|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 12
|
Facility
|
OP
|
$1,232.87
|
|
|
Service Code
|
CPT C1730
|
| Hospital Charge Code |
27200325
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$1,109.58 |
| Rate for Payer: Aetna American Axle |
$801.37
|
| Rate for Payer: Aetna Commercial |
$1,047.94
|
| Rate for Payer: Aetna Medicare |
$616.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$801.37
|
| Rate for Payer: BCBS Complete |
$493.15
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$986.30
|
| Rate for Payer: Cash Price |
$986.30
|
| Rate for Payer: Cofinity Advantage |
$863.01
|
| Rate for Payer: Cofinity Commercial |
$1,060.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.30
|
| Rate for Payer: Healthscope Commercial |
$1,109.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$863.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$986.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,047.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$924.65
|
| Rate for Payer: PHP Commercial |
$1,047.94
|
| Rate for Payer: Priority Health SBD |
$776.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$801.37
|
| Rate for Payer: UHC Core |
$642.33
|
| Rate for Payer: UHC Exchange |
$484.52
|
| Rate for Payer: UMR Bronson Commercial |
$456.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.65
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 28
|
Facility
|
IP
|
$2,871.30
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200299
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,263.37 |
| Max. Negotiated Rate |
$2,584.17 |
| Rate for Payer: Aetna American Axle |
$1,866.35
|
| Rate for Payer: Aetna Commercial |
$2,440.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,866.35
|
| Rate for Payer: Cash Price |
$2,297.04
|
| Rate for Payer: Cofinity Advantage |
$2,009.91
|
| Rate for Payer: Cofinity Commercial |
$2,469.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,297.04
|
| Rate for Payer: Healthscope Commercial |
$2,584.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,009.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,153.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,440.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,153.47
|
| Rate for Payer: PHP Commercial |
$2,440.61
|
| Rate for Payer: Priority Health SBD |
$1,808.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,263.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,153.47
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 28
|
Facility
|
OP
|
$2,871.30
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200299
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$2,584.17 |
| Rate for Payer: Aetna American Axle |
$1,866.35
|
| Rate for Payer: Aetna Commercial |
$2,440.61
|
| Rate for Payer: Aetna Medicare |
$1,435.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,866.35
|
| Rate for Payer: BCBS Complete |
$1,148.52
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$2,297.04
|
| Rate for Payer: Cash Price |
$2,297.04
|
| Rate for Payer: Cofinity Advantage |
$2,009.91
|
| Rate for Payer: Cofinity Commercial |
$2,469.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,297.04
|
| Rate for Payer: Healthscope Commercial |
$2,584.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,009.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,153.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,297.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,440.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,153.47
|
| Rate for Payer: PHP Commercial |
$2,440.61
|
| Rate for Payer: Priority Health SBD |
$1,808.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,866.35
|
| Rate for Payer: UHC Core |
$1,495.95
|
| Rate for Payer: UHC Exchange |
$1,128.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,062.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,153.47
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 32
|
Facility
|
IP
|
$3,264.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200304
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,436.16 |
| Max. Negotiated Rate |
$2,937.60 |
| Rate for Payer: Aetna American Axle |
$2,121.60
|
| Rate for Payer: Aetna Commercial |
$2,774.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,121.60
|
| Rate for Payer: Cash Price |
$2,611.20
|
| Rate for Payer: Cofinity Advantage |
$2,284.80
|
| Rate for Payer: Cofinity Commercial |
$2,807.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,611.20
|
| Rate for Payer: Healthscope Commercial |
$2,937.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,284.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,448.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,774.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,448.00
|
| Rate for Payer: PHP Commercial |
$2,774.40
|
| Rate for Payer: Priority Health SBD |
$2,056.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,436.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,448.00
