|
HC CRP-SF
|
Facility
|
IP
|
$29.97
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.19 |
| Max. Negotiated Rate |
$26.97 |
| Rate for Payer: Aetna American Axle |
$19.48
|
| Rate for Payer: Aetna Commercial |
$25.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.48
|
| Rate for Payer: Cash Price |
$23.98
|
| Rate for Payer: Cofinity Commercial |
$20.98
|
| Rate for Payer: Cofinity Commercial |
$25.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.98
|
| Rate for Payer: Healthscope Commercial |
$26.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.47
|
| Rate for Payer: PHP Commercial |
$25.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.48
|
| Rate for Payer: Priority Health SBD |
$18.88
|
| Rate for Payer: UMR Bronson Commercial |
$13.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.48
|
|
|
HC CRP-SF
|
Facility
|
OP
|
$29.97
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.78 |
| Max. Negotiated Rate |
$26.97 |
| Rate for Payer: Aetna American Axle |
$19.48
|
| Rate for Payer: Aetna Commercial |
$25.47
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.48
|
| Rate for Payer: BCBS Complete |
$2.92
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$5.00
|
| Rate for Payer: BCN Commercial |
$5.00
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$23.98
|
| Rate for Payer: Cash Price |
$23.98
|
| Rate for Payer: Cofinity Commercial |
$25.77
|
| Rate for Payer: Cofinity Commercial |
$20.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$26.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.48
|
| Rate for Payer: Mclaren Medicaid |
$2.78
|
| 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 |
$2.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.47
|
| Rate for Payer: Nomi Health Commercial |
$7.77
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$25.47
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.33
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$4.26
|
| Rate for Payer: Priority Health SBD |
$18.88
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Exchange |
$5.18
|
| Rate for Payer: UHC Medicare Advantage |
$5.18
|
| Rate for Payer: UHCCP Medicaid |
$2.78
|
| Rate for Payer: UMR Bronson Commercial |
$11.09
|
| Rate for Payer: VA VA |
$5.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.48
|
|
|
HC CRRT INITIAL
|
Facility
|
OP
|
$714.00
|
|
| Hospital Charge Code |
27000607
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$264.18 |
| Max. Negotiated Rate |
$642.60 |
| Rate for Payer: Aetna American Axle |
$464.10
|
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: Aetna Medicare |
$357.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.10
|
| Rate for Payer: BCBS Complete |
$285.60
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$499.80
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$499.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Healthscope Commercial |
$642.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$499.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$606.90
|
| Rate for Payer: PHP Commercial |
$606.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health SBD |
$449.82
|
| Rate for Payer: UMR Bronson Commercial |
$264.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.50
|
|
|
HC CRRT INITIAL
|
Facility
|
IP
|
$714.00
|
|
| Hospital Charge Code |
27000607
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$314.16 |
| Max. Negotiated Rate |
$642.60 |
| Rate for Payer: Healthscope Commercial |
$642.60
|
| Rate for Payer: Aetna American Axle |
$464.10
|
| Rate for Payer: Aetna Commercial |
$606.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$464.10
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cofinity Commercial |
$499.80
|
| Rate for Payer: Cofinity Commercial |
$614.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$499.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$571.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$499.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$535.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$606.90
|
| Rate for Payer: PHP Commercial |
$606.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: Priority Health SBD |
$449.82
|
| Rate for Payer: UMR Bronson Commercial |
$314.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$535.50
|
|
|
HC CRRT INITIATION/REINITIATION
|
Facility
|
OP
|
$1,135.08
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
88000001
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$81.17 |
| Max. Negotiated Rate |
$1,311.28 |
| Rate for Payer: Aetna American Axle |
$737.80
|
| Rate for Payer: Aetna Commercial |
$964.82
|
| Rate for Payer: Aetna Medicare |
