|
HC IR HEPATIC VENOGRAPHY
|
Facility
|
OP
|
$4,219.50
|
|
|
Service Code
|
CPT 75889
|
| Hospital Charge Code |
32000208
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$121.15 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$2,742.68
|
| Rate for Payer: Aetna Commercial |
$3,586.58
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,742.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$138.10
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,375.60
|
| Rate for Payer: Cash Price |
$3,375.60
|
| Rate for Payer: Cofinity Commercial |
$3,628.77
|
| Rate for Payer: Cofinity Commercial |
$2,953.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,375.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$3,797.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,953.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,164.62
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,586.58
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,586.58
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,953.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$2,658.28
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.26
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$121.15
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,561.22
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,164.62
|
|
|
HC IR INFERIOR VENACAVAGRAM
|
Facility
|
OP
|
$3,402.31
|
|
|
Service Code
|
CPT 75825
|
| Hospital Charge Code |
32000205
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$111.99 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$2,211.50
|
| Rate for Payer: Aetna Commercial |
$2,891.96
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,211.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$117.20
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,721.85
|
| Rate for Payer: Cash Price |
$2,721.85
|
| Rate for Payer: Cofinity Commercial |
$2,381.62
|
| Rate for Payer: Cofinity Commercial |
$2,925.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,721.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$3,062.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,381.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,551.73
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,891.96
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$2,891.96
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,381.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$2,143.46
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.19
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$111.99
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,258.85
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,551.73
|
|
|
HC IR INFERIOR VENACAVAGRAM
|
Facility
|
IP
|
$3,402.31
|
|
|
Service Code
|
CPT 75825
|
| Hospital Charge Code |
32000205
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,497.02 |
| Max. Negotiated Rate |
$3,062.08 |
| Rate for Payer: Aetna American Axle |
$2,211.50
|
| Rate for Payer: Aetna Commercial |
$2,891.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,211.50
|
| Rate for Payer: Cash Price |
$2,721.85
|
| Rate for Payer: Cofinity Commercial |
$2,381.62
|
| Rate for Payer: Cofinity Commercial |
$2,925.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,721.85
|
| Rate for Payer: Healthscope Commercial |
$3,062.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,381.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,551.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,891.96
|
| Rate for Payer: PHP Commercial |
$2,891.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,381.62
|
| Rate for Payer: Priority Health SBD |
$2,143.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,497.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,551.73
|
|
|
HC IR INJECTION FACET JOINT C OR T 1ST LEVEL
|
Facility
|
OP
|
$1,243.18
|
|
|
Service Code
|
CPT 64490
|
| Hospital Charge Code |
36100290
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$102.82 |
| Max. Negotiated Rate |
$2,550.52 |
| Rate for Payer: Aetna American Axle |
$808.07
|
| Rate for Payer: Aetna Commercial |
$1,056.70
|
| Rate for Payer: Aetna Medicare |
$842.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,355.00
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$994.54
|
| Rate for Payer: Cash Price |
$994.54
|
| Rate for Payer: Cofinity Commercial |
$1,069.13
|
| Rate for Payer: Cofinity Commercial |
$870.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$994.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,118.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$870.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$932.38
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.70
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$1,056.70
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$870.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,550.52
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,040.42
|
| Rate for Payer: Priority Health SBD |
$783.20
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.10
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.19
|
| Rate for Payer: UHC Exchange |
$102.82
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$459.98
|
| Rate for Payer: VA VA |
$810.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$932.38
|
|
|
HC IR INJECTION FACET JOINT C OR T 1ST LEVEL
|
Facility
|
IP
|
$1,243.18
|
|
|
Service Code
|
CPT 64490
|
| Hospital Charge Code |
36100290
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$547.00 |
| Max. Negotiated Rate |
$1,118.86 |
| Rate for Payer: Aetna American Axle |
$808.07
|
| Rate for Payer: Aetna Commercial |
$1,056.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$808.07
|
| Rate for Payer: Cash Price |
$994.54
|
| Rate for Payer: Cofinity Commercial |
$1,069.13
|
| Rate for Payer: Cofinity Commercial |
$870.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$994.54
|
| Rate for Payer: Healthscope Commercial |
$1,118.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$870.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$932.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,056.70
|
| Rate for Payer: PHP Commercial |
$1,056.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$870.23
|
| Rate for Payer: Priority Health SBD |
$783.20
|
| Rate for Payer: UMR Bronson Commercial |
$547.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$932.38
|
|
|
HC IR INJECTION FACET JOINT L OR S 1ST LEVEL
|
Facility
|
IP
|
$1,618.52
|
|
|
Service Code
|
CPT 64493
|
| Hospital Charge Code |
36100293
