|
HC I-131 CAP (DX) PER MCI
|
Facility
|
OP
|
$256.00
|
|
|
Service Code
|
HCPCS A9528
|
| Hospital Charge Code |
34300011
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$94.72 |
| Max. Negotiated Rate |
$230.40 |
| Rate for Payer: Aetna American Axle |
$166.40
|
| Rate for Payer: Aetna Commercial |
$217.60
|
| Rate for Payer: Aetna Medicare |
$128.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.40
|
| Rate for Payer: BCBS Complete |
$102.40
|
| Rate for Payer: BCBS Trust/PPO |
$192.66
|
| Rate for Payer: BCN Commercial |
$192.66
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Advantage |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$220.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.80
|
| Rate for Payer: Healthscope Commercial |
$230.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$179.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: PHP Commercial |
$217.60
|
| Rate for Payer: Priority Health SBD |
$161.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.92
|
| Rate for Payer: UHC Core |
$160.92
|
| Rate for Payer: UHC Exchange |
$160.92
|
| Rate for Payer: UMR Bronson Commercial |
$94.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.00
|
|
|
HC I-131 CAP (DX) PER MCI
|
Facility
|
IP
|
$256.00
|
|
|
Service Code
|
HCPCS A9528
|
| Hospital Charge Code |
34300011
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$112.64 |
| Max. Negotiated Rate |
$230.40 |
| Rate for Payer: Aetna American Axle |
$166.40
|
| Rate for Payer: Aetna Commercial |
$217.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.40
|
| Rate for Payer: Cash Price |
$204.80
|
| Rate for Payer: Cofinity Advantage |
$179.20
|
| Rate for Payer: Cofinity Commercial |
$220.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.80
|
| Rate for Payer: Healthscope Commercial |
$230.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$179.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$192.00
|
| Rate for Payer: PHP Commercial |
$217.60
|
| Rate for Payer: Priority Health SBD |
$161.28
|
| Rate for Payer: UMR Bronson Commercial |
$112.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.00
|
|
|
HC I-131 CAP (TX) PER MCI
|
Facility
|
IP
|
$69.49
|
|
|
Service Code
|
HCPCS A9517
|
| Hospital Charge Code |
34400001
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$30.58 |
| Max. Negotiated Rate |
$62.54 |
| Rate for Payer: Aetna American Axle |
$45.17
|
| Rate for Payer: Aetna Commercial |
$59.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.17
|
| Rate for Payer: Cash Price |
$55.59
|
| Rate for Payer: Cofinity Advantage |
$48.64
|
| Rate for Payer: Cofinity Commercial |
$59.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.59
|
| Rate for Payer: Healthscope Commercial |
$62.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.12
|
| Rate for Payer: PHP Commercial |
$59.07
|
| Rate for Payer: Priority Health SBD |
$43.78
|
| Rate for Payer: UMR Bronson Commercial |
$30.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.12
|
|
|
HC I-131 CAP (TX) PER MCI
|
Facility
|
OP
|
$69.49
|
|
|
Service Code
|
HCPCS A9517
|
| Hospital Charge Code |
34400001
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$12.59 |
| Max. Negotiated Rate |
$75.91 |
| Rate for Payer: Aetna American Axle |
$45.17
|
| Rate for Payer: Aetna Commercial |
$59.07
|
| Rate for Payer: Aetna Medicare |
$25.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.09
|
| Rate for Payer: BCBS Complete |
$13.22
|
| Rate for Payer: BCBS MAPPO |
$24.07
|
| Rate for Payer: BCBS Trust/PPO |
$35.65
|
| Rate for Payer: BCN Commercial |
$35.65
|
| Rate for Payer: BCN Medicare Advantage |
$24.07
|
| Rate for Payer: Cash Price |
$55.59
|
| Rate for Payer: Cash Price |
$55.59
|
| Rate for Payer: Cofinity Advantage |
$48.64
|
| Rate for Payer: Cofinity Commercial |
$59.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.07
|
| Rate for Payer: Healthscope Commercial |
$62.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.12
|
| Rate for Payer: Mclaren Medicaid |
$24.07
|
| Rate for Payer: Mclaren Medicare |
$24.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.27
|
| Rate for Payer: Meridian Medicaid |
$25.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.07
|
| Rate for Payer: Nomi Health Commercial |
$72.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.12
|
| Rate for Payer: PACE Medicare |
$22.87
|
| Rate for Payer: PACE SWMI |
$24.07
|
| Rate for Payer: PHP Commercial |
$59.07
|
| Rate for Payer: PHP Medicare Advantage |
$24.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$75.91
|
| Rate for Payer: Priority Health Medicare |
$24.07
|
| Rate for Payer: Priority Health SBD |
$43.78
|
| Rate for Payer: Priority Health Tiered Network |
$60.73
|
| Rate for Payer: Railroad Medicare Medicare |
