|
HC INTRAVENTRICULAR PACING
|
Facility
|
IP
|
$3,693.37
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
48100034
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,625.08 |
| Max. Negotiated Rate |
$3,324.03 |
| Rate for Payer: Aetna American Axle |
$2,400.69
|
| Rate for Payer: Aetna Commercial |
$3,139.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,400.69
|
| Rate for Payer: Cash Price |
$2,954.70
|
| Rate for Payer: Cofinity Commercial |
$2,585.36
|
| Rate for Payer: Cofinity Commercial |
$3,176.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,954.70
|
| Rate for Payer: Healthscope Commercial |
$3,324.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,585.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,139.36
|
| Rate for Payer: PHP Commercial |
$3,139.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,585.36
|
| Rate for Payer: Priority Health SBD |
$2,326.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,625.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.03
|
|
|
HC INTRAVENTRICULAR PACING
|
Facility
|
OP
|
$3,693.37
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
48100034
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,366.55 |
| Max. Negotiated Rate |
$21,354.26 |
| Rate for Payer: Aetna American Axle |
$2,400.69
|
| Rate for Payer: Aetna Commercial |
$3,139.36
|
| Rate for Payer: Aetna Medicare |
$6,903.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,400.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,297.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,297.88
|
| Rate for Payer: BCBS Complete |
$3,813.04
|
| Rate for Payer: BCBS MAPPO |
$6,638.30
|
| Rate for Payer: BCBS Trust/PPO |
$21,354.26
|
| Rate for Payer: BCN Medicare Advantage |
$6,638.30
|
| Rate for Payer: Cash Price |
$2,954.70
|
| Rate for Payer: Cash Price |
$2,954.70
|
| Rate for Payer: Cofinity Commercial |
$2,585.36
|
| Rate for Payer: Cofinity Commercial |
$3,176.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,954.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,638.30
|
| Rate for Payer: Healthscope Commercial |
$3,324.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,585.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.03
|
| Rate for Payer: Mclaren Medicaid |
$3,631.15
|
| Rate for Payer: Mclaren Medicare |
$6,638.30
|
| Rate for Payer: Meridian Medicaid |
$3,813.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,970.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,634.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,139.36
|
| Rate for Payer: PACE Medicare |
$6,306.38
|
| Rate for Payer: PACE SWMI |
$6,638.30
|
| Rate for Payer: PHP Commercial |
$3,139.36
|
| Rate for Payer: PHP Medicare Advantage |
$6,638.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,631.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,585.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,897.69
|
| Rate for Payer: Priority Health Medicare |
$6,638.30
|
| Rate for Payer: Priority Health Narrow Network |
$16,718.15
|
| Rate for Payer: Priority Health SBD |
$2,326.82
|
| Rate for Payer: Railroad Medicare Medicare |
$6,638.30
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,638.30
|
| Rate for Payer: UHC Medicare Advantage |
$6,837.45
|
| Rate for Payer: UMR Bronson Commercial |
$1,366.55
|
| Rate for Payer: VA VA |
$6,638.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.03
|
|
|
HC INTRINSIC FACTOR ANTIBODIES
|
Facility
|
IP
|
$48.00
|
|
|
Service Code
|
CPT 86340
|
| Hospital Charge Code |
30200200
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.12 |
| Max. Negotiated Rate |
$43.20 |
| Rate for Payer: Aetna American Axle |
$31.20
|
| Rate for Payer: Aetna Commercial |
$40.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.20
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$41.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.40
|
| Rate for Payer: Healthscope Commercial |
$43.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.80
|
| Rate for Payer: PHP Commercial |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.60
|
| Rate for Payer: Priority Health SBD |
$30.24
|
| Rate for Payer: UMR Bronson Commercial |
$21.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.00
|
|
|
HC INTRINSIC FACTOR ANTIBODIES
|
Facility
|
OP
|
$48.00
|
|
|
Service Code
|
CPT 86340
|
| Hospital Charge Code |
30200200
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$43.20 |
| Rate for Payer: Aetna American Axle |
$31.20
|
| Rate for Payer: Aetna Commercial |
$40.80
|
| Rate for Payer: Aetna Medicare |
$15.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.85
|
| Rate for Payer: BCBS Complete |
$8.66
|
| Rate for Payer: BCBS MAPPO |
$15.08
|
