|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPINGLEVEL 31
|
Facility
|
IP
|
$3,150.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200369
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,386.00 |
| Max. Negotiated Rate |
$2,835.00 |
| Rate for Payer: Aetna American Axle |
$2,047.50
|
| Rate for Payer: Aetna Commercial |
$2,677.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,047.50
|
| Rate for Payer: Cash Price |
$2,520.00
|
| Rate for Payer: Cofinity Commercial |
$2,205.00
|
| Rate for Payer: Cofinity Commercial |
$2,709.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,205.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,520.00
|
| Rate for Payer: Healthscope Commercial |
$2,835.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,205.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,362.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,677.50
|
| Rate for Payer: PHP Commercial |
$2,677.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,047.50
|
| Rate for Payer: Priority Health SBD |
$1,984.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,386.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,362.50
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 39
|
Facility
|
OP
|
$3,988.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200371
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$3,589.20 |
| Rate for Payer: Aetna American Axle |
$2,592.20
|
| Rate for Payer: Aetna Commercial |
$3,389.80
|
| Rate for Payer: Aetna Medicare |
$1,994.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,592.20
|
| Rate for Payer: BCBS Complete |
$1,595.20
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$3,190.40
|
| Rate for Payer: Cash Price |
$3,190.40
|
| Rate for Payer: Cofinity Commercial |
$2,791.60
|
| Rate for Payer: Cofinity Commercial |
$3,429.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,791.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.40
|
| Rate for Payer: Healthscope Commercial |
$3,589.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,791.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,991.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,389.80
|
| Rate for Payer: PHP Commercial |
$3,389.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,592.20
|
| Rate for Payer: Priority Health SBD |
$2,512.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,475.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,991.00
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 39
|
Facility
|
IP
|
$3,988.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200371
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,754.72 |
| Max. Negotiated Rate |
$3,589.20 |
| Rate for Payer: Aetna American Axle |
$2,592.20
|
| Rate for Payer: Aetna Commercial |
$3,389.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,592.20
|
| Rate for Payer: Cash Price |
$3,190.40
|
| Rate for Payer: Cofinity Commercial |
$2,791.60
|
| Rate for Payer: Cofinity Commercial |
$3,429.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,791.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,190.40
|
| Rate for Payer: Healthscope Commercial |
$3,589.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,791.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,991.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,389.80
|
| Rate for Payer: PHP Commercial |
$3,389.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,592.20
|
| Rate for Payer: Priority Health SBD |
$2,512.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,754.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,991.00
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 46
|
Facility
|
OP
|
$4,620.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200372
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$4,158.00 |
| Rate for Payer: Aetna American Axle |
$3,003.00
|
| Rate for Payer: Aetna Commercial |
$3,927.00
|
| Rate for Payer: Aetna Medicare |
$2,310.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,003.00
|
| Rate for Payer: BCBS Complete |
$1,848.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$3,696.00
|
| Rate for Payer: Cash Price |
$3,696.00
|
| Rate for Payer: Cofinity Commercial |
$3,234.00
|
| Rate for Payer: Cofinity Commercial |
$3,973.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,234.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,696.00
|
| Rate for Payer: Healthscope Commercial |
$4,158.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,234.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,465.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,927.00
|
| Rate for Payer: PHP Commercial |
$3,927.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,003.00
|
| Rate for Payer: Priority Health SBD |
$2,910.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,709.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,465.00
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 46
|
Facility
|
IP
|
$4,620.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200372
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,032.80 |
| Max. Negotiated Rate |
$4,158.00 |
| Rate for Payer: Aetna American Axle |
$3,003.00
|
| Rate for Payer: Aetna Commercial |
$3,927.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,003.00
|
| Rate for Payer: Cash Price |
$3,696.00
|
| Rate for Payer: Cofinity Commercial |
$3,234.00
|
| Rate for Payer: Cofinity Commercial |
$3,973.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,234.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,696.00
|
| Rate for Payer: Healthscope Commercial |
$4,158.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,234.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,465.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,927.00
|
| Rate for Payer: PHP Commercial |
$3,927.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,003.00
