|
HC EMBOLIC GLUE LVL 1
|
Facility
|
IP
|
$5,656.01
|
|
| Hospital Charge Code |
27800050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,488.64 |
| Max. Negotiated Rate |
$5,090.41 |
| Rate for Payer: Aetna American Axle |
$3,676.41
|
| Rate for Payer: Aetna Commercial |
$4,807.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,676.41
|
| Rate for Payer: Cash Price |
$4,524.81
|
| Rate for Payer: Cofinity Commercial |
$3,959.21
|
| Rate for Payer: Cofinity Commercial |
$4,864.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,959.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,524.81
|
| Rate for Payer: Healthscope Commercial |
$5,090.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,959.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,242.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,807.61
|
| Rate for Payer: PHP Commercial |
$4,807.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,676.41
|
| Rate for Payer: Priority Health SBD |
$3,563.29
|
| Rate for Payer: UMR Bronson Commercial |
$2,488.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,242.01
|
|
|
HC EMBOLIC GLUE LVL 1
|
Facility
|
OP
|
$5,656.01
|
|
| Hospital Charge Code |
27800050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,092.72 |
| Max. Negotiated Rate |
$5,090.41 |
| Rate for Payer: Aetna American Axle |
$3,676.41
|
| Rate for Payer: Aetna Commercial |
$4,807.61
|
| Rate for Payer: Aetna Medicare |
$2,828.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,676.41
|
| Rate for Payer: BCBS Complete |
$2,262.40
|
| Rate for Payer: Cash Price |
$4,524.81
|
| Rate for Payer: Cofinity Commercial |
$3,959.21
|
| Rate for Payer: Cofinity Commercial |
$4,864.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,959.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,524.81
|
| Rate for Payer: Healthscope Commercial |
$5,090.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,959.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,242.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,807.61
|
| Rate for Payer: PHP Commercial |
$4,807.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,676.41
|
| Rate for Payer: Priority Health SBD |
$3,563.29
|
| Rate for Payer: UMR Bronson Commercial |
$2,092.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,242.01
|
|
|
HC EMBOLI DETECTION WITH BUBBLE STUDY
|
Facility
|
IP
|
$2,046.45
|
|
|
Service Code
|
CPT 93893
|
| Hospital Charge Code |
92100035
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$900.44 |
| Max. Negotiated Rate |
$1,841.81 |
| Rate for Payer: Aetna American Axle |
$1,330.19
|
| Rate for Payer: Aetna Commercial |
$1,739.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,330.19
|
| Rate for Payer: Cash Price |
$1,637.16
|
| Rate for Payer: Cofinity Commercial |
$1,432.52
|
| Rate for Payer: Cofinity Commercial |
$1,759.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,432.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,637.16
|
| Rate for Payer: Healthscope Commercial |
$1,841.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,432.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,534.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,739.48
|
| Rate for Payer: PHP Commercial |
$1,739.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,330.19
|
| Rate for Payer: Priority Health SBD |
$1,289.26
|
| Rate for Payer: UMR Bronson Commercial |
$900.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,534.84
|
|
|
HC EMBOLI DETECTION WITH BUBBLE STUDY
|
Facility
|
OP
|
$2,046.45
|
|
|
Service Code
|
CPT 93893
|
| Hospital Charge Code |
92100035
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$1,841.81 |
| Rate for Payer: Aetna American Axle |
$1,330.19
|
| Rate for Payer: Aetna Commercial |
$1,739.48
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,330.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$1,637.16
|
| Rate for Payer: Cash Price |
$1,637.16
|
| Rate for Payer: Cash Price |
$1,637.16
|
| Rate for Payer: Cofinity Commercial |
$1,432.52
|
| Rate for Payer: Cofinity Commercial |
$1,759.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,432.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,637.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$1,841.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,432.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,534.84
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,739.48
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$1,739.48
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,330.19
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$1,289.26
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$757.19
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,534.84
|
|
|
HC EMBOLI DETECTION WITH OUT BUBBLE STUDY
|
Facility
|
OP
|
$795.50
|
|
|
Service Code
|
CPT 93892
|
| Hospital Charge Code |
92100034
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$715.95 |
| Rate for Payer: Aetna American Axle |
$517.08
|
| Rate for Payer: Aetna Commercial |
$676.17
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$517.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$636.40
|
| Rate for Payer: Cash Price |
$636.40
|
| Rate for Payer: Cash Price |
