|
HC OXYTOCIN CHALLENGE TEST
|
Facility
|
IP
|
$786.48
|
|
|
Service Code
|
CPT 59020
|
| Hospital Charge Code |
92000003
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$346.05 |
| Max. Negotiated Rate |
$707.83 |
| Rate for Payer: Aetna American Axle |
$511.21
|
| Rate for Payer: Aetna Commercial |
$668.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.21
|
| Rate for Payer: Cash Price |
$629.18
|
| Rate for Payer: Cofinity Commercial |
$550.54
|
| Rate for Payer: Cofinity Commercial |
$676.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$629.18
|
| Rate for Payer: Healthscope Commercial |
$707.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$550.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$589.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$668.51
|
| Rate for Payer: PHP Commercial |
$668.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$550.54
|
| Rate for Payer: Priority Health SBD |
$495.48
|
| Rate for Payer: UMR Bronson Commercial |
$346.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$589.86
|
|
|
HC OYSTER IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200053
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.70
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.16
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$5.73
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: UMR Bronson Commercial |
$9.21
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC OYSTER IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200053
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: UMR Bronson Commercial |
$10.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC PACEMAKER DUAL CHAMBER LVL 7
|
Facility
|
IP
|
$7,952.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500354
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,498.88 |
| Max. Negotiated Rate |
$7,156.80 |
| Rate for Payer: Aetna American Axle |
$5,168.80
|
| Rate for Payer: Aetna Commercial |
$6,759.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,168.80
|
| Rate for Payer: Cash Price |
$6,361.60
|
| Rate for Payer: Cofinity Commercial |
$5,566.40
|
| Rate for Payer: Cofinity Commercial |
$6,838.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,361.60
|
| Rate for Payer: Healthscope Commercial |
$7,156.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,566.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,964.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,759.20
|
| Rate for Payer: PHP Commercial |
$6,759.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,566.40
|
| Rate for Payer: Priority Health SBD |
$5,009.76
|
| Rate for Payer: UMR Bronson Commercial |
$3,498.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,964.00
|
|
|
HC PACEMAKER DUAL CHAMBER LVL 7
|
Facility
|
OP
|
$7,952.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500354
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,942.24 |
| Max. Negotiated Rate |
$7,156.80 |
| Rate for Payer: Aetna American Axle |
$5,168.80
|
| Rate for Payer: Aetna Commercial |
$6,759.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,168.80
|
| Rate for Payer: BCBS Complete |
$3,180.80
|
| Rate for Payer: Cash Price |
$6,361.60
|
| Rate for Payer: Cofinity Commercial |
$5,566.40
|
| Rate for Payer: Cofinity Commercial |
$6,838.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,361.60
|
| Rate for Payer: Healthscope Commercial |
$7,156.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,566.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,964.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,759.20
|
| Rate for Payer: PHP Commercial |
$6,759.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,566.40
|
| Rate for Payer: Priority Health SBD |
$5,009.76
|
| Rate for Payer: UMR Bronson Commercial |
$2,942.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,964.00
|
|
|
HC PACEMAKER DUAL CHAMBER LVL 9
|
Facility
|
IP
|
$9,052.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500349
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,982.88 |
| Max. Negotiated Rate |
$8,146.80 |
| Rate for Payer: Aetna American Axle |
$5,883.80
|
| Rate for Payer: Aetna Commercial |
$7,694.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,883.80
|
| Rate for Payer: Cash Price |
$7,241.60
|
| Rate for Payer: Cofinity Commercial |
$6,336.40
|
| Rate for Payer: Cofinity Commercial |
$7,784.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,241.60
|
| Rate for Payer: Healthscope Commercial |
$8,146.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,336.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,789.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,694.20
|
| Rate for Payer: PHP Commercial |
$7,694.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,336.40
|
| Rate for Payer: Priority Health SBD |
$5,702.76
|
| Rate for Payer: UMR Bronson Commercial |
$3,982.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,789.00
|
|
|
HC PACEMAKER DUAL CHAMBER LVL 9
|
Facility
|
OP
|
$9,052.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500349
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,349.24 |
| Max. Negotiated Rate |
$8,146.80 |
| Rate for Payer: Aetna American Axle |
$5,883.80
|
| Rate for Payer: Aetna Commercial |
$7,694.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,883.80
|
| Rate for Payer: BCBS Complete |
$3,620.80
|
| Rate for Payer: Cash Price |
$7,241.60
|
| Rate for Payer: Cofinity Commercial |
$6,336.40
|
| Rate for Payer: Cofinity Commercial |
