|
HC PLACE BILIARY DRAIN CATH WITH GUIDE INTERNAL EXTERNAL
|
Facility
|
OP
|
$3,610.82
|
|
|
Service Code
|
CPT 47534
|
| Hospital Charge Code |
36100491
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$350.04 |
| Max. Negotiated Rate |
$9,680.93 |
| Rate for Payer: Aetna American Axle |
$2,347.03
|
| Rate for Payer: Aetna Commercial |
$3,069.20
|
| Rate for Payer: Aetna Medicare |
$3,198.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,347.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,844.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,844.02
|
| Rate for Payer: BCBS Complete |
$1,766.41
|
| Rate for Payer: BCBS MAPPO |
$3,075.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,421.13
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cofinity Commercial |
$2,527.57
|
| Rate for Payer: Cofinity Commercial |
$3,105.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,888.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$3,249.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,527.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,708.12
|
| Rate for Payer: Mclaren Medicaid |
$1,682.15
|
| Rate for Payer: Mclaren Medicare |
$3,075.22
|
| Rate for Payer: Meridian Medicaid |
$1,766.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,228.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,536.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,069.20
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$3,069.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,075.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,682.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,527.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,680.93
|
| Rate for Payer: Priority Health Medicare |
$3,075.22
|
| Rate for Payer: Priority Health Narrow Network |
$7,744.74
|
| Rate for Payer: Priority Health SBD |
$2,274.82
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.04
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,075.22
|
| Rate for Payer: UHC Exchange |
$350.04
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,336.00
|
| Rate for Payer: VA VA |
$3,075.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,708.12
|
|
|
HC PLACE BILIARY DRAIN CATH WITH GUIDE INTERNAL EXTERNAL
|
Facility
|
IP
|
$3,610.82
|
|
|
Service Code
|
CPT 47534
|
| Hospital Charge Code |
36100491
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,588.76 |
| Max. Negotiated Rate |
$3,249.74 |
| Rate for Payer: Aetna American Axle |
$2,347.03
|
| Rate for Payer: Aetna Commercial |
$3,069.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,347.03
|
| Rate for Payer: Cash Price |
$2,888.66
|
| Rate for Payer: Cofinity Commercial |
$2,527.57
|
| Rate for Payer: Cofinity Commercial |
$3,105.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,888.66
|
| Rate for Payer: Healthscope Commercial |
$3,249.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,527.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,708.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,069.20
|
| Rate for Payer: PHP Commercial |
$3,069.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,527.57
|
| Rate for Payer: Priority Health SBD |
$2,274.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,588.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,708.12
|
|
|
HC PLACE BILIARY DRAIN WITH GUIDE EXTERNAL
|
Facility
|
OP
|
$3,119.16
|
|
|
Service Code
|
CPT 47533
|
| Hospital Charge Code |
36100490
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$250.17 |
| Max. Negotiated Rate |
$9,680.93 |
| Rate for Payer: Aetna American Axle |
$2,027.45
|
| Rate for Payer: Aetna Commercial |
$2,651.29
|
| Rate for Payer: Aetna Medicare |
$3,198.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,027.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,844.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,844.02
|
| Rate for Payer: BCBS Complete |
$1,766.41
|
| Rate for Payer: BCBS MAPPO |
$3,075.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,421.13
|
| Rate for Payer: BCN Medicare Advantage |
$3,075.22
|
| Rate for Payer: Cash Price |
$2,495.33
|
| Rate for Payer: Cash Price |
$2,495.33
|
| Rate for Payer: Cofinity Commercial |
$2,183.41
|
| Rate for Payer: Cofinity Commercial |
$2,682.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,495.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,075.22
|
| Rate for Payer: Healthscope Commercial |
$2,807.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,183.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,339.37
|
| Rate for Payer: Mclaren Medicaid |
$1,682.15
|
| Rate for Payer: Mclaren Medicare |
$3,075.22
|
| Rate for Payer: Meridian Medicaid |
$1,766.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,228.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,536.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,651.29
|
| Rate for Payer: PACE Medicare |
$2,921.46
|
| Rate for Payer: PACE SWMI |
$3,075.22
|
| Rate for Payer: PHP Commercial |
$2,651.29
|
| Rate for Payer: PHP Medicare Advantage |
$3,075.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,682.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,183.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,680.93
|
| Rate for Payer: Priority Health Medicare |
$3,075.22
|
| Rate for Payer: Priority Health Narrow Network |
$7,744.74
|
| Rate for Payer: Priority Health SBD |
$1,965.07
|
| Rate for Payer: Railroad Medicare Medicare |
$3,075.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$275.19
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,075.22
|
| Rate for Payer: UHC Exchange |
$250.17