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$712.15 |
| Max. Negotiated Rate |
$1,456.67 |
| Rate for Payer: Aetna American Axle |
$1,052.04
|
| Rate for Payer: Aetna Commercial |
$1,375.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,052.04
|
| Rate for Payer: Cash Price |
$1,294.82
|
| Rate for Payer: Cofinity Commercial |
$1,132.96
|
| Rate for Payer: Cofinity Commercial |
$1,391.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,294.82
|
| Rate for Payer: Healthscope Commercial |
$1,456.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,132.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,213.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,375.74
|
| Rate for Payer: PHP Commercial |
$1,375.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,132.96
|
| Rate for Payer: Priority Health SBD |
$1,019.67
|
| Rate for Payer: UMR Bronson Commercial |
$712.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,213.89
|
|
|
HC IR INJECTION FACET JOINT L OR S 1ST LEVEL
|
Facility
|
OP
|
$1,618.52
|
|
|
Service Code
|
CPT 64493
|
| Hospital Charge Code |
36100293
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$88.41 |
| Max. Negotiated Rate |
$2,550.52 |
| Rate for Payer: Aetna American Axle |
$1,052.04
|
| Rate for Payer: Aetna Commercial |
$1,375.74
|
| Rate for Payer: Aetna Medicare |
$842.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,052.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$975.43
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$1,294.82
|
| Rate for Payer: Cash Price |
$1,294.82
|
| Rate for Payer: Cofinity Commercial |
$1,132.96
|
| Rate for Payer: Cofinity Commercial |
$1,391.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,294.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,456.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,132.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,213.89
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,375.74
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$1,375.74
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,132.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,550.52
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,040.42
|
| Rate for Payer: Priority Health SBD |
$1,019.67
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.25
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.19
|
| Rate for Payer: UHC Exchange |
$88.41
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$598.85
|
| Rate for Payer: VA VA |
$810.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,213.89
|
|
|
HC IR INSERTION CATH TUNNELED INTRAPERI W FLUORO
|
Facility
|
IP
|
$4,750.87
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
36100219
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,090.38 |
| Max. Negotiated Rate |
$4,275.78 |
| Rate for Payer: Aetna American Axle |
$3,088.07
|
| Rate for Payer: Aetna Commercial |
$4,038.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,088.07
|
| Rate for Payer: Cash Price |
$3,800.70
|
| Rate for Payer: Cofinity Commercial |
$4,085.75
|
| Rate for Payer: Cofinity Commercial |
$3,325.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,800.70
|
| Rate for Payer: Healthscope Commercial |
$4,275.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,325.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,563.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,038.24
|
| Rate for Payer: PHP Commercial |
$4,038.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,325.61
|
| Rate for Payer: Priority Health SBD |
$2,993.05
|
| Rate for Payer: UMR Bronson Commercial |
$2,090.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,563.15
|
|
|
HC IR INSERTION CATH TUNNELED INTRAPERI W FLUORO
|
Facility
|
OP
|
$4,750.87
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
36100219
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$191.55 |
| Max. Negotiated Rate |
$9,680.93 |
| Rate for Payer: Aetna American Axle |
$3,088.07
|
| Rate for Payer: Aetna Commercial |
$4,038.24
|
| Rate for Payer: Aetna Medicare |
$3,198.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,088.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,844.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,844.02
|
| Rate for Payer: BCBS Complete |
$1,766.41
|
| Rate for Payer: BCBS MAPPO |
$3,075.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,889.48
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$3,800.70
|
| Rate for Payer: Cash Price |
$3,800.70
|
| Rate for Payer: Cofinity Commercial |
$3,325.61
|
| Rate for Payer: Cofinity Commercial |
$4,085.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,800.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$4,275.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,325.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,563.15
|
| Rate for Payer: Mclaren Medicaid |
$1,682.15
|
| Rate for Payer: Mclaren Medicare |
$3,075.22
|
| Rate for Payer: Meridian Medicaid |
$1,766.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,228.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,536.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,038.24
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$4,038.24
|
| Rate for Payer: PHP Medicare Advantage |
$3,075.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,682.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,325.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,680.93
|
| Rate for Payer: Priority Health Medicare |
$3,075.22
|
| Rate for Payer: Priority Health Narrow Network |
$7,744.74
|
| Rate for Payer: Priority Health SBD |
$2,993.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.70
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,075.22
|
| Rate for Payer: UHC Exchange |
$191.55
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,757.82
|
| Rate for Payer: VA VA |
$3,075.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,563.15
|
|
|
HC IR INSERTION CHEST PORT ABOVE 5 YRS AGE
|
Facility
|
IP
|
$4,765.57
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36100125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,096.85 |
| Max. Negotiated Rate |
$4,289.01 |
| Rate for Payer: Aetna American Axle |
$3,097.62
|
| Rate for Payer: Aetna Commercial |
$4,050.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,097.62
|
| Rate for Payer: Cash Price |
$3,812.46
|
| Rate for Payer: Cofinity Commercial |
$3,335.90
|
| Rate for Payer: Cofinity Commercial |
$4,098.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,812.46
|
| Rate for Payer: Healthscope Commercial |
