|
HC BONE MARROW BIOPSY
|
Facility
|
IP
|
$2,064.67
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$908.45 |
| Max. Negotiated Rate |
$1,858.20 |
| Rate for Payer: Aetna American Axle |
$1,342.04
|
| Rate for Payer: Aetna Commercial |
$1,754.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,342.04
|
| Rate for Payer: Cash Price |
$1,651.74
|
| Rate for Payer: Cofinity Commercial |
$1,445.27
|
| Rate for Payer: Cofinity Commercial |
$1,775.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,445.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,651.74
|
| Rate for Payer: Healthscope Commercial |
$1,858.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,445.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,548.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,754.97
|
| Rate for Payer: PHP Commercial |
$1,754.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,342.04
|
| Rate for Payer: Priority Health SBD |
$1,300.74
|
| Rate for Payer: UMR Bronson Commercial |
$908.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,548.50
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
OP
|
$2,429.03
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$71.45 |
| Max. Negotiated Rate |
$8,813.49 |
| Rate for Payer: Aetna American Axle |
$1,578.87
|
| Rate for Payer: Aetna Commercial |
$2,064.68
|
| Rate for Payer: Aetna Medicare |
$2,916.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,578.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,505.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,505.22
|
| Rate for Payer: BCBS Complete |
$1,578.19
|
| Rate for Payer: BCBS MAPPO |
$2,804.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,897.37
|
| Rate for Payer: BCN Commercial |
$2,897.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,804.18
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cofinity Commercial |
$2,088.97
|
| Rate for Payer: Cofinity Commercial |
$1,700.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,700.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,943.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,804.18
|
| Rate for Payer: Healthscope Commercial |
$2,186.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,700.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,821.77
|
| Rate for Payer: Mclaren Medicaid |
$1,503.04
|
| Rate for Payer: Mclaren Medicare |
$2,804.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,944.39
|
| Rate for Payer: Meridian Medicaid |
$1,578.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,224.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,064.68
|
| Rate for Payer: Nomi Health Commercial |
$5,888.78
|
| Rate for Payer: PACE Medicare |
$2,663.97
|
| Rate for Payer: PACE SWMI |
$2,804.18
|
| Rate for Payer: PHP Commercial |
$2,064.68
|
| Rate for Payer: PHP Medicare Advantage |
$2,804.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,503.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,813.49
|
| Rate for Payer: Priority Health Medicare |
$2,804.18
|
| Rate for Payer: Priority Health Narrow Network |
$7,050.79
|
| Rate for Payer: Priority Health SBD |
$1,530.29
|
| Rate for Payer: Railroad Medicare Medicare |
$2,804.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.60
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,804.18
|
| Rate for Payer: UHC Exchange |
$71.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,804.18
|
| Rate for Payer: UHCCP Medicaid |
$1,503.04
|
| Rate for Payer: UMR Bronson Commercial |
$898.74
|
| Rate for Payer: VA VA |
$2,804.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,821.77
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
IP
|
$2,429.03
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,068.77 |
| Max. Negotiated Rate |
$2,186.13 |
| Rate for Payer: Aetna American Axle |
$1,578.87
|
| Rate for Payer: Aetna Commercial |
$2,064.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,578.87
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cofinity Commercial |
$1,700.32
|
| Rate for Payer: Cofinity Commercial |
$2,088.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,700.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,943.22
|
| Rate for Payer: Healthscope Commercial |
$2,186.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,700.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,821.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,064.68
|
| Rate for Payer: PHP Commercial |
$2,064.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.87
|
| Rate for Payer: Priority Health SBD |
$1,530.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,068.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,821.77
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
IP
|
$167.73
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$73.80 |
| Max. Negotiated Rate |
$150.96 |
| Rate for Payer: Aetna American Axle |
$109.02
|
| Rate for Payer: Aetna Commercial |
$142.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.02
|
| Rate for Payer: Cash Price |
$134.18
|
| Rate for Payer: Cofinity Commercial |
$117.41