|
| Rate for Payer: Priority Health SBD |
$2,910.60
|
| Rate for Payer: UMR Bronson Commercial |
$2,032.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,465.00
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 47
|
Facility
|
OP
|
$4,788.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200373
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$4,309.20 |
| Rate for Payer: Aetna American Axle |
$3,112.20
|
| Rate for Payer: Aetna Commercial |
$4,069.80
|
| Rate for Payer: Aetna Medicare |
$2,394.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,112.20
|
| Rate for Payer: BCBS Complete |
$1,915.20
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$3,830.40
|
| Rate for Payer: Cash Price |
$3,830.40
|
| Rate for Payer: Cofinity Commercial |
$3,351.60
|
| Rate for Payer: Cofinity Commercial |
$4,117.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,351.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,830.40
|
| Rate for Payer: Healthscope Commercial |
$4,309.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,351.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,591.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,069.80
|
| Rate for Payer: PHP Commercial |
$4,069.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,112.20
|
| Rate for Payer: Priority Health SBD |
$3,016.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,771.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,591.00
|
|
|
HC ELECTROPHYSIOLOGY CATH 3D OR VECTOR MAPPING LEVEL 47
|
Facility
|
IP
|
$4,788.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200373
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,106.72 |
| Max. Negotiated Rate |
$4,309.20 |
| Rate for Payer: UMR Bronson Commercial |
$2,106.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,591.00
|
| Rate for Payer: Aetna American Axle |
$3,112.20
|
| Rate for Payer: Aetna Commercial |
$4,069.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,112.20
|
| Rate for Payer: Cash Price |
$3,830.40
|
| Rate for Payer: Cofinity Commercial |
$3,351.60
|
| Rate for Payer: Cofinity Commercial |
$4,117.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,351.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,830.40
|
| Rate for Payer: Healthscope Commercial |
$4,309.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,351.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,591.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,069.80
|
| Rate for Payer: PHP Commercial |
$4,069.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,112.20
|
| Rate for Payer: Priority Health SBD |
$3,016.44
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 11
|
Facility
|
IP
|
$1,119.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$492.36 |
| Max. Negotiated Rate |
$1,007.10 |
| Rate for Payer: Aetna American Axle |
$727.35
|
| Rate for Payer: Aetna Commercial |
$951.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$727.35
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cofinity Commercial |
$783.30
|
| Rate for Payer: Cofinity Commercial |
$962.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$783.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.20
|
| Rate for Payer: Healthscope Commercial |
$1,007.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$783.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$839.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.15
|
| Rate for Payer: PHP Commercial |
$951.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$727.35
|
| Rate for Payer: Priority Health SBD |
$704.97
|
| Rate for Payer: UMR Bronson Commercial |
$492.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$839.25
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 11
|
Facility
|
OP
|
$1,119.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$1,007.10 |
| Rate for Payer: Aetna American Axle |
$727.35
|
| Rate for Payer: Aetna Commercial |
$951.15
|
| Rate for Payer: Aetna Medicare |
$559.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$727.35
|
| Rate for Payer: BCBS Complete |
$447.60
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cash Price |
$895.20
|
| Rate for Payer: Cofinity Commercial |
$783.30
|
| Rate for Payer: Cofinity Commercial |
$962.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$783.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$895.20
|
| Rate for Payer: Healthscope Commercial |
$1,007.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$783.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$839.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$951.15
|
| Rate for Payer: PHP Commercial |
$951.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$727.35
|
| Rate for Payer: Priority Health SBD |
$704.97
|
| Rate for Payer: UMR Bronson Commercial |
$414.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$839.25
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 13
|
Facility
|
IP
|
$1,342.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200375
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$590.70 |
| Max. Negotiated Rate |
$1,208.25 |
| Rate for Payer: Aetna American Axle |
$872.62
|
| Rate for Payer: Aetna Commercial |
$1,141.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.62
|
| Rate for Payer: Cash Price |
$1,074.00
|
| Rate for Payer: Cofinity Commercial |
$1,154.55
|
| Rate for Payer: Cofinity Commercial |
$939.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$939.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.00
|
| Rate for Payer: Healthscope Commercial |
$1,208.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$939.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,006.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,141.12
|
| Rate for Payer: PHP Commercial |
$1,141.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.62
|
| Rate for Payer: Priority Health SBD |
