|
HC CRP-SF
|
Facility
|
OP
|
$30.57
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$27.51 |
| Rate for Payer: Aetna American Axle |
$19.87
|
| Rate for Payer: Aetna Commercial |
$25.98
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: BCBS Complete |
$2.84
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$6.00
|
| Rate for Payer: BCN Commercial |
$6.00
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$24.46
|
| Rate for Payer: Cash Price |
$24.46
|
| Rate for Payer: Cofinity Advantage |
$21.40
|
| Rate for Payer: Cofinity Commercial |
$26.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$27.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.93
|
| Rate for Payer: Mclaren Medicaid |
$5.18
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$5.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.98
|
| Rate for Payer: Nomi Health Commercial |
$7.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.93
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$25.98
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.18
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health SBD |
$19.26
|
| Rate for Payer: Priority Health Tiered Network |
$4.14
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.77
|
| Rate for Payer: UHC Core |
$7.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.18
|
| Rate for Payer: UHC Exchange |
$7.77
|
| Rate for Payer: UHC Medicaid |
$2.71
|
| Rate for Payer: UHCCP Medicaid |
$2.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.31
|
| Rate for Payer: VA VA |
$5.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.93
|
|
|
HC CRRT INITIAL
|
Facility
|
OP
|
$728.28
|
|
| Hospital Charge Code |
27000607
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$269.46 |
| Max. Negotiated Rate |
$655.45 |
| Rate for Payer: Aetna American Axle |
$473.38
|
| Rate for Payer: Aetna Commercial |
$619.04
|
| Rate for Payer: Aetna Medicare |
$364.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.38
|
| Rate for Payer: BCBS Complete |
$291.31
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cofinity Advantage |
$509.80
|
| Rate for Payer: Cofinity Commercial |
$626.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.62
|
| Rate for Payer: Healthscope Commercial |
$655.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$509.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$582.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.21
|
| Rate for Payer: PHP Commercial |
$619.04
|
| Rate for Payer: Priority Health SBD |
$458.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$473.38
|
| Rate for Payer: UHC Core |
$379.43
|
| Rate for Payer: UHC Exchange |
$286.21
|
| Rate for Payer: UMR Bronson Commercial |
$269.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.21
|
|
|
HC CRRT INITIAL
|
Facility
|
IP
|
$728.28
|
|
| Hospital Charge Code |
27000607
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$320.44 |
| Max. Negotiated Rate |
$655.45 |
| Rate for Payer: Aetna American Axle |
$473.38
|
| Rate for Payer: Aetna Commercial |
$619.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.38
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cofinity Advantage |
$509.80
|
| Rate for Payer: Cofinity Commercial |
$626.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.62
|
| Rate for Payer: Healthscope Commercial |
$655.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$509.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.21
|
| Rate for Payer: PHP Commercial |
$619.04
|
| Rate for Payer: Priority Health SBD |
$458.82
|
| Rate for Payer: UMR Bronson Commercial |
$320.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.21
|
|
|
HC CRRT INITIATION/REINITIATION
|
Facility
|
OP
|
$1,157.78
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
88000001
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$217.44 |
| Max. Negotiated Rate |
$1,344.55 |
| Rate for Payer: Aetna American Axle |
$752.56
|
| Rate for Payer: Aetna Commercial |
$984.11
|
| Rate for Payer: Aetna Medicare |
$432.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$752.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$519.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$519.70
|
| Rate for Payer: BCBS Complete |
$228.34
|
| Rate for Payer: BCBS MAPPO |
$415.76
|
| Rate for Payer: BCN Medicare Advantage |
$415.76
|
| Rate for Payer: Cash Price |
$926.22
|
| Rate for Payer: Cash Price |
$926.22
|
| Rate for Payer: Cofinity Advantage |
$810.45
|
| Rate for Payer: Cofinity Commercial |
$995.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$926.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$415.76
|
| Rate for Payer: Healthscope Commercial |
$1,042.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$810.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$868.34
