|
HC INJECTION SHUNTOGRAM
|
Facility
|
OP
|
$381.09
|
|
|
Service Code
|
CPT 49427
|
| Hospital Charge Code |
36100224
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$37.33 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$247.71
|
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.71
|
| Rate for Payer: BCBS Complete |
$152.44
|
| Rate for Payer: BCBS Trust/PPO |
$160.21
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$266.76
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$266.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health SBD |
$240.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.06
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$37.33
|
| Rate for Payer: UMR Bronson Commercial |
$141.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC INJECTION SHUNTOGRAM
|
Facility
|
IP
|
$381.09
|
|
|
Service Code
|
CPT 49427
|
| Hospital Charge Code |
36100224
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$167.68 |
| Max. Negotiated Rate |
$342.98 |
| Rate for Payer: Aetna American Axle |
$247.71
|
| Rate for Payer: Aetna Commercial |
$323.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.71
|
| Rate for Payer: Cash Price |
$304.87
|
| Rate for Payer: Cofinity Commercial |
$266.76
|
| Rate for Payer: Cofinity Commercial |
$327.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.87
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$266.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.93
|
| Rate for Payer: PHP Commercial |
$323.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.76
|
| Rate for Payer: Priority Health SBD |
$240.09
|
| Rate for Payer: UMR Bronson Commercial |
$167.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.82
|
|
|
HC INJECTION SIALOGRAM
|
Facility
|
OP
|
$286.12
|
|
|
Service Code
|
CPT 42550
|
| Hospital Charge Code |
36100190
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$58.94 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$185.98
|
| Rate for Payer: Aetna Commercial |
$243.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.98
|
| Rate for Payer: BCBS Complete |
$114.45
|
| Rate for Payer: BCBS Trust/PPO |
$466.23
|
| Rate for Payer: Cash Price |
$228.90
|
| Rate for Payer: Cash Price |
$228.90
|
| Rate for Payer: Cofinity Commercial |
$246.06
|
| Rate for Payer: Cofinity Commercial |
$200.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.90
|
| Rate for Payer: Healthscope Commercial |
$257.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.20
|
| Rate for Payer: PHP Commercial |
$243.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.28
|
| Rate for Payer: Priority Health SBD |
$180.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.83
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$58.94
|
| Rate for Payer: UMR Bronson Commercial |
$105.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.59
|
|
|
HC INJECTION SIALOGRAM
|
Facility
|
IP
|
$286.12
|
|
|
Service Code
|
CPT 42550
|
| Hospital Charge Code |
36100190
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$125.89 |
| Max. Negotiated Rate |
$257.51 |
| Rate for Payer: Aetna American Axle |
$185.98
|
| Rate for Payer: Aetna Commercial |
$243.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.98
|
| Rate for Payer: Cash Price |
$228.90
|
| Rate for Payer: Cofinity Commercial |
$200.28
|
| Rate for Payer: Cofinity Commercial |
$246.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.90
|
| Rate for Payer: Healthscope Commercial |
$257.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$243.20
|
| Rate for Payer: PHP Commercial |
$243.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.28
|
| Rate for Payer: Priority Health SBD |
$180.26
|
| Rate for Payer: UMR Bronson Commercial |
$125.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.59
|
|
|
HC INJECTION SI JOINT ANESTHESIA/STEROID
|
Facility
|
OP
|
$991.42
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100042
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$80.88 |
| Max. Negotiated Rate |
$892.28 |
| Rate for Payer: Aetna American Axle |
$644.42
|
| Rate for Payer: Aetna Commercial |
$842.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.42
|
| Rate for Payer: BCBS Complete |
$396.57
|
| Rate for Payer: BCBS Trust/PPO |
$733.81
|
| Rate for Payer: Cash Price |
$793.14
|
| Rate for Payer: Cash Price |
$793.14
|
| Rate for Payer: Cofinity Commercial |
$852.62
|
| Rate for Payer: Cofinity Commercial |
$693.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.14
|
| Rate for Payer: Healthscope Commercial |
$892.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$693.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$842.71
|
| Rate for Payer: PHP Commercial |
$842.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$693.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$323.52
|
| Rate for Payer: Priority Health Narrow Network |
$258.82
|
| Rate for Payer: Priority Health SBD |
