|
HC PERIDARDIOCENTESIS WITH GUIDANCE
|
Facility
|
IP
|
$2,495.36
|
|
|
Service Code
|
CPT 33016
|
| Hospital Charge Code |
36100582
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,097.96 |
| Max. Negotiated Rate |
$2,245.82 |
| Rate for Payer: Aetna American Axle |
$1,621.98
|
| Rate for Payer: Aetna Commercial |
$2,121.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,621.98
|
| Rate for Payer: Cash Price |
$1,996.29
|
| Rate for Payer: Cofinity Commercial |
$1,746.75
|
| Rate for Payer: Cofinity Commercial |
$2,146.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,996.29
|
| Rate for Payer: Healthscope Commercial |
$2,245.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,746.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,871.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,121.06
|
| Rate for Payer: PHP Commercial |
$2,121.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,746.75
|
| Rate for Payer: Priority Health SBD |
$1,572.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,097.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,871.52
|
|
|
HC PERIPH ARTERY DISEASE REHAB
|
Facility
|
IP
|
$101.22
|
|
|
Service Code
|
CPT 93668
|
| Hospital Charge Code |
94000006
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$44.54 |
| Max. Negotiated Rate |
$91.10 |
| Rate for Payer: Aetna American Axle |
$65.79
|
| Rate for Payer: Aetna Commercial |
$86.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.79
|
| Rate for Payer: Cash Price |
$80.98
|
| Rate for Payer: Cofinity Commercial |
$70.85
|
| Rate for Payer: Cofinity Commercial |
$87.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.98
|
| Rate for Payer: Healthscope Commercial |
$91.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.04
|
| Rate for Payer: PHP Commercial |
$86.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.85
|
| Rate for Payer: Priority Health SBD |
$63.77
|
| Rate for Payer: UMR Bronson Commercial |
$44.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.92
|
|
|
HC PERIPH ARTERY DISEASE REHAB
|
Facility
|
OP
|
$101.22
|
|
|
Service Code
|
CPT 93668
|
| Hospital Charge Code |
94000006
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$14.41 |
| Max. Negotiated Rate |
$196.00 |
| Rate for Payer: Aetna American Axle |
$65.79
|
| Rate for Payer: Aetna Commercial |
$86.04
|
| Rate for Payer: Aetna Medicare |
$56.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$15.11
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$80.98
|
| Rate for Payer: Cash Price |
$80.98
|
| Rate for Payer: Cash Price |
$80.98
|
| Rate for Payer: Cofinity Commercial |
$87.05
|
| Rate for Payer: Cofinity Commercial |
$70.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$91.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.92
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.04
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$86.04
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.15
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$136.92
|
| Rate for Payer: Priority Health SBD |
$63.77
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.85
|
| Rate for Payer: UHC Core |
$196.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.37
|
| Rate for Payer: UHC Exchange |
$14.41
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: UMR Bronson Commercial |
$37.45
|
| Rate for Payer: VA VA |
$54.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.92
|
|
|
HC PERIPHERAL DIAGNOSTIC CATHETER
|
Facility
|
OP
|
$278.26
|
|
| Hospital Charge Code |
27200145
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$102.96 |
| Max. Negotiated Rate |
$250.43 |
| Rate for Payer: Aetna American Axle |
$180.87
|
| Rate for Payer: Aetna Commercial |
$236.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.87
|
| Rate for Payer: BCBS Complete |
$111.30
|
| Rate for Payer: Cash Price |
$222.61
|
| Rate for Payer: Cofinity Commercial |
$194.78
|
| Rate for Payer: Cofinity Commercial |
$239.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.61
|
| Rate for Payer: Healthscope Commercial |
$250.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$194.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$236.52
|
| Rate for Payer: PHP Commercial |
$236.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.78
|
| Rate for Payer: Priority Health SBD |
$175.30
|
| Rate for Payer: UMR Bronson Commercial |
$102.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.70
|
|
|
HC PERIPHERAL DIAGNOSTIC CATHETER
|
Facility
|
IP
|
$278.26
|
|
| Hospital Charge Code |
27200145
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$122.43 |
| Max. Negotiated Rate |
$250.43 |
| Rate for Payer: Aetna American Axle |
$180.87
|
| Rate for Payer: Aetna Commercial |
$236.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.87
|
| Rate for Payer: Cash Price |
$222.61
|
| Rate for Payer: Cofinity Commercial |
$194.78
|
| Rate for Payer: Cofinity Commercial |
