|
HC NON OPEN HEART PLATELET MAPPING
|
Facility
|
IP
|
$1,110.46
|
|
| Hospital Charge Code |
27000389
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$488.60 |
| Max. Negotiated Rate |
$999.41 |
| Rate for Payer: Aetna American Axle |
$721.80
|
| Rate for Payer: Aetna Commercial |
$943.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$721.80
|
| Rate for Payer: Cash Price |
$888.37
|
| Rate for Payer: Cofinity Commercial |
$777.32
|
| Rate for Payer: Cofinity Commercial |
$955.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$888.37
|
| Rate for Payer: Healthscope Commercial |
$999.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$777.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$832.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$943.89
|
| Rate for Payer: PHP Commercial |
$943.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$777.32
|
| Rate for Payer: Priority Health SBD |
$699.59
|
| Rate for Payer: UMR Bronson Commercial |
$488.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$832.84
|
|
|
HC NON OPEN HEART PLATELET MAPPING
|
Facility
|
OP
|
$1,110.46
|
|
| Hospital Charge Code |
27000389
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$410.87 |
| Max. Negotiated Rate |
$999.41 |
| Rate for Payer: Aetna American Axle |
$721.80
|
| Rate for Payer: Aetna Commercial |
$943.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$721.80
|
| Rate for Payer: BCBS Complete |
$444.18
|
| Rate for Payer: Cash Price |
$888.37
|
| Rate for Payer: Cofinity Commercial |
$777.32
|
| Rate for Payer: Cofinity Commercial |
$955.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$888.37
|
| Rate for Payer: Healthscope Commercial |
$999.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$777.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$832.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$943.89
|
| Rate for Payer: PHP Commercial |
$943.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$777.32
|
| Rate for Payer: Priority Health SBD |
$699.59
|
| Rate for Payer: UMR Bronson Commercial |
$410.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$832.84
|
|
|
HC NON OPEN HEART TEG
|
Facility
|
IP
|
$906.19
|
|
| Hospital Charge Code |
27000197
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$398.72 |
| Max. Negotiated Rate |
$815.57 |
| Rate for Payer: Aetna American Axle |
$589.02
|
| Rate for Payer: Aetna Commercial |
$770.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.02
|
| Rate for Payer: Cash Price |
$724.95
|
| Rate for Payer: Cofinity Commercial |
$634.33
|
| Rate for Payer: Cofinity Commercial |
$779.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.95
|
| Rate for Payer: Healthscope Commercial |
$815.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$634.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$679.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$770.26
|
| Rate for Payer: PHP Commercial |
$770.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.33
|
| Rate for Payer: Priority Health SBD |
$570.90
|
| Rate for Payer: UMR Bronson Commercial |
$398.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$679.64
|
|
|
HC NON OPEN HEART TEG
|
Facility
|
OP
|
$906.19
|
|
| Hospital Charge Code |
27000197
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$335.29 |
| Max. Negotiated Rate |
$815.57 |
| Rate for Payer: Aetna American Axle |
$589.02
|
| Rate for Payer: Aetna Commercial |
$770.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$589.02
|
| Rate for Payer: BCBS Complete |
$362.48
|
| Rate for Payer: Cash Price |
$724.95
|
| Rate for Payer: Cofinity Commercial |
$634.33
|
| Rate for Payer: Cofinity Commercial |
$779.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.95
|
| Rate for Payer: Healthscope Commercial |
$815.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$634.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$679.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$770.26
|
| Rate for Payer: PHP Commercial |
$770.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.33
|
| Rate for Payer: Priority Health SBD |
$570.90
|
| Rate for Payer: UMR Bronson Commercial |
$335.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$679.64
|
|
|
HC NON-SELECTIVE DEBRIDEMENT
|
Facility
|
OP
|
$351.90
|
|
|
Service Code
|
CPT 97602
|
| Hospital Charge Code |
42000037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$29.86 |
| Max. Negotiated Rate |
$316.71 |
| Rate for Payer: Aetna American Axle |
$228.74
|
| Rate for Payer: Aetna Commercial |
$299.12
|
| Rate for Payer: Aetna Medicare |
$185.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$70.58
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$281.52
|
| Rate for Payer: Cash Price |
$281.52
|
| Rate for Payer: Cofinity Commercial |
$246.33
