|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
IP
|
$1,491.52
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$656.27 |
| Max. Negotiated Rate |
$1,342.37 |
| Rate for Payer: Aetna American Axle |
$969.49
|
| Rate for Payer: Aetna Commercial |
$1,267.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$969.49
|
| Rate for Payer: Cash Price |
$1,193.22
|
| Rate for Payer: Cofinity Commercial |
$1,044.06
|
| Rate for Payer: Cofinity Commercial |
$1,282.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.22
|
| Rate for Payer: Healthscope Commercial |
$1,342.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,044.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,118.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,267.79
|
| Rate for Payer: PHP Commercial |
$1,267.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.06
|
| Rate for Payer: Priority Health SBD |
$939.66
|
| Rate for Payer: UMR Bronson Commercial |
$656.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,118.64
|
|
|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
OP
|
$1,491.52
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$231.50 |
| Max. Negotiated Rate |
$5,324.53 |
| Rate for Payer: Aetna American Axle |
$969.49
|
| Rate for Payer: Aetna Commercial |
$1,267.79
|
| Rate for Payer: Aetna Medicare |
$1,759.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$969.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,114.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,114.21
|
| Rate for Payer: BCBS Complete |
$971.52
|
| Rate for Payer: BCBS MAPPO |
$1,691.37
|
| Rate for Payer: BCBS Trust/PPO |
$903.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,691.37
|
| Rate for Payer: Cash Price |
$1,193.22
|
| Rate for Payer: Cash Price |
$1,193.22
|
| Rate for Payer: Cofinity Commercial |
$1,044.06
|
| Rate for Payer: Cofinity Commercial |
$1,282.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,691.37
|
| Rate for Payer: Healthscope Commercial |
$1,342.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,044.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,118.64
|
| Rate for Payer: Mclaren Medicaid |
$925.18
|
| Rate for Payer: Mclaren Medicare |
$1,691.37
|
| Rate for Payer: Meridian Medicaid |
$971.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,775.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,945.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,267.79
|
| Rate for Payer: PACE Medicare |
$1,606.80
|
| Rate for Payer: PACE SWMI |
$1,691.37
|
| Rate for Payer: PHP Commercial |
$1,267.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,691.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$925.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,324.53
|
| Rate for Payer: Priority Health Medicare |
$1,691.37
|
| Rate for Payer: Priority Health Narrow Network |
$4,259.62
|
| Rate for Payer: Priority Health SBD |
$939.66
|
| Rate for Payer: Railroad Medicare Medicare |
$1,691.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.65
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,691.37
|
| Rate for Payer: UHC Exchange |
$231.50
|
| Rate for Payer: UHC Medicare Advantage |
$1,742.11
|
| Rate for Payer: UMR Bronson Commercial |
$551.86
|
| Rate for Payer: VA VA |
$1,691.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,118.64
|
|
|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$162.93
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$60.28 |
| Max. Negotiated Rate |
$357.43 |
| Rate for Payer: Aetna American Axle |
$105.90
|
| Rate for Payer: Aetna Commercial |
$138.49
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$124.17
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$130.34
|
| Rate for Payer: Cash Price |
$130.34
|
| Rate for Payer: Cofinity Commercial |
$114.05
|
| Rate for Payer: Cofinity Commercial |
$140.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$146.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.20
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.49
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$138.49
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.43
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$285.94
|
| Rate for Payer: Priority Health SBD |
$102.65
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$61.23
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$60.28
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.20
|
|
|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$162.93
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$71.69 |
| Max. Negotiated Rate |
$146.64 |
| Rate for Payer: Aetna American Axle |
$105.90
|
| Rate for Payer: Aetna Commercial |
$138.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.90
|
| Rate for Payer: Cash Price |
$130.34
|
| Rate for Payer: Cofinity Commercial |
$114.05
|
| Rate for Payer: Cofinity Commercial |
$140.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.34
|
| Rate for Payer: Healthscope Commercial |
$146.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.49
|
| Rate for Payer: PHP Commercial |
$138.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.05
|
| Rate for Payer: Priority Health SBD |
$102.65
|
| Rate for Payer: UMR Bronson Commercial |
$71.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.20
|
|
|
HC INSERTION GASTRO TUBE W FLUORO
|
Facility
|
IP
|
$1,417.27
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$623.60 |
| Max. Negotiated Rate |
$1,275.54 |
| Rate for Payer: Aetna American Axle |
$921.23
|
| Rate for Payer: Aetna Commercial |
$1,204.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$921.23
|
| Rate for Payer: Cash Price |
$1,133.82
|
| Rate for Payer: Cofinity Commercial |
$1,218.85
|
| Rate for Payer: Cofinity Commercial |
$992.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,133.82
|
| Rate for Payer: Healthscope Commercial |
$1,275.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$992.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,062.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,204.68
|
| Rate for Payer: PHP Commercial |
$1,204.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$992.09
|
| Rate for Payer: Priority Health SBD |
$892.88
|
| Rate for Payer: UMR Bronson Commercial |
$623.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,062.95
|
|
|
