|
HC HEARING AID CHECK MONAURAL
|
Facility
|
OP
|
$55.14
|
|
|
Service Code
|
CPT 92592
|
| Hospital Charge Code |
47100402
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$49.63 |
| Rate for Payer: Aetna American Axle |
$35.84
|
| Rate for Payer: Aetna Commercial |
$46.87
|
| Rate for Payer: Aetna Medicare |
$27.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.84
|
| Rate for Payer: BCBS Complete |
$22.06
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Advantage |
$38.60
|
| Rate for Payer: Cofinity Commercial |
$47.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Healthscope Commercial |
$49.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.35
|
| Rate for Payer: PHP Commercial |
$46.87
|
| Rate for Payer: Priority Health SBD |
$34.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.84
|
| Rate for Payer: UHC Core |
$28.73
|
| Rate for Payer: UHC Exchange |
$21.67
|
| Rate for Payer: UMR Bronson Commercial |
$20.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.35
|
|
|
HC HEARING AID CHECK MONAURAL
|
Facility
|
IP
|
$55.14
|
|
|
Service Code
|
CPT 92592
|
| Hospital Charge Code |
47100402
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$24.26 |
| Max. Negotiated Rate |
$49.63 |
| Rate for Payer: Aetna American Axle |
$35.84
|
| Rate for Payer: Aetna Commercial |
$46.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.84
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Advantage |
$38.60
|
| Rate for Payer: Cofinity Commercial |
$47.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Healthscope Commercial |
$49.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.35
|
| Rate for Payer: PHP Commercial |
$46.87
|
| Rate for Payer: Priority Health SBD |
$34.74
|
| Rate for Payer: UMR Bronson Commercial |
$24.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.35
|
|
|
HC HEARING AID EXAM BOTH EARS
|
Facility
|
IP
|
$123.81
|
|
|
Service Code
|
CPT 92591
|
| Hospital Charge Code |
76100504
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$111.43 |
| Rate for Payer: Aetna American Axle |
$80.48
|
| Rate for Payer: Aetna Commercial |
$105.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.48
|
| Rate for Payer: Cash Price |
$99.05
|
| Rate for Payer: Cofinity Advantage |
$86.67
|
| Rate for Payer: Cofinity Commercial |
$106.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.05
|
| Rate for Payer: Healthscope Commercial |
$111.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.86
|
| Rate for Payer: PHP Commercial |
$105.24
|
| Rate for Payer: Priority Health SBD |
$78.00
|
| Rate for Payer: UMR Bronson Commercial |
$54.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.86
|
|
|
HC HEARING AID EXAM BOTH EARS
|
Facility
|
OP
|
$123.81
|
|
|
Service Code
|
CPT 92591
|
| Hospital Charge Code |
76100504
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$45.81 |
| Max. Negotiated Rate |
$111.43 |
| Rate for Payer: Aetna American Axle |
$80.48
|
| Rate for Payer: Aetna Commercial |
$105.24
|
| Rate for Payer: Aetna Medicare |
$61.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.48
|
| Rate for Payer: BCBS Complete |
$49.52
|
| Rate for Payer: Cash Price |
$99.05
|
| Rate for Payer: Cofinity Advantage |
$86.67
|
| Rate for Payer: Cofinity Commercial |
$106.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.05
|
| Rate for Payer: Healthscope Commercial |
$111.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.86
|
| Rate for Payer: PHP Commercial |
$105.24
|
| Rate for Payer: Priority Health SBD |
$78.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.48
|
| Rate for Payer: UHC Core |
$64.51
|
| Rate for Payer: UHC Exchange |
$48.66
|
| Rate for Payer: UMR Bronson Commercial |
$45.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.86
|
|
|
HC HEARING AID EXAM ONE EAR
|
Facility
|
IP
|
$113.40
|
|
|
Service Code
|
CPT 92590
|
| Hospital Charge Code |
76100505
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$49.90 |
| Max. Negotiated Rate |
$102.06 |
| Rate for Payer: Aetna American Axle |
$73.71
|
| Rate for Payer: Aetna Commercial |
$96.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.71
|
| Rate for Payer: Cash Price |
$90.72
|
| Rate for Payer: Cofinity Advantage |
$79.38
|
| Rate for Payer: Cofinity Commercial |
$97.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.72
|
| Rate for Payer: Healthscope Commercial |
$102.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.05
|
| Rate for Payer: PHP Commercial |
$96.39
|
| Rate for Payer: Priority Health SBD |
$71.44
|
| Rate for Payer: UMR Bronson Commercial |
$49.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.05
|
|
|
HC HEARING AID EXAM ONE EAR
|
Facility
|
OP
|
$113.40
|
|
|
Service Code
|
CPT 92590
|
| Hospital Charge Code |
76100505
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$41.96 |
| Max. Negotiated Rate |
$102.06 |