|
| Rate for Payer: Cofinity Commercial |
$302.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$316.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.92
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$299.12
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$299.12
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.32
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$29.86
|
| Rate for Payer: Priority Health SBD |
$221.70
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.95
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: UMR Bronson Commercial |
$130.20
|
| Rate for Payer: VA VA |
$177.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.92
|
|
|
HC NON-SELECTIVE DEBRIDEMENT
|
Facility
|
IP
|
$351.90
|
|
|
Service Code
|
CPT 97602
|
| Hospital Charge Code |
42000037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$154.84 |
| Max. Negotiated Rate |
$316.71 |
| Rate for Payer: Aetna American Axle |
$228.74
|
| Rate for Payer: Aetna Commercial |
$299.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.74
|
| Rate for Payer: Cash Price |
$281.52
|
| Rate for Payer: Cofinity Commercial |
$246.33
|
| Rate for Payer: Cofinity Commercial |
$302.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.52
|
| Rate for Payer: Healthscope Commercial |
$316.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$299.12
|
| Rate for Payer: PHP Commercial |
$299.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.33
|
| Rate for Payer: Priority Health SBD |
$221.70
|
| Rate for Payer: UMR Bronson Commercial |
$154.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.92
|
|
|
HC NON-SELECTIVE THORACIC AORTA W ANGIO
|
Facility
|
IP
|
$3,877.64
|
|
|
Service Code
|
CPT 36221
|
| Hospital Charge Code |
36100376
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,706.16 |
| Max. Negotiated Rate |
$3,489.88 |
| Rate for Payer: Aetna American Axle |
$2,520.47
|
| Rate for Payer: Aetna Commercial |
$3,295.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,520.47
|
| Rate for Payer: Cash Price |
$3,102.11
|
| Rate for Payer: Cofinity Commercial |
$2,714.35
|
| Rate for Payer: Cofinity Commercial |
$3,334.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,102.11
|
| Rate for Payer: Healthscope Commercial |
$3,489.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,714.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,908.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,295.99
|
| Rate for Payer: PHP Commercial |
$3,295.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,714.35
|
| Rate for Payer: Priority Health SBD |
$2,442.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,706.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,908.23
|
|
|
HC NON-SELECTIVE THORACIC AORTA W ANGIO
|
Facility
|
OP
|
$3,877.64
|
|
|
Service Code
|
CPT 36221
|
| Hospital Charge Code |
36100376
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$191.55 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$2,520.47
|
| Rate for Payer: Aetna Commercial |
$3,295.99
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,520.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,357.09
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,102.11
|
| Rate for Payer: Cash Price |
$3,102.11
|
| Rate for Payer: Cofinity Commercial |
$3,334.77
|
| Rate for Payer: Cofinity Commercial |
$2,714.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,102.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$3,489.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,714.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,908.23
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,295.99
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,295.99
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,714.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$2,442.91
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.70
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$191.55
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,434.73
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,908.23
|
|
|
HC NON-SELECTIVE VERTEBRAL ARTERY UNI
|
Facility
|
IP
|
$9,359.88
|
|
|
Service Code
|
CPT 36225
|
| Hospital Charge Code |
36100380
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,118.35 |
| Max. Negotiated Rate |
$8,423.89 |
| Rate for Payer: Aetna American Axle |
$6,083.92
|
| Rate for Payer: Aetna Commercial |
$7,955.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,083.92
|
| Rate for Payer: Cash Price |
$7,487.90
|
| Rate for Payer: Cofinity Commercial |
$6,551.92
|
| Rate for Payer: Cofinity Commercial |
$8,049.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,487.90
|
| Rate for Payer: Healthscope Commercial |