|
| Rate for Payer: Cofinity Commercial |
$144.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$117.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.18
|
| Rate for Payer: Healthscope Commercial |
$150.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.57
|
| Rate for Payer: PHP Commercial |
$142.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.02
|
| Rate for Payer: Priority Health SBD |
$105.67
|
| Rate for Payer: UMR Bronson Commercial |
$73.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.80
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
OP
|
$167.73
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$45.23 |
| Max. Negotiated Rate |
$2,515.60 |
| Rate for Payer: Aetna American Axle |
$109.02
|
| Rate for Payer: Aetna Commercial |
$142.57
|
| Rate for Payer: Aetna Medicare |
$832.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,000.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,000.48
|
| Rate for Payer: BCBS Complete |
$450.45
|
| Rate for Payer: BCBS MAPPO |
$800.38
|
| Rate for Payer: BCBS Trust/PPO |
$106.74
|
| Rate for Payer: BCN Commercial |
$106.74
|
| Rate for Payer: BCN Medicare Advantage |
$800.38
|
| Rate for Payer: Cash Price |
$134.18
|
| Rate for Payer: Cash Price |
$134.18
|
| Rate for Payer: Cofinity Commercial |
$144.25
|
| Rate for Payer: Cofinity Commercial |
$117.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$117.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$800.38
|
| Rate for Payer: Healthscope Commercial |
$150.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.80
|
| Rate for Payer: Mclaren Medicaid |
$429.00
|
| Rate for Payer: Mclaren Medicare |
$800.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$840.40
|
| Rate for Payer: Meridian Medicaid |
$450.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$920.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.57
|
| Rate for Payer: Nomi Health Commercial |
$2,401.14
|
| Rate for Payer: PACE Medicare |
$760.36
|
| Rate for Payer: PACE SWMI |
$800.38
|
| Rate for Payer: PHP Commercial |
$142.57
|
| Rate for Payer: PHP Medicare Advantage |
$800.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$429.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,515.60
|
| Rate for Payer: Priority Health Medicare |
$800.38
|
| Rate for Payer: Priority Health Narrow Network |
$2,012.48
|
| Rate for Payer: Priority Health SBD |
$105.67
|
| Rate for Payer: Railroad Medicare Medicare |
$800.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$800.38
|
| Rate for Payer: UHC Exchange |
$45.23
|
| Rate for Payer: UHC Medicare Advantage |
$800.38
|
| Rate for Payer: UHCCP Medicaid |
$429.00
|
| Rate for Payer: UMR Bronson Commercial |
$62.06
|
| Rate for Payer: VA VA |
$800.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.80
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
IP
|
$148.17
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$65.19 |
| Max. Negotiated Rate |
$133.35 |
| Rate for Payer: Aetna American Axle |
$96.31
|
| Rate for Payer: Aetna Commercial |
$125.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.31
|
| Rate for Payer: Cash Price |
$118.54
|
| Rate for Payer: Cofinity Commercial |
$103.72
|
| Rate for Payer: Cofinity Commercial |
$127.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$103.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.54
|
| Rate for Payer: Healthscope Commercial |
$133.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.94
|
| Rate for Payer: PHP Commercial |
$125.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.31
|
| Rate for Payer: Priority Health SBD |
$93.35
|
| Rate for Payer: UMR Bronson Commercial |
$65.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.13
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
OP
|
$148.17
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.82 |
| Max. Negotiated Rate |
$133.35 |
| Rate for Payer: Aetna American Axle |
$96.31
|
| Rate for Payer: Aetna Commercial |
$125.94
|
| Rate for Payer: Aetna Medicare |
$74.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.31
|
| Rate for Payer: BCBS Complete |
$59.27
|
| Rate for Payer: Cash Price |
$118.54
|
| Rate for Payer: Cofinity Commercial |
$103.72
|
| Rate for Payer: Cofinity Commercial |
$127.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$103.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.54
|
| Rate for Payer: Healthscope Commercial |
$133.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.94
|
| Rate for Payer: PHP Commercial |
$125.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.31
|
| Rate for Payer: Priority Health SBD |
$93.35
|
| Rate for Payer: UMR Bronson Commercial |
$54.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.13
|
|
|
HC BOOT STATIC AIR W/STAB Z-FLEX
|
Facility
|
OP
|
$48.80
|
|
| Hospital Charge Code |
27000631
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.06 |
| Max. Negotiated Rate |
$43.92 |
| Rate for Payer: Cash Price |
$39.04
|
| Rate for Payer: Cofinity Commercial |
$34.16
|
| Rate for Payer: Cofinity Commercial |