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 32
|
Facility
|
OP
|
$3,264.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200304
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$2,937.60 |
| Rate for Payer: Aetna American Axle |
$2,121.60
|
| Rate for Payer: Aetna Commercial |
$2,774.40
|
| Rate for Payer: Aetna Medicare |
$1,632.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,121.60
|
| Rate for Payer: BCBS Complete |
$1,305.60
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$2,611.20
|
| Rate for Payer: Cash Price |
$2,611.20
|
| Rate for Payer: Cofinity Advantage |
$2,284.80
|
| Rate for Payer: Cofinity Commercial |
$2,807.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,611.20
|
| Rate for Payer: Healthscope Commercial |
$2,937.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,284.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,448.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,611.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,774.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,448.00
|
| Rate for Payer: PHP Commercial |
$2,774.40
|
| Rate for Payer: Priority Health SBD |
$2,056.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,121.60
|
| Rate for Payer: UHC Core |
$1,700.54
|
| Rate for Payer: UHC Exchange |
$1,282.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,207.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,448.00
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 6
|
Facility
|
IP
|
$688.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$302.94 |
| Max. Negotiated Rate |
$619.65 |
| Rate for Payer: Aetna American Axle |
$447.52
|
| Rate for Payer: Aetna Commercial |
$585.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.52
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cofinity Advantage |
$481.95
|
| Rate for Payer: Cofinity Commercial |
$592.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.80
|
| Rate for Payer: Healthscope Commercial |
$619.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$481.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$516.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$516.38
|
| Rate for Payer: PHP Commercial |
$585.23
|
| Rate for Payer: Priority Health SBD |
$433.75
|
| Rate for Payer: UMR Bronson Commercial |
$302.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$516.38
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 19 OR < ELECTRODES LEVEL 6
|
Facility
|
OP
|
$688.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$619.65 |
| Rate for Payer: Aetna American Axle |
$447.52
|
| Rate for Payer: Aetna Commercial |
$585.23
|
| Rate for Payer: Aetna Medicare |
$344.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.52
|
| Rate for Payer: BCBS Complete |
$275.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cofinity Advantage |
$481.95
|
| Rate for Payer: Cofinity Commercial |
$592.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.80
|
| Rate for Payer: Healthscope Commercial |
$619.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$481.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$516.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$550.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$516.38
|
| Rate for Payer: PHP Commercial |
$585.23
|
| Rate for Payer: Priority Health SBD |
$433.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$447.52
|
| Rate for Payer: UHC Core |
$358.71
|
| Rate for Payer: UHC Exchange |
$270.58
|
| Rate for Payer: UMR Bronson Commercial |
$254.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$516.38
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 20 OR > ELECTRODES LEVEL 46
|
Facility
|
OP
|
$4,888.23
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$4,399.41 |
| Rate for Payer: Aetna American Axle |
$3,177.35
|
| Rate for Payer: Aetna Commercial |
$4,155.00
|
| Rate for Payer: Aetna Medicare |
$2,444.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,177.35
|
| Rate for Payer: BCBS Complete |
$1,955.29
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$3,910.58
|
| Rate for Payer: Cash Price |
$3,910.58
|
| Rate for Payer: Cofinity Advantage |
$3,421.76
|
| Rate for Payer: Cofinity Commercial |
$4,203.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,910.58
|
| Rate for Payer: Healthscope Commercial |
$4,399.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,421.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,666.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,910.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,155.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,666.17
|
| Rate for Payer: PHP Commercial |
$4,155.00
|
| Rate for Payer: Priority Health SBD |
$3,079.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,177.35
|
| Rate for Payer: UHC Core |
$2,546.77
|
| Rate for Payer: UHC Exchange |