$624.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.97
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$80.88
|
| Rate for Payer: UMR Bronson Commercial |
$366.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.56
|
|
|
HC INJECTION SI JOINT ANESTHESIA/STEROID
|
Facility
|
IP
|
$991.42
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100042
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$436.22 |
| Max. Negotiated Rate |
$892.28 |
| Rate for Payer: Aetna American Axle |
$644.42
|
| Rate for Payer: Aetna Commercial |
$842.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.42
|
| Rate for Payer: Cash Price |
$793.14
|
| Rate for Payer: Cofinity Commercial |
$693.99
|
| Rate for Payer: Cofinity Commercial |
$852.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.14
|
| Rate for Payer: Healthscope Commercial |
$892.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$693.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$842.71
|
| Rate for Payer: PHP Commercial |
$842.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$693.99
|
| Rate for Payer: Priority Health SBD |
$624.59
|
| Rate for Payer: UMR Bronson Commercial |
$436.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.56
|
|
|
HC INJECTION SI JOINT BIL ANESTHESIA/STEROID
|
Facility
|
IP
|
$1,027.30
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100043
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$452.01 |
| Max. Negotiated Rate |
$924.57 |
| Rate for Payer: Aetna American Axle |
$667.74
|
| Rate for Payer: Aetna Commercial |
$873.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$667.74
|
| Rate for Payer: Cash Price |
$821.84
|
| Rate for Payer: Cofinity Commercial |
$719.11
|
| Rate for Payer: Cofinity Commercial |
$883.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$821.84
|
| Rate for Payer: Healthscope Commercial |
$924.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$719.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$770.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$873.20
|
| Rate for Payer: PHP Commercial |
$873.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$719.11
|
| Rate for Payer: Priority Health SBD |
$647.20
|
| Rate for Payer: UMR Bronson Commercial |
$452.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$770.48
|
|
|
HC INJECTION SI JOINT BIL ANESTHESIA/STEROID
|
Facility
|
OP
|
$1,027.30
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100043
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$80.88 |
| Max. Negotiated Rate |
$924.57 |
| Rate for Payer: Aetna American Axle |
$667.74
|
| Rate for Payer: Aetna Commercial |
$873.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$667.74
|
| Rate for Payer: BCBS Complete |
$410.92
|
| Rate for Payer: BCBS Trust/PPO |
$733.81
|
| Rate for Payer: Cash Price |
$821.84
|
| Rate for Payer: Cash Price |
$821.84
|
| Rate for Payer: Cofinity Commercial |
$883.48
|
| Rate for Payer: Cofinity Commercial |
$719.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$821.84
|
| Rate for Payer: Healthscope Commercial |
$924.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$719.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$770.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$873.20
|
| Rate for Payer: PHP Commercial |
$873.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$719.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$323.52
|
| Rate for Payer: Priority Health Narrow Network |
$258.82
|
| Rate for Payer: Priority Health SBD |
$647.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.97
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$80.88
|
| Rate for Payer: UMR Bronson Commercial |
$380.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$770.48
|
|
|
HC INJECTION SINGLE TENDON ORIGIN/INSERTION
|
Facility
|
OP
|
$273.88
|
|
|
Service Code
|
CPT 20551
|
| Hospital Charge Code |
36100519
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$37.66 |
| Max. Negotiated Rate |
$828.79 |
| Rate for Payer: Aetna American Axle |
$178.02
|
| Rate for Payer: Aetna Commercial |
$232.80
|
| Rate for Payer: Aetna Medicare |
$273.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.02
|
| 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 |
$219.10
|
| Rate for Payer: Cash Price |
$219.10
|
| Rate for Payer: Cofinity Commercial |
$235.54
|
| Rate for Payer: Cofinity Commercial |
$191.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$246.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$191.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.41
|
| 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 |
$232.80
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$232.80
|
| 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 |
$191.72
|
| 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 |
$172.54
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.27
|
| Rate for Payer: UHC Exchange |
$37.66