$8,423.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,551.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,019.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,955.90
|
| Rate for Payer: PHP Commercial |
$7,955.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,551.92
|
| Rate for Payer: Priority Health SBD |
$5,896.72
|
| Rate for Payer: UMR Bronson Commercial |
$4,118.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,019.91
|
|
|
HC NON-SELECTIVE VERTEBRAL ARTERY UNI
|
Facility
|
OP
|
$9,359.88
|
|
|
Service Code
|
CPT 36225
|
| Hospital Charge Code |
36100380
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$315.98 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$6,083.92
|
| Rate for Payer: Aetna Commercial |
$7,955.90
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,083.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,357.09
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$7,487.90
|
| Rate for Payer: Cash Price |
$7,487.90
|
| Rate for Payer: Cofinity Commercial |
$6,551.92
|
| Rate for Payer: Cofinity Commercial |
$8,049.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,487.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$8,423.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,551.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,019.91
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,955.90
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$7,955.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,551.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$5,896.72
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$347.58
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$315.98
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$3,463.16
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,019.91
|
|
|
HC NONSTRESS TEST
|
Facility
|
IP
|
$320.40
|
|
|
Service Code
|
CPT 59025
|
| Hospital Charge Code |
92000004
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$140.98 |
| Max. Negotiated Rate |
$288.36 |
| Rate for Payer: Aetna American Axle |
$208.26
|
| Rate for Payer: Aetna Commercial |
$272.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.26
|
| Rate for Payer: Cash Price |
$256.32
|
| Rate for Payer: Cofinity Commercial |
$224.28
|
| Rate for Payer: Cofinity Commercial |
$275.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.32
|
| Rate for Payer: Healthscope Commercial |
$288.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$224.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$272.34
|
| Rate for Payer: PHP Commercial |
$272.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.28
|
| Rate for Payer: Priority Health SBD |
$201.85
|
| Rate for Payer: UMR Bronson Commercial |
$140.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.30
|
|
|
HC NONSTRESS TEST
|
Facility
|
OP
|
$320.40
|
|
|
Service Code
|
CPT 59025
|
| Hospital Charge Code |
92000004
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$48.46 |
| Max. Negotiated Rate |
$557.61 |
| Rate for Payer: Aetna American Axle |
$208.26
|
| Rate for Payer: Aetna Commercial |
$272.34
|
| Rate for Payer: Aetna Medicare |
$184.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.40
|
| Rate for Payer: BCBS Complete |
$101.74
|
| Rate for Payer: BCBS MAPPO |
$177.12
|
| Rate for Payer: BCBS Trust/PPO |
$190.49
|
| Rate for Payer: BCN Medicare Advantage |
$177.12
|
| Rate for Payer: Cash Price |
$256.32
|
| Rate for Payer: Cash Price |
$256.32
|
| Rate for Payer: Cash Price |
$256.32
|
| Rate for Payer: Cofinity Commercial |
$224.28
|
| Rate for Payer: Cofinity Commercial |
$275.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.12
|
| Rate for Payer: Healthscope Commercial |
$288.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$224.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.30
|
| Rate for Payer: Mclaren Medicaid |
$96.88
|
| Rate for Payer: Mclaren Medicare |
$177.12
|
| Rate for Payer: Meridian Medicaid |
$101.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$185.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$272.34
|
| Rate for Payer: PACE Medicare |
$168.26
|
| Rate for Payer: PACE SWMI |
$177.12
|
| Rate for Payer: PHP Commercial |
$272.34
|
| Rate for Payer: PHP Medicare Advantage |
$177.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$557.61
|
| Rate for Payer: Priority Health Medicare |
$177.12
|
| Rate for Payer: Priority Health Narrow Network |
$446.09
|
| Rate for Payer: Priority Health SBD |
$201.85
|
| Rate for Payer: Railroad Medicare Medicare |
$177.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.31
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.12
|
| Rate for Payer: UHC Exchange |
$48.46
|
| Rate for Payer: UHC Medicare Advantage |
$182.43
|
| Rate for Payer: UMR Bronson Commercial |
$118.55
|
| Rate for Payer: VA VA |