| Rate for Payer: BCBS Trust/PPO |
$13.56
|
| Rate for Payer: BCN Medicare Advantage |
$15.08
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$41.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$43.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.00
|
| Rate for Payer: Mclaren Medicaid |
$8.25
|
| Rate for Payer: Mclaren Medicare |
$15.08
|
| Rate for Payer: Meridian Medicaid |
$8.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.80
|
| Rate for Payer: PACE Medicare |
$14.33
|
| Rate for Payer: PACE SWMI |
$15.08
|
| Rate for Payer: PHP Commercial |
$40.80
|
| Rate for Payer: PHP Medicare Advantage |
$15.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.68
|
| Rate for Payer: Priority Health Medicare |
$15.08
|
| Rate for Payer: Priority Health Narrow Network |
$16.54
|
| Rate for Payer: Priority Health SBD |
$30.24
|
| Rate for Payer: Railroad Medicare Medicare |
$15.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.10
|
| Rate for Payer: UHC Core |
$24.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.08
|
| Rate for Payer: UHC Exchange |
$15.08
|
| Rate for Payer: UHC Medicare Advantage |
$15.53
|
| Rate for Payer: UMR Bronson Commercial |
$17.76
|
| Rate for Payer: VA VA |
$15.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.00
|
|
|
HC INTRO AORTA TRANSLUMBAR
|
Facility
|
OP
|
$3,672.00
|
|
|
Service Code
|
CPT 36160
|
| Hospital Charge Code |
36100621
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$117.55 |
| Max. Negotiated Rate |
$3,304.80 |
| Rate for Payer: Aetna American Axle |
$2,386.80
|
| Rate for Payer: Aetna Commercial |
$3,121.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,386.80
|
| Rate for Payer: BCBS Complete |
$1,468.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,678.10
|
| Rate for Payer: Cash Price |
$2,937.60
|
| Rate for Payer: Cash Price |
$2,937.60
|
| Rate for Payer: Cofinity Commercial |
$3,157.92
|
| Rate for Payer: Cofinity Commercial |
$2,570.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,937.60
|
| Rate for Payer: Healthscope Commercial |
$3,304.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,570.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,754.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,121.20
|
| Rate for Payer: PHP Commercial |
$3,121.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,570.40
|
| Rate for Payer: Priority Health SBD |
$2,313.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.30
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$117.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,358.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,754.00
|
|
|
HC INTRO AORTA TRANSLUMBAR
|
Facility
|
IP
|
$3,672.00
|
|
|
Service Code
|
CPT 36160
|
| Hospital Charge Code |
36100621
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,615.68 |
| Max. Negotiated Rate |
$3,304.80 |
| Rate for Payer: Aetna American Axle |
$2,386.80
|
| Rate for Payer: Aetna Commercial |
$3,121.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,386.80
|
| Rate for Payer: Cash Price |
$2,937.60
|
| Rate for Payer: Cofinity Commercial |
$2,570.40
|
| Rate for Payer: Cofinity Commercial |
$3,157.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,937.60
|
| Rate for Payer: Healthscope Commercial |
$3,304.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,570.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,754.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,121.20
|
| Rate for Payer: PHP Commercial |
$3,121.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,570.40
|
| Rate for Payer: Priority Health SBD |
$2,313.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,615.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,754.00
|
|
|
HC INTRODUCER
|
Facility
|
OP
|
$293.71
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200049
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$108.67 |
| Max. Negotiated Rate |
$264.34 |
| Rate for Payer: Aetna American Axle |
$190.91
|
| Rate for Payer: Aetna Commercial |
$249.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.91
|
| Rate for Payer: BCBS Complete |
$117.48
|
| Rate for Payer: Cash Price |
$234.97
|
| Rate for Payer: Cofinity Commercial |
$205.60
|
| Rate for Payer: Cofinity Commercial |
$252.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.97
|
| Rate for Payer: Healthscope Commercial |
$264.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$205.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.65
|
| Rate for Payer: PHP Commercial |
$249.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.60
|
| Rate for Payer: Priority Health SBD |
$185.04
|
| Rate for Payer: UMR Bronson Commercial |
$108.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.28
