|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
OP
|
$10,312.70
|
|
|
Service Code
|
CPT 37234
|
| Hospital Charge Code |
36100178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$267.85 |
| Max. Negotiated Rate |
$13,253.79 |
| Rate for Payer: Aetna American Axle |
$6,703.26
|
| Rate for Payer: Aetna Commercial |
$8,765.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,703.26
|
| Rate for Payer: BCBS Complete |
$4,125.08
|
| Rate for Payer: BCBS Trust/PPO |
$13,253.79
|
| Rate for Payer: Cash Price |
$8,250.16
|
| Rate for Payer: Cash Price |
$8,250.16
|
| Rate for Payer: Cofinity Commercial |
$8,868.92
|
| Rate for Payer: Cofinity Commercial |
$7,218.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,250.16
|
| Rate for Payer: Healthscope Commercial |
$9,281.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,218.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,734.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,765.80
|
| Rate for Payer: PHP Commercial |
$8,765.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,218.89
|
| Rate for Payer: Priority Health SBD |
$6,497.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$294.64
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Exchange |
$267.85
|
| Rate for Payer: UMR Bronson Commercial |
$3,815.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,734.52
|
|
|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
IP
|
$10,312.70
|
|
|
Service Code
|
CPT 37234
|
| Hospital Charge Code |
36100178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,537.59 |
| Max. Negotiated Rate |
$9,281.43 |
| Rate for Payer: Aetna American Axle |
$6,703.26
|
| Rate for Payer: Aetna Commercial |
$8,765.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,703.26
|
| Rate for Payer: Cash Price |
$8,250.16
|
| Rate for Payer: Cofinity Commercial |
$7,218.89
|
| Rate for Payer: Cofinity Commercial |
$8,868.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,250.16
|
| Rate for Payer: Healthscope Commercial |
$9,281.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,218.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,734.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,765.80
|
| Rate for Payer: PHP Commercial |
$8,765.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,218.89
|
| Rate for Payer: Priority Health SBD |
$6,497.00
|
| Rate for Payer: UMR Bronson Commercial |
$4,537.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,734.52
|
|
|
HC IR REVISION TIPS WITH FLUORO
|
Facility
|
IP
|
$11,160.76
|
|
|
Service Code
|
CPT 37183
|
| Hospital Charge Code |
36100148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,910.73 |
| Max. Negotiated Rate |
$10,044.68 |
| Rate for Payer: Aetna American Axle |
$7,254.49
|
| Rate for Payer: Aetna Commercial |
$9,486.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,254.49
|
| Rate for Payer: Cash Price |
$8,928.61
|
| Rate for Payer: Cofinity Commercial |
$7,812.53
|
| Rate for Payer: Cofinity Commercial |
$9,598.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,928.61
|
| Rate for Payer: Healthscope Commercial |
$10,044.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,812.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,370.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,486.65
|
| Rate for Payer: PHP Commercial |
$9,486.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,812.53
|
| Rate for Payer: Priority Health SBD |
$7,031.28
|
| Rate for Payer: UMR Bronson Commercial |
$4,910.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,370.57
|
|
|
HC IR REVISION TIPS WITH FLUORO
|
Facility
|
OP
|
$11,160.76
|
|
|
Service Code
|
CPT 37183
|
| Hospital Charge Code |
36100148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$355.27 |
| Max. Negotiated Rate |
$15,993.75 |
| Rate for Payer: Aetna American Axle |
$7,254.49
|
| Rate for Payer: Aetna Commercial |
$9,486.65
|
| Rate for Payer: Aetna Medicare |
$5,283.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,254.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,350.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,350.66
|
| Rate for Payer: BCBS Complete |
$2,918.26
|
| Rate for Payer: BCBS MAPPO |
$5,080.53
|
| Rate for Payer: BCBS Trust/PPO |
$4,296.92
|
| Rate for Payer: BCN Medicare Advantage |
$5,080.53
|
| Rate for Payer: Cash Price |
$8,928.61
|
| Rate for Payer: Cash Price |
$8,928.61
|
| Rate for Payer: Cofinity Commercial |
$7,812.53
|
| Rate for Payer: Cofinity Commercial |
$9,598.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,928.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,080.53
|
| Rate for Payer: Healthscope Commercial |
$10,044.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,812.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,370.57
|
| Rate for Payer: Mclaren Medicaid |
$2,779.05
|
| Rate for Payer: Mclaren Medicare |
$5,080.53
|
| Rate for Payer: Meridian Medicaid |