$41.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.16
|
| Rate for Payer: Aetna American Axle |
$31.72
|
| Rate for Payer: Aetna Commercial |
$41.48
|
| Rate for Payer: Aetna Medicare |
$24.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.72
|
| Rate for Payer: BCBS Complete |
$19.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.04
|
| Rate for Payer: Healthscope Commercial |
$43.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.48
|
| Rate for Payer: PHP Commercial |
$41.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.72
|
| Rate for Payer: Priority Health SBD |
$30.74
|
| Rate for Payer: UMR Bronson Commercial |
$18.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.60
|
|
|
HC BOOT STATIC AIR W/STAB Z-FLEX
|
Facility
|
IP
|
$48.80
|
|
| Hospital Charge Code |
27000631
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.47 |
| Max. Negotiated Rate |
$43.92 |
| Rate for Payer: Aetna American Axle |
$31.72
|
| Rate for Payer: Aetna Commercial |
$41.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.72
|
| Rate for Payer: Cash Price |
$39.04
|
| Rate for Payer: Cofinity Commercial |
$34.16
|
| Rate for Payer: Cofinity Commercial |
$41.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.04
|
| Rate for Payer: Healthscope Commercial |
$43.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.48
|
| Rate for Payer: PHP Commercial |
$41.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.72
|
| Rate for Payer: Priority Health SBD |
$30.74
|
| Rate for Payer: UMR Bronson Commercial |
$21.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.60
|
|
|
HC BOSTON SCI CRT ICD
|
Facility
|
OP
|
$26,322.12
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500003
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$23,689.91 |
| Rate for Payer: Aetna American Axle |
$17,109.38
|
| Rate for Payer: Aetna Commercial |
$22,373.80
|
| Rate for Payer: Aetna Medicare |
$13,161.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,109.38
|
| Rate for Payer: BCBS Complete |
$10,528.85
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$21,057.70
|
| Rate for Payer: Cash Price |
$21,057.70
|
| Rate for Payer: Cofinity Commercial |
$18,425.48
|
| Rate for Payer: Cofinity Commercial |
$22,637.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$18,425.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,057.70
|
| Rate for Payer: Healthscope Commercial |
$23,689.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18,425.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19,741.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,373.80
|
| Rate for Payer: PHP Commercial |
$22,373.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,109.38
|
| Rate for Payer: Priority Health SBD |
$16,582.94
|
| Rate for Payer: UMR Bronson Commercial |
$9,739.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19,741.59
|
|
|
HC BOSTON SCI CRT ICD
|
Facility
|
IP
|
$26,322.12
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500003
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$11,581.73 |
| Max. Negotiated Rate |
$23,689.91 |
| Rate for Payer: Aetna American Axle |
$17,109.38
|
| Rate for Payer: Aetna Commercial |
$22,373.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,109.38
|
| Rate for Payer: Cash Price |
$21,057.70
|
| Rate for Payer: Cofinity Commercial |
$18,425.48
|
| Rate for Payer: Cofinity Commercial |
$22,637.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$18,425.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,057.70
|
| Rate for Payer: Healthscope Commercial |
$23,689.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18,425.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19,741.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,373.80
|
| Rate for Payer: PHP Commercial |
$22,373.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,109.38
|
| Rate for Payer: Priority Health SBD |
$16,582.94
|
| Rate for Payer: UMR Bronson Commercial |
$11,581.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19,741.59
|
|
|
HC BOSTON SCI CRT LEAD
|
Facility
|
OP
|
$6,886.81
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$6,198.13 |
| Rate for Payer: Cofinity Commercial |
$5,922.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,820.77
|
| Rate for Payer: Aetna American Axle |
$4,476.43
|
| Rate for Payer: Aetna Commercial |
$5,853.79
|
| Rate for Payer: Aetna Medicare |
$3,443.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,476.43
|
| Rate for Payer: BCBS Complete |
$2,754.72
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$5,509.45
|
| Rate for Payer: Cash Price |
$5,509.45
|
| Rate for Payer: Cofinity Commercial |
$4,820.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,509.45
|
| Rate for Payer: Healthscope Commercial |
$6,198.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,820.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,165.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,853.79
|
| Rate for Payer: PHP Commercial |
$5,853.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,476.43
|
| Rate for Payer: Priority Health SBD |
$4,338.69