| Rate for Payer: Aetna American Axle |
$73.71
|
| Rate for Payer: Aetna Commercial |
$96.39
|
| Rate for Payer: Aetna Medicare |
$56.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.71
|
| Rate for Payer: BCBS Complete |
$45.36
|
| Rate for Payer: Cash Price |
$90.72
|
| Rate for Payer: Cofinity Advantage |
$79.38
|
| Rate for Payer: Cofinity Commercial |
$97.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.72
|
| Rate for Payer: Healthscope Commercial |
$102.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.05
|
| Rate for Payer: PHP Commercial |
$96.39
|
| Rate for Payer: Priority Health SBD |
$71.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.71
|
| Rate for Payer: UHC Core |
$59.08
|
| Rate for Payer: UHC Exchange |
$44.57
|
| Rate for Payer: UMR Bronson Commercial |
$41.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.05
|
|
|
HC HEART CATH CORONARIES CABG'S
|
Facility
|
IP
|
$12,456.64
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100018
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,480.92 |
| Max. Negotiated Rate |
$11,210.98 |
| Rate for Payer: Aetna American Axle |
$8,096.82
|
| Rate for Payer: Aetna Commercial |
$10,588.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,096.82
|
| Rate for Payer: Cash Price |
$9,965.31
|
| Rate for Payer: Cofinity Advantage |
$8,719.65
|
| Rate for Payer: Cofinity Commercial |
$10,712.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,965.31
|
| Rate for Payer: Healthscope Commercial |
$11,210.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,719.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,342.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,588.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,342.48
|
| Rate for Payer: PHP Commercial |
$10,588.14
|
| Rate for Payer: Priority Health SBD |
$7,847.68
|
| Rate for Payer: UMR Bronson Commercial |
$5,480.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,342.48
|
|
|
HC HEART CATH CORONARIES CABG'S
|
Facility
|
OP
|
$12,456.64
|
|
|
Service Code
|
CPT 93459
|
| Hospital Charge Code |
48100018
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$11,210.98 |
| Rate for Payer: Aetna American Axle |
$8,096.82
|
| Rate for Payer: Aetna Commercial |
$10,588.14
|
| Rate for Payer: Aetna Medicare |
$3,359.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,096.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,144.63
|
| Rate for Payer: BCN Commercial |
$3,144.63
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$9,965.31
|
| Rate for Payer: Cash Price |
$9,965.31
|
| Rate for Payer: Cofinity Advantage |
$8,719.65
|
| Rate for Payer: Cofinity Commercial |
$10,712.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,965.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$11,210.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,719.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,342.48
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$3,391.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,588.14
|
| Rate for Payer: Nomi Health Commercial |
$9,690.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,342.48
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$10,588.14
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,446.41
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health SBD |
$7,847.68
|
| Rate for Payer: Priority Health Tiered Network |
$8,357.13
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: UMR Bronson Commercial |
$4,608.96
|
| Rate for Payer: VA VA |
$3,230.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,342.48
|
|
|
HC HEART CATH EXCHANGE WIRE
|
Facility
|
OP
|
$55.67
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$50.10 |
| Rate for Payer: Aetna American Axle |
$36.19
|
| Rate for Payer: Aetna Commercial |
$47.32
|
| Rate for Payer: Aetna Medicare |
$27.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.19
|
| Rate for Payer: BCBS Complete |
$22.27
|
| Rate for Payer: Cash Price |
$44.54
|
| Rate for Payer: Cofinity Advantage |
$38.97
|
| Rate for Payer: Cofinity Commercial |
$47.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.54
|
| Rate for Payer: Healthscope Commercial |
$50.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.75
|
| Rate for Payer: PHP Commercial |
$47.32
|
| Rate for Payer: Priority Health SBD |
$35.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.19
|
| Rate for Payer: UHC Core |
$29.00
|
| Rate for Payer: UHC Exchange |
$21.88
|
| Rate for Payer: UMR Bronson Commercial |
$20.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.75
|
|
|
HC HEART CATH EXCHANGE WIRE
|
Facility
|
IP
|
$55.67
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200047
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.49 |
| Max. Negotiated Rate |
$50.10 |
| Rate for Payer: Aetna American Axle |
$36.19
|
| Rate for Payer: Aetna Commercial |