$636.40
|
| Rate for Payer: Cofinity Commercial |
$556.85
|
| Rate for Payer: Cofinity Commercial |
$684.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$556.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$636.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$715.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$556.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$596.62
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$676.17
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$676.17
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$517.08
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$501.17
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$294.33
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$596.62
|
|
|
HC EMBOLI DETECTION WITH OUT BUBBLE STUDY
|
Facility
|
IP
|
$795.50
|
|
|
Service Code
|
CPT 93892
|
| Hospital Charge Code |
92100034
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$350.02 |
| Max. Negotiated Rate |
$715.95 |
| Rate for Payer: Aetna American Axle |
$517.08
|
| Rate for Payer: Aetna Commercial |
$676.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$517.08
|
| Rate for Payer: Cash Price |
$636.40
|
| Rate for Payer: Cofinity Commercial |
$556.85
|
| Rate for Payer: Cofinity Commercial |
$684.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$556.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$636.40
|
| Rate for Payer: Healthscope Commercial |
$715.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$556.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$596.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$676.17
|
| Rate for Payer: PHP Commercial |
$676.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$517.08
|
| Rate for Payer: Priority Health SBD |
$501.17
|
| Rate for Payer: UMR Bronson Commercial |
$350.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$596.62
|
|
|
HC EMBOLIZATION ARTERIAL OR VENOUS FOR HEMORRHAGE OR LYMPH EXTRAV
|
Facility
|
OP
|
$16,782.27
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
36100431
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,928.28 |
| Max. Negotiated Rate |
$31,133.44 |
| Rate for Payer: Aetna American Axle |
$10,908.48
|
| Rate for Payer: Aetna Commercial |
$14,264.93
|
| Rate for Payer: Aetna Medicare |
$11,502.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,908.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| Rate for Payer: Cash Price |
$13,425.82
|
| Rate for Payer: Cash Price |
$13,425.82
|
| Rate for Payer: Cofinity Commercial |
$14,432.75
|
| Rate for Payer: Cofinity Commercial |
$11,747.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,747.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,425.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$15,104.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,747.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,586.70
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,264.93
|
| Rate for Payer: PACE Medicare |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$14,264.93
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,908.48
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health SBD |
$10,572.83
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,133.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$21,137.21
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: UMR Bronson Commercial |
$6,209.44
|
| Rate for Payer: VA VA |
$11,060.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,586.70
|
|
|
HC EMBOLIZATION ARTERIAL OR VENOUS FOR HEMORRHAGE OR LYMPH EXTRAV
|
Facility
|
IP
|
$16,782.27
|
|
|
Service Code
|
CPT 37244
|
| Hospital Charge Code |
36100431
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,384.20 |
| Max. Negotiated Rate |
$15,104.04 |
| Rate for Payer: Aetna American Axle |
$10,908.48
|
| Rate for Payer: Aetna Commercial |
$14,264.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,908.48
|
| Rate for Payer: Cash Price |
$13,425.82
|
| Rate for Payer: Cofinity Commercial |
$11,747.59
|
| Rate for Payer: Cofinity Commercial |
$14,432.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,747.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,425.82
|
| Rate for Payer: Healthscope Commercial |
$15,104.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,747.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,586.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,264.93
|
| Rate for Payer: PHP Commercial |
$14,264.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,908.48
|
| Rate for Payer: Priority Health SBD |
$10,572.83
|
| Rate for Payer: UMR Bronson Commercial |
$7,384.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,586.70
|
|
|
HC EMBOLIZATION ARTERIAL OTHER THAN HEMORRHAGE
|
Facility
|
IP
|
$18,386.35
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
36100429
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,089.99 |
| Max. Negotiated Rate |
$16,547.72 |
| Rate for Payer: Aetna American Axle |
$11,951.13
|
| Rate for Payer: Aetna Commercial |
$15,628.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,951.13
|
| Rate for Payer: Cash Price |
$14,709.08
|
| Rate for Payer: Cofinity Commercial |
$12,870.44
|