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: UMR Bronson Commercial |
$101.34
|
| Rate for Payer: VA VA |
$263.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.41
|
|
|
HC INJECTION SINGLE TENDON ORIGIN/INSERTION
|
Facility
|
IP
|
$273.88
|
|
|
Service Code
|
CPT 20551
|
| Hospital Charge Code |
36100519
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$120.51 |
| Max. Negotiated Rate |
$246.49 |
| Rate for Payer: Aetna American Axle |
$178.02
|
| Rate for Payer: Aetna Commercial |
$232.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.02
|
| Rate for Payer: Cash Price |
$219.10
|
| Rate for Payer: Cofinity Commercial |
$191.72
|
| Rate for Payer: Cofinity Commercial |
$235.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.10
|
| Rate for Payer: Healthscope Commercial |
$246.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$191.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$232.80
|
| Rate for Payer: PHP Commercial |
$232.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.72
|
| Rate for Payer: Priority Health SBD |
$172.54
|
| Rate for Payer: UMR Bronson Commercial |
$120.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.41
|
|
|
HC INJECTION SPLENOPOTOGRAM SPLENOPORTOG
|
Facility
|
IP
|
$429.05
|
|
|
Service Code
|
CPT 38200
|
| Hospital Charge Code |
36100183
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$188.78 |
| Max. Negotiated Rate |
$386.14 |
| Rate for Payer: Aetna American Axle |
$278.88
|
| Rate for Payer: Aetna Commercial |
$364.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.88
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$300.34
|
| Rate for Payer: Cofinity Commercial |
$368.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.24
|
| Rate for Payer: Healthscope Commercial |
$386.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: PHP Commercial |
$364.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health SBD |
$270.30
|
| Rate for Payer: UMR Bronson Commercial |
$188.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.79
|
|
|
HC INJECTION SPLENOPOTOGRAM SPLENOPORTOG
|
Facility
|
OP
|
$429.05
|
|
|
Service Code
|
CPT 38200
|
| Hospital Charge Code |
36100183
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$125.08 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$278.88
|
| Rate for Payer: Aetna Commercial |
$364.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.88
|
| Rate for Payer: BCBS Complete |
$171.62
|
| Rate for Payer: BCBS Trust/PPO |
$472.24
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$300.34
|
| Rate for Payer: Cofinity Commercial |
$368.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.24
|
| Rate for Payer: Healthscope Commercial |
$386.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: PHP Commercial |
$364.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health SBD |
$270.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.59
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$125.08
|
| Rate for Payer: UMR Bronson Commercial |
$158.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.79
|
|
|
HC INJECTIONS SCLEROSANT FOR SPIDER VEINS /TRNK
|
Facility
|
OP
|
$1,064.00
|
|
|
Service Code
|
CPT 36468
|
| Hospital Charge Code |
76100400
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$136.36 |
| Max. Negotiated Rate |
$1,115.78 |
| Rate for Payer: Aetna American Axle |
$691.60
|
| Rate for Payer: Aetna Commercial |
$904.40
|
| Rate for Payer: Aetna Medicare |
$368.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$691.60
|
| 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 |
$136.36
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$851.20
|
| Rate for Payer: Cash Price |
$851.20
|
| Rate for Payer: Cofinity Commercial |
$915.04
|
| Rate for Payer: Cofinity Commercial |
$744.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$851.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$957.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$744.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.00
|
| 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 |
$904.40
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$904.40
|
| 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 |
$744.80
|
| 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 |
$670.32
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.43
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: UMR Bronson Commercial |
$393.68
|
| Rate for Payer: VA VA |
$354.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.00
|
|
|
HC INJECTIONS SCLEROSANT FOR SPIDER VEINS /TRNK
|
Facility
|
IP
|
$1,064.00
|
|
|
Service Code
|
CPT 36468
|
| Hospital Charge Code |
76100400
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$468.16 |
| Max. Negotiated Rate |
$957.60 |
| Rate for Payer: Aetna American Axle |
$691.60
|
| Rate for Payer: Aetna Commercial |
$904.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$691.60
|
| Rate for Payer: Cash Price |