|
| Rate for Payer: UMR Bronson Commercial |
$2,548.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,165.11
|
|
|
HC BOSTON SCI CRT LEAD
|
Facility
|
IP
|
$6,886.81
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,030.20 |
| Max. Negotiated Rate |
$6,198.13 |
| Rate for Payer: Aetna American Axle |
$4,476.43
|
| Rate for Payer: Aetna Commercial |
$5,853.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,476.43
|
| Rate for Payer: Cash Price |
$5,509.45
|
| Rate for Payer: Cofinity Commercial |
$4,820.77
|
| Rate for Payer: Cofinity Commercial |
$5,922.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,820.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,509.45
|
| Rate for Payer: Healthscope Commercial |
$6,198.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,820.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,165.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,853.79
|
| Rate for Payer: PHP Commercial |
$5,853.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,476.43
|
| Rate for Payer: Priority Health SBD |
$4,338.69
|
| Rate for Payer: UMR Bronson Commercial |
$3,030.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,165.11
|
|
|
HC BOSTON SCI DUAL PACEMAKER
|
Facility
|
IP
|
$8,572.90
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500004
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,772.08 |
| Max. Negotiated Rate |
$7,715.61 |
| Rate for Payer: Aetna American Axle |
$5,572.38
|
| Rate for Payer: Aetna Commercial |
$7,286.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,572.38
|
| Rate for Payer: Cash Price |
$6,858.32
|
| Rate for Payer: Cofinity Commercial |
$6,001.03
|
| Rate for Payer: Cofinity Commercial |
$7,372.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,001.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,858.32
|
| Rate for Payer: Healthscope Commercial |
$7,715.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,001.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,429.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,286.96
|
| Rate for Payer: PHP Commercial |
$7,286.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,572.38
|
| Rate for Payer: Priority Health SBD |
$5,400.93
|
| Rate for Payer: UMR Bronson Commercial |
$3,772.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,429.68
|
|
|
HC BOSTON SCI DUAL PACEMAKER
|
Facility
|
OP
|
$8,572.90
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500004
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,171.97 |
| Max. Negotiated Rate |
$7,715.61 |
| Rate for Payer: Priority Health SBD |
$5,400.93
|
| Rate for Payer: UMR Bronson Commercial |
$3,171.97
|
| Rate for Payer: Aetna American Axle |
$5,572.38
|
| Rate for Payer: Aetna Commercial |
$7,286.96
|
| Rate for Payer: Aetna Medicare |
$4,286.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,572.38
|
| Rate for Payer: BCBS Complete |
$3,429.16
|
| Rate for Payer: Cash Price |
$6,858.32
|
| Rate for Payer: Cofinity Commercial |
$6,001.03
|
| Rate for Payer: Cofinity Commercial |
$7,372.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,001.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,858.32
|
| Rate for Payer: Healthscope Commercial |
$7,715.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,001.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,429.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,286.96
|
| Rate for Payer: PHP Commercial |
$7,286.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,572.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,429.68
|
|
|
HC BOSTON SCI ICD DUAL
|
Facility
|
OP
|
$18,519.12
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800002
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,852.07 |
| Max. Negotiated Rate |
$16,667.21 |
| Rate for Payer: Aetna American Axle |
$12,037.43
|
| Rate for Payer: Aetna Commercial |
$15,741.25
|
| Rate for Payer: Aetna Medicare |
$9,259.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,037.43
|
| Rate for Payer: BCBS Complete |
$7,407.65
|
| Rate for Payer: Cash Price |
$14,815.30
|
| Rate for Payer: Cofinity Commercial |
$12,963.38
|
| Rate for Payer: Cofinity Commercial |
$15,926.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,963.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,815.30
|
| Rate for Payer: Healthscope Commercial |
$16,667.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,963.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,889.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,741.25
|
| Rate for Payer: PHP Commercial |
$15,741.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,037.43
|
| Rate for Payer: Priority Health SBD |
$11,667.05
|
| Rate for Payer: UMR Bronson Commercial |
$6,852.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,889.34
|
|
|
HC BOSTON SCI ICD DUAL
|
Facility
|
IP
|
$18,519.12
|
|
|
Service Code
|
HCPCS C1721
|
| Hospital Charge Code |
27800002
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,148.41 |
| Max. Negotiated Rate |
$16,667.21 |
| Rate for Payer: Aetna American Axle |
$12,037.43
|