$433.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$521.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$521.51
|
| Rate for Payer: BCBS Complete |
$234.81
|
| Rate for Payer: BCBS MAPPO |
$417.21
|
| Rate for Payer: BCN Medicare Advantage |
$417.21
|
| Rate for Payer: Cash Price |
$908.06
|
| Rate for Payer: Cash Price |
$908.06
|
| Rate for Payer: Cofinity Commercial |
$794.56
|
| Rate for Payer: Cofinity Commercial |
$976.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$794.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$417.21
|
| Rate for Payer: Healthscope Commercial |
$1,021.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$794.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$851.31
|
| Rate for Payer: Mclaren Medicaid |
$223.62
|
| Rate for Payer: Mclaren Medicare |
$417.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$438.07
|
| Rate for Payer: Meridian Medicaid |
$234.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$964.82
|
| Rate for Payer: Nomi Health Commercial |
$1,251.63
|
| Rate for Payer: PACE Medicare |
$396.35
|
| Rate for Payer: PACE SWMI |
$417.21
|
| Rate for Payer: PHP Commercial |
$964.82
|
| Rate for Payer: PHP Medicare Advantage |
$417.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,311.28
|
| Rate for Payer: Priority Health Medicare |
$417.21
|
| Rate for Payer: Priority Health Narrow Network |
$1,049.02
|
| Rate for Payer: Priority Health SBD |
$715.10
|
| Rate for Payer: Railroad Medicare Medicare |
$417.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$417.21
|
| Rate for Payer: UHC Exchange |
$81.17
|
| Rate for Payer: UHC Medicare Advantage |
$417.21
|
| Rate for Payer: UHCCP Medicaid |
$223.62
|
| Rate for Payer: UMR Bronson Commercial |
$419.98
|
| Rate for Payer: VA VA |
$417.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$851.31
|
|
|
HC CRRT INITIATION/REINITIATION
|
Facility
|
IP
|
$1,135.08
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
88000001
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$499.44 |
| Max. Negotiated Rate |
$1,021.57 |
| Rate for Payer: Aetna American Axle |
$737.80
|
| Rate for Payer: Aetna Commercial |
$964.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$737.80
|
| Rate for Payer: Cash Price |
$908.06
|
| Rate for Payer: Cofinity Commercial |
$794.56
|
| Rate for Payer: Cofinity Commercial |
$976.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$794.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$908.06
|
| Rate for Payer: Healthscope Commercial |
$1,021.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$794.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$851.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$964.82
|
| Rate for Payer: PHP Commercial |
$964.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$737.80
|
| Rate for Payer: Priority Health SBD |
$715.10
|
| Rate for Payer: UMR Bronson Commercial |
$499.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$851.31
|
|
|
HC CRRT MONITOR FEE
|
Facility
|
IP
|
$127.50
|
|
| Hospital Charge Code |
27000609
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$56.10 |
| Max. Negotiated Rate |
$114.75 |
| Rate for Payer: Aetna American Axle |
$82.88
|
| Rate for Payer: Aetna Commercial |
$108.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.88
|
| Rate for Payer: Cash Price |
$102.00
|
| Rate for Payer: Cofinity Commercial |
$109.65
|
| Rate for Payer: Cofinity Commercial |
$89.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$89.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.00
|
| Rate for Payer: Healthscope Commercial |
$114.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.38
|
| Rate for Payer: PHP Commercial |
$108.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.88
|
| Rate for Payer: Priority Health SBD |
$80.32
|
| Rate for Payer: UMR Bronson Commercial |
$56.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.62
|
|
|
HC CRRT MONITOR FEE
|
Facility
|
OP
|
$127.50
|
|
| Hospital Charge Code |
27000609
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$47.18 |
| Max. Negotiated Rate |
$114.75 |
| Rate for Payer: Aetna Medicare |
$63.75
|
| Rate for Payer: Aetna American Axle |
$82.88
|
| Rate for Payer: Aetna Commercial |
$108.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.88
|
| Rate for Payer: BCBS Complete |
$51.00
|
| Rate for Payer: Cash Price |
$102.00
|
| Rate for Payer: Cofinity Commercial |
$109.65
|
| Rate for Payer: Cofinity Commercial |
$89.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$89.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.00
|
| Rate for Payer: Healthscope Commercial |
$114.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.38
|
| Rate for Payer: PHP Commercial |
$108.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.88
