|
HC CORDIS CATHETER
|
Facility
|
IP
|
$200.55
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$88.24 |
| Max. Negotiated Rate |
$180.50 |
| Rate for Payer: Aetna American Axle |
$130.36
|
| Rate for Payer: Aetna Commercial |
$170.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.36
|
| Rate for Payer: Cash Price |
$160.44
|
| Rate for Payer: Cofinity Advantage |
$140.38
|
| Rate for Payer: Cofinity Commercial |
$172.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.44
|
| Rate for Payer: Healthscope Commercial |
$180.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.41
|
| Rate for Payer: PHP Commercial |
$170.47
|
| Rate for Payer: Priority Health SBD |
$126.35
|
| Rate for Payer: UMR Bronson Commercial |
$88.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.41
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
OP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$93.21 |
| Rate for Payer: Aetna American Axle |
$62.67
|
| Rate for Payer: Aetna Commercial |
$81.96
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: BCBS Complete |
$34.13
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$71.84
|
| Rate for Payer: BCN Commercial |
$71.84
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Advantage |
$67.49
|
| Rate for Payer: Cofinity Commercial |
$82.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$86.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.31
|
| Rate for Payer: Mclaren Medicaid |
$62.14
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Nomi Health Commercial |
$93.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$81.96
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health SBD |
$60.74
|
| Rate for Payer: Priority Health Tiered Network |
$49.71
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.21
|
| Rate for Payer: UHC Core |
$93.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.14
|
| Rate for Payer: UHC Exchange |
$93.21
|
| Rate for Payer: UHC Medicaid |
$32.50
|
| Rate for Payer: UHCCP Medicaid |
$32.50
|
| Rate for Payer: UMR Bronson Commercial |
$35.68
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.31
|
|
|
HC COREWELL DRUG ANALYSIS
|
Facility
|
IP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.42 |
| Max. Negotiated Rate |
$86.78 |
| Rate for Payer: Aetna American Axle |
$62.67
|
| Rate for Payer: Aetna Commercial |
$81.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.67
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Advantage |
$67.49
|
| Rate for Payer: Cofinity Commercial |
$82.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Healthscope Commercial |
$86.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: PHP Commercial |
$81.96
|
| Rate for Payer: Priority Health SBD |
$60.74
|
| Rate for Payer: UMR Bronson Commercial |
$42.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.31
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna American Axle |
$30.43
|
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Advantage |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: UMR Bronson Commercial |
$20.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC COREWELL DRUG ANALYSIS ALCOHOL
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100739
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.32 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna American Axle |
$30.43
|
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$23.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: BCBS Complete |
$18.73
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Advantage |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: UMR Bronson Commercial |
$17.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC CORN IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC CORN IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200036
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC CORN POLLEN IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC CORN POLLEN IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200081
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC CORO ANGIOS W RHC
|
Facility
|
OP
|
$9,143.70
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
48100015
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$10,446.41 |
| Rate for Payer: Aetna American Axle |
$5,943.40
|
| Rate for Payer: Aetna Commercial |
$7,772.15
|
| Rate for Payer: Aetna Medicare |
$3,359.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,943.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,253.11
|
| Rate for Payer: BCN Commercial |
$3,253.11
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$7,314.96
|
| Rate for Payer: Cash Price |
$7,314.96
|
| Rate for Payer: Cofinity Advantage |
$6,400.59
|
| Rate for Payer: Cofinity Commercial |
$7,863.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,314.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$8,229.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,400.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,857.77
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$3,391.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,772.15
|
| Rate for Payer: Nomi Health Commercial |
$9,690.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,857.77