|
| Rate for Payer: UHC Medicare Advantage |
$3,167.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,154.09
|
| Rate for Payer: VA VA |
$3,075.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,339.37
|
|
|
HC PLACE BILIARY DRAIN WITH GUIDE EXTERNAL
|
Facility
|
IP
|
$3,119.16
|
|
|
Service Code
|
CPT 47533
|
| Hospital Charge Code |
36100490
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,372.43 |
| Max. Negotiated Rate |
$2,807.24 |
| Rate for Payer: Aetna American Axle |
$2,027.45
|
| Rate for Payer: Aetna Commercial |
$2,651.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,027.45
|
| Rate for Payer: Cash Price |
$2,495.33
|
| Rate for Payer: Cofinity Commercial |
$2,183.41
|
| Rate for Payer: Cofinity Commercial |
$2,682.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,495.33
|
| Rate for Payer: Healthscope Commercial |
$2,807.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,183.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,339.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,651.29
|
| Rate for Payer: PHP Commercial |
$2,651.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,183.41
|
| Rate for Payer: Priority Health SBD |
$1,965.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,372.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,339.37
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MAMM GUIDE
|
Facility
|
IP
|
$1,142.85
|
|
|
Service Code
|
CPT 19282
|
| Hospital Charge Code |
36100415
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$502.85 |
| Max. Negotiated Rate |
$1,028.56 |
| Rate for Payer: Aetna American Axle |
$742.85
|
| Rate for Payer: Aetna Commercial |
$971.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$742.85
|
| Rate for Payer: Cash Price |
$914.28
|
| Rate for Payer: Cofinity Commercial |
$982.85
|
| Rate for Payer: Cofinity Commercial |
$800.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$914.28
|
| Rate for Payer: Healthscope Commercial |
$1,028.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$800.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$857.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$971.42
|
| Rate for Payer: PHP Commercial |
$971.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.00
|
| Rate for Payer: Priority Health SBD |
$720.00
|
| Rate for Payer: UMR Bronson Commercial |
$502.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$857.14
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MAMM GUIDE
|
Facility
|
OP
|
$1,142.85
|
|
|
Service Code
|
CPT 19282
|
| Hospital Charge Code |
36100415
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$47.48 |
| Max. Negotiated Rate |
$1,028.56 |
| Rate for Payer: Aetna American Axle |
$742.85
|
| Rate for Payer: Aetna Commercial |
$971.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$742.85
|
| Rate for Payer: BCBS Complete |
$457.14
|
| Rate for Payer: BCBS Trust/PPO |
$784.30
|
| Rate for Payer: BCCCP Commercial |
$176.03
|
| Rate for Payer: Cash Price |
$914.28
|
| Rate for Payer: Cash Price |
$914.28
|
| Rate for Payer: Cofinity Commercial |
$800.00
|
| Rate for Payer: Cofinity Commercial |
$982.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$914.28
|
| Rate for Payer: Healthscope Commercial |
$1,028.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$800.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$857.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$971.42
|
| Rate for Payer: PHP Commercial |
$971.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$800.00
|
| Rate for Payer: Priority Health SBD |
$720.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.23
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$47.48
|
| Rate for Payer: UMR Bronson Commercial |
$422.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$857.14
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MR GUIDE
|
Facility
|
OP
|
$1,721.55
|
|
|
Service Code
|
CPT 19288
|
| Hospital Charge Code |
36100421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$60.25 |
| Max. Negotiated Rate |
$2,379.22 |
| Rate for Payer: Aetna American Axle |
$1,119.01
|
| Rate for Payer: Aetna Commercial |
$1,463.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,119.01
|
| Rate for Payer: BCBS Complete |
$688.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,379.22
|
| Rate for Payer: BCCCP Commercial |
$506.78
|
| Rate for Payer: Cash Price |
$1,377.24
|
| Rate for Payer: Cash Price |
$1,377.24
|
| Rate for Payer: Cofinity Commercial |
$1,480.53
|
| Rate for Payer: Cofinity Commercial |
$1,205.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,377.24
|
| Rate for Payer: Healthscope Commercial |
$1,549.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,205.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,463.32
|
| Rate for Payer: PHP Commercial |
$1,463.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.08
|
| Rate for Payer: Priority Health SBD |
$1,084.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.28
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$60.25
|
| Rate for Payer: UMR Bronson Commercial |
$636.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,291.16
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION MR GUIDE
|
Facility
|
IP
|
$1,721.55
|
|
|
Service Code
|
CPT 19288
|
| Hospital Charge Code |
36100421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$757.48 |
| Max. Negotiated Rate |
$1,549.40 |
| Rate for Payer: Aetna American Axle |
$1,119.01
|
| Rate for Payer: Aetna Commercial |
$1,463.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,119.01
|
| Rate for Payer: Cash Price |
$1,377.24
|