$239.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.61
|
| Rate for Payer: Healthscope Commercial |
$250.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$194.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$236.52
|
| Rate for Payer: PHP Commercial |
$236.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.78
|
| Rate for Payer: Priority Health SBD |
$175.30
|
| Rate for Payer: UMR Bronson Commercial |
$122.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.70
|
|
|
HC PERIPHERAL INTRODUCER
|
Facility
|
IP
|
$670.87
|
|
| Hospital Charge Code |
27200146
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$295.18 |
| Max. Negotiated Rate |
$603.78 |
| Rate for Payer: Aetna American Axle |
$436.07
|
| Rate for Payer: Aetna Commercial |
$570.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.07
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cofinity Commercial |
$469.61
|
| Rate for Payer: Cofinity Commercial |
$576.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$536.70
|
| Rate for Payer: Healthscope Commercial |
$603.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$469.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$570.24
|
| Rate for Payer: PHP Commercial |
$570.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.61
|
| Rate for Payer: Priority Health SBD |
$422.65
|
| Rate for Payer: UMR Bronson Commercial |
$295.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.15
|
|
|
HC PERIPHERAL INTRODUCER
|
Facility
|
OP
|
$670.87
|
|
| Hospital Charge Code |
27200146
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$248.22 |
| Max. Negotiated Rate |
$603.78 |
| Rate for Payer: Aetna American Axle |
$436.07
|
| Rate for Payer: Aetna Commercial |
$570.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$436.07
|
| Rate for Payer: BCBS Complete |
$268.35
|
| Rate for Payer: Cash Price |
$536.70
|
| Rate for Payer: Cofinity Commercial |
$469.61
|
| Rate for Payer: Cofinity Commercial |
$576.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$536.70
|
| Rate for Payer: Healthscope Commercial |
$603.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$469.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$503.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$570.24
|
| Rate for Payer: PHP Commercial |
$570.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$469.61
|
| Rate for Payer: Priority Health SBD |
$422.65
|
| Rate for Payer: UMR Bronson Commercial |
$248.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$503.15
|
|
|
HC PERITONEAL DIALYSIS
|
Facility
|
IP
|
$938.26
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
83000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$412.83 |
| Max. Negotiated Rate |
$844.43 |
| Rate for Payer: Aetna American Axle |
$609.87
|
| Rate for Payer: Aetna Commercial |
$797.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.87
|
| Rate for Payer: Cash Price |
$750.61
|
| Rate for Payer: Cofinity Commercial |
$656.78
|
| Rate for Payer: Cofinity Commercial |
$806.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$750.61
|
| Rate for Payer: Healthscope Commercial |
$844.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$656.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$703.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$797.52
|
| Rate for Payer: PHP Commercial |
$797.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$656.78
|
| Rate for Payer: Priority Health SBD |
$591.10
|
| Rate for Payer: UMR Bronson Commercial |
$412.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$703.70
|
|
|
HC PERITONEAL DIALYSIS
|
Facility
|
OP
|
$938.26
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
83000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$83.17 |
| Max. Negotiated Rate |
$1,239.37 |
| Rate for Payer: Aetna American Axle |
$609.87
|
| Rate for Payer: Aetna Commercial |
$797.52
|
| Rate for Payer: Aetna Medicare |
$409.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$492.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$492.11
|
| Rate for Payer: BCBS Complete |
$226.14
|
| Rate for Payer: BCBS MAPPO |
$393.69
|
| Rate for Payer: BCN Medicare Advantage |
$393.69
|
| Rate for Payer: Cash Price |
$750.61
|
| Rate for Payer: Cash Price |
$750.61
|
| Rate for Payer: Cofinity Commercial |
$656.78
|
| Rate for Payer: Cofinity Commercial |
$806.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$750.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$393.69
|
| Rate for Payer: Healthscope Commercial |
$844.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$656.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$703.70
|
| Rate for Payer: Mclaren Medicaid |
$215.35
|
| Rate for Payer: Mclaren Medicare |
$393.69
|
| Rate for Payer: Meridian Medicaid |
$226.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$413.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$452.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$797.52
|
| Rate for Payer: PACE Medicare |