$24.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.72
|
| Rate for Payer: UHC Core |
$39.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.07
|
| Rate for Payer: UHC Exchange |
$39.72
|
| Rate for Payer: UHC Medicaid |
$12.59
|
| Rate for Payer: UHCCP Medicaid |
$12.59
|
| Rate for Payer: UMR Bronson Commercial |
$25.71
|
| Rate for Payer: VA VA |
$24.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.12
|
|
|
HC I-131 SOD IODIDE DIAG PER UCI
|
Facility
|
IP
|
$48.82
|
|
|
Service Code
|
HCPCS A9531
|
| Hospital Charge Code |
34300031
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$21.48 |
| Max. Negotiated Rate |
$43.94 |
| Rate for Payer: Aetna American Axle |
$31.73
|
| Rate for Payer: Aetna Commercial |
$41.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.73
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Advantage |
$34.17
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$43.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PHP Commercial |
$41.50
|
| Rate for Payer: Priority Health SBD |
$30.76
|
| Rate for Payer: UMR Bronson Commercial |
$21.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
HC I-131 SOD IODIDE DIAG PER UCI
|
Facility
|
OP
|
$48.82
|
|
|
Service Code
|
HCPCS A9531
|
| Hospital Charge Code |
34300031
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$7.16 |
| Max. Negotiated Rate |
$43.94 |
| Rate for Payer: Aetna American Axle |
$31.73
|
| Rate for Payer: Aetna Commercial |
$41.50
|
| Rate for Payer: Aetna Medicare |
$24.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.73
|
| Rate for Payer: BCBS Complete |
$19.53
|
| Rate for Payer: BCBS Trust/PPO |
$16.26
|
| Rate for Payer: BCN Commercial |
$16.26
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Advantage |
$34.17
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$43.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PHP Commercial |
$41.50
|
| Rate for Payer: Priority Health SBD |
$30.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.16
|
| Rate for Payer: UHC Core |
$7.16
|
| Rate for Payer: UHC Exchange |
$7.16
|
| Rate for Payer: UMR Bronson Commercial |
$18.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
HC I-131 SOL (DX) PER MCI
|
Facility
|
IP
|
$48.83
|
|
|
Service Code
|
HCPCS A9529
|
| Hospital Charge Code |
34300012
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$21.49 |
| Max. Negotiated Rate |
$43.95 |
| Rate for Payer: Aetna American Axle |
$31.74
|
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.74
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Advantage |
$34.18
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$43.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PHP Commercial |
$41.51
|
| Rate for Payer: Priority Health SBD |
$30.76
|
| Rate for Payer: UMR Bronson Commercial |
$21.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
HC I-131 SOL (DX) PER MCI
|
Facility
|
OP
|
$48.83
|
|
|
Service Code
|
HCPCS A9529
|
| Hospital Charge Code |
34300012
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$10.50 |
| Max. Negotiated Rate |
$43.95 |
| Rate for Payer: Aetna American Axle |
$31.74
|
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: Aetna Medicare |
$24.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.74
|
| Rate for Payer: BCBS Complete |
$19.53
|
| Rate for Payer: BCBS Trust/PPO |
$10.50
|
| Rate for Payer: BCN Commercial |
$10.50
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Advantage |
$34.18
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$43.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PHP Commercial |
$41.51
|
| Rate for Payer: Priority Health SBD |
$30.76
|
| Rate for Payer: UMR Bronson Commercial |
$18.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
HC I-131 SOL (TX) PER MCI
|
Facility
|
OP
|
$48.83
|
|
|
Service Code
|
HCPCS A9530
|
| Hospital Charge Code |
34400002
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$65.51 |
| Rate for Payer: Aetna American Axle |
$31.74
|
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: Aetna Medicare |
$21.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.96
|
| Rate for Payer: BCBS Complete |
$11.41
|
| Rate for Payer: BCBS MAPPO |
$20.77
|
| Rate for Payer: BCBS Trust/PPO |
$32.18
|
| Rate for Payer: BCN Commercial |
$32.18
|
| Rate for Payer: BCN Medicare Advantage |
$20.77
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Advantage |
$34.18
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.77
|
| Rate for Payer: Healthscope Commercial |
$43.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: Mclaren Medicaid |
$20.77
|
| Rate for Payer: Mclaren Medicare |
$20.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.81
|
| Rate for Payer: Meridian Medicaid |