| Rate for Payer: Cofinity Commercial |
$1,205.08
|
| Rate for Payer: Cofinity Commercial |
$1,480.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,377.24
|
| Rate for Payer: Healthscope Commercial |
$1,549.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,205.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,463.32
|
| Rate for Payer: PHP Commercial |
$1,463.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,205.08
|
| Rate for Payer: Priority Health SBD |
$1,084.58
|
| Rate for Payer: UMR Bronson Commercial |
$757.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,291.16
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION STEREO GUIDE
|
Facility
|
OP
|
$2,065.76
|
|
|
Service Code
|
CPT 19284
|
| Hospital Charge Code |
36100417
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$47.81 |
| Max. Negotiated Rate |
$1,859.18 |
| Rate for Payer: Aetna American Axle |
$1,342.74
|
| Rate for Payer: Aetna Commercial |
$1,755.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,342.74
|
| Rate for Payer: BCBS Complete |
$826.30
|
| Rate for Payer: BCBS Trust/PPO |
$697.51
|
| Rate for Payer: BCCCP Commercial |
$197.10
|
| Rate for Payer: Cash Price |
$1,652.61
|
| Rate for Payer: Cash Price |
$1,652.61
|
| Rate for Payer: Cofinity Commercial |
$1,776.55
|
| Rate for Payer: Cofinity Commercial |
$1,446.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,652.61
|
| Rate for Payer: Healthscope Commercial |
$1,859.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,446.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,549.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,755.90
|
| Rate for Payer: PHP Commercial |
$1,755.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,446.03
|
| Rate for Payer: Priority Health SBD |
$1,301.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.59
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$47.81
|
| Rate for Payer: UMR Bronson Commercial |
$764.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,549.32
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION STEREO GUIDE
|
Facility
|
IP
|
$2,065.76
|
|
|
Service Code
|
CPT 19284
|
| Hospital Charge Code |
36100417
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$908.93 |
| Max. Negotiated Rate |
$1,859.18 |
| Rate for Payer: Aetna American Axle |
$1,342.74
|
| Rate for Payer: Aetna Commercial |
$1,755.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,342.74
|
| Rate for Payer: Cash Price |
$1,652.61
|
| Rate for Payer: Cofinity Commercial |
$1,446.03
|
| Rate for Payer: Cofinity Commercial |
$1,776.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,652.61
|
| Rate for Payer: Healthscope Commercial |
$1,859.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,446.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,549.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,755.90
|
| Rate for Payer: PHP Commercial |
$1,755.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,446.03
|
| Rate for Payer: Priority Health SBD |
$1,301.43
|
| Rate for Payer: UMR Bronson Commercial |
$908.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,549.32
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION US GUIDE
|
Facility
|
IP
|
$2,861.45
|
|
|
Service Code
|
CPT 19286
|
| Hospital Charge Code |
36100419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,259.04 |
| Max. Negotiated Rate |
$2,575.30 |
| Rate for Payer: Aetna American Axle |
$1,859.94
|
| Rate for Payer: Aetna Commercial |
$2,432.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,859.94
|
| Rate for Payer: Cash Price |
$2,289.16
|
| Rate for Payer: Cofinity Commercial |
$2,003.02
|
| Rate for Payer: Cofinity Commercial |
$2,460.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,289.16
|
| Rate for Payer: Healthscope Commercial |
$2,575.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,003.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,146.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,432.23
|
| Rate for Payer: PHP Commercial |
$2,432.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,003.02
|
| Rate for Payer: Priority Health SBD |
$1,802.71
|
| Rate for Payer: UMR Bronson Commercial |
$1,259.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,146.09
|
|
|
HC PLACE BREAST LOC DEVICE EACH ADDL LESION US GUIDE
|
Facility
|
OP
|
$2,861.45
|
|
|
Service Code
|
CPT 19286
|
| Hospital Charge Code |
36100419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$2,575.30 |
| Rate for Payer: Aetna American Axle |
$1,859.94
|
| Rate for Payer: Aetna Commercial |
$2,432.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,859.94
|
| Rate for Payer: BCBS Complete |
$1,144.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,394.62
|
| Rate for Payer: BCCCP Commercial |
$312.47
|
| Rate for Payer: Cash Price |
$2,289.16
|
| Rate for Payer: Cash Price |
$2,289.16
|
| Rate for Payer: Cofinity Commercial |
$2,460.85
|
| Rate for Payer: Cofinity Commercial |
$2,003.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,289.16
|
| Rate for Payer: Healthscope Commercial |
$2,575.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,003.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,146.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,432.23
|
| Rate for Payer: PHP Commercial |
$2,432.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,003.02
|
| Rate for Payer: Priority Health SBD |
$1,802.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.66
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$40.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,058.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,146.09