|
|
|
HC INTRODUCER
|
Facility
|
IP
|
$293.71
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200049
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$129.23 |
| Max. Negotiated Rate |
$264.34 |
| Rate for Payer: Aetna American Axle |
$190.91
|
| Rate for Payer: Aetna Commercial |
$249.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.91
|
| Rate for Payer: Cash Price |
$234.97
|
| Rate for Payer: Cofinity Commercial |
$205.60
|
| Rate for Payer: Cofinity Commercial |
$252.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.97
|
| Rate for Payer: Healthscope Commercial |
$264.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$205.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.65
|
| Rate for Payer: PHP Commercial |
$249.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.60
|
| Rate for Payer: Priority Health SBD |
$185.04
|
| Rate for Payer: UMR Bronson Commercial |
$129.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.28
|
|
|
HC INTRODUCER LONG
|
Facility
|
IP
|
$249.93
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200050
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$109.97 |
| Max. Negotiated Rate |
$224.94 |
| Rate for Payer: Aetna American Axle |
$162.45
|
| Rate for Payer: Aetna Commercial |
$212.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.45
|
| Rate for Payer: Cash Price |
$199.94
|
| Rate for Payer: Cofinity Commercial |
$174.95
|
| Rate for Payer: Cofinity Commercial |
$214.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.94
|
| Rate for Payer: Healthscope Commercial |
$224.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$174.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$212.44
|
| Rate for Payer: PHP Commercial |
$212.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.95
|
| Rate for Payer: Priority Health SBD |
$157.46
|
| Rate for Payer: UMR Bronson Commercial |
$109.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.45
|
|
|
HC INTRODUCER LONG
|
Facility
|
OP
|
$249.93
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200050
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$92.47 |
| Max. Negotiated Rate |
$224.94 |
| Rate for Payer: Aetna American Axle |
$162.45
|
| Rate for Payer: Aetna Commercial |
$212.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.45
|
| Rate for Payer: BCBS Complete |
$99.97
|
| Rate for Payer: Cash Price |
$199.94
|
| Rate for Payer: Cofinity Commercial |
$174.95
|
| Rate for Payer: Cofinity Commercial |
$214.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.94
|
| Rate for Payer: Healthscope Commercial |
$224.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$174.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$212.44
|
| Rate for Payer: PHP Commercial |
$212.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.95
|
| Rate for Payer: Priority Health SBD |
$157.46
|
| Rate for Payer: UMR Bronson Commercial |
$92.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.45
|
|
|
HC INTRODUCER REGULAR
|
Facility
|
OP
|
$92.82
|
|
|
Service Code
|
HCPCS C1893
|
| Hospital Charge Code |
27200051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$83.54 |
| Rate for Payer: Aetna American Axle |
$60.33
|
| Rate for Payer: Aetna Commercial |
$78.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.33
|
| Rate for Payer: BCBS Complete |
$37.13
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: Cash Price |
$74.26
|
| Rate for Payer: Cash Price |
$74.26
|
| Rate for Payer: Cofinity Commercial |
$79.83
|
| Rate for Payer: Cofinity Commercial |
$64.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.26
|
| Rate for Payer: Healthscope Commercial |
$83.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.90
|
| Rate for Payer: PHP Commercial |
$78.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: Priority Health SBD |
$58.48
|
| Rate for Payer: UMR Bronson Commercial |
$34.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.62
|
|
|
HC INTRODUCER REGULAR
|
Facility
|
IP
|
$92.82
|
|
|
Service Code
|
HCPCS C1893
|
| Hospital Charge Code |
27200051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.84 |
| Max. Negotiated Rate |
$83.54 |
| Rate for Payer: Aetna American Axle |
$60.33
|
| Rate for Payer: Aetna Commercial |
$78.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.33
|
| Rate for Payer: Cash Price |
$74.26
|
| Rate for Payer: Cofinity Commercial |
$64.97
|
| Rate for Payer: Cofinity Commercial |
$79.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.26
|
| Rate for Payer: Healthscope Commercial |
$83.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.90
|
| Rate for Payer: PHP Commercial |
$78.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: Priority Health SBD |