HC INSERTION GASTRO TUBE W FLUORO
|
Facility
|
OP
|
$1,417.27
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$194.17 |
| Max. Negotiated Rate |
$5,324.53 |
| Rate for Payer: Aetna American Axle |
$921.23
|
| Rate for Payer: Aetna Commercial |
$1,204.68
|
| Rate for Payer: Aetna Medicare |
$1,759.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$921.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,114.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,114.21
|
| Rate for Payer: BCBS Complete |
$971.52
|
| Rate for Payer: BCBS MAPPO |
$1,691.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,862.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,691.37
|
| Rate for Payer: Cash Price |
$1,133.82
|
| Rate for Payer: Cash Price |
$1,133.82
|
| Rate for Payer: Cofinity Commercial |
$992.09
|
| Rate for Payer: Cofinity Commercial |
$1,218.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,133.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,691.37
|
| Rate for Payer: Healthscope Commercial |
$1,275.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$992.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,062.95
|
| Rate for Payer: Mclaren Medicaid |
$925.18
|
| Rate for Payer: Mclaren Medicare |
$1,691.37
|
| Rate for Payer: Meridian Medicaid |
$971.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,775.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,945.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,204.68
|
| Rate for Payer: PACE Medicare |
$1,606.80
|
| Rate for Payer: PACE SWMI |
$1,691.37
|
| Rate for Payer: PHP Commercial |
$1,204.68
|
| Rate for Payer: PHP Medicare Advantage |
$1,691.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$925.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$992.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,324.53
|
| Rate for Payer: Priority Health Medicare |
$1,691.37
|
| Rate for Payer: Priority Health Narrow Network |
$4,259.62
|
| Rate for Payer: Priority Health SBD |
$892.88
|
| Rate for Payer: Railroad Medicare Medicare |
$1,691.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.59
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,691.37
|
| Rate for Payer: UHC Exchange |
$194.17
|
| Rate for Payer: UHC Medicare Advantage |
$1,742.11
|
| Rate for Payer: UMR Bronson Commercial |
$524.39
|
| Rate for Payer: VA VA |
$1,691.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,062.95
|
|
|
HC INSERTION IUD
|
Facility
|
OP
|
$372.48
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.12 |
| Max. Negotiated Rate |
$722.81 |
| Rate for Payer: Aetna American Axle |
$242.11
|
| Rate for Payer: Aetna Commercial |
$316.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.11
|
| Rate for Payer: BCBS Complete |
$148.99
|
| Rate for Payer: BCBS Trust/PPO |
$722.81
|
| Rate for Payer: Cash Price |
$297.98
|
| Rate for Payer: Cash Price |
$297.98
|
| Rate for Payer: Cofinity Commercial |
$260.74
|
| Rate for Payer: Cofinity Commercial |
$320.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.98
|
| Rate for Payer: Healthscope Commercial |
$335.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$316.61
|
| Rate for Payer: PHP Commercial |
$316.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.35
|
| Rate for Payer: Priority Health Narrow Network |
$117.08
|
| Rate for Payer: Priority Health SBD |
$234.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.03
|
| Rate for Payer: UHC Exchange |
$49.12
|
| Rate for Payer: UMR Bronson Commercial |
$137.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.36
|
|
|
HC INSERTION IUD
|
Facility
|
IP
|
$372.48
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$163.89 |
| Max. Negotiated Rate |
$335.23 |
| Rate for Payer: Aetna American Axle |
$242.11
|
| Rate for Payer: Aetna Commercial |
$316.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.11
|
| Rate for Payer: Cash Price |
$297.98
|
| Rate for Payer: Cofinity Commercial |
$260.74
|
| Rate for Payer: Cofinity Commercial |
$320.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.98
|
| Rate for Payer: Healthscope Commercial |
$335.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$316.61
|
| Rate for Payer: PHP Commercial |
$316.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.74
|
| Rate for Payer: Priority Health SBD |
$234.66
|
| Rate for Payer: UMR Bronson Commercial |
$163.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.36
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
OP
|
$2,495.63
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.53 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$1,622.16
|
| Rate for Payer: Aetna Commercial |
$2,121.29
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,622.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,185.71
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$1,746.94
|
| Rate for Payer: Cofinity Commercial |
$2,146.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,246.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,746.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,871.72
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$2,121.29
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$1,572.25
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$81.53
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$923.38
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,871.72
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
IP
|
$2,495.63
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,098.08 |
| Max. Negotiated Rate |
$2,246.07 |
| Rate for Payer: Aetna American Axle |
$1,622.16
|
| Rate for Payer: Aetna Commercial |
$2,121.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,622.16
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$1,746.94
|
| Rate for Payer: Cofinity Commercial |
$2,146.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.50
|
| Rate for Payer: Healthscope Commercial |
$2,246.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,746.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,871.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: PHP Commercial |
$2,121.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: Priority Health SBD |
$1,572.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,098.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,871.72
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