| Rate for Payer: Aetna Commercial |
$15,741.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,037.43
|
| Rate for Payer: Cash Price |
$14,815.30
|
| Rate for Payer: Cofinity Commercial |
$12,963.38
|
| Rate for Payer: Cofinity Commercial |
$15,926.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,963.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,815.30
|
| Rate for Payer: Healthscope Commercial |
$16,667.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,963.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,889.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,741.25
|
| Rate for Payer: PHP Commercial |
$15,741.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,037.43
|
| Rate for Payer: Priority Health SBD |
$11,667.05
|
| Rate for Payer: UMR Bronson Commercial |
$8,148.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,889.34
|
|
|
HC BOSTON SCI ICD SINGLE
|
Facility
|
OP
|
$22,056.48
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,160.90 |
| Max. Negotiated Rate |
$19,850.83 |
| Rate for Payer: Aetna American Axle |
$14,336.71
|
| Rate for Payer: Aetna Commercial |
$18,748.01
|
| Rate for Payer: Aetna Medicare |
$11,028.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,336.71
|
| Rate for Payer: BCBS Complete |
$8,822.59
|
| Rate for Payer: Cash Price |
$17,645.18
|
| Rate for Payer: Cofinity Commercial |
$15,439.54
|
| Rate for Payer: Cofinity Commercial |
$18,968.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$15,439.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,645.18
|
| Rate for Payer: Healthscope Commercial |
$19,850.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15,439.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,542.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,748.01
|
| Rate for Payer: PHP Commercial |
$18,748.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,336.71
|
| Rate for Payer: Priority Health SBD |
$13,895.58
|
| Rate for Payer: UMR Bronson Commercial |
$8,160.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,542.36
|
|
|
HC BOSTON SCI ICD SINGLE
|
Facility
|
IP
|
$22,056.48
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,704.85 |
| Max. Negotiated Rate |
$19,850.83 |
| Rate for Payer: Aetna American Axle |
$14,336.71
|
| Rate for Payer: Aetna Commercial |
$18,748.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14,336.71
|
| Rate for Payer: Cash Price |
$17,645.18
|
| Rate for Payer: Cofinity Commercial |
$15,439.54
|
| Rate for Payer: Cofinity Commercial |
$18,968.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$15,439.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17,645.18
|
| Rate for Payer: Healthscope Commercial |
$19,850.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15,439.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16,542.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,748.01
|
| Rate for Payer: PHP Commercial |
$18,748.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14,336.71
|
| Rate for Payer: Priority Health SBD |
$13,895.58
|
| Rate for Payer: UMR Bronson Commercial |
$9,704.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16,542.36
|
|
|
HC BOSTON SCI PACEMAKER LEAD
|
Facility
|
IP
|
$2,257.76
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$993.41 |
| Max. Negotiated Rate |
$2,031.98 |
| Rate for Payer: Priority Health SBD |
$1,422.39
|
| Rate for Payer: UMR Bronson Commercial |
$993.41
|
| Rate for Payer: Aetna American Axle |
$1,467.54
|
| Rate for Payer: Aetna Commercial |
$1,919.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,467.54
|
| Rate for Payer: Cash Price |
$1,806.21
|
| Rate for Payer: Cofinity Commercial |
$1,580.43
|
| Rate for Payer: Cofinity Commercial |
$1,941.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,580.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,806.21
|
| Rate for Payer: Healthscope Commercial |
$2,031.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,580.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,693.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,919.10
|
| Rate for Payer: PHP Commercial |
$1,919.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,467.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,693.32
|
|
|
HC BOSTON SCI PACEMAKER LEAD
|
Facility
|
OP
|
$2,257.76
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800074
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$835.37 |
| Max. Negotiated Rate |
$2,031.98 |
| Rate for Payer: Aetna American Axle |
$1,467.54
|
| Rate for Payer: Aetna Commercial |
$1,919.10
|
| Rate for Payer: Aetna Medicare |
$1,128.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,467.54
|
| Rate for Payer: BCBS Complete |
$903.10
|
| Rate for Payer: Cash Price |
$1,806.21
|
| Rate for Payer: Cofinity Commercial |
$1,580.43
|
| Rate for Payer: Cofinity Commercial |
$1,941.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,580.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,806.21
|
| Rate for Payer: Healthscope Commercial |