$374.01
|
| Rate for Payer: PACE SWMI |
$393.69
|
| Rate for Payer: PHP Commercial |
$797.52
|
| Rate for Payer: PHP Medicare Advantage |
$393.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$215.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$656.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,239.37
|
| Rate for Payer: Priority Health Medicare |
$393.69
|
| Rate for Payer: Priority Health Narrow Network |
$991.50
|
| Rate for Payer: Priority Health SBD |
$591.10
|
| Rate for Payer: Railroad Medicare Medicare |
$393.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$393.69
|
| Rate for Payer: UHC Exchange |
$83.17
|
| Rate for Payer: UHC Medicare Advantage |
$405.50
|
| Rate for Payer: UMR Bronson Commercial |
$347.16
|
| Rate for Payer: VA VA |
$393.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$703.70
|
|
|
HC PERITONEAL LVG TRAY
|
Facility
|
OP
|
$693.53
|
|
| Hospital Charge Code |
27000135
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$256.61 |
| Max. Negotiated Rate |
$624.18 |
| Rate for Payer: Aetna American Axle |
$450.79
|
| Rate for Payer: Aetna Commercial |
$589.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.79
|
| Rate for Payer: BCBS Complete |
$277.41
|
| Rate for Payer: Cash Price |
$554.82
|
| Rate for Payer: Cofinity Commercial |
$485.47
|
| Rate for Payer: Cofinity Commercial |
$596.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$554.82
|
| Rate for Payer: Healthscope Commercial |
$624.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$485.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$520.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$589.50
|
| Rate for Payer: PHP Commercial |
$589.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.47
|
| Rate for Payer: Priority Health SBD |
$436.92
|
| Rate for Payer: UMR Bronson Commercial |
$256.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$520.15
|
|
|
HC PERITONEAL LVG TRAY
|
Facility
|
IP
|
$693.53
|
|
| Hospital Charge Code |
27000135
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$305.15 |
| Max. Negotiated Rate |
$624.18 |
| Rate for Payer: Aetna American Axle |
$450.79
|
| Rate for Payer: Aetna Commercial |
$589.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.79
|
| Rate for Payer: Cash Price |
$554.82
|
| Rate for Payer: Cofinity Commercial |
$485.47
|
| Rate for Payer: Cofinity Commercial |
$596.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$554.82
|
| Rate for Payer: Healthscope Commercial |
$624.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$485.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$520.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$589.50
|
| Rate for Payer: PHP Commercial |
$589.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$485.47
|
| Rate for Payer: Priority Health SBD |
$436.92
|
| Rate for Payer: UMR Bronson Commercial |
$305.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$520.15
|
|
|
HC PERITONEOGRAM
|
Facility
|
OP
|
$557.52
|
|
|
Service Code
|
CPT 74190
|
| Hospital Charge Code |
32000294
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$206.28 |
| Max. Negotiated Rate |
$1,543.71 |
| Rate for Payer: Aetna American Axle |
$362.39
|
| Rate for Payer: Aetna Commercial |
$473.89
|
| Rate for Payer: Aetna Medicare |
$509.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$362.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$612.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$612.96
|
| Rate for Payer: BCBS Complete |
$281.67
|
| Rate for Payer: BCBS MAPPO |
$490.37
|
| Rate for Payer: BCBS Trust/PPO |
$603.30
|
| Rate for Payer: BCN Medicare Advantage |
$490.37
|
| Rate for Payer: Cash Price |
$446.02
|
| Rate for Payer: Cash Price |
$446.02
|
| Rate for Payer: Cofinity Commercial |
$390.26
|
| Rate for Payer: Cofinity Commercial |
$479.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$446.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$490.37
|
| Rate for Payer: Healthscope Commercial |
$501.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$390.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$418.14
|
| Rate for Payer: Mclaren Medicaid |
$268.23
|
| Rate for Payer: Mclaren Medicare |
$490.37
|
| Rate for Payer: Meridian Medicaid |
$281.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$514.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$563.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$473.89
|
| Rate for Payer: PACE Medicare |
$465.85
|
| Rate for Payer: PACE SWMI |
$490.37
|
| Rate for Payer: PHP Commercial |
$473.89
|
| Rate for Payer: PHP Medicare Advantage |
$490.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,543.71
|
| Rate for Payer: Priority Health Medicare |
$490.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,234.97
|
| Rate for Payer: Priority Health SBD |
$351.24
|
| Rate for Payer: Railroad Medicare Medicare |
$490.37
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$490.37