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MAMM GUIDE
|
Facility
|
OP
|
$1,420.38
|
|
|
Service Code
|
CPT 19281
|
| Hospital Charge Code |
36100414
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$94.63 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$923.25
|
| Rate for Payer: Aetna Commercial |
$1,207.32
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$685.66
|
| Rate for Payer: BCCCP Commercial |
$248.73
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,136.30
|
| Rate for Payer: Cash Price |
$1,136.30
|
| Rate for Payer: Cofinity Commercial |
$1,221.53
|
| Rate for Payer: Cofinity Commercial |
$994.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,136.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,278.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$994.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,065.28
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,207.32
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,207.32
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$894.84
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.09
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$94.63
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$525.54
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,065.28
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MAMM GUIDE
|
Facility
|
IP
|
$1,420.38
|
|
|
Service Code
|
CPT 19281
|
| Hospital Charge Code |
36100414
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$624.97 |
| Max. Negotiated Rate |
$1,278.34 |
| Rate for Payer: Aetna American Axle |
$923.25
|
| Rate for Payer: Aetna Commercial |
$1,207.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$923.25
|
| Rate for Payer: Cash Price |
$1,136.30
|
| Rate for Payer: Cofinity Commercial |
$1,221.53
|
| Rate for Payer: Cofinity Commercial |
$994.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,136.30
|
| Rate for Payer: Healthscope Commercial |
$1,278.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$994.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,065.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,207.32
|
| Rate for Payer: PHP Commercial |
$1,207.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.27
|
| Rate for Payer: Priority Health SBD |
$894.84
|
| Rate for Payer: UMR Bronson Commercial |
$624.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,065.28
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MR GUIDE
|
Facility
|
IP
|
$1,660.51
|
|
|
Service Code
|
CPT 19287
|
| Hospital Charge Code |
36100420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$730.62 |
| Max. Negotiated Rate |
$1,494.46 |
| Rate for Payer: Aetna American Axle |
$1,079.33
|
| Rate for Payer: Aetna Commercial |
$1,411.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,079.33
|
| Rate for Payer: Cash Price |
$1,328.41
|
| Rate for Payer: Cofinity Commercial |
$1,162.36
|
| Rate for Payer: Cofinity Commercial |
$1,428.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,328.41
|
| Rate for Payer: Healthscope Commercial |
$1,494.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,162.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,245.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,411.43
|
| Rate for Payer: PHP Commercial |
$1,411.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.36
|
| Rate for Payer: Priority Health SBD |
$1,046.12
|
| Rate for Payer: UMR Bronson Commercial |
$730.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,245.38
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION MR GUIDE
|
Facility
|
OP
|
$1,660.51
|
|
|
Service Code
|
CPT 19287
|
| Hospital Charge Code |
36100420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$120.83 |
| Max. Negotiated Rate |
$1,968.76 |
| Rate for Payer: Aetna American Axle |
$1,079.33
|
| Rate for Payer: Aetna Commercial |
$1,411.43
|
| Rate for Payer: Aetna Medicare |
$650.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,079.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$480.10
|
| Rate for Payer: BCCCP Commercial |
$656.55
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$1,328.41
|
| Rate for Payer: Cash Price |
$1,328.41
|
| Rate for Payer: Cofinity Commercial |
$1,428.04
|
| Rate for Payer: Cofinity Commercial |
$1,162.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,328.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$1,494.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,162.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,245.38
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,411.43
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$1,411.43
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.76
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.01
|
| Rate for Payer: Priority Health SBD |
$1,046.12
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.91
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.39
|
| Rate for Payer: UHC Exchange |
$120.83
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: UMR Bronson Commercial |
$614.39
|
| Rate for Payer: VA VA |
$625.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,245.38
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION STEREO GUIDE
|
Facility
|
OP
|
$2,343.35
|
|
|
Service Code
|
CPT 19283
|
| Hospital Charge Code |
36100416
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$95.61 |
| Max. Negotiated Rate |
$2,109.02 |
| Rate for Payer: Aetna American Axle |
$1,523.18
|
| Rate for Payer: Aetna Commercial |
$1,991.85
|
| Rate for Payer: Aetna Medicare |
$650.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,523.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$480.10