$21.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.51
|
| Rate for Payer: Nomi Health Commercial |
$62.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PACE Medicare |
$19.73
|
| Rate for Payer: PACE SWMI |
$20.77
|
| Rate for Payer: PHP Commercial |
$41.51
|
| Rate for Payer: PHP Medicare Advantage |
$20.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$65.51
|
| Rate for Payer: Priority Health Medicare |
$20.77
|
| Rate for Payer: Priority Health SBD |
$30.76
|
| Rate for Payer: Priority Health Tiered Network |
$52.41
|
| Rate for Payer: Railroad Medicare Medicare |
$20.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.27
|
| Rate for Payer: UHC Core |
$34.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.77
|
| Rate for Payer: UHC Exchange |
$34.27
|
| Rate for Payer: UHC Medicaid |
$10.86
|
| Rate for Payer: UHCCP Medicaid |
$10.86
|
| Rate for Payer: UMR Bronson Commercial |
$18.07
|
| Rate for Payer: VA VA |
$20.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
HC I-131 SOL (TX) PER MCI
|
Facility
|
IP
|
$48.83
|
|
|
Service Code
|
HCPCS A9530
|
| Hospital Charge Code |
34400002
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$21.49 |
| Max. Negotiated Rate |
$43.95 |
| Rate for Payer: Aetna American Axle |
$31.74
|
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.74
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Advantage |
$34.18
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$43.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PHP Commercial |
$41.51
|
| Rate for Payer: Priority Health SBD |
$30.76
|
| Rate for Payer: UMR Bronson Commercial |
$21.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
HC IAAD NOS EACH ORGANISM AG IA
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600341
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$47.12 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna American Axle |
$69.61
|
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.61
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Advantage |
$74.97
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.33
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: Priority Health SBD |
$67.47
|
| Rate for Payer: UMR Bronson Commercial |
$47.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.33
|
|
|
HC IAAD NOS EACH ORGANISM AG IA
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600341
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna American Axle |
$69.61
|
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: BCBS Complete |
$6.58
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$13.86
|
| Rate for Payer: BCN Commercial |
$13.86
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Advantage |
$74.97
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.33
|
| Rate for Payer: Mclaren Medicaid |
$11.98
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: Nomi Health Commercial |
$17.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.33
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.98
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health SBD |
$67.47
|
| Rate for Payer: Priority Health Tiered Network |
$9.58
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.97
|
| Rate for Payer: UHC Core |
$17.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.98
|
| Rate for Payer: UHC Exchange |
$17.97
|
| Rate for Payer: UHC Medicaid |
$6.27
|
| Rate for Payer: UHCCP Medicaid |
$6.27
|
| Rate for Payer: UMR Bronson Commercial |
$39.63
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.33
|
|
|
HC IAPB MONITORING SERVICES HOURL
|
Facility
|
OP
|
$416.84
|
|
| Hospital Charge Code |
27000118
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$154.23 |
| Max. Negotiated Rate |
$375.16 |
| Rate for Payer: Aetna American Axle |
$270.95
|
| Rate for Payer: Aetna Commercial |
$354.31
|
| Rate for Payer: Aetna Medicare |
$208.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.95
|
| Rate for Payer: BCBS Complete |
$166.74
|
| Rate for Payer: Cash Price |
$333.47
|
| Rate for Payer: Cofinity Advantage |
$291.79
|
| Rate for Payer: Cofinity Commercial |
$358.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.47
|
| Rate for Payer: Healthscope Commercial |
$375.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$333.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.63
|
| Rate for Payer: PHP Commercial |
$354.31
|
| Rate for Payer: Priority Health SBD |
$262.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.95
|
| Rate for Payer: UHC Core |
$217.17
|
| Rate for Payer: UHC Exchange |
$163.82
|
| Rate for Payer: UMR Bronson Commercial |
$154.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.63
|
|
|
HC IAPB MONITORING SERVICES HOURL
|
Facility
|
IP
|
$416.84
|
|
| Hospital Charge Code |