$2,918.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,334.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,842.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,486.65
|
| Rate for Payer: PACE Medicare |
$4,826.50
|
| Rate for Payer: PACE SWMI |
$5,080.53
|
| Rate for Payer: PHP Commercial |
$9,486.65
|
| Rate for Payer: PHP Medicare Advantage |
$5,080.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,779.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,812.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,993.75
|
| Rate for Payer: Priority Health Medicare |
$5,080.53
|
| Rate for Payer: Priority Health Narrow Network |
$12,795.00
|
| Rate for Payer: Priority Health SBD |
$7,031.28
|
| Rate for Payer: Railroad Medicare Medicare |
$5,080.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$390.80
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,080.53
|
| Rate for Payer: UHC Exchange |
$355.27
|
| Rate for Payer: UHC Medicare Advantage |
$5,232.95
|
| Rate for Payer: UMR Bronson Commercial |
$4,129.48
|
| Rate for Payer: VA VA |
$5,080.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,370.57
|
|
|
HC IRRIGATE IMPLANTED VAD
|
Facility
|
OP
|
$178.68
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
51000007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$171.15 |
| Rate for Payer: Aetna American Axle |
$116.14
|
| Rate for Payer: Aetna Commercial |
$151.88
|
| Rate for Payer: Aetna Medicare |
$56.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$136.18
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$142.94
|
| Rate for Payer: Cash Price |
$142.94
|
| Rate for Payer: Cofinity Commercial |
$125.08
|
| Rate for Payer: Cofinity Commercial |
$153.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$160.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$125.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.01
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$151.88
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$151.88
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.15
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$136.92
|
| Rate for Payer: Priority Health SBD |
$112.57
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.37
|
| Rate for Payer: UHC Exchange |
$24.56
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: UMR Bronson Commercial |
$66.11
|
| Rate for Payer: VA VA |
$54.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.01
|
|
|
HC IRRIGATE IMPLANTED VAD
|
Facility
|
IP
|
$178.68
|
|
|
Service Code
|
CPT 96523
|
| Hospital Charge Code |
51000007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$78.62 |
| Max. Negotiated Rate |
$160.81 |
| Rate for Payer: Aetna American Axle |
$116.14
|
| Rate for Payer: Aetna Commercial |
$151.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.14
|
| Rate for Payer: Cash Price |
$142.94
|
| Rate for Payer: Cofinity Commercial |
$125.08
|
| Rate for Payer: Cofinity Commercial |
$153.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.94
|
| Rate for Payer: Healthscope Commercial |
$160.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$125.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$151.88
|
| Rate for Payer: PHP Commercial |
$151.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.08
|
| Rate for Payer: Priority Health SBD |
$112.57
|
| Rate for Payer: UMR Bronson Commercial |
$78.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.01
|
|
|
HC IRRIGATION CONE
|
Facility
|
IP
|
$42.75
|
|
| Hospital Charge Code |
27000081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$38.48 |
| Rate for Payer: Aetna American Axle |
$27.79
|
| Rate for Payer: Aetna Commercial |
$36.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.79
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cofinity Commercial |
$29.92
|
| Rate for Payer: Cofinity Commercial |
$36.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.20
|
| Rate for Payer: Healthscope Commercial |
$38.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.34
|
| Rate for Payer: PHP Commercial |
$36.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.92
|
| Rate for Payer: Priority Health SBD |
$26.93
|
| Rate for Payer: UMR Bronson Commercial |
$18.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.06
|
|
|
HC IRRIGATION CONE
|
Facility
|
OP
|
$42.75
|
|
| Hospital Charge Code |
27000081
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.82 |
| Max. Negotiated Rate |
$38.48 |
| Rate for Payer: Aetna American Axle |
$27.79
|
| Rate for Payer: Aetna Commercial |
$36.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.79
|
| Rate for Payer: BCBS Complete |
$17.10
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cofinity Commercial |
$29.92
|
| Rate for Payer: Cofinity Commercial |
$36.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.20
|
| Rate for Payer: Healthscope Commercial |
$38.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.34
|
| Rate for Payer: PHP Commercial |
$36.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.92
|
| Rate for Payer: Priority Health SBD |
$26.93
|