$1,921.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,808.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,666.17
|
|
|
HC ELECTROPHYSIOLOGY CATHS NO 3D 20 OR > ELECTRODES LEVEL 46
|
Facility
|
IP
|
$4,888.23
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200056
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,150.82 |
| Max. Negotiated Rate |
$4,399.41 |
| Rate for Payer: Aetna American Axle |
$3,177.35
|
| Rate for Payer: Aetna Commercial |
$4,155.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,177.35
|
| Rate for Payer: Cash Price |
$3,910.58
|
| Rate for Payer: Cofinity Advantage |
$3,421.76
|
| Rate for Payer: Cofinity Commercial |
$4,203.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,910.58
|
| Rate for Payer: Healthscope Commercial |
$4,399.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,421.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,666.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,155.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,666.17
|
| Rate for Payer: PHP Commercial |
$4,155.00
|
| Rate for Payer: Priority Health SBD |
$3,079.58
|
| Rate for Payer: UMR Bronson Commercial |
$2,150.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,666.17
|
|
|
HC ELECTROPHYSIOLOGY PACK
|
Facility
|
IP
|
$272.27
|
|
| Hospital Charge Code |
62200002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$119.80 |
| Max. Negotiated Rate |
$245.04 |
| Rate for Payer: Aetna American Axle |
$176.98
|
| Rate for Payer: Aetna Commercial |
$231.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.98
|
| Rate for Payer: Cash Price |
$217.82
|
| Rate for Payer: Cofinity Advantage |
$190.59
|
| Rate for Payer: Cofinity Commercial |
$234.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.82
|
| Rate for Payer: Healthscope Commercial |
$245.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.20
|
| Rate for Payer: PHP Commercial |
$231.43
|
| Rate for Payer: Priority Health SBD |
$171.53
|
| Rate for Payer: UMR Bronson Commercial |
$119.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.20
|
|
|
HC ELECTROPHYSIOLOGY PACK
|
Facility
|
OP
|
$272.27
|
|
| Hospital Charge Code |
62200002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$100.74 |
| Max. Negotiated Rate |
$245.04 |
| Rate for Payer: Aetna American Axle |
$176.98
|
| Rate for Payer: Aetna Commercial |
$231.43
|
| Rate for Payer: Aetna Medicare |
$136.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.98
|
| Rate for Payer: BCBS Complete |
$108.91
|
| Rate for Payer: Cash Price |
$217.82
|
| Rate for Payer: Cofinity Advantage |
$190.59
|
| Rate for Payer: Cofinity Commercial |
$234.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.82
|
| Rate for Payer: Healthscope Commercial |
$245.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$217.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.20
|
| Rate for Payer: PHP Commercial |
$231.43
|
| Rate for Payer: Priority Health SBD |
$171.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.98
|
| Rate for Payer: UHC Core |
$141.85
|
| Rate for Payer: UHC Exchange |
$107.00
|
| Rate for Payer: UMR Bronson Commercial |
$100.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.20
|
|
|
HC ELECTROPHYSIOLOGY STUDY
|
Facility
|
OP
|
$28,474.35
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
48100037
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,064.56 |
| Max. Negotiated Rate |
$25,626.92 |
| Rate for Payer: Aetna American Axle |
$18,508.33
|
| Rate for Payer: Aetna Commercial |
$24,203.20
|
| Rate for Payer: Aetna Medicare |
$8,082.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,508.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,714.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,714.52
|
| Rate for Payer: BCBS Complete |
$4,268.17
|
| Rate for Payer: BCBS MAPPO |
$7,771.62
|
| Rate for Payer: BCBS Trust/PPO |
$20,072.80
|
| Rate for Payer: BCN Commercial |
$20,072.80
|
| Rate for Payer: BCN Medicare Advantage |
$7,771.62
|
| Rate for Payer: Cash Price |
$22,779.48
|
| Rate for Payer: Cash Price |
$22,779.48
|
| Rate for Payer: Cofinity Advantage |
$19,932.04
|
| Rate for Payer: Cofinity Commercial |
$24,487.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,779.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,771.62
|
| Rate for Payer: Healthscope Commercial |
$25,626.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19,932.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,355.76
|
| Rate for Payer: Mclaren Medicaid |
$7,771.62
|
| Rate for Payer: Mclaren Medicare |
$7,771.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,160.20
|
| Rate for Payer: Meridian Medicaid |
$8,160.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,937.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,548.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,203.20
|
| Rate for Payer: Nomi Health Commercial |
$23,314.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,355.76