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$7,772.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,446.41
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health SBD |
$5,760.53
|
| Rate for Payer: Priority Health Tiered Network |
$8,357.13
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: UMR Bronson Commercial |
$3,383.17
|
| Rate for Payer: VA VA |
$3,230.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,857.77
|
|
|
HC CORO ANGIOS W RHC
|
Facility
|
IP
|
$9,143.70
|
|
|
Service Code
|
CPT 93456
|
| Hospital Charge Code |
48100015
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,023.23 |
| Max. Negotiated Rate |
$8,229.33 |
| Rate for Payer: Aetna American Axle |
$5,943.40
|
| Rate for Payer: Aetna Commercial |
$7,772.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,943.40
|
| Rate for Payer: Cash Price |
$7,314.96
|
| Rate for Payer: Cofinity Advantage |
$6,400.59
|
| Rate for Payer: Cofinity Commercial |
$7,863.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,314.96
|
| Rate for Payer: Healthscope Commercial |
$8,229.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,400.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,857.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,772.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,857.77
|
| Rate for Payer: PHP Commercial |
$7,772.15
|
| Rate for Payer: Priority Health SBD |
$5,760.53
|
| Rate for Payer: UMR Bronson Commercial |
$4,023.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,857.77
|
|
|
HC CORO/CABG ANGIOS W RHC
|
Facility
|
IP
|
$7,254.18
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
48100016
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,191.84 |
| Max. Negotiated Rate |
$6,528.76 |
| Rate for Payer: Aetna American Axle |
$4,715.22
|
| Rate for Payer: Aetna Commercial |
$6,166.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,715.22
|
| Rate for Payer: Cash Price |
$5,803.34
|
| Rate for Payer: Cofinity Advantage |
$5,077.93
|
| Rate for Payer: Cofinity Commercial |
$6,238.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,803.34
|
| Rate for Payer: Healthscope Commercial |
$6,528.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,077.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,440.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,166.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,440.64
|
| Rate for Payer: PHP Commercial |
$6,166.05
|
| Rate for Payer: Priority Health SBD |
$4,570.13
|
| Rate for Payer: UMR Bronson Commercial |
$3,191.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,440.64
|
|
|
HC CORO/CABG ANGIOS W RHC
|
Facility
|
OP
|
$7,254.18
|
|
|
Service Code
|
CPT 93457
|
| Hospital Charge Code |
48100016
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$10,446.41 |
| Rate for Payer: Aetna American Axle |
$4,715.22
|
| Rate for Payer: Aetna Commercial |
$6,166.05
|
| Rate for Payer: Aetna Medicare |
$3,359.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,715.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,508.12
|
| Rate for Payer: BCN Commercial |
$3,508.12
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$5,803.34
|
| Rate for Payer: Cash Price |
$5,803.34
|
| Rate for Payer: Cofinity Advantage |
$5,077.93
|
| Rate for Payer: Cofinity Commercial |
$6,238.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,803.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$6,528.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,077.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,440.64
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$3,391.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,166.05
|
| Rate for Payer: Nomi Health Commercial |
$9,690.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,440.64
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$6,166.05
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,446.41
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health SBD |
$4,570.13
|
| Rate for Payer: Priority Health Tiered Network |
$8,357.13
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: UMR Bronson Commercial |
$2,684.05
|
| Rate for Payer: VA VA |
$3,230.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,440.64
|
|
|
HC CORONARY ANGIOS ONLY
|
Facility
|
OP
|
$7,701.38
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
48100013
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$10,446.41 |
| Rate for Payer: Aetna American Axle |
$5,005.90
|
| Rate for Payer: Aetna Commercial |
$6,546.17
|
| Rate for Payer: Aetna Medicare |
$3,359.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,005.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,659.98
|
| Rate for Payer: BCN Commercial |
$2,659.98
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$6,161.10
|
| Rate for Payer: Cash Price |
$6,161.10
|
| Rate for Payer: Cofinity Advantage |
$5,390.97
|
| Rate for Payer: Cofinity Commercial |
$6,623.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,161.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$6,931.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,390.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,776.03
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$3,391.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,546.17