IP
|
$2,495.63
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,098.08 |
| Max. Negotiated Rate |
$2,246.07 |
| Rate for Payer: Aetna American Axle |
$1,622.16
|
| Rate for Payer: Aetna Commercial |
$2,121.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,622.16
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$2,146.24
|
| Rate for Payer: Cofinity Commercial |
$1,746.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.50
|
| Rate for Payer: Healthscope Commercial |
$2,246.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,746.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,871.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: PHP Commercial |
$2,121.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: Priority Health SBD |
$1,572.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,098.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,871.72
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
OP
|
$2,495.63
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$81.21 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$1,622.16
|
| Rate for Payer: Aetna Commercial |
$2,121.29
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,622.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$640.52
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cash Price |
$1,996.50
|
| Rate for Payer: Cofinity Commercial |
$1,746.94
|
| Rate for Payer: Cofinity Commercial |
$2,146.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,246.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,746.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,871.72
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.29
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$2,121.29
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$1,572.25
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.33
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$81.21
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$923.38
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,871.72
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
OP
|
$2,904.48
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$304.19 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$1,887.91
|
| Rate for Payer: Aetna Commercial |
$2,468.81
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,887.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,814.56
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,033.14
|
| Rate for Payer: Cofinity Commercial |
$2,497.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,323.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,614.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,033.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,178.36
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$2,468.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$1,829.82
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.61
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$304.19
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,074.66
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,178.36
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
IP
|
$2,904.48
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,277.97 |
| Max. Negotiated Rate |
$2,614.03 |
| Rate for Payer: Aetna American Axle |
$1,887.91
|
| Rate for Payer: Aetna Commercial |
$2,468.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,887.91
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,033.14
|
| Rate for Payer: Cofinity Commercial |
$2,497.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,323.58
|
| Rate for Payer: Healthscope Commercial |
$2,614.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,033.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,178.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: PHP Commercial |
$2,468.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: Priority Health SBD |
$1,829.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,277.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,178.36
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$2,904.48
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
36100129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$326.13 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$1,887.91
|
| Rate for Payer: Aetna Commercial |
$2,468.81
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,887.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,894.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,033.14
|
| Rate for Payer: Cofinity Commercial |
$2,497.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,323.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,614.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,033.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,178.36
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$2,468.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$1,829.82
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$358.74
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$326.13
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,074.66
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,178.36
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$2,904.48
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
36100129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,277.97 |
| Max. Negotiated Rate |
$2,614.03 |
| Rate for Payer: Aetna American Axle |
$1,887.91
|
| Rate for Payer: Aetna Commercial |
$2,468.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,887.91
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,033.14
|
| Rate for Payer: Cofinity Commercial |
$2,497.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,323.58
|
| Rate for Payer: Healthscope Commercial |
$2,614.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,033.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,178.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: PHP Commercial |
$2,468.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: Priority Health SBD |
$1,829.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,277.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,178.36
|
|
|
HC INSERTION PICC 5 YRS OR ABOVE WO IMAGING
|
Facility
|
IP
|
$1,686.32
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