$851.20
|
| Rate for Payer: Cofinity Commercial |
$744.80
|
| Rate for Payer: Cofinity Commercial |
$915.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$851.20
|
| Rate for Payer: Healthscope Commercial |
$957.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$744.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$798.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$904.40
|
| Rate for Payer: PHP Commercial |
$904.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.80
|
| Rate for Payer: Priority Health SBD |
$670.32
|
| Rate for Payer: UMR Bronson Commercial |
$468.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$798.00
|
|
|
HC INJECTION, TESTOSTERONE CYPIONATE, 1 MG
|
Facility
|
OP
|
$0.16
|
|
|
Service Code
|
CPT J1071
|
| Hospital Charge Code |
63600109
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: Aetna American Axle |
$0.10
|
| Rate for Payer: Aetna Commercial |
$0.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.10
|
| Rate for Payer: BCBS Complete |
$0.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: Cash Price |
$0.13
|
| Rate for Payer: Cash Price |
$0.13
|
| Rate for Payer: Cofinity Commercial |
$0.11
|
| Rate for Payer: Cofinity Commercial |
$0.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.13
|
| Rate for Payer: Healthscope Commercial |
$0.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$0.14
|
| Rate for Payer: PHP Commercial |
$0.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.11
|
| Rate for Payer: Priority Health SBD |
$0.10
|
| Rate for Payer: UMR Bronson Commercial |
$0.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.12
|
|
|
HC INJECTION, TESTOSTERONE CYPIONATE, 1 MG
|
Facility
|
IP
|
$0.16
|
|
|
Service Code
|
CPT J1071
|
| Hospital Charge Code |
63600109
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: Aetna American Axle |
$0.10
|
| Rate for Payer: Aetna Commercial |
$0.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.10
|
| Rate for Payer: Cash Price |
$0.13
|
| Rate for Payer: Cofinity Commercial |
$0.11
|
| Rate for Payer: Cofinity Commercial |
$0.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.13
|
| Rate for Payer: Healthscope Commercial |
$0.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$0.14
|
| Rate for Payer: PHP Commercial |
$0.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.11
|
| Rate for Payer: Priority Health SBD |
$0.10
|
| Rate for Payer: UMR Bronson Commercial |
$0.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.12
|
|
|
HC INJECTION THERAPEUTIC SINUS TRACT
|
Facility
|
OP
|
$905.55
|
|
|
Service Code
|
CPT 20500
|
| Hospital Charge Code |
36100020
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$69.28 |
| Max. Negotiated Rate |
$4,267.42 |
| Rate for Payer: Aetna American Axle |
$588.61
|
| Rate for Payer: Aetna Commercial |
$769.72
|
| Rate for Payer: Aetna Medicare |
$1,409.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$588.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,694.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,694.48
|
| Rate for Payer: BCBS Complete |
$778.65
|
| Rate for Payer: BCBS MAPPO |
$1,355.58
|
| Rate for Payer: BCBS Trust/PPO |
$69.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,355.58
|
| Rate for Payer: Cash Price |
$724.44
|
| Rate for Payer: Cash Price |
$724.44
|
| Rate for Payer: Cofinity Commercial |
$633.88
|
| Rate for Payer: Cofinity Commercial |
$778.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,355.58
|
| Rate for Payer: Healthscope Commercial |
$815.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$633.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$679.16
|
| Rate for Payer: Mclaren Medicaid |
$741.50
|
| Rate for Payer: Mclaren Medicare |
$1,355.58
|
| Rate for Payer: Meridian Medicaid |
$778.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,423.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,558.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$769.72
|
| Rate for Payer: PACE Medicare |
$1,287.80
|
| Rate for Payer: PACE SWMI |
$1,355.58
|
| Rate for Payer: PHP Commercial |
$769.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,355.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$741.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,267.42
|
| Rate for Payer: Priority Health Medicare |
$1,355.58
|
| Rate for Payer: Priority Health Narrow Network |
$3,413.94
|
| Rate for Payer: Priority Health SBD |
$570.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,355.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.89
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,355.58
|
| Rate for Payer: UHC Exchange |
$88.08
|
| Rate for Payer: UHC Medicare Advantage |
$1,396.25
|
| Rate for Payer: UMR Bronson Commercial |
$335.05
|
| Rate for Payer: VA VA |
$1,355.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$679.16
|
|
|
HC INJECTION THERAPEUTIC SINUS TRACT
|
Facility
|
IP
|