| Rate for Payer: UMR Bronson Commercial |
$15.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.06
|
|
|
HC IRRIGATION OF BLADDER
|
Facility
|
IP
|
$354.07
|
|
|
Service Code
|
CPT 51700
|
| Hospital Charge Code |
76100188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$155.79 |
| Max. Negotiated Rate |
$318.66 |
| Rate for Payer: Aetna American Axle |
$230.15
|
| Rate for Payer: Aetna Commercial |
$300.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.15
|
| Rate for Payer: Cash Price |
$283.26
|
| Rate for Payer: Cofinity Commercial |
$247.85
|
| Rate for Payer: Cofinity Commercial |
$304.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.26
|
| Rate for Payer: Healthscope Commercial |
$318.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$247.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$300.96
|
| Rate for Payer: PHP Commercial |
$300.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.85
|
| Rate for Payer: Priority Health SBD |
$223.06
|
| Rate for Payer: UMR Bronson Commercial |
$155.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.55
|
|
|
HC IRRIGATION OF BLADDER
|
Facility
|
OP
|
$354.07
|
|
|
Service Code
|
CPT 51700
|
| Hospital Charge Code |
76100188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$29.14 |
| Max. Negotiated Rate |
$691.57 |
| Rate for Payer: Aetna American Axle |
$230.15
|
| Rate for Payer: Aetna Commercial |
$300.96
|
| Rate for Payer: Aetna Medicare |
$228.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.60
|
| Rate for Payer: BCBS Complete |
$126.18
|
| Rate for Payer: BCBS MAPPO |
$219.68
|
| Rate for Payer: BCBS Trust/PPO |
$229.78
|
| Rate for Payer: BCN Medicare Advantage |
$219.68
|
| Rate for Payer: Cash Price |
$283.26
|
| Rate for Payer: Cash Price |
$283.26
|
| Rate for Payer: Cofinity Commercial |
$247.85
|
| Rate for Payer: Cofinity Commercial |
$304.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.68
|
| Rate for Payer: Healthscope Commercial |
$318.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$247.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.55
|
| Rate for Payer: Mclaren Medicaid |
$120.16
|
| Rate for Payer: Mclaren Medicare |
$219.68
|
| Rate for Payer: Meridian Medicaid |
$126.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$300.96
|
| Rate for Payer: PACE Medicare |
$208.70
|
| Rate for Payer: PACE SWMI |
$219.68
|
| Rate for Payer: PHP Commercial |
$300.96
|
| Rate for Payer: PHP Medicare Advantage |
$219.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$691.57
|
| Rate for Payer: Priority Health Medicare |
$219.68
|
| Rate for Payer: Priority Health Narrow Network |
$553.26
|
| Rate for Payer: Priority Health SBD |
$223.06
|
| Rate for Payer: Railroad Medicare Medicare |
$219.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.68
|
| Rate for Payer: UHC Exchange |
$29.14
|
| Rate for Payer: UHC Medicare Advantage |
$226.27
|
| Rate for Payer: UMR Bronson Commercial |
$131.01
|
| Rate for Payer: VA VA |
$219.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.55
|
|
|
HC IRRIGATION SLEEVE
|
Facility
|
IP
|
$17.72
|
|
| Hospital Charge Code |
27000119
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$15.95 |
| Rate for Payer: Aetna American Axle |
$11.52
|
| Rate for Payer: Aetna Commercial |
$15.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.52
|
| Rate for Payer: Cash Price |
$14.18
|
| Rate for Payer: Cofinity Commercial |
$12.40
|
| Rate for Payer: Cofinity Commercial |
$15.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$15.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.06
|
| Rate for Payer: PHP Commercial |
$15.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.40
|
| Rate for Payer: Priority Health SBD |
$11.16
|
| Rate for Payer: UMR Bronson Commercial |
$7.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.29
|
|
|
HC IRRIGATION SLEEVE
|
Facility
|
OP
|
$17.72
|
|
| Hospital Charge Code |
27000119
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.56 |
| Max. Negotiated Rate |
$15.95 |
| Rate for Payer: Aetna American Axle |
$11.52
|
| Rate for Payer: Aetna Commercial |
$15.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.52
|
| Rate for Payer: BCBS Complete |
$7.09
|
| Rate for Payer: Cash Price |
$14.18
|
| Rate for Payer: Cofinity Commercial |
$12.40
|
| Rate for Payer: Cofinity Commercial |
$15.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$15.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.06
|
| Rate for Payer: PHP Commercial |
$15.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.40
|
| Rate for Payer: Priority Health SBD |
$11.16
|
| Rate for Payer: UMR Bronson Commercial |
$6.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.29
|
|
|
HC IR SELECTIVE EACH ADDITION VESSEL
|
Facility
|
IP
|
$1,921.31
|
|
|
Service Code
|
CPT 75774
|
| Hospital Charge Code |
32000200
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$845.38 |
| Max. Negotiated Rate |
$1,729.18 |
| Rate for Payer: Aetna American Axle |
$1,248.85
|