27000118
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$183.41 |
| Max. Negotiated Rate |
$375.16 |
| Rate for Payer: Aetna American Axle |
$270.95
|
| Rate for Payer: Aetna Commercial |
$354.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.95
|
| Rate for Payer: Cash Price |
$333.47
|
| Rate for Payer: Cofinity Advantage |
$291.79
|
| Rate for Payer: Cofinity Commercial |
$358.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.47
|
| Rate for Payer: Healthscope Commercial |
$375.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.63
|
| Rate for Payer: PHP Commercial |
$354.31
|
| Rate for Payer: Priority Health SBD |
$262.61
|
| Rate for Payer: UMR Bronson Commercial |
$183.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.63
|
|
|
HC IAP CHEMO ADMINISTRATON
|
Facility
|
IP
|
$406.41
|
|
|
Service Code
|
CPT 96420
|
| Hospital Charge Code |
33500010
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$178.82 |
| Max. Negotiated Rate |
$365.77 |
| Rate for Payer: Aetna American Axle |
$264.17
|
| Rate for Payer: Aetna Commercial |
$345.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.17
|
| Rate for Payer: Cash Price |
$325.13
|
| Rate for Payer: Cofinity Advantage |
$284.49
|
| Rate for Payer: Cofinity Commercial |
$349.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.13
|
| Rate for Payer: Healthscope Commercial |
$365.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.81
|
| Rate for Payer: PHP Commercial |
$345.45
|
| Rate for Payer: Priority Health SBD |
$256.04
|
| Rate for Payer: UMR Bronson Commercial |
$178.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.81
|
|
|
HC IAP CHEMO ADMINISTRATON
|
Facility
|
OP
|
$406.41
|
|
|
Service Code
|
CPT 96420
|
| Hospital Charge Code |
33500010
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$150.37 |
| Max. Negotiated Rate |
$1,064.33 |
| Rate for Payer: Aetna American Axle |
$264.17
|
| Rate for Payer: Aetna Commercial |
$345.45
|
| Rate for Payer: Aetna Medicare |
$342.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$411.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$411.40
|
| Rate for Payer: BCBS Complete |
$180.75
|
| Rate for Payer: BCBS MAPPO |
$329.12
|
| Rate for Payer: BCBS Trust/PPO |
$494.96
|
| Rate for Payer: BCN Commercial |
$494.96
|
| Rate for Payer: BCN Medicare Advantage |
$329.12
|
| Rate for Payer: Cash Price |
$325.13
|
| Rate for Payer: Cash Price |
$325.13
|
| Rate for Payer: Cofinity Advantage |
$284.49
|
| Rate for Payer: Cofinity Commercial |
$349.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.12
|
| Rate for Payer: Healthscope Commercial |
$365.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$304.81
|
| Rate for Payer: Mclaren Medicaid |
$329.12
|
| Rate for Payer: Mclaren Medicare |
$329.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$345.58
|
| Rate for Payer: Meridian Medicaid |
$345.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$378.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$362.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$345.45
|
| Rate for Payer: Nomi Health Commercial |
$987.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$304.81
|
| Rate for Payer: PACE Medicare |
$312.66
|
| Rate for Payer: PACE SWMI |
$329.12
|
| Rate for Payer: PHP Commercial |
$345.45
|
| Rate for Payer: PHP Medicare Advantage |
$329.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,064.33
|
| Rate for Payer: Priority Health Medicare |
$329.12
|
| Rate for Payer: Priority Health SBD |
$256.04
|
| Rate for Payer: Priority Health Tiered Network |
$851.46
|
| Rate for Payer: Railroad Medicare Medicare |
$329.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.17
|
| Rate for Payer: UHC Core |
$211.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$329.12
|
| Rate for Payer: UHC Exchange |
$159.72
|
| Rate for Payer: UHC Medicaid |
$172.13
|
| Rate for Payer: UHCCP Medicaid |
$172.13
|
| Rate for Payer: UMR Bronson Commercial |
$150.37
|
| Rate for Payer: VA VA |
$329.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$304.81
|
|
|
HC IBD DIFF
|
Facility
|
OP
|
$63.46
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200488
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna American Axle |
$41.25
|
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$13.93
|
| Rate for Payer: BCN Commercial |
$13.93
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Advantage |
$44.42
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.59
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$39.98
|
| Rate for Payer: Priority Health Tiered Network |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.08
|
| Rate for Payer: UHC Core |
$18.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.08