$4,289.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,335.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,574.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,050.73
|
| Rate for Payer: PHP Commercial |
$4,050.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,335.90
|
| Rate for Payer: Priority Health SBD |
$3,002.31
|
| Rate for Payer: UMR Bronson Commercial |
$2,096.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,574.18
|
|
|
HC IR INSERTION CHEST PORT ABOVE 5 YRS AGE
|
Facility
|
OP
|
$4,765.57
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36100125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$321.22 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$3,097.62
|
| Rate for Payer: Aetna Commercial |
$4,050.73
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,097.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,441.65
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,812.46
|
| Rate for Payer: Cash Price |
$3,812.46
|
| Rate for Payer: Cofinity Commercial |
$4,098.39
|
| Rate for Payer: Cofinity Commercial |
$3,335.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,812.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$4,289.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,335.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,574.18
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,050.73
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$4,050.73
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,335.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$3,002.31
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.34
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$321.22
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,763.26
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,574.18
|
|
|
HC IR INSERTION CHEST PORT LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$4,484.14
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
36100124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,973.02 |
| Max. Negotiated Rate |
$4,035.73 |
| Rate for Payer: Aetna American Axle |
$2,914.69
|
| Rate for Payer: Aetna Commercial |
$3,811.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,914.69
|
| Rate for Payer: Cash Price |
$3,587.31
|
| Rate for Payer: Cofinity Commercial |
$3,138.90
|
| Rate for Payer: Cofinity Commercial |
$3,856.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,587.31
|
| Rate for Payer: Healthscope Commercial |
$4,035.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,138.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,363.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,811.52
|
| Rate for Payer: PHP Commercial |
$3,811.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,138.90
|
| Rate for Payer: Priority Health SBD |
$2,825.01
|
| Rate for Payer: UMR Bronson Commercial |
$1,973.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,363.10
|
|
|
HC IR INSERTION CHEST PORT LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$4,484.14
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
36100124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$375.58 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$2,914.69
|
| Rate for Payer: Aetna Commercial |
$3,811.52
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,914.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,894.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,587.31
|
| Rate for Payer: Cash Price |
$3,587.31
|
| Rate for Payer: Cofinity Commercial |
$3,856.36
|
| Rate for Payer: Cofinity Commercial |
$3,138.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,587.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$4,035.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,138.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,363.10
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,811.52
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,811.52
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,138.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$2,825.01
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$413.14
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$375.58
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,659.13
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,363.10
|
|
|
HC IR INSERT TUNNEL PERI CATH W PORT
|
Facility
|
OP
|
$4,770.51
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
36100366
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$408.65 |
| Max. Negotiated Rate |
$15,377.24 |
| Rate for Payer: Aetna American Axle |
$3,100.83
|
| Rate for Payer: Aetna Commercial |
$4,054.93
|
| Rate for Payer: Aetna Medicare |
$5,080.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,100.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,105.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,105.86
|
| Rate for Payer: BCBS Complete |
$2,805.77
|
| Rate for Payer: BCBS MAPPO |
$4,884.69
|
| Rate for Payer: BCBS Trust/PPO |
$2,168.19
|
| Rate for Payer: BCN Medicare Advantage |
$4,884.69
|
| Rate for Payer: Cash Price |
$3,816.41
|
| Rate for Payer: Cash Price |
$3,816.41
|
| Rate for Payer: Cofinity Commercial |
$3,339.36
|
| Rate for Payer: Cofinity Commercial |
$4,102.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,816.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,884.69
|
| Rate for Payer: Healthscope Commercial |
$4,293.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,339.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,577.88
|
| Rate for Payer: Mclaren Medicaid |
$2,671.93
|
| Rate for Payer: Mclaren Medicare |
$4,884.69
|
| Rate for Payer: Meridian Medicaid |
$2,805.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,128.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,617.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,054.93
|
| Rate for Payer: PACE Medicare |
$4,640.46
|
| Rate for Payer: PACE SWMI |
$4,884.69
|
| Rate for Payer: PHP Commercial |
$4,054.93
|
| Rate for Payer: PHP Medicare Advantage |
$4,884.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,671.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,339.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,377.24
|
| Rate for Payer: Priority Health Medicare |
$4,884.69
|
| Rate for Payer: Priority Health Narrow Network |
$12,301.79
|
| Rate for Payer: Priority Health SBD |
$3,005.42
|
| Rate for Payer: Railroad Medicare Medicare |
$4,884.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.52
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,884.69
|
| Rate for Payer: UHC Exchange |