|
| Rate for Payer: UHC Medicare Advantage |
$505.08
|
| Rate for Payer: UMR Bronson Commercial |
$206.28
|
| Rate for Payer: VA VA |
$490.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$418.14
|
|
|
HC PERITONEOGRAM
|
Facility
|
IP
|
$557.52
|
|
|
Service Code
|
CPT 74190
|
| Hospital Charge Code |
32000294
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$245.31 |
| Max. Negotiated Rate |
$501.77 |
| Rate for Payer: Aetna American Axle |
$362.39
|
| Rate for Payer: Aetna Commercial |
$473.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$362.39
|
| Rate for Payer: Cash Price |
$446.02
|
| Rate for Payer: Cofinity Commercial |
$390.26
|
| Rate for Payer: Cofinity Commercial |
$479.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$446.02
|
| Rate for Payer: Healthscope Commercial |
$501.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$390.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$418.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$473.89
|
| Rate for Payer: PHP Commercial |
$473.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.26
|
| Rate for Payer: Priority Health SBD |
$351.24
|
| Rate for Payer: UMR Bronson Commercial |
$245.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$418.14
|
|
|
HC PERMANENT PACEMAKER INTRODUCER
|
Facility
|
IP
|
$242.23
|
|
|
Service Code
|
HCPCS C1892
|
| Hospital Charge Code |
27200062
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.58 |
| Max. Negotiated Rate |
$218.01 |
| Rate for Payer: Aetna American Axle |
$157.45
|
| Rate for Payer: Aetna Commercial |
$205.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.45
|
| Rate for Payer: Cash Price |
$193.78
|
| Rate for Payer: Cofinity Commercial |
$169.56
|
| Rate for Payer: Cofinity Commercial |
$208.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.78
|
| Rate for Payer: Healthscope Commercial |
$218.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$169.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$205.90
|
| Rate for Payer: PHP Commercial |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.56
|
| Rate for Payer: Priority Health SBD |
$152.60
|
| Rate for Payer: UMR Bronson Commercial |
$106.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.67
|
|
|
HC PERMANENT PACEMAKER INTRODUCER
|
Facility
|
OP
|
$242.23
|
|
|
Service Code
|
HCPCS C1892
|
| Hospital Charge Code |
27200062
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$89.63 |
| Max. Negotiated Rate |
$218.01 |
| Rate for Payer: Aetna American Axle |
$157.45
|
| Rate for Payer: Aetna Commercial |
$205.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.45
|
| Rate for Payer: BCBS Complete |
$96.89
|
| Rate for Payer: Cash Price |
$193.78
|
| Rate for Payer: Cofinity Commercial |
$169.56
|
| Rate for Payer: Cofinity Commercial |
$208.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.78
|
| Rate for Payer: Healthscope Commercial |
$218.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$169.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$205.90
|
| Rate for Payer: PHP Commercial |
$205.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.56
|
| Rate for Payer: Priority Health SBD |
$152.60
|
| Rate for Payer: UMR Bronson Commercial |
$89.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.67
|
|
|
HC PERMANENT PACEMAKER PACK
|
Facility
|
OP
|
$330.12
|
|
| Hospital Charge Code |
62200010
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$122.14 |
| Max. Negotiated Rate |
$297.11 |
| Rate for Payer: Aetna American Axle |
$214.58
|
| Rate for Payer: Aetna Commercial |
$280.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.58
|
| Rate for Payer: BCBS Complete |
$132.05
|
| Rate for Payer: Cash Price |
$264.10
|
| Rate for Payer: Cofinity Commercial |
$231.08
|
| Rate for Payer: Cofinity Commercial |
$283.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.10
|
| Rate for Payer: Healthscope Commercial |
$297.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$231.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.60
|
| Rate for Payer: PHP Commercial |
$280.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.08
|
| Rate for Payer: Priority Health SBD |
$207.98
|
| Rate for Payer: UMR Bronson Commercial |
$122.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.59
|
|
|
HC PERMANENT PACEMAKER PACK
|
Facility
|
IP
|
$330.12
|
|
| Hospital Charge Code |
62200010
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$145.25 |
| Max. Negotiated Rate |
$297.11 |
| Rate for Payer: Aetna American Axle |
$214.58
|
| Rate for Payer: Aetna Commercial |
$280.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.58
|
| Rate for Payer: Cash Price |
$264.10
|
| Rate for Payer: Cofinity Commercial |
$231.08
|
| Rate for Payer: Cofinity Commercial |
$283.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.10
|
| Rate for Payer: Healthscope Commercial |
$297.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$231.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$280.60