| Rate for Payer: Cofinity Commercial |
$15,812.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,870.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,709.08
|
| Rate for Payer: Healthscope Commercial |
$16,547.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,870.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,789.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,628.40
|
| Rate for Payer: PHP Commercial |
$15,628.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,951.13
|
| Rate for Payer: Priority Health SBD |
$11,583.40
|
| Rate for Payer: UMR Bronson Commercial |
$8,089.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,789.76
|
|
|
HC EMBOLIZATION ARTERIAL OTHER THAN HEMORRHAGE
|
Facility
|
OP
|
$18,386.35
|
|
|
Service Code
|
CPT 37242
|
| Hospital Charge Code |
36100429
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,802.95 |
| Max. Negotiated Rate |
$49,296.87 |
| Rate for Payer: Aetna American Axle |
$11,951.13
|
| Rate for Payer: Aetna Commercial |
$15,628.40
|
| Rate for Payer: Aetna Medicare |
$18,213.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,951.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,891.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,891.04
|
| Rate for Payer: BCBS Complete |
$9,856.22
|
| Rate for Payer: BCBS MAPPO |
$17,512.83
|
| Rate for Payer: BCN Medicare Advantage |
$17,512.83
|
| Rate for Payer: Cash Price |
$14,709.08
|
| Rate for Payer: Cash Price |
$14,709.08
|
| Rate for Payer: Cofinity Commercial |
$15,812.26
|
| Rate for Payer: Cofinity Commercial |
$12,870.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,870.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,709.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,512.83
|
| Rate for Payer: Healthscope Commercial |
$16,547.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,870.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,789.76
|
| Rate for Payer: Mclaren Medicaid |
$9,386.88
|
| Rate for Payer: Mclaren Medicare |
$17,512.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,388.47
|
| Rate for Payer: Meridian Medicaid |
$9,856.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,139.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,628.40
|
| Rate for Payer: PACE Medicare |
$16,637.19
|
| Rate for Payer: PACE SWMI |
$17,512.83
|
| Rate for Payer: PHP Commercial |
$15,628.40
|
| Rate for Payer: PHP Medicare Advantage |
$17,512.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,386.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,951.13
|
| Rate for Payer: Priority Health Medicare |
$17,512.83
|
| Rate for Payer: Priority Health SBD |
$11,583.40
|
| Rate for Payer: Railroad Medicare Medicare |
$17,512.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,296.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,512.83
|
| Rate for Payer: UHC Exchange |
$33,468.77
|
| Rate for Payer: UHC Medicare Advantage |
$17,512.83
|
| Rate for Payer: UHCCP Medicaid |
$9,386.88
|
| Rate for Payer: UMR Bronson Commercial |
$6,802.95
|
| Rate for Payer: VA VA |
$17,512.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,789.76
|
|
|
HC EMBOLIZATION CNS
|
Facility
|
IP
|
$7,628.69
|
|
|
Service Code
|
CPT 61624
|
| Hospital Charge Code |
36100271
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,356.62 |
| Max. Negotiated Rate |
$6,865.82 |
| Rate for Payer: Aetna American Axle |
$4,958.65
|
| Rate for Payer: Aetna Commercial |
$6,484.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,958.65
|
| Rate for Payer: Cash Price |
$6,102.95
|
| Rate for Payer: Cofinity Commercial |
$5,340.08
|
| Rate for Payer: Cofinity Commercial |
$6,560.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,340.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,102.95
|
| Rate for Payer: Healthscope Commercial |
$6,865.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,340.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,721.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,484.39
|
| Rate for Payer: PHP Commercial |
$6,484.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,958.65
|
| Rate for Payer: Priority Health SBD |
$4,806.07
|
| Rate for Payer: UMR Bronson Commercial |
$3,356.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,721.52
|
|
|
HC EMBOLIZATION CNS
|
Facility
|
OP
|
$7,628.69
|
|
|
Service Code
|
CPT 61624
|
| Hospital Charge Code |
36100271
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,822.62 |
| Max. Negotiated Rate |
$6,865.82 |
| Rate for Payer: Aetna American Axle |
$4,958.65
|
| Rate for Payer: Aetna Commercial |
$6,484.39
|
| Rate for Payer: Aetna Medicare |
$3,814.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,958.65
|
| Rate for Payer: BCBS Complete |
$3,051.48
|
| Rate for Payer: Cash Price |
$6,102.95
|
| Rate for Payer: Cofinity Commercial |
$5,340.08
|
| Rate for Payer: Cofinity Commercial |
$6,560.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,340.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,102.95
|
| Rate for Payer: Healthscope Commercial |
$6,865.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,340.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,721.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,484.39