|
| Rate for Payer: PACE Medicare |
$7,383.04
|
| Rate for Payer: PACE SWMI |
$7,771.62
|
| Rate for Payer: PHP Commercial |
$24,203.20
|
| Rate for Payer: PHP Medicare Advantage |
$7,771.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,064.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,132.71
|
| Rate for Payer: Priority Health Medicare |
$7,771.62
|
| Rate for Payer: Priority Health SBD |
$17,938.84
|
| Rate for Payer: Priority Health Tiered Network |
$20,106.17
|
| Rate for Payer: Railroad Medicare Medicare |
$7,771.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,771.62
|
| Rate for Payer: UHC Medicaid |
$4,064.56
|
| Rate for Payer: UHCCP Medicaid |
$4,064.56
|
| Rate for Payer: UMR Bronson Commercial |
$10,535.51
|
| Rate for Payer: VA VA |
$7,771.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,355.76
|
|
|
HC ELECTROPHYSIOLOGY STUDY
|
Facility
|
IP
|
$28,474.35
|
|
|
Service Code
|
CPT 93620
|
| Hospital Charge Code |
48100037
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,528.71 |
| Max. Negotiated Rate |
$25,626.92 |
| Rate for Payer: Aetna American Axle |
$18,508.33
|
| Rate for Payer: Aetna Commercial |
$24,203.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,508.33
|
| Rate for Payer: Cash Price |
$22,779.48
|
| Rate for Payer: Cofinity Advantage |
$19,932.04
|
| Rate for Payer: Cofinity Commercial |
$24,487.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,779.48
|
| Rate for Payer: Healthscope Commercial |
$25,626.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19,932.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,355.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,203.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,355.76
|
| Rate for Payer: PHP Commercial |
$24,203.20
|
| Rate for Payer: Priority Health SBD |
$17,938.84
|
| Rate for Payer: UMR Bronson Commercial |
$12,528.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,355.76
|
|
|
HC ELM IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200042
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC ELM IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200042
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC EMBOLIC GLUE LVL
|
Facility
|
IP
|
$12,094.65
|
|
| Hospital Charge Code |
27800128
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,321.65 |
| Max. Negotiated Rate |
$10,885.18 |
| Rate for Payer: Aetna American Axle |
$7,861.52
|
| Rate for Payer: Aetna Commercial |
$10,280.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,861.52
|
| Rate for Payer: Cash Price |
$9,675.72
|
| Rate for Payer: Cofinity Advantage |
$8,466.25
|
| Rate for Payer: Cofinity Commercial |
$10,401.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,675.72
|
| Rate for Payer: Healthscope Commercial |
$10,885.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,466.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,070.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,280.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,070.99
|
| Rate for Payer: PHP Commercial |
$10,280.45
|
| Rate for Payer: Priority Health SBD |
$7,619.63
|
| Rate for Payer: UMR Bronson Commercial |
$5,321.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,070.99
|
|
|
HC EMBOLIC GLUE LVL
|
Facility
|
OP
|
$12,094.65
|
|
| Hospital Charge Code |
27800128
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,475.02 |
| Max. Negotiated Rate |
$10,885.18 |
| Rate for Payer: Aetna American Axle |
$7,861.52
|
| Rate for Payer: Aetna Commercial |
$10,280.45
|
| Rate for Payer: Aetna Medicare |
$6,047.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,861.52
|
| Rate for Payer: BCBS Complete |
$4,837.86
|
| Rate for Payer: Cash Price |
$9,675.72
|
| Rate for Payer: Cofinity Advantage |
$8,466.25
|
| Rate for Payer: Cofinity Commercial |
$10,401.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,675.72
|
| Rate for Payer: Healthscope Commercial |
$10,885.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,466.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,070.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,675.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,280.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,070.99
|
| Rate for Payer: PHP Commercial |
$10,280.45
|
| Rate for Payer: Priority Health SBD |
$7,619.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,861.52
|
| Rate for Payer: UHC Core |
$6,301.31
|
| Rate for Payer: UHC Exchange |
$4,753.20
|
| Rate for Payer: UMR Bronson Commercial |
$4,475.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,070.99
|
|
|
HC EMBOLIC GLUE LVL 1
|
Facility
|
OP
|
$5,769.13
|
|
| Hospital Charge Code |
27800050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,134.58 |
| Max. Negotiated Rate |
$5,192.22 |
| Rate for Payer: Aetna American Axle |
$3,749.93
|
| Rate for Payer: Aetna Commercial |
$4,903.76
|
| Rate for Payer: Aetna Medicare |