|
| Rate for Payer: Mclaren Medicaid |
$415.76
|
| Rate for Payer: Mclaren Medicare |
$415.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$436.55
|
| Rate for Payer: Meridian Medicaid |
$436.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$478.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$457.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$984.11
|
| Rate for Payer: Nomi Health Commercial |
$1,247.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$868.34
|
| Rate for Payer: PACE Medicare |
$394.97
|
| Rate for Payer: PACE SWMI |
$415.76
|
| Rate for Payer: PHP Commercial |
$984.11
|
| Rate for Payer: PHP Medicare Advantage |
$415.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,344.55
|
| Rate for Payer: Priority Health Medicare |
$415.76
|
| Rate for Payer: Priority Health SBD |
$729.40
|
| Rate for Payer: Priority Health Tiered Network |
$1,075.64
|
| Rate for Payer: Railroad Medicare Medicare |
$415.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$752.56
|
| Rate for Payer: UHC Core |
$603.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$415.76
|
| Rate for Payer: UHC Exchange |
$455.01
|
| Rate for Payer: UHC Medicaid |
$217.44
|
| Rate for Payer: UHCCP Medicaid |
$217.44
|
| Rate for Payer: UMR Bronson Commercial |
$428.38
|
| Rate for Payer: VA VA |
$415.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$868.34
|
|
|
HC CRRT INITIATION/REINITIATION
|
Facility
|
IP
|
$1,157.78
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
88000001
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$509.42 |
| Max. Negotiated Rate |
$1,042.00 |
| Rate for Payer: Aetna American Axle |
$752.56
|
| Rate for Payer: Aetna Commercial |
$984.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$752.56
|
| Rate for Payer: Cash Price |
$926.22
|
| Rate for Payer: Cofinity Advantage |
$810.45
|
| Rate for Payer: Cofinity Commercial |
$995.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$926.22
|
| Rate for Payer: Healthscope Commercial |
$1,042.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$810.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$868.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$984.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$868.34
|
| Rate for Payer: PHP Commercial |
$984.11
|
| Rate for Payer: Priority Health SBD |
$729.40
|
| Rate for Payer: UMR Bronson Commercial |
$509.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$868.34
|
|
|
HC CRRT MONITOR FEE
|
Facility
|
IP
|
$130.05
|
|
| Hospital Charge Code |
27000609
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$57.22 |
| Max. Negotiated Rate |
$117.05 |
| Rate for Payer: Aetna American Axle |
$84.53
|
| Rate for Payer: Aetna Commercial |
$110.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.53
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cofinity Advantage |
$91.03
|
| Rate for Payer: Cofinity Commercial |
$111.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.04
|
| Rate for Payer: Healthscope Commercial |
$117.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.54
|
| Rate for Payer: PHP Commercial |
$110.54
|
| Rate for Payer: Priority Health SBD |
$81.93
|
| Rate for Payer: UMR Bronson Commercial |
$57.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.54
|
|
|
HC CRRT MONITOR FEE
|
Facility
|
OP
|
$130.05
|
|
| Hospital Charge Code |
27000609
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$48.12 |
| Max. Negotiated Rate |
$117.05 |
| Rate for Payer: Aetna American Axle |
$84.53
|
| Rate for Payer: Aetna Commercial |
$110.54
|
| Rate for Payer: Aetna Medicare |
$65.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.53
|
| Rate for Payer: BCBS Complete |
$52.02
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cofinity Advantage |
$91.03
|
| Rate for Payer: Cofinity Commercial |
$111.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.04
|
| Rate for Payer: Healthscope Commercial |
$117.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.54
|
| Rate for Payer: PHP Commercial |
$110.54
|
| Rate for Payer: Priority Health SBD |
$81.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.53
|
| Rate for Payer: UHC Core |
$67.76
|
| Rate for Payer: UHC Exchange |
$51.11
|
| Rate for Payer: UMR Bronson Commercial |
$48.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.54
|
|
|
HC CRRT MONITORING PER HOUR
|
Facility
|
OP
|
$425.18
|
|
| Hospital Charge Code |
88000002
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$157.32 |
| Max. Negotiated Rate |
$382.66 |
| Rate for Payer: Aetna American Axle |
$276.37
|
| Rate for Payer: Aetna Commercial |
$361.40
|
| Rate for Payer: Aetna Medicare |
$212.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.37
|
| Rate for Payer: BCBS Complete |
$170.07
|
| Rate for Payer: Cash Price |
$340.14