$2,031.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,580.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,693.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,919.10
|
| Rate for Payer: PHP Commercial |
$1,919.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,467.54
|
| Rate for Payer: Priority Health SBD |
$1,422.39
|
| Rate for Payer: UMR Bronson Commercial |
$835.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,693.32
|
|
|
HC BOSTON SCI SINGLE PACEMAKER
|
Facility
|
OP
|
$14,226.44
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500005
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,263.78 |
| Max. Negotiated Rate |
$12,803.80 |
| Rate for Payer: Aetna American Axle |
$9,247.19
|
| Rate for Payer: Aetna Commercial |
$12,092.47
|
| Rate for Payer: Aetna Medicare |
$7,113.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,247.19
|
| Rate for Payer: BCBS Complete |
$5,690.58
|
| Rate for Payer: Cash Price |
$11,381.15
|
| Rate for Payer: Cofinity Commercial |
$12,234.74
|
| Rate for Payer: Cofinity Commercial |
$9,958.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,958.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,381.15
|
| Rate for Payer: Healthscope Commercial |
$12,803.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,958.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,669.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,092.47
|
| Rate for Payer: PHP Commercial |
$12,092.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,247.19
|
| Rate for Payer: Priority Health SBD |
$8,962.66
|
| Rate for Payer: UMR Bronson Commercial |
$5,263.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,669.83
|
|
|
HC BOSTON SCI SINGLE PACEMAKER
|
Facility
|
IP
|
$14,226.44
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500005
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,259.63 |
| Max. Negotiated Rate |
$12,803.80 |
| Rate for Payer: Aetna American Axle |
$9,247.19
|
| Rate for Payer: Aetna Commercial |
$12,092.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,247.19
|
| Rate for Payer: Cash Price |
$11,381.15
|
| Rate for Payer: Cofinity Commercial |
$12,234.74
|
| Rate for Payer: Cofinity Commercial |
$9,958.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,958.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,381.15
|
| Rate for Payer: Healthscope Commercial |
$12,803.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,958.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,669.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,092.47
|
| Rate for Payer: PHP Commercial |
$12,092.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,247.19
|
| Rate for Payer: Priority Health SBD |
$8,962.66
|
| Rate for Payer: UMR Bronson Commercial |
$6,259.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,669.83
|
|
|
HC BOSTON SCI TACHY (ICD) LEAD
|
Facility
|
IP
|
$8,773.00
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,860.12 |
| Max. Negotiated Rate |
$7,895.70 |
| Rate for Payer: Aetna American Axle |
$5,702.45
|
| Rate for Payer: Aetna Commercial |
$7,457.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,702.45
|
| Rate for Payer: Cash Price |
$7,018.40
|
| Rate for Payer: Cofinity Commercial |
$6,141.10
|
| Rate for Payer: Cofinity Commercial |
$7,544.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,141.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,018.40
|
| Rate for Payer: Healthscope Commercial |
$7,895.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,141.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,579.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,457.05
|
| Rate for Payer: PHP Commercial |
$7,457.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,702.45
|
| Rate for Payer: Priority Health SBD |
$5,526.99
|
| Rate for Payer: UMR Bronson Commercial |
$3,860.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,579.75
|
|
|
HC BOSTON SCI TACHY (ICD) LEAD
|
Facility
|
OP
|
$8,773.00
|
|
|
Service Code
|
HCPCS C1895
|
| Hospital Charge Code |
27800075
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,246.01 |
| Max. Negotiated Rate |
$7,895.70 |
| Rate for Payer: Aetna American Axle |
$5,702.45
|
| Rate for Payer: Aetna Commercial |
$7,457.05
|
| Rate for Payer: Aetna Medicare |
$4,386.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,702.45
|
| Rate for Payer: BCBS Complete |
$3,509.20
|
| Rate for Payer: Cash Price |
$7,018.40
|
| Rate for Payer: Cofinity Commercial |
$6,141.10
|
| Rate for Payer: Cofinity Commercial |
$7,544.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,141.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,018.40
|
| Rate for Payer: Healthscope Commercial |
$7,895.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,141.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,579.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,457.05
|
| Rate for Payer: PHP Commercial |
$7,457.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,702.45
|
| Rate for Payer: Priority Health SBD |
$5,526.99
|
| Rate for Payer: UMR Bronson Commercial |
$3,246.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,579.75
|
|
