936.17
|
| Rate for Payer: Cash Price |
$936.17
|
| Rate for Payer: Cofinity Commercial |
$819.15
|
| Rate for Payer: Cofinity Commercial |
$1,006.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$936.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,053.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$819.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$877.66
|
| 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 |
$994.68
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$994.68
|
| 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 |
$819.15
|
| 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 |
$737.23
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.71
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.19
|
| Rate for Payer: UHC Exchange |
$53.37
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$432.98
|
| Rate for Payer: VA VA |
$810.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$877.66
|
|
|
HC INJECTION PUDENDAL NERVE
|
Facility
|
IP
|
$1,170.21
|
|
|
Service Code
|
CPT 64430
|
| Hospital Charge Code |
36100570
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$514.89 |
| Max. Negotiated Rate |
$1,053.19 |
| Rate for Payer: Aetna American Axle |
$760.64
|
| Rate for Payer: Aetna Commercial |
$994.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$760.64
|
| Rate for Payer: Cash Price |
$936.17
|
| Rate for Payer: Cofinity Commercial |
$1,006.38
|
| Rate for Payer: Cofinity Commercial |
$819.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$936.17
|
| Rate for Payer: Healthscope Commercial |
$1,053.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$819.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$877.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$994.68
|
| Rate for Payer: PHP Commercial |
$994.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.15
|
| Rate for Payer: Priority Health SBD |
$737.23
|
| Rate for Payer: UMR Bronson Commercial |
$514.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$877.66
|
|
|
HC INJECTION SCLEROSING SOL MULTIPLE
|
Facility
|
IP
|
$322.83
|
|
|
Service Code
|
CPT 36471
|
| Hospital Charge Code |
36100117
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$142.05 |
| Max. Negotiated Rate |
$290.55 |
| Rate for Payer: Aetna American Axle |
$209.84
|
| Rate for Payer: Aetna Commercial |
$274.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.84
|
| Rate for Payer: Cash Price |
$258.26
|
| Rate for Payer: Cofinity Commercial |
$225.98
|
| Rate for Payer: Cofinity Commercial |
$277.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.26
|
| Rate for Payer: Healthscope Commercial |
$290.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$225.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$242.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$274.41
|
| Rate for Payer: PHP Commercial |
$274.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.98
|
| Rate for Payer: Priority Health SBD |
$203.38
|
| Rate for Payer: UMR Bronson Commercial |
$142.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$242.12
|
|
|
HC INJECTION SCLEROSING SOL MULTIPLE
|
Facility
|
OP
|
$322.83
|
|
|
Service Code
|
CPT 36471
|
| Hospital Charge Code |
36100117
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$73.02 |
| Max. Negotiated Rate |
$1,115.78 |
| Rate for Payer: Aetna American Axle |
$209.84
|
| Rate for Payer: Aetna Commercial |
$274.41
|
| Rate for Payer: Aetna Medicare |
$368.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$294.85
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$258.26
|
| Rate for Payer: Cash Price |
$258.26
|
| Rate for Payer: Cofinity Commercial |
$225.98
|
| Rate for Payer: Cofinity Commercial |
$277.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$258.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$290.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$225.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$242.12
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$274.41
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$274.41
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.78
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$892.62
|
| Rate for Payer: Priority Health SBD |
$203.38
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.43
|
| Rate for Payer: UHC Exchange |
$73.02
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: UMR Bronson Commercial |
$119.45
|
| Rate for Payer: VA VA |
$354.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$242.12
|
|
|
HC INJECTION SCLEROSING SOL SINGLE
|
Facility
|
OP
|
$245.28
|
|
|
Service Code
|
CPT 36470
|
| Hospital Charge Code |
36100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$36.67 |
| Max. Negotiated Rate |
$1,115.78 |
| Rate for Payer: Aetna American Axle |
$159.43
|
| Rate for Payer: Aetna Commercial |
$208.49
|
| Rate for Payer: Aetna Medicare |
$368.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$130.83
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$196.22
|
| Rate for Payer: Cash Price |
$196.22
|
| Rate for Payer: Cofinity Commercial |
$171.70
|
| Rate for Payer: Cofinity Commercial |
$210.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$220.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.96
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$208.49
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$208.49
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.78
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$892.62
|
| Rate for Payer: Priority Health SBD |
$154.53
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.43
|
| Rate for Payer: UHC Exchange |
$36.67
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: UMR Bronson Commercial |
$90.75
|
| Rate for Payer: VA VA |
$354.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.96
|
|
|
HC INJECTION SCLEROSING SOL SINGLE
|
Facility
|
IP
|
$245.28
|
|
|
Service Code
|
CPT 36470
|
| Hospital Charge Code |
36100116
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$107.92 |
| Max. Negotiated Rate |
$220.75 |
| Rate for Payer: Aetna American Axle |
$159.43
|
| Rate for Payer: Aetna Commercial |
$208.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.43
|
| Rate for Payer: Cash Price |
$196.22
|
| Rate for Payer: Cofinity Commercial |
$171.70
|
| Rate for Payer: Cofinity Commercial |
$210.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.22
|
| Rate for Payer: Healthscope Commercial |
$220.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$208.49
|
| Rate for Payer: PHP Commercial |
$208.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.70
|
| Rate for Payer: Priority Health SBD |
$154.53
|
| Rate for Payer: UMR Bronson Commercial |
$107.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.96
|
|
|
HC INJECTION SHOULDER ARTHROGRAM
|
Facility
|
OP
|
$846.52
|
|
|
Service Code
|
CPT 23350
|
| Hospital Charge Code |
36100037
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$48.13 |
| Max. Negotiated Rate |
$761.87 |
| Rate for Payer: Aetna American Axle |
$550.24
|
| Rate for Payer: Aetna Commercial |
$719.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$550.24
|
| Rate for Payer: BCBS Complete |
$338.61
|
| Rate for Payer: BCBS Trust/PPO |
$302.55
|
| Rate for Payer: Cash Price |
$677.22
|
| Rate for Payer: Cash Price |
$677.22
|
| Rate for Payer: Cofinity Commercial |
$592.56
|
| Rate for Payer: Cofinity Commercial |
$728.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$677.22
|
| Rate for Payer: Healthscope Commercial |
$761.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$592.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$634.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$719.54
|
| Rate for Payer: PHP Commercial |
$719.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$592.56
|
| Rate for Payer: Priority Health SBD |
$533.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.94
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$48.13
|
| Rate for Payer: UMR Bronson Commercial |
$313.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$634.89
|
|
|
HC INJECTION SHOULDER ARTHROGRAM
|
Facility
|
IP
|
$846.52
|
|
|
Service Code
|
CPT 23350
|
| Hospital Charge Code |
36100037
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$372.47 |
| Max. Negotiated Rate |
$761.87 |
| Rate for Payer: Aetna American Axle |
$550.24
|
| Rate for Payer: Aetna Commercial |
$719.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$550.24
|
| Rate for Payer: Cash Price |
$677.22
|
| Rate for Payer: Cofinity Commercial |
$728.01
|
| Rate for Payer: Cofinity Commercial |
$592.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$677.22
|
| Rate for Payer: Healthscope Commercial |
$761.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$592.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$634.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$719.54
|
| Rate for Payer: PHP Commercial |
$719.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$592.56
|
| Rate for Payer: Priority Health SBD |
$533.31
|
| Rate for Payer: UMR Bronson Commercial |
$372.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$634.89
|
|