|
| Rate for Payer: Cofinity Advantage |
$297.63
|
| Rate for Payer: Cofinity Commercial |
$365.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.14
|
| Rate for Payer: Healthscope Commercial |
$382.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$297.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$318.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$340.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$361.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.88
|
| Rate for Payer: PHP Commercial |
$361.40
|
| Rate for Payer: Priority Health SBD |
$267.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$276.37
|
| Rate for Payer: UHC Core |
$221.52
|
| Rate for Payer: UHC Exchange |
$167.10
|
| Rate for Payer: UMR Bronson Commercial |
$157.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$318.88
|
|
|
HC CRRT MONITORING PER HOUR
|
Facility
|
IP
|
$425.18
|
|
| Hospital Charge Code |
88000002
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$187.08 |
| Max. Negotiated Rate |
$382.66 |
| Rate for Payer: Aetna American Axle |
$276.37
|
| Rate for Payer: Aetna Commercial |
$361.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.37
|
| Rate for Payer: Cash Price |
$340.14
|
| Rate for Payer: Cofinity Advantage |
$297.63
|
| Rate for Payer: Cofinity Commercial |
$365.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.14
|
| Rate for Payer: Healthscope Commercial |
$382.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$297.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$318.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$361.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.88
|
| Rate for Payer: PHP Commercial |
$361.40
|
| Rate for Payer: Priority Health SBD |
$267.86
|
| Rate for Payer: UMR Bronson Commercial |
$187.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$318.88
|
|
|
HC CRRT SUBSEQUENT CARTRIDGE
|
Facility
|
OP
|
$286.11
|
|
| Hospital Charge Code |
27000608
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$105.86 |
| Max. Negotiated Rate |
$257.50 |
| Rate for Payer: Aetna American Axle |
$185.97
|
| Rate for Payer: Aetna Commercial |
$243.19
|
| Rate for Payer: Aetna Medicare |
$143.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.97
|
| Rate for Payer: BCBS Complete |
$114.44
|
| Rate for Payer: Cash Price |
$228.89
|
| Rate for Payer: Cofinity Advantage |
$200.28
|
| Rate for Payer: Cofinity Commercial |
$246.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.89
|
| Rate for Payer: Healthscope Commercial |
$257.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.58
|
| Rate for Payer: PHP Commercial |
$243.19
|
| Rate for Payer: Priority Health SBD |
$180.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.97
|
| Rate for Payer: UHC Core |
$149.06
|
| Rate for Payer: UHC Exchange |
$112.44
|
| Rate for Payer: UMR Bronson Commercial |
$105.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.58
|
|
|
HC CRRT SUBSEQUENT CARTRIDGE
|
Facility
|
IP
|
$286.11
|
|
| Hospital Charge Code |
27000608
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$125.89 |
| Max. Negotiated Rate |
$257.50 |
| Rate for Payer: Aetna American Axle |
$185.97
|
| Rate for Payer: Aetna Commercial |
$243.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.97
|
| Rate for Payer: Cash Price |
$228.89
|
| Rate for Payer: Cofinity Advantage |
$200.28
|
| Rate for Payer: Cofinity Commercial |
$246.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.89
|
| Rate for Payer: Healthscope Commercial |
$257.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.58
|
| Rate for Payer: PHP Commercial |
$243.19
|
| Rate for Payer: Priority Health SBD |
$180.25
|
| Rate for Payer: UMR Bronson Commercial |
$125.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.58
|
|
|
HC CRUTCHES
|
Facility
|
IP
|
$129.23
|
|
| Hospital Charge Code |
96000002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$56.86 |
| Max. Negotiated Rate |
$116.31 |
| Rate for Payer: Aetna American Axle |
$84.00
|
| Rate for Payer: Aetna Commercial |
$109.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.00
|
| Rate for Payer: Cash Price |
$103.38
|
| Rate for Payer: Cofinity Advantage |
$90.46
|
| Rate for Payer: Cofinity Commercial |
$111.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.38
|
| Rate for Payer: Healthscope Commercial |
$116.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.92
|
| Rate for Payer: PHP Commercial |
$109.85
|
| Rate for Payer: Priority Health SBD |
$81.41
|
| Rate for Payer: UMR Bronson Commercial |
$56.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.92
|
|
|
HC CRUTCHES
|
Facility
|
OP
|
$129.23
|
|
| Hospital Charge Code |
96000002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$47.82 |
| Max. Negotiated Rate |
$116.31 |