$58.48
|
| Rate for Payer: UMR Bronson Commercial |
$40.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.62
|
|
|
HC INTRODUCTION OF URETRAL CATH VIA NEPHROSTOMY
|
Facility
|
OP
|
$3,389.80
|
|
|
Service Code
|
CPT 50553
|
| Hospital Charge Code |
36100246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$303.21 |
| Max. Negotiated Rate |
$14,479.04 |
| Rate for Payer: Aetna American Axle |
$2,203.37
|
| Rate for Payer: Aetna Commercial |
$2,881.33
|
| Rate for Payer: Aetna Medicare |
$4,783.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,203.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,749.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,749.21
|
| Rate for Payer: BCBS Complete |
$2,641.88
|
| Rate for Payer: BCBS MAPPO |
$4,599.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,584.37
|
| Rate for Payer: BCN Medicare Advantage |
$4,599.37
|
| Rate for Payer: Cash Price |
$2,711.84
|
| Rate for Payer: Cash Price |
$2,711.84
|
| Rate for Payer: Cofinity Commercial |
$2,915.23
|
| Rate for Payer: Cofinity Commercial |
$2,372.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,711.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,599.37
|
| Rate for Payer: Healthscope Commercial |
$3,050.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,372.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,542.35
|
| Rate for Payer: Mclaren Medicaid |
$2,515.86
|
| Rate for Payer: Mclaren Medicare |
$4,599.37
|
| Rate for Payer: Meridian Medicaid |
$2,641.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4,829.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,289.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,881.33
|
| Rate for Payer: PACE Medicare |
$4,369.40
|
| Rate for Payer: PACE SWMI |
$4,599.37
|
| Rate for Payer: PHP Commercial |
$2,881.33
|
| Rate for Payer: PHP Medicare Advantage |
$4,599.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,515.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,372.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14,479.04
|
| Rate for Payer: Priority Health Medicare |
$4,599.37
|
| Rate for Payer: Priority Health Narrow Network |
$11,583.23
|
| Rate for Payer: Priority Health SBD |
$2,135.57
|
| Rate for Payer: Railroad Medicare Medicare |
$4,599.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.53
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,599.37
|
| Rate for Payer: UHC Exchange |
$303.21
|
| Rate for Payer: UHC Medicare Advantage |
$4,737.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,254.23
|
| Rate for Payer: VA VA |
$4,599.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,542.35
|
|
|
HC INTRODUCTION OF URETRAL CATH VIA NEPHROSTOMY
|
Facility
|
IP
|
$3,389.80
|
|
|
Service Code
|
CPT 50553
|
| Hospital Charge Code |
36100246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,491.51 |
| Max. Negotiated Rate |
$3,050.82 |
| Rate for Payer: Aetna American Axle |
$2,203.37
|
| Rate for Payer: Aetna Commercial |
$2,881.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,203.37
|
| Rate for Payer: Cash Price |
$2,711.84
|
| Rate for Payer: Cofinity Commercial |
$2,372.86
|
| Rate for Payer: Cofinity Commercial |
$2,915.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,711.84
|
| Rate for Payer: Healthscope Commercial |
$3,050.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,372.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,542.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,881.33
|
| Rate for Payer: PHP Commercial |
$2,881.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,372.86
|
| Rate for Payer: Priority Health SBD |
$2,135.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,491.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,542.35
|
|
|
HC INTRO SHEATH NON GUIDE LVL 1
|
Facility
|
IP
|
$40.95
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.02 |
| Max. Negotiated Rate |
$36.86 |
| Rate for Payer: Aetna American Axle |
$26.62
|
| Rate for Payer: Aetna Commercial |
$34.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.62
|
| Rate for Payer: Cash Price |
$32.76
|
| Rate for Payer: Cofinity Commercial |
$28.66
|
| Rate for Payer: Cofinity Commercial |
$35.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.76
|
| Rate for Payer: Healthscope Commercial |
$36.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.81
|
| Rate for Payer: PHP Commercial |
$34.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.66
|
| Rate for Payer: Priority Health SBD |
$25.80
|
| Rate for Payer: UMR Bronson Commercial |
$18.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.71
|
|
|
HC INTRO SHEATH NON GUIDE LVL 1
|
Facility
|
OP
|
$40.95
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.15 |