| Rate for Payer: Aetna Commercial |
$1,633.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,248.85
|
| Rate for Payer: Cash Price |
$1,537.05
|
| Rate for Payer: Cofinity Commercial |
$1,344.92
|
| Rate for Payer: Cofinity Commercial |
$1,652.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,537.05
|
| Rate for Payer: Healthscope Commercial |
$1,729.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,344.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,440.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,633.11
|
| Rate for Payer: PHP Commercial |
$1,633.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.92
|
| Rate for Payer: Priority Health SBD |
$1,210.43
|
| Rate for Payer: UMR Bronson Commercial |
$845.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,440.98
|
|
|
HC IR SELECTIVE EACH ADDITION VESSEL
|
Facility
|
OP
|
$1,921.31
|
|
|
Service Code
|
CPT 75774
|
| Hospital Charge Code |
32000200
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$94.63 |
| Max. Negotiated Rate |
$1,729.18 |
| Rate for Payer: Aetna American Axle |
$1,248.85
|
| Rate for Payer: Aetna Commercial |
$1,633.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,248.85
|
| Rate for Payer: BCBS Complete |
$768.52
|
| Rate for Payer: BCBS Trust/PPO |
$97.56
|
| Rate for Payer: Cash Price |
$1,537.05
|
| Rate for Payer: Cash Price |
$1,537.05
|
| Rate for Payer: Cofinity Commercial |
$1,344.92
|
| Rate for Payer: Cofinity Commercial |
$1,652.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,537.05
|
| Rate for Payer: Healthscope Commercial |
$1,729.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,344.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,440.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,633.11
|
| Rate for Payer: PHP Commercial |
$1,633.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,344.92
|
| Rate for Payer: Priority Health SBD |
$1,210.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.09
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Exchange |
$94.63
|
| Rate for Payer: UMR Bronson Commercial |
$710.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,440.98
|
|
|
HC IR SHEATH
|
Facility
|
OP
|
$229.50
|
|
| Hospital Charge Code |
27200314
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.92 |
| Max. Negotiated Rate |
$206.55 |
| Rate for Payer: Aetna American Axle |
$149.18
|
| Rate for Payer: Aetna Commercial |
$195.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.18
|
| Rate for Payer: BCBS Complete |
$91.80
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$160.65
|
| Rate for Payer: Cofinity Commercial |
$197.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$206.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.08
|
| Rate for Payer: PHP Commercial |
$195.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.65
|
| Rate for Payer: Priority Health SBD |
$144.58
|
| Rate for Payer: UMR Bronson Commercial |
$84.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.12
|
|
|
HC IR SHEATH
|
Facility
|
IP
|
$229.50
|
|
| Hospital Charge Code |
27200314
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$100.98 |
| Max. Negotiated Rate |
$206.55 |
| Rate for Payer: Aetna American Axle |
$149.18
|
| Rate for Payer: Aetna Commercial |
$195.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.18
|
| Rate for Payer: Cash Price |
$183.60
|
| Rate for Payer: Cofinity Commercial |
$160.65
|
| Rate for Payer: Cofinity Commercial |
$197.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$183.60
|
| Rate for Payer: Healthscope Commercial |
$206.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$160.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$195.08
|
| Rate for Payer: PHP Commercial |
$195.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.65
|
| Rate for Payer: Priority Health SBD |
$144.58
|
| Rate for Payer: UMR Bronson Commercial |
$100.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.12
|
|
|
HC IR SHUNTOGRAM PREVIOUS SHUNT
|
Facility
|
IP
|
$714.77
|
|
|
Service Code
|
CPT 75809
|
| Hospital Charge Code |
32000202
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$314.50 |
| Max. Negotiated Rate |
$643.29 |
| Rate for Payer: Aetna American Axle |
$464.60
|
| Rate for Payer: Aetna Commercial |
$607.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.60
|
| Rate for Payer: Cash Price |
$571.82
|
| Rate for Payer: Cofinity Commercial |
$500.34
|
| Rate for Payer: Cofinity Commercial |
$614.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.82
|
| Rate for Payer: Healthscope Commercial |
$643.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$500.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$536.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$607.55
|
| Rate for Payer: PHP Commercial |
$607.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$500.34
|
| Rate for Payer: Priority Health SBD |
$450.31
|
| Rate for Payer: UMR Bronson Commercial |
$314.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$536.08
|
|
|