$905.55
|
|
|
Service Code
|
CPT 20500
|
| Hospital Charge Code |
36100020
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$398.44 |
| Max. Negotiated Rate |
$815.00 |
| Rate for Payer: Aetna American Axle |
$588.61
|
| Rate for Payer: Aetna Commercial |
$769.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$588.61
|
| Rate for Payer: Cash Price |
$724.44
|
| Rate for Payer: Cofinity Commercial |
$633.88
|
| Rate for Payer: Cofinity Commercial |
$778.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.44
|
| Rate for Payer: Healthscope Commercial |
$815.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$633.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$679.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$769.72
|
| Rate for Payer: PHP Commercial |
$769.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$633.88
|
| Rate for Payer: Priority Health SBD |
$570.50
|
| Rate for Payer: UMR Bronson Commercial |
$398.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$679.16
|
|
|
HC INJECTION TRANSFORAMINAL CERVICAL OR THORACIC
|
Facility
|
IP
|
$1,690.61
|
|
|
Service Code
|
CPT 64479
|
| Hospital Charge Code |
36100286
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$743.87 |
| Max. Negotiated Rate |
$1,521.55 |
| Rate for Payer: Aetna American Axle |
$1,098.90
|
| Rate for Payer: Aetna Commercial |
$1,437.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,098.90
|
| Rate for Payer: Cash Price |
$1,352.49
|
| Rate for Payer: Cofinity Commercial |
$1,183.43
|
| Rate for Payer: Cofinity Commercial |
$1,453.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,352.49
|
| Rate for Payer: Healthscope Commercial |
$1,521.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,183.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,267.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,437.02
|
| Rate for Payer: PHP Commercial |
$1,437.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,183.43
|
| Rate for Payer: Priority Health SBD |
$1,065.08
|
| Rate for Payer: UMR Bronson Commercial |
$743.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,267.96
|
|
|
HC INJECTION TRANSFORAMINAL CERVICAL OR THORACIC
|
Facility
|
OP
|
$1,690.61
|
|
|
Service Code
|
CPT 64479
|
| Hospital Charge Code |
36100286
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.37 |
| Max. Negotiated Rate |
$2,550.52 |
| Rate for Payer: Aetna American Axle |
$1,098.90
|
| Rate for Payer: Aetna Commercial |
$1,437.02
|
| Rate for Payer: Aetna Medicare |
$842.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,098.90
|
| 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 |
$873.81
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$1,352.49
|
| Rate for Payer: Cash Price |
$1,352.49
|
| Rate for Payer: Cofinity Commercial |
$1,453.92
|
| Rate for Payer: Cofinity Commercial |
$1,183.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,352.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,521.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,183.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,267.96
|
| 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 |
$1,437.02
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$1,437.02
|
| 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 |
$1,183.43
|
| 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 |
$1,065.08
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.11
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.19
|
| Rate for Payer: UHC Exchange |
$127.37
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$625.53
|
| Rate for Payer: VA VA |
$810.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,267.96
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC BIL
|
Facility
|
IP
|
$2,535.91
|
|
|
Service Code
|
CPT 64479
|
| Hospital Charge Code |
36100623
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,115.80 |
| Max. Negotiated Rate |
$2,282.32 |
| Rate for Payer: Aetna American Axle |
$1,648.34
|
| Rate for Payer: Aetna Commercial |
$2,155.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,648.34
|
| Rate for Payer: Cash Price |
$2,028.73
|
| Rate for Payer: Cofinity Commercial |
$1,775.14
|
| Rate for Payer: Cofinity Commercial |
$2,180.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,028.73
|
| Rate for Payer: Healthscope Commercial |
$2,282.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,775.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,901.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,155.52
|
| Rate for Payer: PHP Commercial |
$2,155.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,775.14
|
| Rate for Payer: Priority Health SBD |
$1,597.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,115.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,901.93
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC BIL
|
Facility
|
OP
|
$2,535.91
|
|
|
Service Code
|
CPT 64479
|
| Hospital Charge Code |
36100623