|
| Rate for Payer: PHP Commercial |
$6,484.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,958.65
|
| Rate for Payer: Priority Health SBD |
$4,806.07
|
| Rate for Payer: UMR Bronson Commercial |
$2,822.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,721.52
|
|
|
HC EMBOLIZATION COILS LEVEL 8
|
Facility
|
OP
|
$1,874.25
|
|
| Hospital Charge Code |
27800104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$693.47 |
| Max. Negotiated Rate |
$1,686.83 |
| Rate for Payer: Aetna American Axle |
$1,218.26
|
| Rate for Payer: Aetna Commercial |
$1,593.11
|
| Rate for Payer: Aetna Medicare |
$937.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,218.26
|
| Rate for Payer: BCBS Complete |
$749.70
|
| Rate for Payer: Cash Price |
$1,499.40
|
| Rate for Payer: Cofinity Commercial |
$1,311.97
|
| Rate for Payer: Cofinity Commercial |
$1,611.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,311.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,499.40
|
| Rate for Payer: Healthscope Commercial |
$1,686.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,311.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,405.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,593.11
|
| Rate for Payer: PHP Commercial |
$1,593.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,218.26
|
| Rate for Payer: Priority Health SBD |
$1,180.78
|
| Rate for Payer: UMR Bronson Commercial |
$693.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,405.69
|
|
|
HC EMBOLIZATION COILS LEVEL 8
|
Facility
|
IP
|
$1,874.25
|
|
| Hospital Charge Code |
27800104
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$824.67 |
| Max. Negotiated Rate |
$1,686.83 |
| Rate for Payer: Aetna American Axle |
$1,218.26
|
| Rate for Payer: Aetna Commercial |
$1,593.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,218.26
|
| Rate for Payer: Cash Price |
$1,499.40
|
| Rate for Payer: Cofinity Commercial |
$1,311.97
|
| Rate for Payer: Cofinity Commercial |
$1,611.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,311.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,499.40
|
| Rate for Payer: Healthscope Commercial |
$1,686.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,311.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,405.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,593.11
|
| Rate for Payer: PHP Commercial |
$1,593.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,218.26
|
| Rate for Payer: Priority Health SBD |
$1,180.78
|
| Rate for Payer: UMR Bronson Commercial |
$824.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,405.69
|
|
|
HC EMBOLIZATION COILS LVL 1
|
Facility
|
OP
|
$160.65
|
|
| Hospital Charge Code |
27800091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$59.44 |
| Max. Negotiated Rate |
$144.59 |
| Rate for Payer: Aetna American Axle |
$104.42
|
| Rate for Payer: Aetna Commercial |
$136.55
|
| Rate for Payer: Aetna Medicare |
$80.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.42
|
| Rate for Payer: BCBS Complete |
$64.26
|
| Rate for Payer: Cash Price |
$128.52
|
| Rate for Payer: Cofinity Commercial |
$112.45
|
| Rate for Payer: Cofinity Commercial |
$138.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$112.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.52
|
| Rate for Payer: Healthscope Commercial |
$144.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.55
|
| Rate for Payer: PHP Commercial |
$136.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.42
|
| Rate for Payer: Priority Health SBD |
$101.21
|
| Rate for Payer: UMR Bronson Commercial |
$59.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.49
|
|
|
HC EMBOLIZATION COILS LVL 1
|
Facility
|
IP
|
$160.65
|
|
| Hospital Charge Code |
27800091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.69 |
| Max. Negotiated Rate |
$144.59 |
| Rate for Payer: Aetna American Axle |
$104.42
|
| Rate for Payer: Aetna Commercial |
$136.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.42
|
| Rate for Payer: Cash Price |
$128.52
|
| Rate for Payer: Cofinity Commercial |
$112.45
|
| Rate for Payer: Cofinity Commercial |
$138.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$112.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.52
|
| Rate for Payer: Healthscope Commercial |
$144.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.55
|
| Rate for Payer: PHP Commercial |
$136.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.42
|
| Rate for Payer: Priority Health SBD |
$101.21
|
| Rate for Payer: UMR Bronson Commercial |
$70.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.49
|
|
|
HC EMBOLIZATION COILS LVL2
|
Facility
|
OP
|
$481.95
|
|
| Hospital Charge Code |
27800092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$178.32 |
| Max. Negotiated Rate |
$433.75 |
| Rate for Payer: Aetna American Axle |
$313.27
|
| Rate for Payer: Aetna Commercial |
$409.66
|
| Rate for Payer: Aetna Medicare |
$240.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.27
|
| Rate for Payer: BCBS Complete |
$192.78
|
| Rate for Payer: Cash Price |
$385.56
|
| Rate for Payer: Cofinity Commercial |
$337.37
|
| Rate for Payer: Cofinity Commercial |