| Rate for Payer: Aetna American Axle |
$84.00
|
| Rate for Payer: Aetna Commercial |
$109.85
|
| Rate for Payer: Aetna Medicare |
$64.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.00
|
| Rate for Payer: BCBS Complete |
$51.69
|
| Rate for Payer: Cash Price |
$103.38
|
| Rate for Payer: Cofinity Advantage |
$90.46
|
| Rate for Payer: Cofinity Commercial |
$111.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.38
|
| Rate for Payer: Healthscope Commercial |
$116.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.92
|
| Rate for Payer: PHP Commercial |
$109.85
|
| Rate for Payer: Priority Health SBD |
$81.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.00
|
| Rate for Payer: UHC Core |
$67.33
|
| Rate for Payer: UHC Exchange |
$50.79
|
| Rate for Payer: UMR Bronson Commercial |
$47.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.92
|
|
|
HC CRYOABLATION KIDNEY UNILATERAL
|
Facility
|
IP
|
$12,685.18
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
36100572
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,581.48 |
| Max. Negotiated Rate |
$11,416.66 |
| Rate for Payer: Aetna American Axle |
$8,245.37
|
| Rate for Payer: Aetna Commercial |
$10,782.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,245.37
|
| Rate for Payer: Cash Price |
$10,148.14
|
| Rate for Payer: Cofinity Advantage |
$8,879.63
|
| Rate for Payer: Cofinity Commercial |
$10,909.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,148.14
|
| Rate for Payer: Healthscope Commercial |
$11,416.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,879.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,513.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,782.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,513.89
|
| Rate for Payer: PHP Commercial |
$10,782.40
|
| Rate for Payer: Priority Health SBD |
$7,991.66
|
| Rate for Payer: UMR Bronson Commercial |
$5,581.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,513.89
|
|
|
HC CRYOABLATION KIDNEY UNILATERAL
|
Facility
|
OP
|
$12,685.18
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
36100572
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,693.52 |
| Max. Negotiated Rate |
$34,252.33 |
| Rate for Payer: Aetna American Axle |
$8,245.37
|
| Rate for Payer: Aetna Commercial |
$10,782.40
|
| Rate for Payer: Aetna Medicare |
$11,015.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,245.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,239.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,239.51
|
| Rate for Payer: BCBS Complete |
$5,816.91
|
| Rate for Payer: BCBS MAPPO |
$10,591.61
|
| Rate for Payer: BCBS Trust/PPO |
$7,579.78
|
| Rate for Payer: BCN Commercial |
$7,579.78
|
| Rate for Payer: BCN Medicare Advantage |
$10,591.61
|
| Rate for Payer: Cash Price |
$10,148.14
|
| Rate for Payer: Cash Price |
$10,148.14
|
| Rate for Payer: Cash Price |
$10,148.14
|
| Rate for Payer: Cofinity Advantage |
$8,879.63
|
| Rate for Payer: Cofinity Commercial |
$10,909.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,148.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,591.61
|
| Rate for Payer: Healthscope Commercial |
$11,416.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,879.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,513.89
|
| Rate for Payer: Mclaren Medicaid |
$10,591.61
|
| Rate for Payer: Mclaren Medicare |
$10,591.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,121.19
|
| Rate for Payer: Meridian Medicaid |
$11,121.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,180.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$11,650.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,782.40
|
| Rate for Payer: Nomi Health Commercial |
$31,774.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,513.89
|
| Rate for Payer: PACE Medicare |
$10,062.03
|
| Rate for Payer: PACE SWMI |
$10,591.61
|
| Rate for Payer: PHP Commercial |
$10,782.40
|
| Rate for Payer: PHP Medicare Advantage |
$10,591.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,539.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$34,252.33
|
| Rate for Payer: Priority Health Medicare |
$10,591.61
|
| Rate for Payer: Priority Health SBD |
$7,991.66
|
| Rate for Payer: Priority Health Tiered Network |
$27,401.86
|
| Rate for Payer: Railroad Medicare Medicare |
$10,591.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10,591.61
|
| Rate for Payer: UHC Medicaid |
$5,539.41
|
| Rate for Payer: UHCCP Medicaid |
$5,539.41
|
| Rate for Payer: UMR Bronson Commercial |
$4,693.52
|
| Rate for Payer: VA VA |
$10,591.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,513.89
|
|
|
HC CRYOABLATION LIVER TUMOR
|
Facility
|
IP
|
$10,740.37
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
36100613
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,725.76 |