|
| Rate for Payer: Priority Health SBD |
$80.32
|
| Rate for Payer: UMR Bronson Commercial |
$47.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.62
|
|
|
HC CRRT MONITORING PER HOUR
|
Facility
|
IP
|
$416.84
|
|
| Hospital Charge Code |
88000002
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$183.41 |
| Max. Negotiated Rate |
$375.16 |
| Rate for Payer: Aetna American Axle |
$270.95
|
| Rate for Payer: Aetna Commercial |
$354.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.95
|
| Rate for Payer: Cash Price |
$333.47
|
| Rate for Payer: Cofinity Commercial |
$291.79
|
| Rate for Payer: Cofinity Commercial |
$358.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$291.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.47
|
| Rate for Payer: Healthscope Commercial |
$375.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.31
|
| Rate for Payer: PHP Commercial |
$354.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$270.95
|
| Rate for Payer: Priority Health SBD |
$262.61
|
| Rate for Payer: UMR Bronson Commercial |
$183.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.63
|
|
|
HC CRRT MONITORING PER HOUR
|
Facility
|
OP
|
$416.84
|
|
| Hospital Charge Code |
88000002
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$154.23 |
| Max. Negotiated Rate |
$375.16 |
| Rate for Payer: Aetna American Axle |
$270.95
|
| Rate for Payer: Aetna Commercial |
$354.31
|
| Rate for Payer: Aetna Medicare |
$208.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.95
|
| Rate for Payer: BCBS Complete |
$166.74
|
| Rate for Payer: Cash Price |
$333.47
|
| Rate for Payer: Cofinity Commercial |
$291.79
|
| Rate for Payer: Cofinity Commercial |
$358.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$291.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.47
|
| Rate for Payer: Healthscope Commercial |
$375.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.31
|
| Rate for Payer: PHP Commercial |
$354.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$270.95
|
| Rate for Payer: Priority Health SBD |
$262.61
|
| Rate for Payer: UMR Bronson Commercial |
$154.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.63
|
|
|
HC CRRT SUBSEQUENT CARTRIDGE
|
Facility
|
OP
|
$280.50
|
|
| Hospital Charge Code |
27000608
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$103.78 |
| Max. Negotiated Rate |
$252.45 |
| Rate for Payer: Aetna American Axle |
$182.32
|
| Rate for Payer: Aetna Commercial |
$238.42
|
| Rate for Payer: Aetna Medicare |
$140.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.32
|
| Rate for Payer: BCBS Complete |
$112.20
|
| Rate for Payer: Cash Price |
$224.40
|
| Rate for Payer: Cofinity Commercial |
$196.35
|
| Rate for Payer: Cofinity Commercial |
$241.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$196.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.40
|
| Rate for Payer: Healthscope Commercial |
$252.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$196.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.42
|
| Rate for Payer: PHP Commercial |
$238.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.32
|
| Rate for Payer: Priority Health SBD |
$176.72
|
| Rate for Payer: UMR Bronson Commercial |
$103.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.38
|
|
|
HC CRRT SUBSEQUENT CARTRIDGE
|
Facility
|
IP
|
$280.50
|
|
| Hospital Charge Code |
27000608
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$123.42 |
| Max. Negotiated Rate |
$252.45 |
| Rate for Payer: Aetna American Axle |
$182.32
|
| Rate for Payer: Aetna Commercial |
$238.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.32
|
| Rate for Payer: Cash Price |
$224.40
|
| Rate for Payer: Cofinity Commercial |
$196.35
|
| Rate for Payer: Cofinity Commercial |
$241.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$196.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.40
|
| Rate for Payer: Healthscope Commercial |
$252.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$196.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.42
|
| Rate for Payer: PHP Commercial |
$238.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.32
|
| Rate for Payer: Priority Health SBD |
$176.72
|
| Rate for Payer: UMR Bronson Commercial |
$123.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.38
|
|
|
HC CRUTCHES
|
Facility
|
IP
|
$126.70
|
|
| Hospital Charge Code |
96000002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.75 |
| Max. Negotiated Rate |
$114.03 |
| Rate for Payer: Aetna American Axle |
$82.36
|
| Rate for Payer: Aetna Commercial |
$107.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.36
|
| Rate for Payer: Cash Price |
$101.36
|
| Rate for Payer: Cofinity Commercial |