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: UMR Bronson Commercial |
$23.48
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.59
|
|
|
HC IBD DIFF
|
Facility
|
IP
|
$63.46
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200488
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.92 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna American Axle |
$41.25
|
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.25
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Advantage |
$44.42
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: Priority Health SBD |
$39.98
|
| Rate for Payer: UMR Bronson Commercial |
$27.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.59
|
|
|
HC IBD DIFFERENTIATION
|
Facility
|
OP
|
$63.46
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200174
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna American Axle |
$41.25
|
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$13.93
|
| Rate for Payer: BCN Commercial |
$13.93
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Advantage |
$44.42
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.59
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$39.98
|
| Rate for Payer: Priority Health Tiered Network |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.08
|
| Rate for Payer: UHC Core |
$18.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.08
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: UMR Bronson Commercial |
$23.48
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.59
|
|
|
HC IBD DIFFERENTIATION
|
Facility
|
IP
|
$63.46
|
|
|
Service Code
|
CPT 86036
|
| Hospital Charge Code |
30200174
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.92 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna American Axle |
$41.25
|
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.25
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Advantage |
$44.42
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: Priority Health SBD |
$39.98
|
| Rate for Payer: UMR Bronson Commercial |
$27.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.59
|
|
|
HC IBD DIFFERENTIATION CMPT
|
Facility
|
IP
|
$59.30
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200386
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.09 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna American Axle |
$38.55
|
| Rate for Payer: Aetna Commercial |
$50.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.55
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Advantage |
$41.51
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.48
|
| Rate for Payer: PHP Commercial |
$50.41
|
| Rate for Payer: Priority Health SBD |
$37.36
|
| Rate for Payer: UMR Bronson Commercial |
$26.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC IBD DIFFERENTIATION CMPT
|
Facility
|
OP
|
$59.30
|
|
|
Service Code
|
CPT 86671
|
| Hospital Charge Code |
30200386
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna American Axle |
$38.55
|
| Rate for Payer: Aetna Commercial |
$50.41
|
| Rate for Payer: Aetna Medicare |
$12.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.31
|
| Rate for Payer: BCBS Complete |
$6.73
|
| Rate for Payer: BCBS MAPPO |
$12.25
|
| Rate for Payer: BCBS Trust/PPO |
$14.16
|
| Rate for Payer: BCN Commercial |
$14.16
|
| Rate for Payer: BCN Medicare Advantage |
$12.25
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Advantage |
$41.51
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.25
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: Mclaren Medicaid |
$12.25
|
| Rate for Payer: Mclaren Medicare |
$12.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.86
|
| Rate for Payer: Meridian Medicaid |
$12.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: Nomi Health Commercial |
$18.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.48
|
| Rate for Payer: PACE Medicare |
$11.64
|
| Rate for Payer: PACE SWMI |
$12.25
|
| Rate for Payer: PHP Commercial |
$50.41
|
| Rate for Payer: PHP Medicare Advantage |
$12.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.25
|
| Rate for Payer: Priority Health Medicare |
$12.25
|
| Rate for Payer: Priority Health SBD |
$37.36
|
| Rate for Payer: Priority Health Tiered Network |
$9.80
|
| Rate for Payer: Railroad Medicare Medicare |
$12.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.38
|
| Rate for Payer: UHC Core |
$18.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.25
|
| Rate for Payer: UHC Exchange |
$18.38
|
| Rate for Payer: UHC Medicaid |
$6.41
|
| Rate for Payer: UHCCP Medicaid |
$6.41
|
| Rate for Payer: UMR Bronson Commercial |
$21.94
|
| Rate for Payer: VA VA |
$12.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC ICD CRT/DUAL IMPLANT/REPLACE
|
Facility
|
IP
|
$28,274.40