$845.78
|
| Rate for Payer: UMR Bronson Commercial |
$590.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,006.88
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 13
|
Facility
|
OP
|
$1,342.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200375
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$1,208.25 |
| Rate for Payer: Aetna American Axle |
$872.62
|
| Rate for Payer: Aetna Commercial |
$1,141.12
|
| Rate for Payer: Aetna Medicare |
$671.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$872.62
|
| Rate for Payer: BCBS Complete |
$537.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$1,074.00
|
| Rate for Payer: Cash Price |
$1,074.00
|
| Rate for Payer: Cofinity Commercial |
$1,154.55
|
| Rate for Payer: Cofinity Commercial |
$939.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$939.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,074.00
|
| Rate for Payer: Healthscope Commercial |
$1,208.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$939.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,006.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,141.12
|
| Rate for Payer: PHP Commercial |
$1,141.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$872.62
|
| Rate for Payer: Priority Health SBD |
$845.78
|
| Rate for Payer: UMR Bronson Commercial |
$496.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,006.88
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 15
|
Facility
|
IP
|
$1,537.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$676.50 |
| Max. Negotiated Rate |
$1,383.75 |
| Rate for Payer: Aetna American Axle |
$999.38
|
| Rate for Payer: Aetna Commercial |
$1,306.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$999.38
|
| Rate for Payer: Cash Price |
$1,230.00
|
| Rate for Payer: Cofinity Commercial |
$1,076.25
|
| Rate for Payer: Cofinity Commercial |
$1,322.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,076.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,230.00
|
| Rate for Payer: Healthscope Commercial |
$1,383.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,076.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,153.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.88
|
| Rate for Payer: PHP Commercial |
$1,306.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.38
|
| Rate for Payer: Priority Health SBD |
$968.62
|
| Rate for Payer: UMR Bronson Commercial |
$676.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,153.12
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 15
|
Facility
|
OP
|
$1,537.50
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$1,383.75 |
| Rate for Payer: Aetna American Axle |
$999.38
|
| Rate for Payer: Aetna Commercial |
$1,306.88
|
| Rate for Payer: Aetna Medicare |
$768.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$999.38
|
| Rate for Payer: BCBS Complete |
$615.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$1,230.00
|
| Rate for Payer: Cash Price |
$1,230.00
|
| Rate for Payer: Cofinity Commercial |
$1,076.25
|
| Rate for Payer: Cofinity Commercial |
$1,322.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,076.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,230.00
|
| Rate for Payer: Healthscope Commercial |
$1,383.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,076.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,153.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,306.88
|
| Rate for Payer: PHP Commercial |
$1,306.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$999.38
|
| Rate for Payer: Priority Health SBD |
$968.62
|
| Rate for Payer: UMR Bronson Commercial |
$568.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,153.12
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 37
|
Facility
|
IP
|
$3,750.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200365
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,650.00 |
| Max. Negotiated Rate |
$3,375.00 |
| Rate for Payer: Cofinity Commercial |
$2,625.00
|
| Rate for Payer: Cofinity Commercial |
$3,225.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,625.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,000.00
|
| Rate for Payer: Healthscope Commercial |
$3,375.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,625.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,812.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,187.50
|
| Rate for Payer: PHP Commercial |
$3,187.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,437.50
|
| Rate for Payer: Priority Health SBD |
$2,362.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,650.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,812.50
|
| Rate for Payer: Aetna American Axle |
$2,437.50
|
| Rate for Payer: Aetna Commercial |
$3,187.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,437.50
|
| Rate for Payer: Cash Price |
$3,000.00
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 37
|
Facility
|
OP
|
$3,750.00
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200365
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$3,375.00 |
| Rate for Payer: Aetna American Axle |
$2,437.50
|
| Rate for Payer: Aetna Commercial |
$3,187.50
|
| Rate for Payer: Aetna Medicare |
$1,875.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,437.50
|
| Rate for Payer: BCBS Complete |
$1,500.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$3,000.00
|
| Rate for Payer: Cash Price |
$3,000.00
|
| Rate for Payer: Cofinity Commercial |
$2,625.00
|
| Rate for Payer: Cofinity Commercial |
$3,225.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,625.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,000.00
|
| Rate for Payer: Healthscope Commercial |
$3,375.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,625.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,812.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,187.50
|