|
| Rate for Payer: Nomi Health Commercial |
$9,690.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,776.03
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$6,546.17
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,446.41
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health SBD |
$4,851.87
|
| Rate for Payer: Priority Health Tiered Network |
$8,357.13
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: UMR Bronson Commercial |
$2,849.51
|
| Rate for Payer: VA VA |
$3,230.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,776.03
|
|
|
HC CORONARY ANGIOS ONLY
|
Facility
|
IP
|
$7,701.38
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
48100013
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,388.61 |
| Max. Negotiated Rate |
$6,931.24 |
| Rate for Payer: Aetna American Axle |
$5,005.90
|
| Rate for Payer: Aetna Commercial |
$6,546.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,005.90
|
| Rate for Payer: Cash Price |
$6,161.10
|
| Rate for Payer: Cofinity Advantage |
$5,390.97
|
| Rate for Payer: Cofinity Commercial |
$6,623.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,161.10
|
| Rate for Payer: Healthscope Commercial |
$6,931.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,390.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,776.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,546.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,776.03
|
| Rate for Payer: PHP Commercial |
$6,546.17
|
| Rate for Payer: Priority Health SBD |
$4,851.87
|
| Rate for Payer: UMR Bronson Commercial |
$3,388.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,776.03
|
|
|
HC CORONARY CRITICAL CARE R&B
|
Facility
|
IP
|
$6,464.21
|
|
| Hospital Charge Code |
21000001
|
|
Hospital Revenue Code
|
210
|
| Min. Negotiated Rate |
$2,844.25 |
| Max. Negotiated Rate |
$5,817.79 |
| Rate for Payer: Aetna American Axle |
$4,201.74
|
| Rate for Payer: Aetna Commercial |
$5,494.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,201.74
|
| Rate for Payer: Cash Price |
$5,171.37
|
| Rate for Payer: Cofinity Advantage |
$4,524.95
|
| Rate for Payer: Cofinity Commercial |
$5,559.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,171.37
|
| Rate for Payer: Healthscope Commercial |
$5,817.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,524.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,848.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,494.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,848.16
|
| Rate for Payer: PHP Commercial |
$5,494.58
|
| Rate for Payer: Priority Health SBD |
$4,072.45
|
| Rate for Payer: UMR Bronson Commercial |
$2,844.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,848.16
|
|
|
HC CORONARY SINUS CATHETER
|
Facility
|
OP
|
$1,592.74
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$1,433.47 |
| Rate for Payer: Aetna American Axle |
$1,035.28
|
| Rate for Payer: Aetna Commercial |
$1,353.83
|
| Rate for Payer: Aetna Medicare |
$796.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,035.28
|
| Rate for Payer: BCBS Complete |
$637.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$1,274.19
|
| Rate for Payer: Cash Price |
$1,274.19
|
| Rate for Payer: Cofinity Advantage |
$1,114.92
|
| Rate for Payer: Cofinity Commercial |
$1,369.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,274.19
|
| Rate for Payer: Healthscope Commercial |
$1,433.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,114.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,194.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,274.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,353.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,194.56
|
| Rate for Payer: PHP Commercial |
$1,353.83
|
| Rate for Payer: Priority Health SBD |
$1,003.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,035.28
|
| Rate for Payer: UHC Core |
$829.82
|
| Rate for Payer: UHC Exchange |
$625.95
|
| Rate for Payer: UMR Bronson Commercial |
$589.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,194.56
|
|
|
HC CORONARY SINUS CATHETER
|
Facility
|
IP
|
$1,592.74
|
|
|
Service Code
|
HCPCS C1733
|
| Hospital Charge Code |
27200023
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$700.81 |
| Max. Negotiated Rate |
$1,433.47 |
| Rate for Payer: Aetna American Axle |
$1,035.28
|
| Rate for Payer: Aetna Commercial |
$1,353.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,035.28
|
| Rate for Payer: Cash Price |
$1,274.19
|
| Rate for Payer: Cofinity Advantage |
$1,114.92
|
| Rate for Payer: Cofinity Commercial |
$1,369.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,274.19
|
| Rate for Payer: Healthscope Commercial |
$1,433.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,114.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,194.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,353.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,194.56
|
| Rate for Payer: PHP Commercial |
$1,353.83
|
| Rate for Payer: Priority Health SBD |
$1,003.43
|
| Rate for Payer: UMR Bronson Commercial |
$700.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,194.56
|
|
|
HC CORONARY STENT DRUG ELUTING
|
Facility
|
IP
|
$11,340.73