$108.96
|
| Rate for Payer: Cofinity Commercial |
$88.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$88.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.36
|
| Rate for Payer: Healthscope Commercial |
$114.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.70
|
| Rate for Payer: PHP Commercial |
$107.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.36
|
| Rate for Payer: Priority Health SBD |
$79.82
|
| Rate for Payer: UMR Bronson Commercial |
$55.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.02
|
|
|
HC CRUTCHES
|
Facility
|
OP
|
$126.70
|
|
| Hospital Charge Code |
96000002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$46.88 |
| Max. Negotiated Rate |
$114.03 |
| Rate for Payer: Aetna American Axle |
$82.36
|
| Rate for Payer: Aetna Commercial |
$107.70
|
| Rate for Payer: Aetna Medicare |
$63.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.36
|
| Rate for Payer: BCBS Complete |
$50.68
|
| Rate for Payer: Cash Price |
$101.36
|
| Rate for Payer: Cofinity Commercial |
$108.96
|
| Rate for Payer: Cofinity Commercial |
$88.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$88.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.36
|
| Rate for Payer: Healthscope Commercial |
$114.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.70
|
| Rate for Payer: PHP Commercial |
$107.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.36
|
| Rate for Payer: Priority Health SBD |
$79.82
|
| Rate for Payer: UMR Bronson Commercial |
$46.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.02
|
|
|
HC CRYOABLATION KIDNEY UNILATERAL
|
Facility
|
OP
|
$12,081.12
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
36100572
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$433.19 |
| Max. Negotiated Rate |
$32,060.66 |
| Rate for Payer: Aetna American Axle |
$7,852.73
|
| Rate for Payer: Aetna Commercial |
$10,268.95
|
| Rate for Payer: Aetna Medicare |
$10,608.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,852.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,750.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,750.89
|
| Rate for Payer: BCBS Complete |
$5,740.96
|
| Rate for Payer: BCBS MAPPO |
$10,200.71
|
| Rate for Payer: BCBS Trust/PPO |
$6,274.15
|
| Rate for Payer: BCN Commercial |
$6,274.15
|
| Rate for Payer: BCN Medicare Advantage |
$10,200.71
|
| Rate for Payer: Cash Price |
$9,664.90
|
| Rate for Payer: Cash Price |
$9,664.90
|
| Rate for Payer: Cash Price |
$9,664.90
|
| Rate for Payer: Cofinity Commercial |
$8,456.78
|
| Rate for Payer: Cofinity Commercial |
$10,389.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,456.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,664.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,200.71
|
| Rate for Payer: Healthscope Commercial |
$10,873.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,456.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,060.84
|
| Rate for Payer: Mclaren Medicaid |
$5,467.58
|
| Rate for Payer: Mclaren Medicare |
$10,200.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,710.75
|
| Rate for Payer: Meridian Medicaid |
$5,740.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,730.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,268.95
|
| Rate for Payer: Nomi Health Commercial |
$21,421.49
|
| Rate for Payer: PACE Medicare |
$9,690.67
|
| Rate for Payer: PACE SWMI |
$10,200.71
|
| Rate for Payer: PHP Commercial |
$10,268.95
|
| Rate for Payer: PHP Medicare Advantage |
$10,200.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,467.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,852.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32,060.66
|
| Rate for Payer: Priority Health Medicare |
$10,200.71
|
| Rate for Payer: Priority Health Narrow Network |
$25,648.53
|
| Rate for Payer: Priority Health SBD |
$7,611.11
|
| Rate for Payer: Railroad Medicare Medicare |
$10,200.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$476.51
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,200.71
|
| Rate for Payer: UHC Exchange |
$433.19
|
| Rate for Payer: UHC Medicare Advantage |
$10,200.71
|
| Rate for Payer: UHCCP Medicaid |
$5,467.58
|
| Rate for Payer: UMR Bronson Commercial |
$4,470.01
|
| Rate for Payer: VA VA |
$10,200.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,060.84
|
|
|
HC CRYOABLATION KIDNEY UNILATERAL
|
Facility
|
IP
|
$12,081.12
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
36100572
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,315.69 |
| Max. Negotiated Rate |
$10,873.01 |
| Rate for Payer: Aetna American Axle |
$7,852.73
|
| Rate for Payer: Aetna Commercial |
$10,268.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,852.73
|