$408.65
|
| Rate for Payer: UHC Medicare Advantage |
$5,031.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,765.09
|
| Rate for Payer: VA VA |
$4,884.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,577.88
|
|
|
HC IR INSERT TUNNEL PERI CATH W PORT
|
Facility
|
IP
|
$4,770.51
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
36100366
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,099.02 |
| Max. Negotiated Rate |
$4,293.46 |
| Rate for Payer: Aetna American Axle |
$3,100.83
|
| Rate for Payer: Aetna Commercial |
$4,054.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,100.83
|
| Rate for Payer: Cash Price |
$3,816.41
|
| Rate for Payer: Cofinity Commercial |
$3,339.36
|
| Rate for Payer: Cofinity Commercial |
$4,102.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,816.41
|
| Rate for Payer: Healthscope Commercial |
$4,293.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,339.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,577.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,054.93
|
| Rate for Payer: PHP Commercial |
$4,054.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,339.36
|
| Rate for Payer: Priority Health SBD |
$3,005.42
|
| Rate for Payer: UMR Bronson Commercial |
$2,099.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,577.88
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
OP
|
$1,936.98
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$162.08 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$1,259.04
|
| Rate for Payer: Aetna Commercial |
$1,646.43
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,259.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$203.34
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$1,549.58
|
| Rate for Payer: Cash Price |
$1,549.58
|
| Rate for Payer: Cofinity Commercial |
$1,355.89
|
| Rate for Payer: Cofinity Commercial |
$1,665.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,549.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$1,743.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,355.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,452.74
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,646.43
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$1,646.43
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,355.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$1,220.30
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.29
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$162.08
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$716.68
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,452.74
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
IP
|
$1,936.98
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$852.27 |
| Max. Negotiated Rate |
$1,743.28 |
| Rate for Payer: Aetna American Axle |
$1,259.04
|
| Rate for Payer: Aetna Commercial |
$1,646.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,259.04
|
| Rate for Payer: Cash Price |
$1,549.58
|
| Rate for Payer: Cofinity Commercial |
$1,355.89
|
| Rate for Payer: Cofinity Commercial |
$1,665.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,549.58
|
| Rate for Payer: Healthscope Commercial |
$1,743.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,355.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,452.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,646.43
|
| Rate for Payer: PHP Commercial |
$1,646.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,355.89
|
| Rate for Payer: Priority Health SBD |
$1,220.30
|
| Rate for Payer: UMR Bronson Commercial |
$852.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,452.74
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
OP
|
$2,536.68
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$162.08 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$1,648.84
|
| Rate for Payer: Aetna Commercial |
$2,156.18
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,648.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$203.34
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,029.34
|
| Rate for Payer: Cash Price |
$2,029.34
|
| Rate for Payer: Cofinity Commercial |
$2,181.54
|
| Rate for Payer: Cofinity Commercial |
$1,775.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,029.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,283.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,775.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,902.51
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,156.18
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$2,156.18
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,775.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$1,598.11
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$178.29
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$162.08
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$938.57
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,902.51
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
IP
|
$2,536.68
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,116.14 |
| Max. Negotiated Rate |
$2,283.01 |
| Rate for Payer: Aetna American Axle |
$1,648.84
|
| Rate for Payer: Aetna Commercial |
$2,156.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,648.84
|
| Rate for Payer: Cash Price |
$2,029.34
|
| Rate for Payer: Cofinity Commercial |
$1,775.68
|
| Rate for Payer: Cofinity Commercial |
$2,181.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,029.34
|
| Rate for Payer: Healthscope Commercial |
$2,283.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,775.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,902.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,156.18
|
| Rate for Payer: PHP Commercial |
$2,156.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,775.68
|
| Rate for Payer: Priority Health SBD |
$1,598.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,116.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,902.51
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$1,299.25
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$82.52 |
| Max. Negotiated Rate |
$1,935.09 |
| Rate for Payer: Aetna American Axle |
$844.51
|
| Rate for Payer: Aetna Commercial |
$1,104.36
|
| Rate for Payer: Aetna Medicare |
$639.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$844.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$765.77
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$1,039.40
|
| Rate for Payer: Cash Price |
$1,039.40
|
| Rate for Payer: Cofinity Commercial |
$1,117.36
|
| Rate for Payer: Cofinity Commercial |