$2,884.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,749.93
|
| Rate for Payer: BCBS Complete |
$2,307.65
|
| Rate for Payer: Cash Price |
$4,615.30
|
| Rate for Payer: Cofinity Advantage |
$4,038.39
|
| Rate for Payer: Cofinity Commercial |
$4,961.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,615.30
|
| Rate for Payer: Healthscope Commercial |
$5,192.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,038.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,326.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,615.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,903.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,326.85
|
| Rate for Payer: PHP Commercial |
$4,903.76
|
| Rate for Payer: Priority Health SBD |
$3,634.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,749.93
|
| Rate for Payer: UHC Core |
$3,005.72
|
| Rate for Payer: UHC Exchange |
$2,267.27
|
| Rate for Payer: UMR Bronson Commercial |
$2,134.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,326.85
|
|
|
HC EMBOLIC GLUE LVL 1
|
Facility
|
IP
|
$5,769.13
|
|
| Hospital Charge Code |
27800050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,538.42 |
| Max. Negotiated Rate |
$5,192.22 |
| Rate for Payer: Aetna American Axle |
$3,749.93
|
| Rate for Payer: Aetna Commercial |
$4,903.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,749.93
|
| Rate for Payer: Cash Price |
$4,615.30
|
| Rate for Payer: Cofinity Advantage |
$4,038.39
|
| Rate for Payer: Cofinity Commercial |
$4,961.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,615.30
|
| Rate for Payer: Healthscope Commercial |
$5,192.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,038.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,326.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,903.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,326.85
|
| Rate for Payer: PHP Commercial |
$4,903.76
|
| Rate for Payer: Priority Health SBD |
$3,634.55
|
| Rate for Payer: UMR Bronson Commercial |
$2,538.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,326.85
|
|
|
HC EMBOLI DETECTION WITH BUBBLE STUDY
|
Facility
|
OP
|
$2,087.38
|
|
|
Service Code
|
CPT 93893
|
| Hospital Charge Code |
92100035
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$1,878.64 |
| Rate for Payer: Aetna American Axle |
$1,356.80
|
| Rate for Payer: Aetna Commercial |
$1,774.27
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,356.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,163.75
|
| Rate for Payer: BCN Commercial |
$1,163.75
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$1,669.90
|
| Rate for Payer: Cash Price |
$1,669.90
|
| Rate for Payer: Cofinity Advantage |
$1,461.17
|
| Rate for Payer: Cofinity Commercial |
$1,795.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,669.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$1,878.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,461.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,565.54
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,774.27
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,565.54
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$1,774.27
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$1,315.05
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,356.80
|
| Rate for Payer: UHC Core |
$1,087.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$820.34
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$772.33
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,565.54
|
|
|
HC EMBOLI DETECTION WITH BUBBLE STUDY
|
Facility
|
IP
|
$2,087.38
|
|
|
Service Code
|
CPT 93893
|
| Hospital Charge Code |
92100035
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$918.45 |
| Max. Negotiated Rate |
$1,878.64 |
| Rate for Payer: Aetna American Axle |
$1,356.80
|
| Rate for Payer: Aetna Commercial |
$1,774.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,356.80
|
| Rate for Payer: Cash Price |
$1,669.90
|
| Rate for Payer: Cofinity Advantage |
$1,461.17
|
| Rate for Payer: Cofinity Commercial |
$1,795.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,669.90
|
| Rate for Payer: Healthscope Commercial |
$1,878.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,461.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,565.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,774.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,565.54
|
| Rate for Payer: PHP Commercial |
$1,774.27
|
| Rate for Payer: Priority Health SBD |
$1,315.05
|
| Rate for Payer: UMR Bronson Commercial |
$918.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,565.54
|
|
|
HC EMBOLI DETECTION WITH OUT BUBBLE STUDY
|
Facility
|
OP
|
$954.60
|
|
|
Service Code
|
CPT 93892
|
| Hospital Charge Code |
92100034
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$991.86 |
| Rate for Payer: Aetna American Axle |
$620.49
|
| Rate for Payer: Aetna Commercial |
$811.41
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$991.86