|
| Rate for Payer: PHP Commercial |
$280.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.08
|
| Rate for Payer: Priority Health SBD |
$207.98
|
| Rate for Payer: UMR Bronson Commercial |
$145.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.59
|
|
|
HC PERNICIOUS ANEMIA EVALUATION
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 82607
|
| Hospital Charge Code |
30100186
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$15.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.85
|
| Rate for Payer: BCBS Complete |
$8.66
|
| Rate for Payer: BCBS MAPPO |
$15.08
|
| Rate for Payer: BCBS Trust/PPO |
$13.56
|
| Rate for Payer: BCN Medicare Advantage |
$15.08
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Mclaren Medicaid |
$8.25
|
| Rate for Payer: Mclaren Medicare |
$15.08
|
| Rate for Payer: Meridian Medicaid |
$8.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Medicare |
$14.33
|
| Rate for Payer: PACE SWMI |
$15.08
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.68
|
| Rate for Payer: Priority Health Medicare |
$15.08
|
| Rate for Payer: Priority Health Narrow Network |
$16.54
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: Railroad Medicare Medicare |
$15.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.10
|
| Rate for Payer: UHC Core |
$24.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.08
|
| Rate for Payer: UHC Exchange |
$15.08
|
| Rate for Payer: UHC Medicare Advantage |
$15.53
|
| Rate for Payer: UMR Bronson Commercial |
$16.98
|
| Rate for Payer: VA VA |
$15.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC PERNICIOUS ANEMIA EVALUATION
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 82607
|
| Hospital Charge Code |
30100186
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: UMR Bronson Commercial |
$20.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY
|
Facility
|
IP
|
$1,734.00
|
|
|
Service Code
|
CPT 33017
|
| Hospital Charge Code |
36100616
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$762.96 |
| Max. Negotiated Rate |
$1,560.60 |
| Rate for Payer: Aetna American Axle |
$1,127.10
|
| Rate for Payer: Aetna Commercial |
$1,473.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,127.10
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$1,213.80
|
| Rate for Payer: Cofinity Commercial |
$1,491.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,387.20
|
| Rate for Payer: Healthscope Commercial |
$1,560.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,213.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,300.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,473.90
|
| Rate for Payer: PHP Commercial |
$1,473.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,213.80
|
| Rate for Payer: Priority Health SBD |
$1,092.42
|
| Rate for Payer: UMR Bronson Commercial |
$762.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,300.50
|
|
|
HC PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY
|
Facility
|
OP
|
$1,734.00
|
|
|
Service Code
|
CPT 33017
|
| Hospital Charge Code |
36100616
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$237.40 |
| Max. Negotiated Rate |
$1,879.00 |
| Rate for Payer: Aetna American Axle |
$1,127.10
|
| Rate for Payer: Aetna Commercial |
$1,473.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,127.10
|
| Rate for Payer: BCBS Complete |
$693.60
|
| Rate for Payer: BCBS Trust/PPO |
$831.31
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cash Price |
$1,387.20
|
| Rate for Payer: Cofinity Commercial |
$1,213.80
|
| Rate for Payer: Cofinity Commercial |
$1,491.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,387.20
|
| Rate for Payer: Healthscope Commercial |
$1,560.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,213.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,300.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,473.90
|
| Rate for Payer: PHP Commercial |
$1,473.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,213.80
|
| Rate for Payer: Priority Health SBD |
$1,092.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.14
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UHC Exchange |
$237.40
|
| Rate for Payer: UMR Bronson Commercial |
$641.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,300.50
|
|
|
HC PERQ REPLACE GTUBE NOT REQ REV GSTRST TRACT
|
Facility
|
OP
|
$434.34
|
|
|
Service Code
|
CPT 43762
|
| Hospital Charge Code |
76100320
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$36.35 |
| Max. Negotiated Rate |
$691.57 |
| Rate for Payer: Aetna American Axle |
$282.32
|
| Rate for Payer: Aetna Commercial |
$369.19
|
| Rate for Payer: Aetna Medicare |
$228.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$282.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.60
|
| Rate for Payer: BCBS Complete |
$126.18
|
| Rate for Payer: BCBS MAPPO |
$219.68
|
| Rate for Payer: BCBS Trust/PPO |
$415.02
|
| Rate for Payer: BCN Medicare Advantage |
$219.68