$7,784.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,241.60
|
| Rate for Payer: Healthscope Commercial |
$8,146.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,336.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,789.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,694.20
|
| Rate for Payer: PHP Commercial |
$7,694.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,336.40
|
| Rate for Payer: Priority Health SBD |
$5,702.76
|
| Rate for Payer: UMR Bronson Commercial |
$3,349.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,789.00
|
|
|
HC PACEMAKER IMPLANT, DUAL
|
Facility
|
IP
|
$17,588.23
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
36100059
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,738.82 |
| Max. Negotiated Rate |
$15,829.41 |
| Rate for Payer: Aetna American Axle |
$11,432.35
|
| Rate for Payer: Aetna Commercial |
$14,950.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,432.35
|
| Rate for Payer: Cash Price |
$14,070.58
|
| Rate for Payer: Cofinity Commercial |
$12,311.76
|
| Rate for Payer: Cofinity Commercial |
$15,125.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,070.58
|
| Rate for Payer: Healthscope Commercial |
$15,829.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,311.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,191.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,950.00
|
| Rate for Payer: PHP Commercial |
$14,950.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,311.76
|
| Rate for Payer: Priority Health SBD |
$11,080.58
|
| Rate for Payer: UMR Bronson Commercial |
$7,738.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,191.17
|
|
|
HC PACEMAKER IMPLANT, DUAL
|
Facility
|
OP
|
$17,588.23
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
36100059
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$499.35 |
| Max. Negotiated Rate |
$29,880.23 |
| Rate for Payer: Aetna American Axle |
$11,432.35
|
| Rate for Payer: Aetna Commercial |
$14,950.00
|
| Rate for Payer: Aetna Medicare |
$9,871.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,432.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,864.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11,864.60
|
| Rate for Payer: BCBS Complete |
$5,452.02
|
| Rate for Payer: BCBS MAPPO |
$9,491.68
|
| Rate for Payer: BCBS Trust/PPO |
$13,083.77
|
| Rate for Payer: BCN Medicare Advantage |
$9,491.68
|
| Rate for Payer: Cash Price |
$14,070.58
|
| Rate for Payer: Cash Price |
$14,070.58
|
| Rate for Payer: Cofinity Commercial |
$12,311.76
|
| Rate for Payer: Cofinity Commercial |
$15,125.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,070.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,491.68
|
| Rate for Payer: Healthscope Commercial |
$15,829.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,311.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,191.17
|
| Rate for Payer: Mclaren Medicaid |
$5,191.95
|
| Rate for Payer: Mclaren Medicare |
$9,491.68
|
| Rate for Payer: Meridian Medicaid |
$5,452.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,966.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,915.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,950.00
|
| Rate for Payer: PACE Medicare |
$9,017.10
|
| Rate for Payer: PACE SWMI |
$9,491.68
|
| Rate for Payer: PHP Commercial |
$14,950.00
|
| Rate for Payer: PHP Medicare Advantage |
$9,491.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,191.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,311.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29,880.23
|
| Rate for Payer: Priority Health Medicare |
$9,491.68
|
| Rate for Payer: Priority Health Narrow Network |
$23,904.18
|
| Rate for Payer: Priority Health SBD |
$11,080.58
|
| Rate for Payer: Railroad Medicare Medicare |
$9,491.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.28
|
| Rate for Payer: UHC Core |
$18,337.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,491.68
|
| Rate for Payer: UHC Exchange |
$499.35
|
| Rate for Payer: UHC Medicare Advantage |
$9,776.43
|
| Rate for Payer: UMR Bronson Commercial |
$6,507.65
|
| Rate for Payer: VA VA |
$9,491.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,191.17
|
|
|
HC PACEMAKER LEAD
|
Facility
|
OP
|
$1,911.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800024
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$707.07 |
| Max. Negotiated Rate |
$1,719.90 |
| Rate for Payer: Aetna American Axle |
$1,242.15
|
| Rate for Payer: Aetna Commercial |
$1,624.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,242.15
|
| Rate for Payer: BCBS Complete |
$764.40
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cofinity Commercial |
$1,337.70
|
| Rate for Payer: Cofinity Commercial |
$1,643.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,528.80
|
| Rate for Payer: Healthscope Commercial |
$1,719.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,337.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,433.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,624.35
|
| Rate for Payer: PHP Commercial |
$1,624.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,337.70
|
| Rate for Payer: Priority Health SBD |
$1,203.93
|
| Rate for Payer: UMR Bronson Commercial |
$707.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,433.25
|
|
|
HC PACEMAKER LEAD
|
Facility
|
IP
|
$1,911.00
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800024
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$840.84 |
| Max. Negotiated Rate |
$1,719.90 |
| Rate for Payer: Aetna American Axle |