|
| Rate for Payer: BCN Commercial |
$991.86
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$763.68
|
| Rate for Payer: Cash Price |
$763.68
|
| Rate for Payer: Cofinity Advantage |
$668.22
|
| Rate for Payer: Cofinity Commercial |
$820.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$763.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$859.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$668.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$715.95
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$811.41
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$715.95
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$811.41
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$601.40
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$620.49
|
| Rate for Payer: UHC Core |
$497.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$375.16
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$353.20
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$715.95
|
|
|
HC EMBOLI DETECTION WITH OUT BUBBLE STUDY
|
Facility
|
IP
|
$954.60
|
|
|
Service Code
|
CPT 93892
|
| Hospital Charge Code |
92100034
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$420.02 |
| Max. Negotiated Rate |
$859.14 |
| Rate for Payer: Aetna American Axle |
$620.49
|
| Rate for Payer: Aetna Commercial |
$811.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.49
|
| Rate for Payer: Cash Price |
$763.68
|
| Rate for Payer: Cofinity Advantage |
$668.22
|
| Rate for Payer: Cofinity Commercial |
$820.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$763.68
|
| Rate for Payer: Healthscope Commercial |
$859.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$668.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$715.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$811.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$715.95
|
| Rate for Payer: PHP Commercial |
$811.41
|
| Rate for Payer: Priority Health SBD |
$601.40
|
| Rate for Payer: UMR Bronson Commercial |
$420.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$715.95
|
|
|
HC EMBOLIZATION ARTERIAL OR VENOUS FOR HEMORRHAGE OR LYMPH EXTRAV
|
Facility
|
OP
|
$17,117.92
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
36100431
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$37,198.61 |
| Rate for Payer: Aetna American Axle |
$11,126.65
|
| Rate for Payer: Aetna Commercial |
$14,550.23
|
| Rate for Payer: Aetna Medicare |
$11,962.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,126.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$11,004.10
|
| Rate for Payer: BCN Commercial |
$11,004.10
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$13,694.34
|
| Rate for Payer: Cash Price |
$13,694.34
|
| Rate for Payer: Cash Price |
$13,694.34
|
| Rate for Payer: Cofinity Advantage |
$11,982.54
|
| Rate for Payer: Cofinity Commercial |
$14,721.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,694.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$15,406.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,982.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,838.44
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$12,077.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,550.23
|
| Rate for Payer: Nomi Health Commercial |
$34,508.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,838.44
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$14,550.23
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,198.61
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health SBD |
$10,784.29
|
| Rate for Payer: Priority Health Tiered Network |
$29,758.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: UMR Bronson Commercial |
$6,333.63
|
| Rate for Payer: VA VA |
$11,502.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,838.44
|
|
|
HC EMBOLIZATION ARTERIAL OR VENOUS FOR HEMORRHAGE OR LYMPH EXTRAV
|
Facility
|
IP
|
$17,117.92
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
36100431
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,531.88 |
| Max. Negotiated Rate |
$15,406.13 |
| Rate for Payer: Aetna American Axle |
$11,126.65
|
| Rate for Payer: Aetna Commercial |
$14,550.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,126.65
|
| Rate for Payer: Cash Price |
$13,694.34
|
| Rate for Payer: Cofinity Advantage |
$11,982.54
|
| Rate for Payer: Cofinity Commercial |
$14,721.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,694.34
|
| Rate for Payer: Healthscope Commercial |
$15,406.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,982.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,838.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,550.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,838.44
|
| Rate for Payer: PHP Commercial |
$14,550.23
|
| Rate for Payer: Priority Health SBD |
$10,784.29
|
| Rate for Payer: UMR Bronson Commercial |
$7,531.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,838.44
|
|