| Max. Negotiated Rate |
$9,666.33 |
| Rate for Payer: Aetna American Axle |
$6,981.24
|
| Rate for Payer: Aetna Commercial |
$9,129.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,981.24
|
| Rate for Payer: Cash Price |
$8,592.30
|
| Rate for Payer: Cofinity Advantage |
$7,518.26
|
| Rate for Payer: Cofinity Commercial |
$9,236.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,592.30
|
| Rate for Payer: Healthscope Commercial |
$9,666.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,518.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,055.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,129.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,055.28
|
| Rate for Payer: PHP Commercial |
$9,129.31
|
| Rate for Payer: Priority Health SBD |
$6,766.43
|
| Rate for Payer: UMR Bronson Commercial |
$4,725.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,055.28
|
|
|
HC CRYOABLATION LIVER TUMOR
|
Facility
|
OP
|
$10,740.37
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
36100613
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,973.94 |
| Max. Negotiated Rate |
$34,252.33 |
| Rate for Payer: Aetna American Axle |
$6,981.24
|
| Rate for Payer: Aetna Commercial |
$9,129.31
|
| Rate for Payer: Aetna Medicare |
$11,015.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,981.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,239.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,239.51
|
| Rate for Payer: BCBS Complete |
$5,816.91
|
| Rate for Payer: BCBS MAPPO |
$10,591.61
|
| Rate for Payer: BCBS Trust/PPO |
$4,955.41
|
| Rate for Payer: BCN Commercial |
$4,955.41
|
| Rate for Payer: BCN Medicare Advantage |
$10,591.61
|
| Rate for Payer: Cash Price |
$8,592.30
|
| Rate for Payer: Cash Price |
$8,592.30
|
| Rate for Payer: Cash Price |
$8,592.30
|
| Rate for Payer: Cofinity Advantage |
$7,518.26
|
| Rate for Payer: Cofinity Commercial |
$9,236.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,592.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,591.61
|
| Rate for Payer: Healthscope Commercial |
$9,666.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,518.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,055.28
|
| Rate for Payer: Mclaren Medicaid |
$10,591.61
|
| Rate for Payer: Mclaren Medicare |
$10,591.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,121.19
|
| Rate for Payer: Meridian Medicaid |
$11,121.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,180.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$11,650.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,129.31
|
| Rate for Payer: Nomi Health Commercial |
$31,774.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,055.28
|
| Rate for Payer: PACE Medicare |
$10,062.03
|
| Rate for Payer: PACE SWMI |
$10,591.61
|
| Rate for Payer: PHP Commercial |
$9,129.31
|
| Rate for Payer: PHP Medicare Advantage |
$10,591.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,539.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$34,252.33
|
| Rate for Payer: Priority Health Medicare |
$10,591.61
|
| Rate for Payer: Priority Health SBD |
$6,766.43
|
| Rate for Payer: Priority Health Tiered Network |
$27,401.86
|
| Rate for Payer: Railroad Medicare Medicare |
$10,591.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10,591.61
|
| Rate for Payer: UHC Medicaid |
$5,539.41
|
| Rate for Payer: UHCCP Medicaid |
$5,539.41
|
| Rate for Payer: UMR Bronson Commercial |
$3,973.94
|
| Rate for Payer: VA VA |
$10,591.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,055.28
|
|
|
HC CRYOABLATION NASAL TISSUE OR NERVES UNI OR BIL
|
Facility
|
IP
|
$11,109.39
|
|
|
Service Code
|
CPT 31243
|
| Hospital Charge Code |
76100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,888.13 |
| Max. Negotiated Rate |
$9,998.45 |
| Rate for Payer: Aetna American Axle |
$7,221.10
|
| Rate for Payer: Aetna Commercial |
$9,442.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,221.10
|
| Rate for Payer: Cash Price |
$8,887.51
|
| Rate for Payer: Cofinity Advantage |
$7,776.57
|
| Rate for Payer: Cofinity Commercial |
$9,554.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,887.51
|
| Rate for Payer: Healthscope Commercial |
$9,998.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,776.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,332.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,442.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,332.04
|
| Rate for Payer: PHP Commercial |
$9,442.98
|
| Rate for Payer: Priority Health SBD |
$6,998.92
|
| Rate for Payer: UMR Bronson Commercial |
$4,888.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,332.04
|
|
|
HC CRYOABLATION NASAL TISSUE OR NERVES UNI OR BIL
|
Facility
|
OP
|
$11,109.39
|
|
|
Service Code
|
CPT 31243
|
| Hospital Charge Code |