$47.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.19
|
| Rate for Payer: Cash Price |
$44.54
|
| Rate for Payer: Cofinity Advantage |
$38.97
|
| Rate for Payer: Cofinity Commercial |
$47.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.54
|
| Rate for Payer: Healthscope Commercial |
$50.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.75
|
| Rate for Payer: PHP Commercial |
$47.32
|
| Rate for Payer: Priority Health SBD |
$35.07
|
| Rate for Payer: UMR Bronson Commercial |
$24.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.75
|
|
|
HC HEART CATH LT ONLY
|
Facility
|
OP
|
$8,650.65
|
|
|
Service Code
|
CPT 93452
|
| Hospital Charge Code |
48100011
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$10,446.41 |
| Rate for Payer: Aetna American Axle |
$5,622.92
|
| Rate for Payer: Aetna Commercial |
$7,353.05
|
| Rate for Payer: Aetna Medicare |
$3,359.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,622.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,644.48
|
| Rate for Payer: BCN Commercial |
$2,644.48
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$6,920.52
|
| Rate for Payer: Cash Price |
$6,920.52
|
| Rate for Payer: Cofinity Advantage |
$6,055.45
|
| Rate for Payer: Cofinity Commercial |
$7,439.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,920.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$7,785.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,055.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,487.99
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$3,391.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,353.05
|
| Rate for Payer: Nomi Health Commercial |
$9,690.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,487.99
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$7,353.05
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,446.41
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health SBD |
$5,449.91
|
| Rate for Payer: Priority Health Tiered Network |
$8,357.13
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: UMR Bronson Commercial |
$3,200.74
|
| Rate for Payer: VA VA |
$3,230.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,487.99
|
|
|
HC HEART CATH LT ONLY
|
Facility
|
IP
|
$8,650.65
|
|
|
Service Code
|
CPT 93452
|
| Hospital Charge Code |
48100011
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,806.29 |
| Max. Negotiated Rate |
$7,785.59 |
| Rate for Payer: Aetna American Axle |
$5,622.92
|
| Rate for Payer: Aetna Commercial |
$7,353.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,622.92
|
| Rate for Payer: Cash Price |
$6,920.52
|
| Rate for Payer: Cofinity Advantage |
$6,055.45
|
| Rate for Payer: Cofinity Commercial |
$7,439.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,920.52
|
| Rate for Payer: Healthscope Commercial |
$7,785.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,055.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,487.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,353.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,487.99
|
| Rate for Payer: PHP Commercial |
$7,353.05
|
| Rate for Payer: Priority Health SBD |
$5,449.91
|
| Rate for Payer: UMR Bronson Commercial |
$3,806.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,487.99
|
|
|
HC HEART CATH LT/RT/C/CABGS
|
Facility
|
IP
|
$15,402.66
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100052
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,777.17 |
| Max. Negotiated Rate |
$13,862.39 |
| Rate for Payer: Aetna American Axle |
$10,011.73
|
| Rate for Payer: Aetna Commercial |
$13,092.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,011.73
|
| Rate for Payer: Cash Price |
$12,322.13
|
| Rate for Payer: Cofinity Advantage |
$10,781.86
|
| Rate for Payer: Cofinity Commercial |
$13,246.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,322.13
|
| Rate for Payer: Healthscope Commercial |
$13,862.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,781.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,552.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,092.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,552.00
|
| Rate for Payer: PHP Commercial |
$13,092.26
|
| Rate for Payer: Priority Health SBD |
$9,703.68
|
| Rate for Payer: UMR Bronson Commercial |
$6,777.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,552.00
|
|
|
HC HEART CATH LT/RT/C/CABGS
|
Facility
|
OP
|
$15,402.66
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100052
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$13,862.39 |
| Rate for Payer: Aetna American Axle |
$10,011.73
|
| Rate for Payer: Aetna Commercial |
$13,092.26
|
| Rate for Payer: Aetna Medicare |
$3,359.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,011.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,829.36
|
| Rate for Payer: BCN Commercial |