| Rate for Payer: PHP Commercial |
$3,187.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,437.50
|
| Rate for Payer: Priority Health SBD |
$2,362.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,387.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,812.50
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 4
|
Facility
|
OP
|
$438.60
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200360
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$394.74 |
| Rate for Payer: Aetna American Axle |
$285.09
|
| Rate for Payer: Aetna Commercial |
$372.81
|
| Rate for Payer: Aetna Medicare |
$219.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.09
|
| Rate for Payer: BCBS Complete |
$175.44
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cofinity Commercial |
$307.02
|
| Rate for Payer: Cofinity Commercial |
$377.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$307.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.88
|
| Rate for Payer: Healthscope Commercial |
$394.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$307.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.81
|
| Rate for Payer: PHP Commercial |
$372.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.09
|
| Rate for Payer: Priority Health SBD |
$276.32
|
| Rate for Payer: UMR Bronson Commercial |
$162.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.95
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 19 OR < ELECTRODES LEVEL 4
|
Facility
|
IP
|
$438.60
|
|
|
Service Code
|
HCPCS C1730
|
| Hospital Charge Code |
27200360
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$192.98 |
| Max. Negotiated Rate |
$394.74 |
| Rate for Payer: Aetna American Axle |
$285.09
|
| Rate for Payer: Aetna Commercial |
$372.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.09
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cofinity Commercial |
$307.02
|
| Rate for Payer: Cofinity Commercial |
$377.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$307.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.88
|
| Rate for Payer: Healthscope Commercial |
$394.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$307.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.81
|
| Rate for Payer: PHP Commercial |
$372.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.09
|
| Rate for Payer: Priority Health SBD |
$276.32
|
| Rate for Payer: UMR Bronson Commercial |
$192.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.95
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 25
|
Facility
|
OP
|
$2,500.00
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$2,250.00 |
| Rate for Payer: Aetna American Axle |
$1,625.00
|
| Rate for Payer: Aetna Commercial |
$2,125.00
|
| Rate for Payer: Aetna Medicare |
$1,250.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,625.00
|
| Rate for Payer: BCBS Complete |
$1,000.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cofinity Commercial |
$1,750.00
|
| Rate for Payer: Cofinity Commercial |
$2,150.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,750.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,000.00
|
| Rate for Payer: Healthscope Commercial |
$2,250.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,750.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,875.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,125.00
|
| Rate for Payer: PHP Commercial |
$2,125.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,625.00
|
| Rate for Payer: Priority Health SBD |
$1,575.00
|
| Rate for Payer: UMR Bronson Commercial |
$925.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,875.00
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 25
|
Facility
|
IP
|
$2,500.00
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,100.00 |
| Max. Negotiated Rate |
$2,250.00 |
| Rate for Payer: Aetna American Axle |
$1,625.00
|
| Rate for Payer: Aetna Commercial |
$2,125.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,625.00
|
| Rate for Payer: Cash Price |
$2,000.00
|
| Rate for Payer: Cofinity Commercial |
$1,750.00
|
| Rate for Payer: Cofinity Commercial |
$2,150.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,750.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,000.00
|
| Rate for Payer: Healthscope Commercial |
$2,250.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,750.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,875.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,125.00
|
| Rate for Payer: PHP Commercial |
$2,125.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,625.00
|
| Rate for Payer: Priority Health SBD |
$1,575.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,100.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,875.00
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 32
|
Facility
|
IP
|
$3,242.50
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,426.70 |
| Max. Negotiated Rate |
$2,918.25 |
| Rate for Payer: Aetna American Axle |
$2,107.62
|
| Rate for Payer: Aetna Commercial |
$2,756.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,107.62
|
| Rate for Payer: Cash Price |
$2,594.00
|
| Rate for Payer: Cofinity Commercial |
$2,269.75
|
| Rate for Payer: Cofinity Commercial |
$2,788.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,269.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,594.00
|
| Rate for Payer: Healthscope Commercial |
$2,918.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,269.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,431.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,756.12
|
| Rate for Payer: PHP Commercial |
$2,756.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,107.62
|
| Rate for Payer: Priority Health SBD |
$2,042.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,426.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,431.88
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 32
|