|
| Rate for Payer: Cash Price |
$347.47
|
| Rate for Payer: Cash Price |
$347.47
|
| Rate for Payer: Cofinity Commercial |
$304.04
|
| Rate for Payer: Cofinity Commercial |
$373.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$347.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.68
|
| Rate for Payer: Healthscope Commercial |
$390.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$304.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$325.76
|
| Rate for Payer: Mclaren Medicaid |
$120.16
|
| Rate for Payer: Mclaren Medicare |
$219.68
|
| Rate for Payer: Meridian Medicaid |
$126.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$230.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$369.19
|
| Rate for Payer: PACE Medicare |
$208.70
|
| Rate for Payer: PACE SWMI |
$219.68
|
| Rate for Payer: PHP Commercial |
$369.19
|
| Rate for Payer: PHP Medicare Advantage |
$219.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$691.57
|
| Rate for Payer: Priority Health Medicare |
$219.68
|
| Rate for Payer: Priority Health Narrow Network |
$553.26
|
| Rate for Payer: Priority Health SBD |
$273.63
|
| Rate for Payer: Railroad Medicare Medicare |
$219.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.68
|
| Rate for Payer: UHC Exchange |
$36.35
|
| Rate for Payer: UHC Medicare Advantage |
$226.27
|
| Rate for Payer: UMR Bronson Commercial |
$160.71
|
| Rate for Payer: VA VA |
$219.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$325.76
|
|
|
HC PERQ REPLACE GTUBE NOT REQ REV GSTRST TRACT
|
Facility
|
IP
|
$434.34
|
|
|
Service Code
|
CPT 43762
|
| Hospital Charge Code |
76100320
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$191.11 |
| Max. Negotiated Rate |
$390.91 |
| Rate for Payer: Aetna American Axle |
$282.32
|
| Rate for Payer: Aetna Commercial |
$369.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$282.32
|
| Rate for Payer: Cash Price |
$347.47
|
| Rate for Payer: Cofinity Commercial |
$304.04
|
| Rate for Payer: Cofinity Commercial |
$373.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$347.47
|
| Rate for Payer: Healthscope Commercial |
$390.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$304.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$325.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$369.19
|
| Rate for Payer: PHP Commercial |
$369.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.04
|
| Rate for Payer: Priority Health SBD |
$273.63
|
| Rate for Payer: UMR Bronson Commercial |
$191.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$325.76
|
|
|
HC PERQ TRLUML CORONRY LITHOTRIPSY
|
Facility
|
IP
|
$433.65
|
|
|
Service Code
|
CPT 92972
|
| Hospital Charge Code |
48000402
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$190.81 |
| Max. Negotiated Rate |
$390.28 |
| Rate for Payer: Aetna American Axle |
$281.87
|
| Rate for Payer: Aetna Commercial |
$368.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$281.87
|
| Rate for Payer: Cash Price |
$346.92
|
| Rate for Payer: Cofinity Commercial |
$303.56
|
| Rate for Payer: Cofinity Commercial |
$372.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$346.92
|
| Rate for Payer: Healthscope Commercial |
$390.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$303.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$325.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$368.60
|
| Rate for Payer: PHP Commercial |
$368.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.56
|
| Rate for Payer: Priority Health SBD |
$273.20
|
| Rate for Payer: UMR Bronson Commercial |
$190.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$325.24
|
|
|
HC PERQ TRLUML CORONRY LITHOTRIPSY
|
Facility
|
OP
|
$433.65
|
|
|
Service Code
|
CPT 92972
|
| Hospital Charge Code |
48000402
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$140.15 |
| Max. Negotiated Rate |
$816.00 |
| Rate for Payer: Aetna American Axle |
$281.87
|
| Rate for Payer: Aetna Commercial |
$368.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$281.87
|
| Rate for Payer: BCBS Complete |
$173.46
|
| Rate for Payer: Cash Price |
$346.92
|
| Rate for Payer: Cash Price |
$346.92
|
| Rate for Payer: Cash Price |
$346.92
|
| Rate for Payer: Cofinity Commercial |
$303.56
|
| Rate for Payer: Cofinity Commercial |
$372.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$346.92
|
| Rate for Payer: Healthscope Commercial |
$390.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$303.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$325.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$368.60
|
| Rate for Payer: PHP Commercial |
$368.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$303.56
|
| Rate for Payer: Priority Health SBD |
$273.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.16
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UHC Exchange |
$140.15
|
| Rate for Payer: UMR Bronson Commercial |
$160.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$325.24
|
|