| Max. Negotiated Rate |
$36.86 |
| Rate for Payer: Aetna American Axle |
$26.62
|
| Rate for Payer: Aetna Commercial |
$34.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.62
|
| Rate for Payer: BCBS Complete |
$16.38
|
| Rate for Payer: Cash Price |
$32.76
|
| Rate for Payer: Cofinity Commercial |
$28.66
|
| Rate for Payer: Cofinity Commercial |
$35.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.76
|
| Rate for Payer: Healthscope Commercial |
$36.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.81
|
| Rate for Payer: PHP Commercial |
$34.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.66
|
| Rate for Payer: Priority Health SBD |
$25.80
|
| Rate for Payer: UMR Bronson Commercial |
$15.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.71
|
|
|
HC INTRO SHEATH NON GUIDE LVL 11
|
Facility
|
IP
|
$1,195.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200322
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$525.80 |
| Max. Negotiated Rate |
$1,075.50 |
| Rate for Payer: Aetna American Axle |
$776.75
|
| Rate for Payer: Aetna Commercial |
$1,015.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$776.75
|
| Rate for Payer: Cash Price |
$956.00
|
| Rate for Payer: Cofinity Commercial |
$1,027.70
|
| Rate for Payer: Cofinity Commercial |
$836.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$956.00
|
| Rate for Payer: Healthscope Commercial |
$1,075.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$836.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$896.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,015.75
|
| Rate for Payer: PHP Commercial |
$1,015.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$836.50
|
| Rate for Payer: Priority Health SBD |
$752.85
|
| Rate for Payer: UMR Bronson Commercial |
$525.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$896.25
|
|
|
HC INTRO SHEATH NON GUIDE LVL 11
|
Facility
|
OP
|
$1,195.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200322
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$442.15 |
| Max. Negotiated Rate |
$1,075.50 |
| Rate for Payer: Aetna American Axle |
$776.75
|
| Rate for Payer: Aetna Commercial |
$1,015.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$776.75
|
| Rate for Payer: BCBS Complete |
$478.00
|
| Rate for Payer: Cash Price |
$956.00
|
| Rate for Payer: Cofinity Commercial |
$1,027.70
|
| Rate for Payer: Cofinity Commercial |
$836.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$956.00
|
| Rate for Payer: Healthscope Commercial |
$1,075.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$836.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$896.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,015.75
|
| Rate for Payer: PHP Commercial |
$1,015.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$836.50
|
| Rate for Payer: Priority Health SBD |
$752.85
|
| Rate for Payer: UMR Bronson Commercial |
$442.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$896.25
|
|
|
HC INTRO SHEATH NON GUIDE LVL 2
|
Facility
|
OP
|
$159.12
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$58.87 |
| Max. Negotiated Rate |
$143.21 |
| Rate for Payer: Aetna American Axle |
$103.43
|
| Rate for Payer: Aetna Commercial |
$135.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.43
|
| Rate for Payer: BCBS Complete |
$63.65
|
| Rate for Payer: Cash Price |
$127.30
|
| Rate for Payer: Cofinity Commercial |
$111.38
|
| Rate for Payer: Cofinity Commercial |
$136.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.30
|
| Rate for Payer: Healthscope Commercial |
$143.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$111.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$135.25
|
| Rate for Payer: PHP Commercial |
$135.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.38
|
| Rate for Payer: Priority Health SBD |
$100.25
|
| Rate for Payer: UMR Bronson Commercial |
$58.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.34
|
|
|
HC INTRO SHEATH NON GUIDE LVL 2
|
Facility
|
IP
|
$159.12
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.01 |
| Max. Negotiated Rate |
$143.21 |
| Rate for Payer: Aetna American Axle |
$103.43
|
| Rate for Payer: Aetna Commercial |
$135.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.43
|
| Rate for Payer: Cash Price |
$127.30
|
| Rate for Payer: Cofinity Commercial |
$111.38
|
| Rate for Payer: Cofinity Commercial |
$136.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.30
|
| Rate for Payer: Healthscope Commercial |
$143.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$111.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$135.25
|
| Rate for Payer: PHP Commercial |
$135.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.38
|