$177.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.30
|
|
|
HC NON THROMBOLYTIC INTRACRANIAL EA ADDL VASCULAR TERRITORY
|
Facility
|
IP
|
$3,247.14
|
|
|
Service Code
|
CPT 61651
|
| Hospital Charge Code |
36100515
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,428.74 |
| Max. Negotiated Rate |
$2,922.43 |
| Rate for Payer: Aetna American Axle |
$2,110.64
|
| Rate for Payer: Aetna Commercial |
$2,760.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,110.64
|
| Rate for Payer: Cash Price |
$2,597.71
|
| Rate for Payer: Cofinity Commercial |
$2,792.54
|
| Rate for Payer: Cofinity Commercial |
$2,273.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,597.71
|
| Rate for Payer: Healthscope Commercial |
$2,922.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,273.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,435.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,760.07
|
| Rate for Payer: PHP Commercial |
$2,760.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,273.00
|
| Rate for Payer: Priority Health SBD |
$2,045.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,428.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,435.36
|
|
|
HC NON THROMBOLYTIC INTRACRANIAL EA ADDL VASCULAR TERRITORY
|
Facility
|
OP
|
$3,247.14
|
|
|
Service Code
|
CPT 61651
|
| Hospital Charge Code |
36100515
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$243.62 |
| Max. Negotiated Rate |
$2,922.43 |
| Rate for Payer: Aetna American Axle |
$2,110.64
|
| Rate for Payer: Aetna Commercial |
$2,760.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,110.64
|
| Rate for Payer: BCBS Complete |
$1,298.86
|
| Rate for Payer: BCBS Trust/PPO |
$894.20
|
| Rate for Payer: Cash Price |
$2,597.71
|
| Rate for Payer: Cash Price |
$2,597.71
|
| Rate for Payer: Cofinity Commercial |
$2,792.54
|
| Rate for Payer: Cofinity Commercial |
$2,273.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,597.71
|
| Rate for Payer: Healthscope Commercial |
$2,922.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,273.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,435.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,760.07
|
| Rate for Payer: PHP Commercial |
$2,760.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,273.00
|
| Rate for Payer: Priority Health SBD |
$2,045.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$267.98
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UHC Exchange |
$243.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,201.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,435.36
|
|
|
HC NON THROMBOLYTIC INTRACRANIAL INITIAL VASCULAR TERRITORY
|
Facility
|
IP
|
$4,427.92
|
|
|
Service Code
|
CPT 61650
|
| Hospital Charge Code |
36100514
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,948.28 |
| Max. Negotiated Rate |
$3,985.13 |
| Rate for Payer: Aetna American Axle |
$2,878.15
|
| Rate for Payer: Aetna Commercial |
$3,763.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,878.15
|
| Rate for Payer: Cash Price |
$3,542.34
|
| Rate for Payer: Cofinity Commercial |
$3,099.54
|
| Rate for Payer: Cofinity Commercial |
$3,808.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,542.34
|
| Rate for Payer: Healthscope Commercial |
$3,985.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,099.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,320.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,763.73
|
| Rate for Payer: PHP Commercial |
$3,763.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,099.54
|
| Rate for Payer: Priority Health SBD |
$2,789.59
|
| Rate for Payer: UMR Bronson Commercial |
$1,948.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,320.94
|
|
|
HC NON THROMBOLYTIC INTRACRANIAL INITIAL VASCULAR TERRITORY
|
Facility
|
OP
|
$4,427.92
|
|
|
Service Code
|
CPT 61650
|
| Hospital Charge Code |
36100514
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$570.40 |
| Max. Negotiated Rate |
$3,985.13 |
| Rate for Payer: Aetna American Axle |
$2,878.15
|
| Rate for Payer: Aetna Commercial |
$3,763.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,878.15
|
| Rate for Payer: BCBS Complete |
$1,771.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,103.16
|
| Rate for Payer: Cash Price |
$3,542.34
|
| Rate for Payer: Cash Price |
$3,542.34
|
| Rate for Payer: Cofinity Commercial |
$3,808.01
|
| Rate for Payer: Cofinity Commercial |
$3,099.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,542.34
|
| Rate for Payer: Healthscope Commercial |
$3,985.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,099.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,320.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,763.73
|
| Rate for Payer: PHP Commercial |
$3,763.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,099.54
|