Facility
|
OP
|
$3,242.50
|
|
|
Service Code
|
HCPCS C1731
|
| Hospital Charge Code |
27200368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$2,918.25 |
| Rate for Payer: Aetna American Axle |
$2,107.62
|
| Rate for Payer: Aetna Commercial |
$2,756.12
|
| Rate for Payer: Aetna Medicare |
$1,621.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,107.62
|
| Rate for Payer: BCBS Complete |
$1,297.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$2,594.00
|
| Rate for Payer: Cash Price |
$2,594.00
|
| Rate for Payer: Cofinity Commercial |
$2,269.75
|
| Rate for Payer: Cofinity Commercial |
$2,788.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,269.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,594.00
|
| Rate for Payer: Healthscope Commercial |
$2,918.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,269.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,431.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,756.12
|
| Rate for Payer: PHP Commercial |
$2,756.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,107.62
|
| Rate for Payer: Priority Health SBD |
$2,042.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,199.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,431.88
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 8
|
Facility
|
IP
|
$825.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200376
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$363.00 |
| Max. Negotiated Rate |
$742.50 |
| Rate for Payer: Aetna American Axle |
$536.25
|
| Rate for Payer: Aetna Commercial |
$701.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.25
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$577.50
|
| Rate for Payer: Cofinity Commercial |
$709.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$577.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.00
|
| Rate for Payer: Healthscope Commercial |
$742.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$577.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$618.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.25
|
| Rate for Payer: PHP Commercial |
$701.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.25
|
| Rate for Payer: Priority Health SBD |
$519.75
|
| Rate for Payer: UMR Bronson Commercial |
$363.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$618.75
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 8
|
Facility
|
OP
|
$825.00
|
|
|
Service Code
|
HCPCS C1732
|
| Hospital Charge Code |
27200376
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$742.50 |
| Rate for Payer: Aetna American Axle |
$536.25
|
| Rate for Payer: Aetna Commercial |
$701.25
|
| Rate for Payer: Aetna Medicare |
$412.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$536.25
|
| Rate for Payer: BCBS Complete |
$330.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cash Price |
$660.00
|
| Rate for Payer: Cofinity Commercial |
$577.50
|
| Rate for Payer: Cofinity Commercial |
$709.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$577.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$660.00
|
| Rate for Payer: Healthscope Commercial |
$742.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$577.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$618.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$701.25
|
| Rate for Payer: PHP Commercial |
$701.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.25
|
| Rate for Payer: Priority Health SBD |
$519.75
|
| Rate for Payer: UMR Bronson Commercial |
$305.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$618.75
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 9
|
Facility
|
IP
|
$900.00
|
|
|
Service Code
|
CPT C1731
|
| Hospital Charge Code |
27200366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$396.00 |
| Max. Negotiated Rate |
$810.00 |
| Rate for Payer: Aetna American Axle |
$585.00
|
| Rate for Payer: Aetna Commercial |
$765.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$585.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cofinity Commercial |
$630.00
|
| Rate for Payer: Cofinity Commercial |
$774.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$630.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.00
|
| Rate for Payer: Healthscope Commercial |
$810.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$630.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$675.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$765.00
|
| Rate for Payer: PHP Commercial |
$765.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.00
|
| Rate for Payer: Priority Health SBD |
$567.00
|
| Rate for Payer: UMR Bronson Commercial |
$396.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$675.00
|
|
|
HC ELECTROPHYSIOLOGY CATH NO 3D 20 OR > ELECTRODES LEVEL 9
|
Facility
|
OP
|
$900.00
|
|
|
Service Code
|
CPT C1731
|
| Hospital Charge Code |
27200366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$810.00 |
| Rate for Payer: Aetna American Axle |
$585.00
|
| Rate for Payer: Aetna Commercial |
$765.00
|
| Rate for Payer: Aetna Medicare |
$450.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$585.00
|
| Rate for Payer: BCBS Complete |
$360.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cofinity Commercial |
$630.00
|
| Rate for Payer: Cofinity Commercial |
$774.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$630.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$720.00
|
| Rate for Payer: Healthscope Commercial |
$810.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$630.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$675.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$765.00
|
| Rate for Payer: PHP Commercial |
$765.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.00
|
| Rate for Payer: Priority Health SBD |
$567.00
|
| Rate for Payer: UMR Bronson Commercial |
$333.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$675.00
|
|