76100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,084.94 |
| Max. Negotiated Rate |
$19,075.37 |
| Rate for Payer: Aetna American Axle |
$7,221.10
|
| Rate for Payer: Aetna Commercial |
$9,442.98
|
| Rate for Payer: Aetna Medicare |
$6,134.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,221.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,373.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,373.18
|
| Rate for Payer: BCBS Complete |
$3,239.48
|
| Rate for Payer: BCBS MAPPO |
$5,898.54
|
| Rate for Payer: BCN Medicare Advantage |
$5,898.54
|
| Rate for Payer: Cash Price |
$8,887.51
|
| Rate for Payer: Cash Price |
$8,887.51
|
| Rate for Payer: Cofinity Advantage |
$7,776.57
|
| Rate for Payer: Cofinity Commercial |
$9,554.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,887.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,898.54
|
| Rate for Payer: Healthscope Commercial |
$9,998.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,776.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,332.04
|
| Rate for Payer: Mclaren Medicaid |
$5,898.54
|
| Rate for Payer: Mclaren Medicare |
$5,898.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,193.47
|
| Rate for Payer: Meridian Medicaid |
$6,193.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,783.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,488.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,442.98
|
| Rate for Payer: Nomi Health Commercial |
$17,695.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,332.04
|
| Rate for Payer: PACE Medicare |
$5,603.61
|
| Rate for Payer: PACE SWMI |
$5,898.54
|
| Rate for Payer: PHP Commercial |
$9,442.98
|
| Rate for Payer: PHP Medicare Advantage |
$5,898.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,084.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,075.37
|
| Rate for Payer: Priority Health Medicare |
$5,898.54
|
| Rate for Payer: Priority Health SBD |
$6,998.92
|
| Rate for Payer: Priority Health Tiered Network |
$15,260.30
|
| Rate for Payer: Railroad Medicare Medicare |
$5,898.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,221.10
|
| Rate for Payer: UHC Core |
$5,787.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,898.54
|
| Rate for Payer: UHC Exchange |
$4,365.99
|
| Rate for Payer: UHC Medicaid |
$3,084.94
|
| Rate for Payer: UHCCP Medicaid |
$3,084.94
|
| Rate for Payer: UMR Bronson Commercial |
$4,110.47
|
| Rate for Payer: VA VA |
$5,898.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,332.04
|
|
|
HC CRYOABLATION NEEDLE/PROBE
|
Facility
|
IP
|
$3,597.50
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,582.90 |
| Max. Negotiated Rate |
$3,237.75 |
| Rate for Payer: Aetna American Axle |
$2,338.38
|
| Rate for Payer: Aetna Commercial |
$3,057.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,338.38
|
| Rate for Payer: Cash Price |
$2,878.00
|
| Rate for Payer: Cofinity Advantage |
$2,518.25
|
| Rate for Payer: Cofinity Commercial |
$3,093.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,878.00
|
| Rate for Payer: Healthscope Commercial |
$3,237.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,518.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,698.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,057.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,698.12
|
| Rate for Payer: PHP Commercial |
$3,057.88
|
| Rate for Payer: Priority Health SBD |
$2,266.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,582.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,698.12
|
|
|
HC CRYOABLATION NEEDLE/PROBE
|
Facility
|
OP
|
$3,597.50
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,331.08 |
| Max. Negotiated Rate |
$3,237.75 |
| Rate for Payer: Aetna American Axle |
$2,338.38
|
| Rate for Payer: Aetna Commercial |
$3,057.88
|
| Rate for Payer: Aetna Medicare |
$1,798.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,338.38
|
| Rate for Payer: BCBS Complete |
$1,439.00
|
| Rate for Payer: Cash Price |
$2,878.00
|
| Rate for Payer: Cofinity Advantage |
$2,518.25
|
| Rate for Payer: Cofinity Commercial |
$3,093.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,878.00
|
| Rate for Payer: Healthscope Commercial |
$3,237.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,518.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,698.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,878.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,057.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,698.12
|
| Rate for Payer: PHP Commercial |
$3,057.88
|
| Rate for Payer: Priority Health SBD |
$2,266.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,338.38
|
| Rate for Payer: UHC Core |
$1,874.30
|
| Rate for Payer: UHC Exchange |
$1,413.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,331.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,698.12