| Rate for Payer: Priority Health SBD |
$2,789.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$627.44
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UHC Exchange |
$570.40
|
| Rate for Payer: UMR Bronson Commercial |
$1,638.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,320.94
|
|
|
HC NORCLOZAPINE LEVEL
|
Facility
|
IP
|
$24.48
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100065
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.77 |
| Max. Negotiated Rate |
$22.03 |
| Rate for Payer: Aetna American Axle |
$15.91
|
| Rate for Payer: Aetna Commercial |
$20.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.91
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$21.05
|
| Rate for Payer: Cofinity Commercial |
$17.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$22.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.81
|
| Rate for Payer: PHP Commercial |
$20.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.14
|
| Rate for Payer: Priority Health SBD |
$15.42
|
| Rate for Payer: UMR Bronson Commercial |
$10.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.36
|
|
|
HC NORCLOZAPINE LEVEL
|
Facility
|
OP
|
$24.48
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100065
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.06 |
| Max. Negotiated Rate |
$23.30 |
| Rate for Payer: Aetna American Axle |
$15.91
|
| Rate for Payer: Aetna Commercial |
$20.81
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.71
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$16.76
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$21.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$22.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.36
|
| Rate for Payer: Mclaren Medicaid |
$10.20
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Medicaid |
$10.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.81
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$20.81
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.14
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health SBD |
$15.42
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.37
|
| Rate for Payer: UHC Core |
$22.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.64
|
| Rate for Payer: UHC Exchange |
$18.64
|
| Rate for Payer: UHC Medicare Advantage |
$19.20
|
| Rate for Payer: UMR Bronson Commercial |
$9.06
|
| Rate for Payer: VA VA |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.36
|
|
|
HC NORTRIPTYLINE LVL
|
Facility
|
IP
|
$43.00
|
|
|
Service Code
|
CPT 80335
|
| Hospital Charge Code |
30100592
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.92 |
| Max. Negotiated Rate |
$38.70 |
| Rate for Payer: Aetna American Axle |
$27.95
|
| Rate for Payer: Aetna Commercial |
$36.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.95
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$30.10
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.40
|
| Rate for Payer: Healthscope Commercial |
$38.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.55
|
| Rate for Payer: PHP Commercial |
$36.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health SBD |
$27.09
|
| Rate for Payer: UMR Bronson Commercial |
$18.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.25
|
|
|
HC NORTRIPTYLINE LVL
|
Facility
|
OP
|
$43.00
|
|
|
Service Code
|
CPT 80335
|
| Hospital Charge Code |
30100592
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.91 |
| Max. Negotiated Rate |
$38.70 |
| Rate for Payer: Aetna American Axle |
$27.95
|
| Rate for Payer: Aetna Commercial |
$36.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.95
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Cofinity Commercial |
$30.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.40
|
| Rate for Payer: Healthscope Commercial |
$38.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.55
|
| Rate for Payer: PHP Commercial |
$36.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health SBD |
$27.09
|
| Rate for Payer: UHC Core |
$29.23
|
| Rate for Payer: UMR Bronson Commercial |
$15.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.25
|
|
|
HC NOSEBLEED/ENT
|
Facility
|
IP
|
$406.40
|
|
| Hospital Charge Code |
45000061
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$178.82 |
| Max. Negotiated Rate |
$365.76 |
| Rate for Payer: Aetna American Axle |
$264.16
|
| Rate for Payer: Aetna Commercial |
$345.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.16
|
| Rate for Payer: Cash Price |
$325.12
|
| Rate for Payer: Cofinity Commercial |
$284.48
|
| Rate for Payer: Cofinity Commercial |
$349.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.12
|
| Rate for Payer: Healthscope Commercial |
$365.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$345.44
|
| Rate for Payer: PHP Commercial |