$1,242.15
|
| Rate for Payer: Aetna Commercial |
$1,624.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,242.15
|
| Rate for Payer: Cash Price |
$1,528.80
|
| Rate for Payer: Cofinity Commercial |
$1,337.70
|
| Rate for Payer: Cofinity Commercial |
$1,643.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,528.80
|
| Rate for Payer: Healthscope Commercial |
$1,719.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,337.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,433.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,624.35
|
| Rate for Payer: PHP Commercial |
$1,624.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,337.70
|
| Rate for Payer: Priority Health SBD |
$1,203.93
|
| Rate for Payer: UMR Bronson Commercial |
$840.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,433.25
|
|
|
HC PACEMAKER OTHER SINGLE OR DUAL LVL 11
|
Facility
|
OP
|
$11,889.00
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500348
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,398.93 |
| Max. Negotiated Rate |
$10,700.10 |
| Rate for Payer: Aetna American Axle |
$7,727.85
|
| Rate for Payer: Aetna Commercial |
$10,105.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,727.85
|
| Rate for Payer: BCBS Complete |
$4,755.60
|
| Rate for Payer: Cash Price |
$9,511.20
|
| Rate for Payer: Cofinity Commercial |
$10,224.54
|
| Rate for Payer: Cofinity Commercial |
$8,322.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,511.20
|
| Rate for Payer: Healthscope Commercial |
$10,700.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,322.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,916.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,105.65
|
| Rate for Payer: PHP Commercial |
$10,105.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,322.30
|
| Rate for Payer: Priority Health SBD |
$7,490.07
|
| Rate for Payer: UMR Bronson Commercial |
$4,398.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,916.75
|
|
|
HC PACEMAKER OTHER SINGLE OR DUAL LVL 11
|
Facility
|
IP
|
$11,889.00
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500348
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,231.16 |
| Max. Negotiated Rate |
$10,700.10 |
| Rate for Payer: Aetna American Axle |
$7,727.85
|
| Rate for Payer: Aetna Commercial |
$10,105.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,727.85
|
| Rate for Payer: Cash Price |
$9,511.20
|
| Rate for Payer: Cofinity Commercial |
$10,224.54
|
| Rate for Payer: Cofinity Commercial |
$8,322.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,511.20
|
| Rate for Payer: Healthscope Commercial |
$10,700.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,322.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,916.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,105.65
|
| Rate for Payer: PHP Commercial |
$10,105.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,322.30
|
| Rate for Payer: Priority Health SBD |
$7,490.07
|
| Rate for Payer: UMR Bronson Commercial |
$5,231.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,916.75
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 13
|
Facility
|
OP
|
$13,500.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500351
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,995.00 |
| Max. Negotiated Rate |
$12,150.00 |
| Rate for Payer: Aetna American Axle |
$8,775.00
|
| Rate for Payer: Aetna Commercial |
$11,475.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,775.00
|
| Rate for Payer: BCBS Complete |
$5,400.00
|
| Rate for Payer: Cash Price |
$10,800.00
|
| Rate for Payer: Cofinity Commercial |
$11,610.00
|
| Rate for Payer: Cofinity Commercial |
$9,450.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,800.00
|
| Rate for Payer: Healthscope Commercial |
$12,150.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,450.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,475.00
|
| Rate for Payer: PHP Commercial |
$11,475.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,450.00
|
| Rate for Payer: Priority Health SBD |
$8,505.00
|
| Rate for Payer: UMR Bronson Commercial |
$4,995.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,125.00
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 13
|
Facility
|
IP
|
$13,500.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500351
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,940.00 |
| Max. Negotiated Rate |
$12,150.00 |
| Rate for Payer: Aetna American Axle |
$8,775.00
|
| Rate for Payer: Aetna Commercial |
$11,475.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,775.00
|
| Rate for Payer: Cash Price |
$10,800.00
|
| Rate for Payer: Cofinity Commercial |
$11,610.00
|
| Rate for Payer: Cofinity Commercial |
$9,450.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,800.00
|
| Rate for Payer: Healthscope Commercial |
$12,150.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,450.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$11,475.00
|
| Rate for Payer: PHP Commercial |
$11,475.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,450.00
|
| Rate for Payer: Priority Health SBD |
$8,505.00
|
| Rate for Payer: UMR Bronson Commercial |
$5,940.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,125.00
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 16
|
Facility
|
IP
|
$16,532.50
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500350
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$7,274.30 |
| Max. Negotiated Rate |
$14,879.25 |
| Rate for Payer: Aetna American Axle |
$10,746.12
|