| Rate for Payer: Cash Price |
$9,664.90
|
| Rate for Payer: Cofinity Commercial |
$10,389.76
|
| Rate for Payer: Cofinity Commercial |
$8,456.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,456.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,664.90
|
| Rate for Payer: Healthscope Commercial |
$10,873.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,456.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,060.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,268.95
|
| Rate for Payer: PHP Commercial |
$10,268.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,852.73
|
| Rate for Payer: Priority Health SBD |
$7,611.11
|
| Rate for Payer: UMR Bronson Commercial |
$5,315.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,060.84
|
|
|
HC CRYOABLATION LIVER TUMOR
|
Facility
|
IP
|
$10,529.77
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
36100613
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,633.10 |
| Max. Negotiated Rate |
$9,476.79 |
| Rate for Payer: Aetna American Axle |
$6,844.35
|
| Rate for Payer: Aetna Commercial |
$8,950.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,844.35
|
| Rate for Payer: Cash Price |
$8,423.82
|
| Rate for Payer: Cofinity Commercial |
$7,370.84
|
| Rate for Payer: Cofinity Commercial |
$9,055.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,370.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,423.82
|
| Rate for Payer: Healthscope Commercial |
$9,476.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,370.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,897.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,950.30
|
| Rate for Payer: PHP Commercial |
$8,950.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,844.35
|
| Rate for Payer: Priority Health SBD |
$6,633.76
|
| Rate for Payer: UMR Bronson Commercial |
$4,633.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,897.33
|
|
|
HC CRYOABLATION LIVER TUMOR
|
Facility
|
OP
|
$10,529.77
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
36100613
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$424.93 |
| Max. Negotiated Rate |
$32,060.66 |
| Rate for Payer: Aetna American Axle |
$6,844.35
|
| Rate for Payer: Aetna Commercial |
$8,950.30
|
| Rate for Payer: Aetna Medicare |
$10,608.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,844.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,750.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,750.89
|
| Rate for Payer: BCBS Complete |
$5,740.96
|
| Rate for Payer: BCBS MAPPO |
$10,200.71
|
| Rate for Payer: BCBS Trust/PPO |
$4,697.95
|
| Rate for Payer: BCN Commercial |
$4,697.95
|
| Rate for Payer: BCN Medicare Advantage |
$10,200.71
|
| Rate for Payer: Cash Price |
$8,423.82
|
| Rate for Payer: Cash Price |
$8,423.82
|
| Rate for Payer: Cash Price |
$8,423.82
|
| Rate for Payer: Cofinity Commercial |
$9,055.60
|
| Rate for Payer: Cofinity Commercial |
$7,370.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,370.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,423.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,200.71
|
| Rate for Payer: Healthscope Commercial |
$9,476.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,370.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,897.33
|
| Rate for Payer: Mclaren Medicaid |
$5,467.58
|
| Rate for Payer: Mclaren Medicare |
$10,200.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,710.75
|
| Rate for Payer: Meridian Medicaid |
$5,740.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,730.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,950.30
|
| Rate for Payer: Nomi Health Commercial |
$21,421.49
|
| Rate for Payer: PACE Medicare |
$9,690.67
|
| Rate for Payer: PACE SWMI |
$10,200.71
|
| Rate for Payer: PHP Commercial |
$8,950.30
|
| Rate for Payer: PHP Medicare Advantage |
$10,200.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,467.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,844.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32,060.66
|
| Rate for Payer: Priority Health Medicare |
$10,200.71
|
| Rate for Payer: Priority Health Narrow Network |
$25,648.53
|
| Rate for Payer: Priority Health SBD |
$6,633.76
|
| Rate for Payer: Railroad Medicare Medicare |
$10,200.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$467.42
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,200.71
|
| Rate for Payer: UHC Exchange |
$424.93
|
| Rate for Payer: UHC Medicare Advantage |
$10,200.71
|
| Rate for Payer: UHCCP Medicaid |
$5,467.58
|
| Rate for Payer: UMR Bronson Commercial |
$3,896.01
|
| Rate for Payer: VA VA |
$10,200.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,897.33
|
|
|
HC CRYOABLATION NASAL TISSUE OR NERVES UNI OR BIL
|