$3,829.36
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$12,322.13
|
| Rate for Payer: Cash Price |
$12,322.13
|
| Rate for Payer: Cofinity Advantage |
$10,781.86
|
| Rate for Payer: Cofinity Commercial |
$13,246.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,322.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$13,862.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,781.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,552.00
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$3,391.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,092.26
|
| Rate for Payer: Nomi Health Commercial |
$9,690.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,552.00
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$13,092.26
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,446.41
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health SBD |
$9,703.68
|
| Rate for Payer: Priority Health Tiered Network |
$8,357.13
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: UMR Bronson Commercial |
$5,698.98
|
| Rate for Payer: VA VA |
$3,230.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,552.00
|
|
|
HC HEART CATH LT/RT CORONARIES
|
Facility
|
OP
|
$13,019.87
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
48100019
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$11,717.88 |
| Rate for Payer: Aetna American Axle |
$8,462.92
|
| Rate for Payer: Aetna Commercial |
$11,066.89
|
| Rate for Payer: Aetna Medicare |
$3,359.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,462.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,472.91
|
| Rate for Payer: BCN Commercial |
$3,472.91
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$10,415.90
|
| Rate for Payer: Cash Price |
$10,415.90
|
| Rate for Payer: Cofinity Advantage |
$9,113.91
|
| Rate for Payer: Cofinity Commercial |
$11,197.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,415.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$11,717.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,113.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,764.90
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$3,391.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,066.89
|
| Rate for Payer: Nomi Health Commercial |
$9,690.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,764.90
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$11,066.89
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,446.41
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health SBD |
$8,202.52
|
| Rate for Payer: Priority Health Tiered Network |
$8,357.13
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: UMR Bronson Commercial |
$4,817.35
|
| Rate for Payer: VA VA |
$3,230.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,764.90
|
|
|
HC HEART CATH LT/RT CORONARIES
|
Facility
|
IP
|
$13,019.87
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
48100019
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,728.74 |
| Max. Negotiated Rate |
$11,717.88 |
| Rate for Payer: Aetna American Axle |
$8,462.92
|
| Rate for Payer: Aetna Commercial |
$11,066.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,462.92
|
| Rate for Payer: Cash Price |
$10,415.90
|
| Rate for Payer: Cofinity Advantage |
$9,113.91
|
| Rate for Payer: Cofinity Commercial |
$11,197.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,415.90
|
| Rate for Payer: Healthscope Commercial |
$11,717.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,113.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,764.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,066.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,764.90
|
| Rate for Payer: PHP Commercial |
$11,066.89
|
| Rate for Payer: Priority Health SBD |
$8,202.52
|
| Rate for Payer: UMR Bronson Commercial |
$5,728.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,764.90
|
|
|
HC HEART CATH LT/RT ONLY
|
Facility
|
IP
|
$9,140.84
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
48100012
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,021.97 |
| Max. Negotiated Rate |
$8,226.76 |
| Rate for Payer: Aetna American Axle |
$5,941.55
|
| Rate for Payer: Aetna Commercial |
$7,769.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,941.55
|
| Rate for Payer: Cash Price |
$7,312.67
|
| Rate for Payer: Cofinity Advantage |
$6,398.59
|
| Rate for Payer: Cofinity Commercial |
$7,861.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,312.67
|
| Rate for Payer: Healthscope Commercial |
$8,226.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,398.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,855.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,769.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,855.63
|
| Rate for Payer: PHP Commercial |
$7,769.71
|
| Rate for Payer: Priority Health SBD |
$5,758.73
|