| Rate for Payer: Aetna Commercial |
$14,052.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,746.12
|
| Rate for Payer: Cash Price |
$13,226.00
|
| Rate for Payer: Cofinity Commercial |
$11,572.75
|
| Rate for Payer: Cofinity Commercial |
$14,217.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,226.00
|
| Rate for Payer: Healthscope Commercial |
$14,879.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,572.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,399.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,052.62
|
| Rate for Payer: PHP Commercial |
$14,052.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,572.75
|
| Rate for Payer: Priority Health SBD |
$10,415.48
|
| Rate for Payer: UMR Bronson Commercial |
$7,274.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,399.38
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 16
|
Facility
|
OP
|
$16,532.50
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500350
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,117.02 |
| Max. Negotiated Rate |
$14,879.25 |
| Rate for Payer: Aetna American Axle |
$10,746.12
|
| Rate for Payer: Aetna Commercial |
$14,052.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,746.12
|
| Rate for Payer: BCBS Complete |
$6,613.00
|
| Rate for Payer: Cash Price |
$13,226.00
|
| Rate for Payer: Cofinity Commercial |
$11,572.75
|
| Rate for Payer: Cofinity Commercial |
$14,217.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,226.00
|
| Rate for Payer: Healthscope Commercial |
$14,879.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,572.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,399.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,052.62
|
| Rate for Payer: PHP Commercial |
$14,052.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,572.75
|
| Rate for Payer: Priority Health SBD |
$10,415.48
|
| Rate for Payer: UMR Bronson Commercial |
$6,117.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,399.38
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 6
|
Facility
|
IP
|
$6,196.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500352
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,726.24 |
| Max. Negotiated Rate |
$5,576.40 |
| Rate for Payer: Aetna American Axle |
$4,027.40
|
| Rate for Payer: Aetna Commercial |
$5,266.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,027.40
|
| Rate for Payer: Cash Price |
$4,956.80
|
| Rate for Payer: Cofinity Commercial |
$4,337.20
|
| Rate for Payer: Cofinity Commercial |
$5,328.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,956.80
|
| Rate for Payer: Healthscope Commercial |
$5,576.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,337.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,647.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,266.60
|
| Rate for Payer: PHP Commercial |
$5,266.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,337.20
|
| Rate for Payer: Priority Health SBD |
$3,903.48
|
| Rate for Payer: UMR Bronson Commercial |
$2,726.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,647.00
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 6
|
Facility
|
OP
|
$6,196.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500352
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,292.52 |
| Max. Negotiated Rate |
$5,576.40 |
| Rate for Payer: Aetna American Axle |
$4,027.40
|
| Rate for Payer: Aetna Commercial |
$5,266.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,027.40
|
| Rate for Payer: BCBS Complete |
$2,478.40
|
| Rate for Payer: Cash Price |
$4,956.80
|
| Rate for Payer: Cofinity Commercial |
$4,337.20
|
| Rate for Payer: Cofinity Commercial |
$5,328.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,956.80
|
| Rate for Payer: Healthscope Commercial |
$5,576.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,337.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,647.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,266.60
|
| Rate for Payer: PHP Commercial |
$5,266.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,337.20
|
| Rate for Payer: Priority Health SBD |
$3,903.48
|
| Rate for Payer: UMR Bronson Commercial |
$2,292.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,647.00
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 8
|
Facility
|
IP
|
$8,152.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500353
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,586.88 |
| Max. Negotiated Rate |
$7,336.80 |
| Rate for Payer: Aetna American Axle |
$5,298.80
|
| Rate for Payer: Aetna Commercial |
$6,929.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,298.80
|
| Rate for Payer: Cash Price |
$6,521.60
|
| Rate for Payer: Cofinity Commercial |
$5,706.40
|
| Rate for Payer: Cofinity Commercial |
$7,010.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,521.60
|
| Rate for Payer: Healthscope Commercial |
$7,336.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,706.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,114.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,929.20
|
| Rate for Payer: PHP Commercial |
$6,929.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,706.40
|
| Rate for Payer: Priority Health SBD |
$5,135.76
|
| Rate for Payer: UMR Bronson Commercial |
$3,586.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,114.00
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 8
|
Facility
|
OP
|
$8,152.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500353
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,016.24 |