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.37 |
| Max. Negotiated Rate |
$2,550.52 |
| Rate for Payer: Aetna American Axle |
$1,648.34
|
| Rate for Payer: Aetna Commercial |
$2,155.52
|
| Rate for Payer: Aetna Medicare |
$842.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,648.34
|
| 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 |
$873.81
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$2,028.73
|
| Rate for Payer: Cash Price |
$2,028.73
|
| Rate for Payer: Cofinity Commercial |
$1,775.14
|
| Rate for Payer: Cofinity Commercial |
$2,180.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,028.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$2,282.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,775.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,901.93
|
| 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 |
$2,155.52
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$2,155.52
|
| 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 |
$1,775.14
|
| 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 |
$1,597.62
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.11
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.19
|
| Rate for Payer: UHC Exchange |
$127.37
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$938.29
|
| Rate for Payer: VA VA |
$810.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,901.93
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC EA ADD
|
Facility
|
OP
|
$893.62
|
|
|
Service Code
|
CPT 64480
|
| Hospital Charge Code |
36100287
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$59.27 |
| Max. Negotiated Rate |
$804.26 |
| Rate for Payer: Aetna American Axle |
$580.85
|
| Rate for Payer: Aetna Commercial |
$759.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.85
|
| Rate for Payer: BCBS Complete |
$357.45
|
| Rate for Payer: BCBS Trust/PPO |
$384.28
|
| Rate for Payer: Cash Price |
$714.90
|
| Rate for Payer: Cash Price |
$714.90
|
| Rate for Payer: Cofinity Commercial |
$625.53
|
| Rate for Payer: Cofinity Commercial |
$768.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$714.90
|
| Rate for Payer: Healthscope Commercial |
$804.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$625.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$670.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$759.58
|
| Rate for Payer: PHP Commercial |
$759.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$625.53
|
| Rate for Payer: Priority Health SBD |
$562.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.20
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$59.27
|
| Rate for Payer: UMR Bronson Commercial |
$330.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$670.22
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC EA ADD
|
Facility
|
IP
|
$893.62
|
|
|
Service Code
|
CPT 64480
|
| Hospital Charge Code |
36100287
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$393.19 |
| Max. Negotiated Rate |
$804.26 |
| Rate for Payer: Aetna American Axle |
$580.85
|
| Rate for Payer: Aetna Commercial |
$759.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$580.85
|
| Rate for Payer: Cash Price |
$714.90
|
| Rate for Payer: Cofinity Commercial |
$625.53
|
| Rate for Payer: Cofinity Commercial |
$768.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$714.90
|
| Rate for Payer: Healthscope Commercial |
$804.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$625.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$670.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$759.58
|
| Rate for Payer: PHP Commercial |
$759.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$625.53
|
| Rate for Payer: Priority Health SBD |
$562.98
|
| Rate for Payer: UMR Bronson Commercial |
$393.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$670.22
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC EACH ADDL BIL
|
Facility
|
IP
|
$1,340.43
|
|
|
Service Code
|
CPT 64480
|
| Hospital Charge Code |
36100624
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$589.79 |
| Max. Negotiated Rate |
$1,206.39 |
| Rate for Payer: Aetna American Axle |
$871.28
|
| Rate for Payer: Aetna Commercial |
$1,139.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$871.28
|
| Rate for Payer: Cash Price |
$1,072.34
|
| Rate for Payer: Cofinity Commercial |
$1,152.77
|
| Rate for Payer: Cofinity Commercial |
$938.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,072.34
|
| Rate for Payer: Healthscope Commercial |
$1,206.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$938.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,005.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,139.37
|
| Rate for Payer: PHP Commercial |
$1,139.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$938.30
|
| Rate for Payer: Priority Health SBD |
$844.47
|
| Rate for Payer: UMR Bronson Commercial |
$589.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,005.32
|
|