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,989.92 |
| Max. Negotiated Rate |
$10,206.66 |
| Rate for Payer: Aetna American Axle |
$7,371.47
|
| Rate for Payer: Aetna Commercial |
$9,639.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,371.47
|
| Rate for Payer: Cash Price |
$9,072.58
|
| Rate for Payer: Cofinity Advantage |
$7,938.51
|
| Rate for Payer: Cofinity Commercial |
$9,753.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,072.58
|
| Rate for Payer: Healthscope Commercial |
$10,206.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,938.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,505.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,639.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,505.55
|
| Rate for Payer: PHP Commercial |
$9,639.62
|
| Rate for Payer: Priority Health SBD |
$7,144.66
|
| Rate for Payer: UMR Bronson Commercial |
$4,989.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,505.55
|
|
|
HC CORONARY STENT DRUG ELUTING
|
Facility
|
OP
|
$11,340.73
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800008
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,196.07 |
| Max. Negotiated Rate |
$10,206.66 |
| Rate for Payer: Aetna American Axle |
$7,371.47
|
| Rate for Payer: Aetna Commercial |
$9,639.62
|
| Rate for Payer: Aetna Medicare |
$5,670.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,371.47
|
| Rate for Payer: BCBS Complete |
$4,536.29
|
| Rate for Payer: Cash Price |
$9,072.58
|
| Rate for Payer: Cofinity Advantage |
$7,938.51
|
| Rate for Payer: Cofinity Commercial |
$9,753.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,072.58
|
| Rate for Payer: Healthscope Commercial |
$10,206.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,938.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,505.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,072.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,639.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,505.55
|
| Rate for Payer: PHP Commercial |
$9,639.62
|
| Rate for Payer: Priority Health SBD |
$7,144.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,371.47
|
| Rate for Payer: UHC Core |
$5,908.52
|
| Rate for Payer: UHC Exchange |
$4,456.91
|
| Rate for Payer: UMR Bronson Commercial |
$4,196.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,505.55
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
IP
|
$4,145.24
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
48100001
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,823.91 |
| Max. Negotiated Rate |
$3,730.72 |
| Rate for Payer: Aetna American Axle |
$2,694.41
|
| Rate for Payer: Aetna Commercial |
$3,523.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,694.41
|
| Rate for Payer: Cash Price |
$3,316.19
|
| Rate for Payer: Cofinity Advantage |
$2,901.67
|
| Rate for Payer: Cofinity Commercial |
$3,564.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,316.19
|
| Rate for Payer: Healthscope Commercial |
$3,730.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,901.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,108.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,523.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,108.93
|
| Rate for Payer: PHP Commercial |
$3,523.45
|
| Rate for Payer: Priority Health SBD |
$2,611.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,823.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,108.93
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
OP
|
$4,145.24
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
48100001
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$82.28 |
| Max. Negotiated Rate |
$3,730.72 |
| Rate for Payer: Aetna American Axle |
$2,694.41
|
| Rate for Payer: Aetna Commercial |
$3,523.45
|
| Rate for Payer: Aetna Medicare |
$2,072.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,694.41
|
| Rate for Payer: BCBS Complete |
$1,658.10
|
| Rate for Payer: BCBS Trust/PPO |
$82.28
|
| Rate for Payer: BCN Commercial |
$82.28
|
| Rate for Payer: Cash Price |
$3,316.19
|
| Rate for Payer: Cash Price |
$3,316.19
|
| Rate for Payer: Cash Price |
$3,316.19
|
| Rate for Payer: Cofinity Advantage |
$2,901.67
|
| Rate for Payer: Cofinity Commercial |
$3,564.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,316.19
|
| Rate for Payer: Healthscope Commercial |
$3,730.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,901.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,108.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,316.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,523.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,108.93
|
| Rate for Payer: PHP Commercial |
$3,523.45
|
| Rate for Payer: Priority Health SBD |
$2,611.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,533.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,108.93
|
|
|
HC CORTICAL MAPPING
|
Facility
|
IP
|
$2,193.52
|
|
|
Service Code
|
CPT 95961
|
| Hospital Charge Code |
92000009
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$965.15 |
| Max. Negotiated Rate |
$1,974.17 |
| Rate for Payer: Aetna American Axle |
$1,425.79
|
| Rate for Payer: Aetna Commercial |
$1,864.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,425.79
|