$909.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,039.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$1,169.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$909.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$974.44
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,104.36
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$1,104.36
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$909.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,935.09
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,548.07
|
| Rate for Payer: Priority Health SBD |
$818.53
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.77
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.70
|
| Rate for Payer: UHC Exchange |
$82.52
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: UMR Bronson Commercial |
$480.72
|
| Rate for Payer: VA VA |
$614.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$974.44
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$1,299.25
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$571.67 |
| Max. Negotiated Rate |
$1,169.32 |
| Rate for Payer: Aetna American Axle |
$844.51
|
| Rate for Payer: Aetna Commercial |
$1,104.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$844.51
|
| Rate for Payer: Cash Price |
$1,039.40
|
| Rate for Payer: Cofinity Commercial |
$1,117.36
|
| Rate for Payer: Cofinity Commercial |
$909.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,039.40
|
| Rate for Payer: Healthscope Commercial |
$1,169.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$909.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$974.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,104.36
|
| Rate for Payer: PHP Commercial |
$1,104.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$909.48
|
| Rate for Payer: Priority Health SBD |
$818.53
|
| Rate for Payer: UMR Bronson Commercial |
$571.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$974.44
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
IP
|
$959.13
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$422.02 |
| Max. Negotiated Rate |
$863.22 |
| Rate for Payer: Aetna American Axle |
$623.43
|
| Rate for Payer: Aetna Commercial |
$815.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.43
|
| Rate for Payer: Cash Price |
$767.30
|
| Rate for Payer: Cofinity Commercial |
$671.39
|
| Rate for Payer: Cofinity Commercial |
$824.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$767.30
|
| Rate for Payer: Healthscope Commercial |
$863.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$671.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$719.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$815.26
|
| Rate for Payer: PHP Commercial |
$815.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$671.39
|
| Rate for Payer: Priority Health SBD |
$604.25
|
| Rate for Payer: UMR Bronson Commercial |
$422.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$719.35
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
OP
|
$959.13
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$101.18 |
| Max. Negotiated Rate |
$1,935.09 |
| Rate for Payer: Aetna American Axle |
$623.43
|
| Rate for Payer: Aetna Commercial |
$815.26
|
| Rate for Payer: Aetna Medicare |
$639.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$584.23
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$767.30
|
| Rate for Payer: Cash Price |
$767.30
|
| Rate for Payer: Cofinity Commercial |
$824.85
|
| Rate for Payer: Cofinity Commercial |
$671.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$767.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$863.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$671.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$719.35
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$815.26
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$815.26
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$671.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,935.09
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,548.07
|
| Rate for Payer: Priority Health SBD |
$604.25
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.30
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.70
|
| Rate for Payer: UHC Exchange |
$101.18
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: UMR Bronson Commercial |
$354.88
|
| Rate for Payer: VA VA |
$614.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$719.35
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
IP
|
$2,968.81
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,306.28 |
| Max. Negotiated Rate |
$2,671.93 |
| Rate for Payer: Aetna American Axle |
$1,929.73
|
| Rate for Payer: Aetna Commercial |
$2,523.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,929.73
|
| Rate for Payer: Cash Price |
$2,375.05
|
| Rate for Payer: Cofinity Commercial |
$2,078.17
|
| Rate for Payer: Cofinity Commercial |
$2,553.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,375.05
|
| Rate for Payer: Healthscope Commercial |
$2,671.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,078.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,226.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,523.49
|
| Rate for Payer: PHP Commercial |
$2,523.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,078.17
|
| Rate for Payer: Priority Health SBD |
$1,870.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,306.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,226.61
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
OP
|
$2,968.81
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$1,929.73
|
| Rate for Payer: Aetna Commercial |
$2,523.49
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,929.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$3,572.08
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,375.05
|
| Rate for Payer: Cash Price |
$2,375.05
|
| Rate for Payer: Cofinity Commercial |
$2,553.18
|
| Rate for Payer: Cofinity Commercial |
$2,078.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,375.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,671.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,078.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,226.61
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,523.49
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$2,523.49
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,078.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$1,870.35
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,098.46
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,226.61
|
|