HC IR SHUNTOGRAM PREVIOUS SHUNT
|
Facility
|
OP
|
$714.77
|
|
|
Service Code
|
CPT 75809
|
| Hospital Charge Code |
32000202
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$643.29 |
| Rate for Payer: Aetna American Axle |
$464.60
|
| Rate for Payer: Aetna Commercial |
$607.55
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$112.76
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$571.82
|
| Rate for Payer: Cash Price |
$571.82
|
| Rate for Payer: Cofinity Commercial |
$500.34
|
| Rate for Payer: Cofinity Commercial |
$614.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$643.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$500.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$536.08
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$607.55
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$607.55
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$500.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$450.31
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.24
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$80.22
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$264.46
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$536.08
|
|
|
HC IR SIALOGRAM
|
Facility
|
IP
|
$571.84
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
32000025
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$251.61 |
| Max. Negotiated Rate |
$514.66 |
| Rate for Payer: Aetna American Axle |
$371.70
|
| Rate for Payer: Aetna Commercial |
$486.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$371.70
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$400.29
|
| Rate for Payer: Cofinity Commercial |
$491.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Healthscope Commercial |
$514.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$400.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$428.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PHP Commercial |
$486.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health SBD |
$360.26
|
| Rate for Payer: UMR Bronson Commercial |
$251.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$428.88
|
|
|
HC IR SIALOGRAM
|
Facility
|
OP
|
$571.84
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
32000025
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$113.62 |
| Max. Negotiated Rate |
$685.66 |
| Rate for Payer: Aetna American Axle |
$371.70
|
| Rate for Payer: Aetna Commercial |
$486.06
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$371.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$190.68
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cash Price |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$491.78
|
| Rate for Payer: Cofinity Commercial |
$400.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$457.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$514.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$400.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$428.88
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$486.06
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$486.06
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$400.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$360.26
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.98
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$113.62
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$211.58
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$428.88
|
|
|
HC IR SI JOINT NERVES ANESTHETIC/STEROID INJ
|
Facility
|
IP
|
$956.25
|
|
|
Service Code
|
HCPCS 64451
|
| Hospital Charge Code |
36100580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$420.75 |
| Max. Negotiated Rate |
$860.62 |
| Rate for Payer: Aetna American Axle |
$621.56
|
| Rate for Payer: Aetna Commercial |
$812.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$621.56
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cofinity Commercial |
$669.38
|
| Rate for Payer: Cofinity Commercial |
$822.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.00
|
| Rate for Payer: Healthscope Commercial |
$860.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$669.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$812.81
|
| Rate for Payer: PHP Commercial |
$812.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$669.38
|
| Rate for Payer: Priority Health SBD |
$602.44
|
| Rate for Payer: UMR Bronson Commercial |
$420.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.19
|
|
|
HC IR SI JOINT NERVES ANESTHETIC/STEROID INJ
|
Facility
|
OP
|
$956.25
|
|
|
Service Code
|
HCPCS 64451
|
| Hospital Charge Code |
36100580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$79.57 |
| Max. Negotiated Rate |
$1,935.09 |
| Rate for Payer: Aetna American Axle |
$621.56
|
| Rate for Payer: Aetna Commercial |
$812.81
|
| Rate for Payer: Aetna Medicare |
$639.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$621.56
|
| 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 |
$512.52
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cash Price |