| Rate for Payer: UMR Bronson Commercial |
$4,021.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,855.63
|
|
|
HC HEART CATH LT/RT ONLY
|
Facility
|
OP
|
$9,140.84
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
48100012
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$10,446.41 |
| Rate for Payer: Aetna American Axle |
$5,941.55
|
| Rate for Payer: Aetna Commercial |
$7,769.71
|
| Rate for Payer: Aetna Medicare |
$3,359.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,941.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,316.52
|
| Rate for Payer: BCN Commercial |
$3,316.52
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$7,312.67
|
| Rate for Payer: Cash Price |
$7,312.67
|
| Rate for Payer: Cofinity Advantage |
$6,398.59
|
| Rate for Payer: Cofinity Commercial |
$7,861.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,312.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$8,226.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,398.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,855.63
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$3,391.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,769.71
|
| Rate for Payer: Nomi Health Commercial |
$9,690.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,855.63
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$7,769.71
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,446.41
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health SBD |
$5,758.73
|
| Rate for Payer: Priority Health Tiered Network |
$8,357.13
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: UMR Bronson Commercial |
$3,382.11
|
| Rate for Payer: VA VA |
$3,230.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,855.63
|
|
|
HC HEART CATH LT W CORONARIES
|
Facility
|
IP
|
$13,107.11
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100017
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,767.13 |
| Max. Negotiated Rate |
$11,796.40 |
| Rate for Payer: Aetna American Axle |
$8,519.62
|
| Rate for Payer: Aetna Commercial |
$11,141.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,519.62
|
| Rate for Payer: Cash Price |
$10,485.69
|
| Rate for Payer: Cofinity Advantage |
$9,174.98
|
| Rate for Payer: Cofinity Commercial |
$11,272.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,485.69
|
| Rate for Payer: Healthscope Commercial |
$11,796.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,174.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,830.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,141.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,830.33
|
| Rate for Payer: PHP Commercial |
$11,141.04
|
| Rate for Payer: Priority Health SBD |
$8,257.48
|
| Rate for Payer: UMR Bronson Commercial |
$5,767.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,830.33
|
|
|
HC HEART CATH LT W CORONARIES
|
Facility
|
OP
|
$13,107.11
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100017
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$11,796.40 |
| Rate for Payer: Aetna American Axle |
$8,519.62
|
| Rate for Payer: Aetna Commercial |
$11,141.04
|
| Rate for Payer: Aetna Medicare |
$3,359.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,519.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,985.43
|
| Rate for Payer: BCN Commercial |
$2,985.43
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$10,485.69
|
| Rate for Payer: Cash Price |
$10,485.69
|
| Rate for Payer: Cofinity Advantage |
$9,174.98
|
| Rate for Payer: Cofinity Commercial |
$11,272.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,485.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$11,796.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,174.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,830.33
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$3,391.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,141.04
|
| Rate for Payer: Nomi Health Commercial |
$9,690.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,830.33
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$11,141.04
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,446.41
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health SBD |
$8,257.48
|
| Rate for Payer: Priority Health Tiered Network |
$8,357.13
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: UMR Bronson Commercial |
$4,849.63
|
| Rate for Payer: VA VA |
$3,230.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,830.33
|
|
|
HC HEART CATH NEEDLE
|
Facility
|
OP
|
$43.96
|
|
| Hospital Charge Code |
62200006
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.27 |
| Max. Negotiated Rate |
$39.56 |
| Rate for Payer: Aetna American Axle |
$28.57
|
| Rate for Payer: Aetna Commercial |
$37.37
|
| Rate for Payer: Aetna Medicare |
$21.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.57
|
| Rate for Payer: BCBS Complete |
$17.58
|