|
| Rate for Payer: BCCCP Commercial |
$268.69
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$1,874.68
|
| Rate for Payer: Cash Price |
$1,874.68
|
| Rate for Payer: Cofinity Commercial |
$1,640.34
|
| Rate for Payer: Cofinity Commercial |
$2,015.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,874.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$2,109.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,640.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,757.51
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,991.85
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$1,991.85
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,640.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.76
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.01
|
| Rate for Payer: Priority Health SBD |
$1,476.31
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.17
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.39
|
| Rate for Payer: UHC Exchange |
$95.61
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: UMR Bronson Commercial |
$867.04
|
| Rate for Payer: VA VA |
$625.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,757.51
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION STEREO GUIDE
|
Facility
|
IP
|
$2,343.35
|
|
|
Service Code
|
CPT 19283
|
| Hospital Charge Code |
36100416
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,031.07 |
| Max. Negotiated Rate |
$2,109.02 |
| Rate for Payer: Aetna American Axle |
$1,523.18
|
| Rate for Payer: Aetna Commercial |
$1,991.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,523.18
|
| Rate for Payer: Cash Price |
$1,874.68
|
| Rate for Payer: Cofinity Commercial |
$1,640.34
|
| Rate for Payer: Cofinity Commercial |
$2,015.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,874.68
|
| Rate for Payer: Healthscope Commercial |
$2,109.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,640.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,757.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,991.85
|
| Rate for Payer: PHP Commercial |
$1,991.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,640.34
|
| Rate for Payer: Priority Health SBD |
$1,476.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,031.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,757.51
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION US GUIDE
|
Facility
|
IP
|
$1,924.49
|
|
|
Service Code
|
CPT 19285
|
| Hospital Charge Code |
36100418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$846.78 |
| Max. Negotiated Rate |
$1,732.04 |
| Rate for Payer: Aetna American Axle |
$1,250.92
|
| Rate for Payer: Aetna Commercial |
$1,635.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,250.92
|
| Rate for Payer: Cash Price |
$1,539.59
|
| Rate for Payer: Cofinity Commercial |
$1,347.14
|
| Rate for Payer: Cofinity Commercial |
$1,655.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,539.59
|
| Rate for Payer: Healthscope Commercial |
$1,732.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,347.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,443.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,635.82
|
| Rate for Payer: PHP Commercial |
$1,635.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.14
|
| Rate for Payer: Priority Health SBD |
$1,212.43
|
| Rate for Payer: UMR Bronson Commercial |
$846.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,443.37
|
|
|
HC PLACE BREAST LOC DEVICE FIRST LESION US GUIDE
|
Facility
|
OP
|
$1,924.49
|
|
|
Service Code
|
CPT 19285
|
| Hospital Charge Code |
36100418
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$80.88 |
| Max. Negotiated Rate |
$1,968.76 |
| Rate for Payer: Aetna American Axle |
$1,250.92
|
| Rate for Payer: Aetna Commercial |
$1,635.82
|
| Rate for Payer: Aetna Medicare |
$650.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,250.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$918.65
|
| Rate for Payer: BCCCP Commercial |
$382.11
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$1,539.59
|
| Rate for Payer: Cash Price |
$1,539.59
|
| Rate for Payer: Cofinity Commercial |
$1,347.14
|
| Rate for Payer: Cofinity Commercial |
$1,655.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,539.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$1,732.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,347.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,443.37
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,635.82
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$1,635.82
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.76
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.01
|
| Rate for Payer: Priority Health SBD |
$1,212.43
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.97
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.39
|
| Rate for Payer: UHC Exchange |
$80.88
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: UMR Bronson Commercial |
$712.06
|
| Rate for Payer: VA VA |
$625.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,443.37
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 1ST ORDER
|
Facility
|
IP
|
$7,123.41
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
36100106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,134.30 |
| Max. Negotiated Rate |
$6,411.07 |
| Rate for Payer: Aetna American Axle |
$4,630.22
|
| Rate for Payer: Aetna Commercial |
$6,054.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,630.22
|
| Rate for Payer: Cash Price |
$5,698.73
|
| Rate for Payer: Cofinity Commercial |
$4,986.39
|
| Rate for Payer: Cofinity Commercial |