| Max. Negotiated Rate |
$7,336.80 |
| Rate for Payer: Aetna American Axle |
$5,298.80
|
| Rate for Payer: Aetna Commercial |
$6,929.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,298.80
|
| Rate for Payer: BCBS Complete |
$3,260.80
|
| Rate for Payer: Cash Price |
$6,521.60
|
| Rate for Payer: Cofinity Commercial |
$5,706.40
|
| Rate for Payer: Cofinity Commercial |
$7,010.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,521.60
|
| Rate for Payer: Healthscope Commercial |
$7,336.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,706.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,114.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,929.20
|
| Rate for Payer: PHP Commercial |
$6,929.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,706.40
|
| Rate for Payer: Priority Health SBD |
$5,135.76
|
| Rate for Payer: UMR Bronson Commercial |
$3,016.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,114.00
|
|
|
HC PACEMAKER TESTING CABLE
|
Facility
|
IP
|
$112.44
|
|
| Hospital Charge Code |
27200143
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.47 |
| Max. Negotiated Rate |
$101.20 |
| Rate for Payer: Aetna American Axle |
$73.09
|
| Rate for Payer: Aetna Commercial |
$95.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.09
|
| Rate for Payer: Cash Price |
$89.95
|
| Rate for Payer: Cofinity Commercial |
$78.71
|
| Rate for Payer: Cofinity Commercial |
$96.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.95
|
| Rate for Payer: Healthscope Commercial |
$101.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$95.57
|
| Rate for Payer: PHP Commercial |
$95.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.71
|
| Rate for Payer: Priority Health SBD |
$70.84
|
| Rate for Payer: UMR Bronson Commercial |
$49.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.33
|
|
|
HC PACEMAKER TESTING CABLE
|
Facility
|
OP
|
$112.44
|
|
| Hospital Charge Code |
27200143
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.60 |
| Max. Negotiated Rate |
$101.20 |
| Rate for Payer: Aetna American Axle |
$73.09
|
| Rate for Payer: Aetna Commercial |
$95.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.09
|
| Rate for Payer: BCBS Complete |
$44.98
|
| Rate for Payer: Cash Price |
$89.95
|
| Rate for Payer: Cofinity Commercial |
$78.71
|
| Rate for Payer: Cofinity Commercial |
$96.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.95
|
| Rate for Payer: Healthscope Commercial |
$101.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$95.57
|
| Rate for Payer: PHP Commercial |
$95.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.71
|
| Rate for Payer: Priority Health SBD |
$70.84
|
| Rate for Payer: UMR Bronson Commercial |
$41.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.33
|
|
|
HC PACER POCKET REVISION
|
Facility
|
OP
|
$2,701.70
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
36100067
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$333.34 |
| Max. Negotiated Rate |
$5,102.91 |
| Rate for Payer: Aetna American Axle |
$1,756.10
|
| Rate for Payer: Aetna Commercial |
$2,296.44
|
| Rate for Payer: Aetna Medicare |
$1,685.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,756.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,336.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Cash Price |
$2,161.36
|
| Rate for Payer: Cash Price |
$2,161.36
|
| Rate for Payer: Cofinity Commercial |
$2,323.46
|
| Rate for Payer: Cofinity Commercial |
$1,891.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,161.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Healthscope Commercial |
$2,431.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,891.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,026.28
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,296.44
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Commercial |
$2,296.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,891.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,102.91
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$4,082.33
|
| Rate for Payer: Priority Health SBD |
$1,702.07
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.67
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,620.98
|
| Rate for Payer: UHC Exchange |
$333.34
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: UMR Bronson Commercial |
$999.63
|
| Rate for Payer: VA VA |
$1,620.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,026.28
|
|
|
HC PACER POCKET REVISION
|
Facility
|
IP
|
$2,701.70
|
|
|
Service Code
|
CPT 33222
|
| Hospital Charge Code |
36100067
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,188.75 |
| Max. Negotiated Rate |
$2,431.53 |
| Rate for Payer: Aetna American Axle |
$1,756.10
|
| Rate for Payer: Aetna Commercial |
$2,296.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,756.10
|
| Rate for Payer: Cash Price |
$2,161.36
|
| Rate for Payer: Cofinity Commercial |
$1,891.19
|
| Rate for Payer: Cofinity Commercial |
$2,323.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,161.36
|
| Rate for Payer: Healthscope Commercial |
$2,431.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,891.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,026.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,296.44
|
| Rate for Payer: PHP Commercial |
$2,296.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,891.19
|
| Rate for Payer: Priority Health SBD |
$1,702.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,188.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,026.28
|
|