| Rate for Payer: Cash Price |
$35.17
|
| Rate for Payer: Cofinity Advantage |
$30.77
|
| Rate for Payer: Cofinity Commercial |
$37.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.17
|
| Rate for Payer: Healthscope Commercial |
$39.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.97
|
| Rate for Payer: PHP Commercial |
$37.37
|
| Rate for Payer: Priority Health SBD |
$27.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.57
|
| Rate for Payer: UHC Core |
$22.90
|
| Rate for Payer: UHC Exchange |
$17.28
|
| Rate for Payer: UMR Bronson Commercial |
$16.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.97
|
|
|
HC HEART CATH NEEDLE
|
Facility
|
IP
|
$43.96
|
|
| Hospital Charge Code |
62200006
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.34 |
| Max. Negotiated Rate |
$39.56 |
| Rate for Payer: Aetna American Axle |
$28.57
|
| Rate for Payer: Aetna Commercial |
$37.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.57
|
| Rate for Payer: Cash Price |
$35.17
|
| Rate for Payer: Cofinity Advantage |
$30.77
|
| Rate for Payer: Cofinity Commercial |
$37.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.17
|
| Rate for Payer: Healthscope Commercial |
$39.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.97
|
| Rate for Payer: PHP Commercial |
$37.37
|
| Rate for Payer: Priority Health SBD |
$27.69
|
| Rate for Payer: UMR Bronson Commercial |
$19.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.97
|
|
|
HC HEART CATH PACK
|
Facility
|
OP
|
$528.75
|
|
| Hospital Charge Code |
62200007
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$195.64 |
| Max. Negotiated Rate |
$475.88 |
| Rate for Payer: Aetna American Axle |
$343.69
|
| Rate for Payer: Aetna Commercial |
$449.44
|
| Rate for Payer: Aetna Medicare |
$264.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$343.69
|
| Rate for Payer: BCBS Complete |
$211.50
|
| Rate for Payer: Cash Price |
$423.00
|
| Rate for Payer: Cofinity Advantage |
$370.12
|
| Rate for Payer: Cofinity Commercial |
$454.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.00
|
| Rate for Payer: Healthscope Commercial |
$475.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$370.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$396.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$423.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$449.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.56
|
| Rate for Payer: PHP Commercial |
$449.44
|
| Rate for Payer: Priority Health SBD |
$333.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.69
|
| Rate for Payer: UHC Core |
$275.48
|
| Rate for Payer: UHC Exchange |
$207.80
|
| Rate for Payer: UMR Bronson Commercial |
$195.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$396.56
|
|
|
HC HEART CATH PACK
|
Facility
|
IP
|
$528.75
|
|
| Hospital Charge Code |
62200007
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$232.65 |
| Max. Negotiated Rate |
$475.88 |
| Rate for Payer: Aetna American Axle |
$343.69
|
| Rate for Payer: Aetna Commercial |
$449.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$343.69
|
| Rate for Payer: Cash Price |
$423.00
|
| Rate for Payer: Cofinity Advantage |
$370.12
|
| Rate for Payer: Cofinity Commercial |
$454.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.00
|
| Rate for Payer: Healthscope Commercial |
$475.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$370.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$396.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$449.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.56
|
| Rate for Payer: PHP Commercial |
$449.44
|
| Rate for Payer: Priority Health SBD |
$333.11
|
| Rate for Payer: UMR Bronson Commercial |
$232.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$396.56
|
|
|
HC HEART CATH RT ONLY
|
Facility
|
IP
|
$9,742.66
|
|
|
Service Code
|
CPT 93451
|
| Hospital Charge Code |
48100010
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,286.77 |
| Max. Negotiated Rate |
$8,768.39 |
| Rate for Payer: Aetna American Axle |
$6,332.73
|
| Rate for Payer: Aetna Commercial |
$8,281.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,332.73
|
| Rate for Payer: Cash Price |
$7,794.13
|
| Rate for Payer: Cofinity Advantage |
$6,819.86
|
| Rate for Payer: Cofinity Commercial |
$8,378.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,794.13
|
| Rate for Payer: Healthscope Commercial |
$8,768.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,819.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,306.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,281.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,306.99
|
| Rate for Payer: PHP Commercial |
$8,281.26
|
| Rate for Payer: Priority Health SBD |
$6,137.88
|
| Rate for Payer: UMR Bronson Commercial |
$4,286.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,306.99
|
|