$414.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$337.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.56
|
| Rate for Payer: Healthscope Commercial |
$433.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$337.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.66
|
| Rate for Payer: PHP Commercial |
$409.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.27
|
| Rate for Payer: Priority Health SBD |
$303.63
|
| Rate for Payer: UMR Bronson Commercial |
$178.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.46
|
|
|
HC EMBOLIZATION COILS LVL2
|
Facility
|
IP
|
$481.95
|
|
| Hospital Charge Code |
27800092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$212.06 |
| Max. Negotiated Rate |
$433.75 |
| Rate for Payer: Aetna American Axle |
$313.27
|
| Rate for Payer: Aetna Commercial |
$409.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.27
|
| Rate for Payer: Cash Price |
$385.56
|
| Rate for Payer: Cofinity Commercial |
$337.37
|
| Rate for Payer: Cofinity Commercial |
$414.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$337.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$385.56
|
| Rate for Payer: Healthscope Commercial |
$433.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$337.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$361.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$409.66
|
| Rate for Payer: PHP Commercial |
$409.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.27
|
| Rate for Payer: Priority Health SBD |
$303.63
|
| Rate for Payer: UMR Bronson Commercial |
$212.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$361.46
|
|
|
HC EMBOLIZATION COILS LVL 9
|
Facility
|
OP
|
$2,366.91
|
|
| Hospital Charge Code |
27800046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$875.76 |
| Max. Negotiated Rate |
$2,130.22 |
| Rate for Payer: Aetna American Axle |
$1,538.49
|
| Rate for Payer: Aetna Commercial |
$2,011.87
|
| Rate for Payer: Aetna Medicare |
$1,183.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,538.49
|
| Rate for Payer: BCBS Complete |
$946.76
|
| Rate for Payer: Cash Price |
$1,893.53
|
| Rate for Payer: Cofinity Commercial |
$1,656.84
|
| Rate for Payer: Cofinity Commercial |
$2,035.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,656.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,893.53
|
| Rate for Payer: Healthscope Commercial |
$2,130.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,656.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,775.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,011.87
|
| Rate for Payer: PHP Commercial |
$2,011.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,538.49
|
| Rate for Payer: Priority Health SBD |
$1,491.15
|
| Rate for Payer: UMR Bronson Commercial |
$875.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,775.18
|
|
|
HC EMBOLIZATION COILS LVL 9
|
Facility
|
IP
|
$2,366.91
|
|
| Hospital Charge Code |
27800046
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,041.44 |
| Max. Negotiated Rate |
$2,130.22 |
| Rate for Payer: Aetna American Axle |
$1,538.49
|
| Rate for Payer: Aetna Commercial |
$2,011.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,538.49
|
| Rate for Payer: Cash Price |
$1,893.53
|
| Rate for Payer: Cofinity Commercial |
$1,656.84
|
| Rate for Payer: Cofinity Commercial |
$2,035.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,656.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,893.53
|
| Rate for Payer: Healthscope Commercial |
$2,130.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,656.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,775.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,011.87
|
| Rate for Payer: PHP Commercial |
$2,011.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,538.49
|
| Rate for Payer: Priority Health SBD |
$1,491.15
|
| Rate for Payer: UMR Bronson Commercial |
$1,041.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,775.18
|
|
|
HC EMBOLIZATION FOR TUMORS ORGANS OR INFARCTION
|
Facility
|
IP
|
$17,260.72
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
36100430
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,594.72 |
| Max. Negotiated Rate |
$15,534.65 |
| Rate for Payer: Aetna American Axle |
$11,219.47
|
| Rate for Payer: Aetna Commercial |
$14,671.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,219.47
|
| Rate for Payer: Cash Price |
$13,808.58
|
| Rate for Payer: Cofinity Commercial |
$12,082.50
|
| Rate for Payer: Cofinity Commercial |
$14,844.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,082.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,808.58
|
| Rate for Payer: Healthscope Commercial |
$15,534.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,082.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,945.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,671.61
|
| Rate for Payer: PHP Commercial |
$14,671.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,219.47
|
| Rate for Payer: Priority Health SBD |
$10,874.25
|
| Rate for Payer: UMR Bronson Commercial |
$7,594.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,945.54
|
|
|
HC EMBOLIZATION FOR TUMORS ORGANS OR INFARCTION
|
Facility
|
OP
|
$17,260.72
|
|
|
Service Code
|
CPT 37243
|
| Hospital Charge Code |
36100430