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,440.74 |
| Max. Negotiated Rate |
$25,446.96 |
| Rate for Payer: Aetna American Axle |
$18,378.36
|
| Rate for Payer: Aetna Commercial |
$24,033.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,378.36
|
| Rate for Payer: Cash Price |
$22,619.52
|
| Rate for Payer: Cofinity Advantage |
$19,792.08
|
| Rate for Payer: Cofinity Commercial |
$24,315.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,619.52
|
| Rate for Payer: Healthscope Commercial |
$25,446.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19,792.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,205.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,033.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,205.80
|
| Rate for Payer: PHP Commercial |
$24,033.24
|
| Rate for Payer: Priority Health SBD |
$17,812.87
|
| Rate for Payer: UMR Bronson Commercial |
$12,440.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,205.80
|
|
|
HC ICD CRT/DUAL IMPLANT/REPLACE
|
Facility
|
OP
|
$28,274.40
|
|
|
Service Code
|
CPT 33249
|
| Hospital Charge Code |
36100080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,461.53 |
| Max. Negotiated Rate |
$101,143.75 |
| Rate for Payer: Aetna American Axle |
$18,378.36
|
| Rate for Payer: Aetna Commercial |
$24,033.24
|
| Rate for Payer: Aetna Medicare |
$32,527.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,378.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39,094.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39,094.99
|
| Rate for Payer: BCBS Complete |
$17,176.77
|
| Rate for Payer: BCBS MAPPO |
$31,275.99
|
| Rate for Payer: BCBS Trust/PPO |
$45,954.19
|
| Rate for Payer: BCN Commercial |
$45,954.19
|
| Rate for Payer: BCN Medicare Advantage |
$31,275.99
|
| Rate for Payer: Cash Price |
$22,619.52
|
| Rate for Payer: Cash Price |
$22,619.52
|
| Rate for Payer: Cash Price |
$22,619.52
|
| Rate for Payer: Cofinity Advantage |
$19,792.08
|
| Rate for Payer: Cofinity Commercial |
$24,315.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,619.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31,275.99
|
| Rate for Payer: Healthscope Commercial |
$25,446.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19,792.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,205.80
|
| Rate for Payer: Mclaren Medicaid |
$31,275.99
|
| Rate for Payer: Mclaren Medicare |
$31,275.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32,839.79
|
| Rate for Payer: Meridian Medicaid |
$32,839.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35,967.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$34,403.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,033.24
|
| Rate for Payer: Nomi Health Commercial |
$93,827.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,205.80
|
| Rate for Payer: PACE Medicare |
$29,712.19
|
| Rate for Payer: PACE SWMI |
$31,275.99
|
| Rate for Payer: PHP Commercial |
$24,033.24
|
| Rate for Payer: PHP Medicare Advantage |
$31,275.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$16,357.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$101,143.75
|
| Rate for Payer: Priority Health Medicare |
$31,275.99
|
| Rate for Payer: Priority Health SBD |
$17,812.87
|
| Rate for Payer: Priority Health Tiered Network |
$80,915.00
|
| Rate for Payer: Railroad Medicare Medicare |
$31,275.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31,275.99
|
| Rate for Payer: UHC Medicaid |
$16,357.34
|
| Rate for Payer: UHCCP Medicaid |
$16,357.34
|
| Rate for Payer: UMR Bronson Commercial |
$10,461.53
|
| Rate for Payer: VA VA |
$31,275.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,205.80
|
|
|
HC ICD CRT/DUAL REPLACEMENT
|
Facility
|
IP
|
$11,673.29
|
|
|
Service Code
|
CPT 33240
|
| Hospital Charge Code |
36100075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,136.25 |
| Max. Negotiated Rate |
$10,505.96 |
| Rate for Payer: Aetna American Axle |
$7,587.64
|
| Rate for Payer: Aetna Commercial |
$9,922.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,587.64
|
| Rate for Payer: Cash Price |
$9,338.63
|
| Rate for Payer: Cofinity Advantage |
$8,171.30
|
| Rate for Payer: Cofinity Commercial |
$10,039.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,338.63
|
| Rate for Payer: Healthscope Commercial |
$10,505.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,171.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,754.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,922.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,754.97
|
| Rate for Payer: PHP Commercial |
$9,922.30
|
| Rate for Payer: Priority Health SBD |
$7,354.17
|
| Rate for Payer: UMR Bronson Commercial |
$5,136.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,754.97
|
|