$345.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.48
|
| Rate for Payer: Priority Health SBD |
$256.03
|
| Rate for Payer: UMR Bronson Commercial |
$178.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.80
|
|
|
HC NOSEBLEED/ENT
|
Facility
|
OP
|
$406.40
|
|
| Hospital Charge Code |
45000061
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$150.37 |
| Max. Negotiated Rate |
$365.76 |
| Rate for Payer: Aetna American Axle |
$264.16
|
| Rate for Payer: Aetna Commercial |
$345.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.16
|
| Rate for Payer: BCBS Complete |
$162.56
|
| Rate for Payer: Cash Price |
$325.12
|
| Rate for Payer: Cofinity Commercial |
$284.48
|
| Rate for Payer: Cofinity Commercial |
$349.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.12
|
| Rate for Payer: Healthscope Commercial |
$365.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$345.44
|
| Rate for Payer: PHP Commercial |
$345.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.48
|
| Rate for Payer: Priority Health SBD |
$256.03
|
| Rate for Payer: UMR Bronson Commercial |
$150.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.80
|
|
|
HC NUC MED STRESS TEST
|
Facility
|
IP
|
$929.67
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200005
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$409.05 |
| Max. Negotiated Rate |
$836.70 |
| Rate for Payer: Aetna American Axle |
$604.29
|
| Rate for Payer: Aetna Commercial |
$790.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$604.29
|
| Rate for Payer: Cash Price |
$743.74
|
| Rate for Payer: Cofinity Commercial |
$650.77
|
| Rate for Payer: Cofinity Commercial |
$799.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$743.74
|
| Rate for Payer: Healthscope Commercial |
$836.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$650.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$697.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$790.22
|
| Rate for Payer: PHP Commercial |
$790.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$650.77
|
| Rate for Payer: Priority Health SBD |
$585.69
|
| Rate for Payer: UMR Bronson Commercial |
$409.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$697.25
|
|
|
HC NUC MED STRESS TEST
|
Facility
|
OP
|
$929.67
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200005
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$37.00 |
| Max. Negotiated Rate |
$878.32 |
| Rate for Payer: Aetna American Axle |
$604.29
|
| Rate for Payer: Aetna Commercial |
$790.22
|
| Rate for Payer: Aetna Medicare |
$290.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$604.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$175.93
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$743.74
|
| Rate for Payer: Cash Price |
$743.74
|
| Rate for Payer: Cash Price |
$743.74
|
| Rate for Payer: Cofinity Commercial |
$799.52
|
| Rate for Payer: Cofinity Commercial |
$650.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$743.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$836.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$650.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$697.25
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$790.22
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$790.22
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$650.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.32
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$702.66
|
| Rate for Payer: Priority Health SBD |
$585.69
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.70
|
| Rate for Payer: UHC Core |
$457.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
| Rate for Payer: UHC Exchange |
$37.00
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: UMR Bronson Commercial |
$343.98
|
| Rate for Payer: VA VA |
$279.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$697.25
|
|
|
HC NURSEMAID ELBOW REDUCTION
|
Facility
|
IP
|
$211.74
|
|
|
Service Code
|
CPT 24640
|
| Hospital Charge Code |
45000008
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.17 |
| Max. Negotiated Rate |
$190.57 |
| Rate for Payer: Aetna American Axle |
$137.63
|
| Rate for Payer: Aetna Commercial |
$179.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.63
|
| Rate for Payer: Cash Price |
$169.39
|
| Rate for Payer: Cofinity Commercial |
$148.22
|
| Rate for Payer: Cofinity Commercial |
$182.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.39
|
| Rate for Payer: Healthscope Commercial |
$190.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$179.98
|
| Rate for Payer: PHP Commercial |
$179.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.22
|
| Rate for Payer: Priority Health SBD |
$133.40
|
| Rate for Payer: UMR Bronson Commercial |
$93.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.80
|
|