$765.00
|
| Rate for Payer: Cofinity Commercial |
$822.38
|
| Rate for Payer: Cofinity Commercial |
$669.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$860.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$669.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.19
|
| 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 |
$812.81
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$812.81
|
| 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 |
$669.38
|
| 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 |
$602.44
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.53
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.70
|
| Rate for Payer: UHC Exchange |
$79.57
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: UMR Bronson Commercial |
$353.81
|
| Rate for Payer: VA VA |
$614.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.19
|
|
|
HC IR SINAGRAM FISTULAGRAM
|
Facility
|
OP
|
$400.20
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000235
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$58.61 |
| Max. Negotiated Rate |
$1,543.71 |
| Rate for Payer: Aetna American Axle |
$260.13
|
| Rate for Payer: Aetna Commercial |
$340.17
|
| Rate for Payer: Aetna Medicare |
$509.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$612.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$612.96
|
| Rate for Payer: BCBS Complete |
$281.67
|
| Rate for Payer: BCBS MAPPO |
$490.37
|
| Rate for Payer: BCBS Trust/PPO |
$67.15
|
| Rate for Payer: BCN Medicare Advantage |
$490.37
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$280.14
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$490.37
|
| Rate for Payer: Healthscope Commercial |
$360.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$280.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.15
|
| Rate for Payer: Mclaren Medicaid |
$268.23
|
| Rate for Payer: Mclaren Medicare |
$490.37
|
| Rate for Payer: Meridian Medicaid |
$281.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$514.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$563.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: PACE Medicare |
$465.85
|
| Rate for Payer: PACE SWMI |
$490.37
|
| Rate for Payer: PHP Commercial |
$340.17
|
| Rate for Payer: PHP Medicare Advantage |
$490.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,543.71
|
| Rate for Payer: Priority Health Medicare |
$490.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,234.97
|
| Rate for Payer: Priority Health SBD |
$252.13
|
| Rate for Payer: Railroad Medicare Medicare |
$490.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.47
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$490.37
|
| Rate for Payer: UHC Exchange |
$58.61
|
| Rate for Payer: UHC Medicare Advantage |
$505.08
|
| Rate for Payer: UMR Bronson Commercial |
$148.07
|
| Rate for Payer: VA VA |
$490.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.15
|
|
|
HC IR SINAGRAM FISTULAGRAM
|
Facility
|
IP
|
$400.20
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000235
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$176.09 |
| Max. Negotiated Rate |
$360.18 |
| Rate for Payer: Aetna American Axle |
$260.13
|
| Rate for Payer: Aetna Commercial |
$340.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.13
|
| Rate for Payer: Cash Price |
$320.16
|
| Rate for Payer: Cofinity Commercial |
$280.14
|
| Rate for Payer: Cofinity Commercial |
$344.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$320.16
|
| Rate for Payer: Healthscope Commercial |
$360.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$280.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$300.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$340.17
|
| Rate for Payer: PHP Commercial |
$340.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.14
|
| Rate for Payer: Priority Health SBD |
$252.13
|
| Rate for Payer: UMR Bronson Commercial |
$176.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$300.15
|
|
|
HC IR SPHENOID ELECTRODE PLACEMENT
|
Facility
|
IP
|
$1,537.29
|
|
|
Service Code
|
CPT 95830
|
| Hospital Charge Code |
74000009
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$676.41 |
| Max. Negotiated Rate |
$1,383.56 |
| Rate for Payer: Aetna American Axle |
$999.24
|
| Rate for Payer: Aetna Commercial |
$1,306.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$999.24
|
| Rate for Payer: Cash Price |
$1,229.83
|
| Rate for Payer: Cofinity Commercial |
$1,076.10
|
| Rate for Payer: Cofinity Commercial |
$1,322.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.83
|
| Rate for Payer: Healthscope Commercial |
$1,383.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,076.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,306.70
|
| Rate for Payer: PHP Commercial |
$1,306.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,076.10
|
| Rate for Payer: Priority Health SBD |
$968.49
|
| Rate for Payer: UMR Bronson Commercial |
$676.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.97
|
|