| Rate for Payer: Cash Price |
$1,754.82
|
| Rate for Payer: Cofinity Advantage |
$1,535.46
|
| Rate for Payer: Cofinity Commercial |
$1,886.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,754.82
|
| Rate for Payer: Healthscope Commercial |
$1,974.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,535.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,645.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,864.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,645.14
|
| Rate for Payer: PHP Commercial |
$1,864.49
|
| Rate for Payer: Priority Health SBD |
$1,381.92
|
| Rate for Payer: UMR Bronson Commercial |
$965.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,645.14
|
|
|
HC CORTICAL MAPPING
|
Facility
|
OP
|
$2,193.52
|
|
|
Service Code
|
CPT 95961
|
| Hospital Charge Code |
92000009
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$447.50 |
| Max. Negotiated Rate |
$2,767.09 |
| Rate for Payer: Aetna American Axle |
$1,425.79
|
| Rate for Payer: Aetna Commercial |
$1,864.49
|
| Rate for Payer: Aetna Medicare |
$889.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,425.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,069.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,069.56
|
| Rate for Payer: BCBS Complete |
$469.92
|
| Rate for Payer: BCBS MAPPO |
$855.65
|
| Rate for Payer: BCBS Trust/PPO |
$717.11
|
| Rate for Payer: BCN Commercial |
$717.11
|
| Rate for Payer: BCN Medicare Advantage |
$855.65
|
| Rate for Payer: Cash Price |
$1,754.82
|
| Rate for Payer: Cash Price |
$1,754.82
|
| Rate for Payer: Cofinity Advantage |
$1,535.46
|
| Rate for Payer: Cofinity Commercial |
$1,886.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,754.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$855.65
|
| Rate for Payer: Healthscope Commercial |
$1,974.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,535.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,645.14
|
| Rate for Payer: Mclaren Medicaid |
$855.65
|
| Rate for Payer: Mclaren Medicare |
$855.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$898.43
|
| Rate for Payer: Meridian Medicaid |
$898.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$984.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$941.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,864.49
|
| Rate for Payer: Nomi Health Commercial |
$2,566.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,645.14
|
| Rate for Payer: PACE Medicare |
$812.87
|
| Rate for Payer: PACE SWMI |
$855.65
|
| Rate for Payer: PHP Commercial |
$1,864.49
|
| Rate for Payer: PHP Medicare Advantage |
$855.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,767.09
|
| Rate for Payer: Priority Health Medicare |
$855.65
|
| Rate for Payer: Priority Health SBD |
$1,381.92
|
| Rate for Payer: Priority Health Tiered Network |
$2,213.67
|
| Rate for Payer: Railroad Medicare Medicare |
$855.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,425.79
|
| Rate for Payer: UHC Core |
$1,142.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$855.65
|
| Rate for Payer: UHC Exchange |
$862.05
|
| Rate for Payer: UHC Medicaid |
$447.50
|
| Rate for Payer: UHCCP Medicaid |
$447.50
|
| Rate for Payer: UMR Bronson Commercial |
$811.60
|
| Rate for Payer: VA VA |
$855.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,645.14
|
|
|
HC CORTICOL SALIVA
|
Facility
|
OP
|
$68.98
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
30100618
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.52 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna American Axle |
$44.84
|
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: Aetna Medicare |
$16.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.38
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS MAPPO |
$16.30
|
| Rate for Payer: BCBS Trust/PPO |
$18.85
|
| Rate for Payer: BCN Commercial |
$18.85
|
| Rate for Payer: BCN Medicare Advantage |
$16.30
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Advantage |
$48.29
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.30
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.73
|
| Rate for Payer: Mclaren Medicaid |
$16.30
|
| Rate for Payer: Mclaren Medicare |
$16.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.11
|
| Rate for Payer: Meridian Medicaid |
$17.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$24.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PACE Medicare |
$15.48
|
| Rate for Payer: PACE SWMI |
$16.30
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: PHP Medicare Advantage |
$16.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.30
|
| Rate for Payer: Priority Health Medicare |
$16.30
|
| Rate for Payer: Priority Health SBD |
$43.46
|
| Rate for Payer: Priority Health Tiered Network |
$13.04
|
| Rate for Payer: Railroad Medicare Medicare |
$16.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.45
|
| Rate for Payer: UHC Core |
$24.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.30
|
| Rate for Payer: UHC Exchange |
$24.45
|
| Rate for Payer: UHC Medicaid |
$8.52
|
| Rate for Payer: UHCCP Medicaid |
$8.52
|
| Rate for Payer: UMR Bronson Commercial |
$25.52
|
| Rate for Payer: VA VA |
$16.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.73
|
|