Facility
|
OP
|
$10,891.56
|
|
|
Service Code
|
CPT 31243
|
| Hospital Charge Code |
76100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$152.10 |
| Max. Negotiated Rate |
$18,216.88 |
| Rate for Payer: Aetna American Axle |
$7,079.51
|
| Rate for Payer: Aetna Commercial |
$9,257.83
|
| Rate for Payer: Aetna Medicare |
$6,027.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,079.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,245.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,245.06
|
| Rate for Payer: BCBS Complete |
$3,262.02
|
| Rate for Payer: BCBS MAPPO |
$5,796.05
|
| Rate for Payer: BCN Medicare Advantage |
$5,796.05
|
| Rate for Payer: Cash Price |
$8,713.25
|
| Rate for Payer: Cash Price |
$8,713.25
|
| Rate for Payer: Cash Price |
$8,713.25
|
| Rate for Payer: Cofinity Commercial |
$9,366.74
|
| Rate for Payer: Cofinity Commercial |
$7,624.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,624.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,713.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,796.05
|
| Rate for Payer: Healthscope Commercial |
$9,802.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,624.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,168.67
|
| Rate for Payer: Mclaren Medicaid |
$3,106.68
|
| Rate for Payer: Mclaren Medicare |
$5,796.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,085.85
|
| Rate for Payer: Meridian Medicaid |
$3,262.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,665.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,257.83
|
| Rate for Payer: Nomi Health Commercial |
$12,171.70
|
| Rate for Payer: PACE Medicare |
$5,506.25
|
| Rate for Payer: PACE SWMI |
$5,796.05
|
| Rate for Payer: PHP Commercial |
$9,257.83
|
| Rate for Payer: PHP Medicare Advantage |
$5,796.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,106.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,079.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18,216.88
|
| Rate for Payer: Priority Health Medicare |
$5,796.05
|
| Rate for Payer: Priority Health Narrow Network |
$14,573.50
|
| Rate for Payer: Priority Health SBD |
$6,861.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5,796.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.31
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,796.05
|
| Rate for Payer: UHC Exchange |
$152.10
|
| Rate for Payer: UHC Medicare Advantage |
$5,796.05
|
| Rate for Payer: UHCCP Medicaid |
$3,106.68
|
| Rate for Payer: UMR Bronson Commercial |
$4,029.88
|
| Rate for Payer: VA VA |
$5,796.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,168.67
|
|
|
HC CRYOABLATION NASAL TISSUE OR NERVES UNI OR BIL
|
Facility
|
IP
|
$10,891.56
|
|
|
Service Code
|
CPT 31243
|
| Hospital Charge Code |
76100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,792.29 |
| Max. Negotiated Rate |
$9,802.40 |
| Rate for Payer: Aetna American Axle |
$7,079.51
|
| Rate for Payer: Aetna Commercial |
$9,257.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,079.51
|
| Rate for Payer: Cash Price |
$8,713.25
|
| Rate for Payer: Cofinity Commercial |
$7,624.09
|
| Rate for Payer: Cofinity Commercial |
$9,366.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,624.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,713.25
|
| Rate for Payer: Healthscope Commercial |
$9,802.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,624.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,168.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,257.83
|
| Rate for Payer: PHP Commercial |
$9,257.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,079.51
|
| Rate for Payer: Priority Health SBD |
$6,861.68
|
| Rate for Payer: UMR Bronson Commercial |
$4,792.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,168.67
|
|
|
HC CRYOABLATION NEEDLE/PROBE
|
Facility
|
IP
|
$3,526.96
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,551.86 |
| Max. Negotiated Rate |
$3,174.26 |
| Rate for Payer: Cofinity Commercial |
$2,468.87
|
| Rate for Payer: Cofinity Commercial |
$3,033.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,468.87
|
| Rate for Payer: Aetna American Axle |
$2,292.52
|
| Rate for Payer: Aetna Commercial |
$2,997.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,292.52
|
| Rate for Payer: Cash Price |
$2,821.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,821.57
|
| Rate for Payer: Healthscope Commercial |
$3,174.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,468.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,645.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,997.92
|
| Rate for Payer: PHP Commercial |
$2,997.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,292.52
|
| Rate for Payer: Priority Health SBD |