$6,126.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,698.73
|
| Rate for Payer: Healthscope Commercial |
$6,411.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,986.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,342.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,054.90
|
| Rate for Payer: PHP Commercial |
$6,054.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,986.39
|
| Rate for Payer: Priority Health SBD |
$4,487.75
|
| Rate for Payer: UMR Bronson Commercial |
$3,134.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,342.56
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 1ST ORDER
|
Facility
|
OP
|
$7,123.41
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
36100106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$203.34 |
| Max. Negotiated Rate |
$6,411.07 |
| Rate for Payer: Aetna American Axle |
$4,630.22
|
| Rate for Payer: Aetna Commercial |
$6,054.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,630.22
|
| Rate for Payer: BCBS Complete |
$2,849.36
|
| Rate for Payer: BCBS Trust/PPO |
$3,835.69
|
| Rate for Payer: Cash Price |
$5,698.73
|
| Rate for Payer: Cash Price |
$5,698.73
|
| Rate for Payer: Cofinity Commercial |
$4,986.39
|
| Rate for Payer: Cofinity Commercial |
$6,126.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,698.73
|
| Rate for Payer: Healthscope Commercial |
$6,411.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,986.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,342.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,054.90
|
| Rate for Payer: PHP Commercial |
$6,054.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,986.39
|
| Rate for Payer: Priority Health SBD |
$4,487.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.67
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$203.34
|
| Rate for Payer: UMR Bronson Commercial |
$2,635.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,342.56
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 2ND ORDER
|
Facility
|
IP
|
$1,000.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
36100107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$440.00 |
| Max. Negotiated Rate |
$900.00 |
| Rate for Payer: Aetna American Axle |
$650.00
|
| Rate for Payer: Aetna Commercial |
$850.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$650.00
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cofinity Commercial |
$700.00
|
| Rate for Payer: Cofinity Commercial |
$860.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.00
|
| Rate for Payer: Healthscope Commercial |
$900.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$700.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$750.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$850.00
|
| Rate for Payer: PHP Commercial |
$850.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.00
|
| Rate for Payer: Priority Health SBD |
$630.00
|
| Rate for Payer: UMR Bronson Commercial |
$440.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$750.00
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 2ND ORDER
|
Facility
|
OP
|
$1,000.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
36100107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$260.97 |
| Max. Negotiated Rate |
$3,965.76 |
| Rate for Payer: Aetna American Axle |
$650.00
|
| Rate for Payer: Aetna Commercial |
$850.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$650.00
|
| Rate for Payer: BCBS Complete |
$400.00
|
| Rate for Payer: BCBS Trust/PPO |
$3,965.76
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cofinity Commercial |
$860.00
|
| Rate for Payer: Cofinity Commercial |
$700.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.00
|
| Rate for Payer: Healthscope Commercial |
$900.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$700.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$750.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$850.00
|
| Rate for Payer: PHP Commercial |
$850.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.00
|
| Rate for Payer: Priority Health SBD |
$630.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.07
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$260.97
|
| Rate for Payer: UMR Bronson Commercial |
$370.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$750.00
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 3RD ORDER
|
Facility
|
OP
|
$828.96
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
36100108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$306.72 |
| Max. Negotiated Rate |
$6,490.77 |
| Rate for Payer: Aetna American Axle |
$538.82
|
| Rate for Payer: Aetna Commercial |
$704.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$538.82
|
| Rate for Payer: BCBS Complete |
$331.58
|
| Rate for Payer: BCBS Trust/PPO |
$6,490.77
|
| Rate for Payer: Cash Price |
$663.17
|
| Rate for Payer: Cash Price |
$663.17
|
| Rate for Payer: Cofinity Commercial |
$580.27
|
| Rate for Payer: Cofinity Commercial |
$712.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$663.17
|
| Rate for Payer: Healthscope Commercial |
$746.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$580.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$621.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$704.62
|
| Rate for Payer: PHP Commercial |
$704.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$580.27
|
| Rate for Payer: Priority Health SBD |
$522.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.26
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$320.24
|
| Rate for Payer: UMR Bronson Commercial |
$306.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$621.72
|
|