| Rate for Payer: Priority Health SBD |
$100.25
|
| Rate for Payer: UMR Bronson Commercial |
$70.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.34
|
|
|
HC INTRO SHEATH NON GUIDE LVL 3
|
Facility
|
OP
|
$330.88
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200042
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$122.43 |
| Max. Negotiated Rate |
$297.79 |
| Rate for Payer: Aetna American Axle |
$215.07
|
| Rate for Payer: Aetna Commercial |
$281.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.07
|
| Rate for Payer: BCBS Complete |
$132.35
|
| Rate for Payer: Cash Price |
$264.70
|
| Rate for Payer: Cofinity Commercial |
$231.62
|
| Rate for Payer: Cofinity Commercial |
$284.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.70
|
| Rate for Payer: Healthscope Commercial |
$297.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$231.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$281.25
|
| Rate for Payer: PHP Commercial |
$281.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.62
|
| Rate for Payer: Priority Health SBD |
$208.45
|
| Rate for Payer: UMR Bronson Commercial |
$122.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.16
|
|
|
HC INTRO SHEATH NON GUIDE LVL 3
|
Facility
|
IP
|
$330.88
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200042
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$145.59 |
| Max. Negotiated Rate |
$297.79 |
| Rate for Payer: Aetna American Axle |
$215.07
|
| Rate for Payer: Aetna Commercial |
$281.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.07
|
| Rate for Payer: Cash Price |
$264.70
|
| Rate for Payer: Cofinity Commercial |
$231.62
|
| Rate for Payer: Cofinity Commercial |
$284.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.70
|
| Rate for Payer: Healthscope Commercial |
$297.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$231.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$281.25
|
| Rate for Payer: PHP Commercial |
$281.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.62
|
| Rate for Payer: Priority Health SBD |
$208.45
|
| Rate for Payer: UMR Bronson Commercial |
$145.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.16
|
|
|
HC INTRO SHEATH NON GUIDE LVL 4
|
Facility
|
IP
|
$475.65
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200277
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$209.29 |
| Max. Negotiated Rate |
$428.08 |
| Rate for Payer: Aetna American Axle |
$309.17
|
| Rate for Payer: Aetna Commercial |
$404.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$309.17
|
| Rate for Payer: Cash Price |
$380.52
|
| Rate for Payer: Cofinity Commercial |
$332.96
|
| Rate for Payer: Cofinity Commercial |
$409.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$380.52
|
| Rate for Payer: Healthscope Commercial |
$428.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$332.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$356.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$404.30
|
| Rate for Payer: PHP Commercial |
$404.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.96
|
| Rate for Payer: Priority Health SBD |
$299.66
|
| Rate for Payer: UMR Bronson Commercial |
$209.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$356.74
|
|
|
HC INTRO SHEATH NON GUIDE LVL 4
|
Facility
|
OP
|
$475.65
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200277
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$175.99 |
| Max. Negotiated Rate |
$428.08 |
| Rate for Payer: Aetna American Axle |
$309.17
|
| Rate for Payer: Aetna Commercial |
$404.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$309.17
|
| Rate for Payer: BCBS Complete |
$190.26
|
| Rate for Payer: Cash Price |
$380.52
|
| Rate for Payer: Cofinity Commercial |
$332.96
|
| Rate for Payer: Cofinity Commercial |
$409.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$380.52
|
| Rate for Payer: Healthscope Commercial |
$428.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$332.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$356.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$404.30
|
| Rate for Payer: PHP Commercial |
$404.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.96
|
| Rate for Payer: Priority Health SBD |
$299.66
|
| Rate for Payer: UMR Bronson Commercial |
$175.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$356.74
|
|
|
HC IODINE, S
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 83789
|
| Hospital Charge Code |
30100687
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.93 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna American Axle |
$39.78
|
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: UMR Bronson Commercial |
$26.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