36100128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$741.98 |
| Max. Negotiated Rate |
$1,517.69 |
| Rate for Payer: Aetna American Axle |
$1,096.11
|
| Rate for Payer: Aetna Commercial |
$1,433.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,096.11
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cofinity Commercial |
$1,180.42
|
| Rate for Payer: Cofinity Commercial |
$1,450.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.06
|
| Rate for Payer: Healthscope Commercial |
$1,517.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,180.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,264.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,433.37
|
| Rate for Payer: PHP Commercial |
$1,433.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.42
|
| Rate for Payer: Priority Health SBD |
$1,062.38
|
| Rate for Payer: UMR Bronson Commercial |
$741.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,264.74
|
|
|
HC INSERTION PICC 5 YRS OR ABOVE WO IMAGING
|
Facility
|
OP
|
$1,686.32
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
36100128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$91.36 |
| Max. Negotiated Rate |
$4,481.48 |
| Rate for Payer: Aetna American Axle |
$1,096.11
|
| Rate for Payer: Aetna Commercial |
$1,433.37
|
| Rate for Payer: Aetna Medicare |
$1,480.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,096.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$1,062.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cofinity Commercial |
$1,180.42
|
| Rate for Payer: Cofinity Commercial |
$1,450.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$1,517.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,180.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,264.74
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,433.37
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$1,433.37
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,180.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,481.48
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$3,585.18
|
| Rate for Payer: Priority Health SBD |
$1,062.38
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.50
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,423.57
|
| Rate for Payer: UHC Exchange |
$91.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: UMR Bronson Commercial |
$623.94
|
| Rate for Payer: VA VA |
$1,423.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,264.74
|
|
|
HC INSERTION PICC LESS THAN 5 YRS WO IMAGING
|
Facility
|
IP
|
$1,610.04
|
|
|
Service Code
|
CPT 36568
|
| Hospital Charge Code |
36100127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$708.42 |
| Max. Negotiated Rate |
$1,449.04 |
| Rate for Payer: Aetna American Axle |
$1,046.53
|
| Rate for Payer: Aetna Commercial |
$1,368.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,046.53
|
| Rate for Payer: Cash Price |
$1,288.03
|
| Rate for Payer: Cofinity Commercial |
$1,127.03
|
| Rate for Payer: Cofinity Commercial |
$1,384.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,288.03
|
| Rate for Payer: Healthscope Commercial |
$1,449.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,127.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,207.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,368.53
|
| Rate for Payer: PHP Commercial |
$1,368.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.03
|
| Rate for Payer: Priority Health SBD |
$1,014.33
|
| Rate for Payer: UMR Bronson Commercial |
$708.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,207.53
|
|
|
HC INSERTION PICC LESS THAN 5 YRS WO IMAGING
|
Facility
|
OP
|
$1,610.04
|
|
|
Service Code
|
CPT 36568
|
| Hospital Charge Code |
36100127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$88.41 |
| Max. Negotiated Rate |
$4,481.48 |
| Rate for Payer: Aetna American Axle |
$1,046.53
|
| Rate for Payer: Aetna Commercial |
$1,368.53
|
| Rate for Payer: Aetna Medicare |
$1,480.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,046.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$640.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,288.03
|
| Rate for Payer: Cash Price |
$1,288.03
|
| Rate for Payer: Cofinity Commercial |
$1,127.03
|
| Rate for Payer: Cofinity Commercial |
$1,384.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,288.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$1,449.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,127.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,207.53
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,368.53
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$1,368.53
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,127.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,481.48
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$3,585.18
|
| Rate for Payer: Priority Health SBD |
$1,014.33
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.25
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,423.57
|
| Rate for Payer: UHC Exchange |
$88.41
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: UMR Bronson Commercial |
$595.71
|
| Rate for Payer: VA VA |
$1,423.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,207.53
|
|
|
HC INSERTION PLEURAL DRAINAGE CATHETER
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
36100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$673.20 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna American Axle |
$994.50
|
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.50
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,071.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,071.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health SBD |
$963.90
|
| Rate for Payer: UMR Bronson Commercial |
$673.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC INSERTION PLEURAL DRAINAGE CATHETER
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
36100053
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$150.30 |
| Max. Negotiated Rate |
$4,481.48 |
| Rate for Payer: Aetna American Axle |
$994.50
|
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna Medicare |
$1,480.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$833.09
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Cofinity Commercial |
$1,071.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,071.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,300.50