|
|
|
HC CRYOABLATION STANDBY
|
Facility
|
OP
|
$8,343.84
|
|
| Hospital Charge Code |
27200283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,087.22 |
| Max. Negotiated Rate |
$7,509.46 |
| Rate for Payer: Aetna American Axle |
$5,423.50
|
| Rate for Payer: Aetna Commercial |
$7,092.26
|
| Rate for Payer: Aetna Medicare |
$4,171.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,423.50
|
| Rate for Payer: BCBS Complete |
$3,337.54
|
| Rate for Payer: Cash Price |
$6,675.07
|
| Rate for Payer: Cofinity Advantage |
$5,840.69
|
| Rate for Payer: Cofinity Commercial |
$7,175.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,675.07
|
| Rate for Payer: Healthscope Commercial |
$7,509.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,840.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,257.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,675.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,092.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,257.88
|
| Rate for Payer: PHP Commercial |
$7,092.26
|
| Rate for Payer: Priority Health SBD |
$5,256.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,423.50
|
| Rate for Payer: UHC Core |
$4,347.14
|
| Rate for Payer: UHC Exchange |
$3,279.13
|
| Rate for Payer: UMR Bronson Commercial |
$3,087.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,257.88
|
|
|
HC CRYOABLATION STANDBY
|
Facility
|
IP
|
$8,343.84
|
|
| Hospital Charge Code |
27200283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,671.29 |
| Max. Negotiated Rate |
$7,509.46 |
| Rate for Payer: Aetna American Axle |
$5,423.50
|
| Rate for Payer: Aetna Commercial |
$7,092.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,423.50
|
| Rate for Payer: Cash Price |
$6,675.07
|
| Rate for Payer: Cofinity Advantage |
$5,840.69
|
| Rate for Payer: Cofinity Commercial |
$7,175.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,675.07
|
| Rate for Payer: Healthscope Commercial |
$7,509.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,840.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,257.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,092.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,257.88
|
| Rate for Payer: PHP Commercial |
$7,092.26
|
| Rate for Payer: Priority Health SBD |
$5,256.62
|
| Rate for Payer: UMR Bronson Commercial |
$3,671.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,257.88
|
|
|
HC CRYOABLATION SUPPLIES
|
Facility
|
OP
|
$12,517.61
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,631.52 |
| Max. Negotiated Rate |
$11,265.85 |
| Rate for Payer: Aetna American Axle |
$8,136.45
|
| Rate for Payer: Aetna Commercial |
$10,639.97
|
| Rate for Payer: Aetna Medicare |
$6,258.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,136.45
|
| Rate for Payer: BCBS Complete |
$5,007.04
|
| Rate for Payer: Cash Price |
$10,014.09
|
| Rate for Payer: Cofinity Advantage |
$8,762.33
|
| Rate for Payer: Cofinity Commercial |
$10,765.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,014.09
|
| Rate for Payer: Healthscope Commercial |
$11,265.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,762.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,388.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,014.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,639.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,388.21
|
| Rate for Payer: PHP Commercial |
$10,639.97
|
| Rate for Payer: Priority Health SBD |
$7,886.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,136.45
|
| Rate for Payer: UHC Core |
$6,521.67
|
| Rate for Payer: UHC Exchange |
$4,919.42
|
| Rate for Payer: UMR Bronson Commercial |
$4,631.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,388.21
|
|
|
HC CRYOABLATION SUPPLIES
|
Facility
|
IP
|
$12,517.61
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,507.75 |
| Max. Negotiated Rate |
$11,265.85 |
| Rate for Payer: Aetna American Axle |
$8,136.45
|
| Rate for Payer: Aetna Commercial |
$10,639.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,136.45
|
| Rate for Payer: Cash Price |
$10,014.09
|
| Rate for Payer: Cofinity Advantage |
$8,762.33
|
| Rate for Payer: Cofinity Commercial |
$10,765.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,014.09
|
| Rate for Payer: Healthscope Commercial |
$11,265.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,762.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,388.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,639.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,388.21
|
| Rate for Payer: PHP Commercial |
$10,639.97
|
| Rate for Payer: Priority Health SBD |
$7,886.09
|
| Rate for Payer: UMR Bronson Commercial |
$5,507.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,388.21
|
|