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,928.28 |
| Max. Negotiated Rate |
$31,133.44 |
| Rate for Payer: Aetna American Axle |
$11,219.47
|
| Rate for Payer: Aetna Commercial |
$14,671.61
|
| Rate for Payer: Aetna Medicare |
$11,502.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,219.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| Rate for Payer: Cash Price |
$13,808.58
|
| Rate for Payer: Cash Price |
$13,808.58
|
| Rate for Payer: Cofinity Commercial |
$14,844.22
|
| Rate for Payer: Cofinity Commercial |
$12,082.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,082.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,808.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$15,534.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,082.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,945.54
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,671.61
|
| Rate for Payer: PACE Medicare |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$14,671.61
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,219.47
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health SBD |
$10,874.25
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,133.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$21,137.21
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: UMR Bronson Commercial |
$6,386.47
|
| Rate for Payer: VA VA |
$11,060.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,945.54
|
|
|
HC EMBOLIZATION NON-CNS HEAD OR NECK
|
Facility
|
IP
|
$5,254.32
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
36100272
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,311.90 |
| Max. Negotiated Rate |
$4,728.89 |
| Rate for Payer: Aetna American Axle |
$3,415.31
|
| Rate for Payer: Aetna Commercial |
$4,466.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,415.31
|
| Rate for Payer: Cash Price |
$4,203.46
|
| Rate for Payer: Cofinity Commercial |
$3,678.02
|
| Rate for Payer: Cofinity Commercial |
$4,518.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,678.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,203.46
|
| Rate for Payer: Healthscope Commercial |
$4,728.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,678.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,940.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,466.17
|
| Rate for Payer: PHP Commercial |
$4,466.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,415.31
|
| Rate for Payer: Priority Health SBD |
$3,310.22
|
| Rate for Payer: UMR Bronson Commercial |
$2,311.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,940.74
|
|
|
HC EMBOLIZATION NON-CNS HEAD OR NECK
|
Facility
|
OP
|
$5,254.32
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
36100272
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,944.10 |
| Max. Negotiated Rate |
$31,133.44 |
| Rate for Payer: Aetna American Axle |
$3,415.31
|
| Rate for Payer: Aetna Commercial |
$4,466.17
|
| Rate for Payer: Aetna Medicare |
$11,502.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,415.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| Rate for Payer: Cash Price |
$4,203.46
|
| Rate for Payer: Cash Price |
$4,203.46
|
| Rate for Payer: Cofinity Commercial |
$4,518.72
|
| Rate for Payer: Cofinity Commercial |
$3,678.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,678.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,203.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$4,728.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,678.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,940.74
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,466.17
|
| Rate for Payer: PACE Medicare |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$4,466.17
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,415.31
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health SBD |
$3,310.22
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,133.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$21,137.21
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,944.10
|
| Rate for Payer: VA VA |
$11,060.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,940.74
|
|
|
HC EMBOLIZATION URETER
|
Facility
|
OP
|
$428.76
|
|
|
Service Code
|
CPT 50705
|
| Hospital Charge Code |
36100511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$158.64 |
| Max. Negotiated Rate |
$385.88 |
| Rate for Payer: Aetna American Axle |
$278.69
|
| Rate for Payer: Aetna Commercial |
$364.45
|
| Rate for Payer: Aetna Medicare |
$214.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.69
|
| Rate for Payer: BCBS Complete |
$171.50
|
| Rate for Payer: Cash Price |
$343.01
|
| Rate for Payer: Cofinity Commercial |
$300.13
|
| Rate for Payer: Cofinity Commercial |
$368.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$300.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.01
|
| Rate for Payer: Healthscope Commercial |
$385.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$364.45
|
| Rate for Payer: PHP Commercial |
$364.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.69
|
| Rate for Payer: Priority Health SBD |
$270.12
|
| Rate for Payer: UMR Bronson Commercial |
$158.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.57
|
|