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,071.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,481.48
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$3,585.18
|
| Rate for Payer: Priority Health SBD |
$963.90
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,423.57
|
| Rate for Payer: UHC Exchange |
$150.30
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: UMR Bronson Commercial |
$566.10
|
| Rate for Payer: VA VA |
$1,423.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC INSERTION TUNNELED CVA W PUMP
|
Facility
|
IP
|
$3,535.76
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
36100126
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,555.73 |
| Max. Negotiated Rate |
$3,182.18 |
| Rate for Payer: Aetna American Axle |
$2,298.24
|
| Rate for Payer: Aetna Commercial |
$3,005.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,298.24
|
| Rate for Payer: Cash Price |
$2,828.61
|
| Rate for Payer: Cofinity Commercial |
$2,475.03
|
| Rate for Payer: Cofinity Commercial |
$3,040.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,828.61
|
| Rate for Payer: Healthscope Commercial |
$3,182.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,475.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,651.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,005.40
|
| Rate for Payer: PHP Commercial |
$3,005.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,475.03
|
| Rate for Payer: Priority Health SBD |
$2,227.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,555.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,651.82
|
|
|
HC INSERTION TUNNELED CVA W PUMP
|
Facility
|
OP
|
$3,535.76
|
|
|
Service Code
|
CPT 36563
|
| Hospital Charge Code |
36100126
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$351.02 |
| Max. Negotiated Rate |
$15,377.24 |
| Rate for Payer: Aetna American Axle |
$2,298.24
|
| Rate for Payer: Aetna Commercial |
$3,005.40
|
| Rate for Payer: Aetna Medicare |
$5,080.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,298.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,105.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,105.86
|
| Rate for Payer: BCBS Complete |
$2,805.77
|
| Rate for Payer: BCBS MAPPO |
$4,884.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,624.89
|
| Rate for Payer: BCN Medicare Advantage |
$4,884.69
|
| Rate for Payer: Cash Price |
$2,828.61
|
| Rate for Payer: Cash Price |
$2,828.61
|
| Rate for Payer: Cofinity Commercial |
$2,475.03
|
| Rate for Payer: Cofinity Commercial |
$3,040.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,828.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,884.69
|
| Rate for Payer: Healthscope Commercial |
$3,182.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,475.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,651.82
|
| Rate for Payer: Mclaren Medicaid |
$2,671.93
|
| Rate for Payer: Mclaren Medicare |
$4,884.69
|
| Rate for Payer: Meridian Medicaid |
$2,805.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,128.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,617.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,005.40
|
| Rate for Payer: PACE Medicare |
$4,640.46
|
| Rate for Payer: PACE SWMI |
$4,884.69
|
| Rate for Payer: PHP Commercial |
$3,005.40
|
| Rate for Payer: PHP Medicare Advantage |
$4,884.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,671.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,475.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,377.24
|
| Rate for Payer: Priority Health Medicare |
$4,884.69
|
| Rate for Payer: Priority Health Narrow Network |
$12,301.79
|
| Rate for Payer: Priority Health SBD |
$2,227.53
|
| Rate for Payer: Railroad Medicare Medicare |
$4,884.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.12
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,884.69
|
| Rate for Payer: UHC Exchange |
$351.02
|
| Rate for Payer: UHC Medicare Advantage |
$5,031.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,308.23
|
| Rate for Payer: VA VA |
$4,884.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,651.82
|
|
|
HC INSERTION TUNNELED PLEURAL CATHETER
|
Facility
|
OP
|
$3,221.06
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
36100052
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$196.47 |
| Max. Negotiated Rate |
$9,680.93 |
| Rate for Payer: Aetna American Axle |
$2,093.69
|
| Rate for Payer: Aetna Commercial |
$2,737.90
|
| Rate for Payer: Aetna Medicare |
$3,198.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,093.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,844.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,844.02
|
| Rate for Payer: BCBS Complete |
$1,766.41
|
| Rate for Payer: BCBS MAPPO |
$3,075.22
|
| Rate for Payer: BCBS Trust/PPO |
$3,019.18
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$2,576.85
|
| Rate for Payer: Cash Price |
$2,576.85
|
| Rate for Payer: Cofinity Commercial |
$2,770.11
|
| Rate for Payer: Cofinity Commercial |
$2,254.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,576.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$2,898.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,254.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,415.80
|
| Rate for Payer: Mclaren Medicaid |
$1,682.15
|
| Rate for Payer: Mclaren Medicare |
$3,075.22
|
| Rate for Payer: Meridian Medicaid |
$1,766.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,228.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,536.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,737.90
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$2,737.90
|
| Rate for Payer: PHP Medicare Advantage |
$3,075.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,682.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,254.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,680.93
|
| Rate for Payer: Priority Health Medicare |
$3,075.22
|
| Rate for Payer: Priority Health Narrow Network |
$7,744.74
|
| Rate for Payer: Priority Health SBD |
$2,029.27
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,075.22
|
| Rate for Payer: UHC Exchange |
$196.47
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,191.79
|
| Rate for Payer: VA VA |
$3,075.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,415.80
|
|