$2,221.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,551.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,645.22
|
|
|
HC CRYOABLATION NEEDLE/PROBE
|
Facility
|
OP
|
$3,526.96
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,304.98 |
| Max. Negotiated Rate |
$3,174.26 |
| Rate for Payer: Aetna American Axle |
$2,292.52
|
| Rate for Payer: Aetna Commercial |
$2,997.92
|
| Rate for Payer: Aetna Medicare |
$1,763.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,292.52
|
| Rate for Payer: BCBS Complete |
$1,410.78
|
| Rate for Payer: Cash Price |
$2,821.57
|
| Rate for Payer: Cofinity Commercial |
$2,468.87
|
| Rate for Payer: Cofinity Commercial |
$3,033.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,468.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,821.57
|
| Rate for Payer: Healthscope Commercial |
$3,174.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,468.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,645.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,997.92
|
| Rate for Payer: PHP Commercial |
$2,997.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,292.52
|
| Rate for Payer: Priority Health SBD |
$2,221.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,304.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,645.22
|
|
|
HC CRYOABLATION STANDBY
|
Facility
|
IP
|
$8,180.24
|
|
| Hospital Charge Code |
27200283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,599.31 |
| Max. Negotiated Rate |
$7,362.22 |
| Rate for Payer: Aetna American Axle |
$5,317.16
|
| Rate for Payer: Aetna Commercial |
$6,953.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,317.16
|
| Rate for Payer: Cash Price |
$6,544.19
|
| Rate for Payer: Cofinity Commercial |
$5,726.17
|
| Rate for Payer: Cofinity Commercial |
$7,035.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,726.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,544.19
|
| Rate for Payer: Healthscope Commercial |
$7,362.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,726.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,135.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,953.20
|
| Rate for Payer: PHP Commercial |
$6,953.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,317.16
|
| Rate for Payer: Priority Health SBD |
$5,153.55
|
| Rate for Payer: UMR Bronson Commercial |
$3,599.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,135.18
|
|
|
HC CRYOABLATION STANDBY
|
Facility
|
OP
|
$8,180.24
|
|
| Hospital Charge Code |
27200283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,026.69 |
| Max. Negotiated Rate |
$7,362.22 |
| Rate for Payer: Aetna American Axle |
$5,317.16
|
| Rate for Payer: Aetna Commercial |
$6,953.20
|
| Rate for Payer: Aetna Medicare |
$4,090.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,317.16
|
| Rate for Payer: BCBS Complete |
$3,272.10
|
| Rate for Payer: Cash Price |
$6,544.19
|
| Rate for Payer: Cofinity Commercial |
$5,726.17
|
| Rate for Payer: Cofinity Commercial |
$7,035.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,726.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,544.19
|
| Rate for Payer: Healthscope Commercial |
$7,362.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,726.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,135.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,953.20
|
| Rate for Payer: PHP Commercial |
$6,953.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,317.16
|
| Rate for Payer: Priority Health SBD |
$5,153.55
|
| Rate for Payer: UMR Bronson Commercial |
$3,026.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,135.18
|
|
|
HC CRYOABLATION SUPPLIES
|
Facility
|
IP
|
$12,272.17
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,399.75 |
| Max. Negotiated Rate |
$11,044.95 |
| Rate for Payer: Aetna American Axle |
$7,976.91
|
| Rate for Payer: Aetna Commercial |
$10,431.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,976.91
|
| Rate for Payer: Cash Price |
$9,817.74
|
| Rate for Payer: Cofinity Commercial |
$10,554.07
|
| Rate for Payer: Cofinity Commercial |
$8,590.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,590.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,817.74
|
| Rate for Payer: Healthscope Commercial |
$11,044.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,590.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,204.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,431.34
|
| Rate for Payer: PHP Commercial |
$10,431.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,976.91
|
| Rate for Payer: Priority Health SBD |
$7,731.47
|
| Rate for Payer: UMR Bronson Commercial |
$5,399.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,204.13
|
|
