|
HC IMMUNOHISTOCHEMISTY MULTIPLEX STAINS
|
Facility
|
OP
|
$386.14
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
31000117
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$142.87 |
| Max. Negotiated Rate |
$1,155.01 |
| Rate for Payer: Aetna American Axle |
$250.99
|
| Rate for Payer: Aetna Commercial |
$328.22
|
| Rate for Payer: Aetna Medicare |
$371.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.45
|
| Rate for Payer: BCBS Complete |
$196.15
|
| Rate for Payer: BCBS MAPPO |
$357.16
|
| Rate for Payer: BCBS Trust/PPO |
$249.35
|
| Rate for Payer: BCN Commercial |
$249.35
|
| Rate for Payer: BCN Medicare Advantage |
$357.16
|
| Rate for Payer: Cash Price |
$308.91
|
| Rate for Payer: Cash Price |
$308.91
|
| Rate for Payer: Cofinity Advantage |
$270.30
|
| Rate for Payer: Cofinity Commercial |
$332.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.16
|
| Rate for Payer: Healthscope Commercial |
$347.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$270.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.61
|
| Rate for Payer: Mclaren Medicaid |
$357.16
|
| Rate for Payer: Mclaren Medicare |
$357.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.02
|
| Rate for Payer: Meridian Medicaid |
$375.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$392.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.22
|
| Rate for Payer: Nomi Health Commercial |
$1,071.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.61
|
| Rate for Payer: PACE Medicare |
$339.30
|
| Rate for Payer: PACE SWMI |
$357.16
|
| Rate for Payer: PHP Commercial |
$328.22
|
| Rate for Payer: PHP Medicare Advantage |
$357.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,155.01
|
| Rate for Payer: Priority Health Medicare |
$357.16
|
| Rate for Payer: Priority Health SBD |
$243.27
|
| Rate for Payer: Priority Health Tiered Network |
$924.01
|
| Rate for Payer: Railroad Medicare Medicare |
$357.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.58
|
| Rate for Payer: UHC Core |
$539.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$357.16
|
| Rate for Payer: UHC Exchange |
$539.58
|
| Rate for Payer: UHC Medicaid |
$186.79
|
| Rate for Payer: UHCCP Medicaid |
$186.79
|
| Rate for Payer: UMR Bronson Commercial |
$142.87
|
| Rate for Payer: VA VA |
$357.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.61
|
|
|
HC IMPELLA LVAD
|
Facility
|
IP
|
$47,152.14
|
|
| Hospital Charge Code |
27200132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20,746.94 |
| Max. Negotiated Rate |
$42,436.93 |
| Rate for Payer: Aetna American Axle |
$30,648.89
|
| Rate for Payer: Aetna Commercial |
$40,079.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30,648.89
|
| Rate for Payer: Cash Price |
$37,721.71
|
| Rate for Payer: Cofinity Advantage |
$33,006.50
|
| Rate for Payer: Cofinity Commercial |
$40,550.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37,721.71
|
| Rate for Payer: Healthscope Commercial |
$42,436.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33,006.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35,364.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40,079.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35,364.11
|
| Rate for Payer: PHP Commercial |
$40,079.32
|
| Rate for Payer: Priority Health SBD |
$29,705.85
|
| Rate for Payer: UMR Bronson Commercial |
$20,746.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35,364.11
|
|
|
HC IMPELLA LVAD
|
Facility
|
OP
|
$47,152.14
|
|
| Hospital Charge Code |
27200132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17,446.29 |
| Max. Negotiated Rate |
$42,436.93 |
| Rate for Payer: Aetna American Axle |
$30,648.89
|
| Rate for Payer: Aetna Commercial |
$40,079.32
|
| Rate for Payer: Aetna Medicare |
$23,576.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30,648.89
|
| Rate for Payer: BCBS Complete |
$18,860.86
|
| Rate for Payer: Cash Price |
$37,721.71
|
| Rate for Payer: Cofinity Advantage |
$33,006.50
|
| Rate for Payer: Cofinity Commercial |
$40,550.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37,721.71
|
| Rate for Payer: Healthscope Commercial |
$42,436.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33,006.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35,364.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37,721.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40,079.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35,364.11
|
| Rate for Payer: PHP Commercial |
$40,079.32
|
| Rate for Payer: Priority Health SBD |
$29,705.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30,648.89
|
| Rate for Payer: UHC Core |
$24,566.26
|
| Rate for Payer: UHC Exchange |
$18,530.79
|
| Rate for Payer: UMR Bronson Commercial |
$17,446.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35,364.11
|
|
|
HC IMPELLA MONITORING KIT
|
Facility
|
OP
|
$346.24
|
|
| Hospital Charge Code |
27200133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$128.11 |
| Max. Negotiated Rate |
$311.62 |
| Rate for Payer: Aetna American Axle |
$225.06
|
| Rate for Payer: Aetna Commercial |
$294.30
|
| Rate for Payer: Aetna Medicare |
$173.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.06
|
| Rate for Payer: BCBS Complete |
$138.50
|
| Rate for Payer: Cash Price |
$276.99
|
| Rate for Payer: Cofinity Advantage |
$242.37
|
| Rate for Payer: Cofinity Commercial |
$297.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.99
|
| Rate for Payer: Healthscope Commercial |
$311.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$242.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$276.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.68
|
| Rate for Payer: PHP Commercial |
$294.30
|
| Rate for Payer: Priority Health SBD |
$218.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.06
|
| Rate for Payer: UHC Core |
$180.39
|
| Rate for Payer: UHC Exchange |
$136.07
|
| Rate for Payer: UMR Bronson Commercial |
$128.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.68
|
|
|
HC IMPELLA MONITORING KIT
|
Facility
|
IP
|
$346.24
|
|
| Hospital Charge Code |
27200133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$152.35 |
| Max. Negotiated Rate |
$311.62 |
| Rate for Payer: Aetna American Axle |
$225.06
|
| Rate for Payer: Aetna Commercial |
$294.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.06
|
| Rate for Payer: Cash Price |
$276.99
|
| Rate for Payer: Cofinity Advantage |
$242.37
|
| Rate for Payer: Cofinity Commercial |
$297.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.99
|
| Rate for Payer: Healthscope Commercial |
$311.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$242.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.68
|
| Rate for Payer: PHP Commercial |
$294.30
|
| Rate for Payer: Priority Health SBD |
$218.13
|
| Rate for Payer: UMR Bronson Commercial |
$152.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.68
|
|
|
HC IMPELLA REMOVAL
|
Facility
|
IP
|
$2,989.19
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
48100114
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,315.24 |
| Max. Negotiated Rate |
$2,690.27 |
| Rate for Payer: Aetna American Axle |
$1,942.97
|
| Rate for Payer: Aetna Commercial |
$2,540.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,942.97
|
| Rate for Payer: Cash Price |
$2,391.35
|
| Rate for Payer: Cofinity Advantage |
$2,092.43
|
| Rate for Payer: Cofinity Commercial |
$2,570.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,391.35
|
| Rate for Payer: Healthscope Commercial |
$2,690.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,092.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,241.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,540.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,241.89
|
| Rate for Payer: PHP Commercial |
$2,540.81
|
| Rate for Payer: Priority Health SBD |
$1,883.19
|
| Rate for Payer: UMR Bronson Commercial |
$1,315.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,241.89
|
|
|
HC IMPELLA REMOVAL
|
Facility
|
OP
|
$2,989.19
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
48100114
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$891.43 |
| Max. Negotiated Rate |
$2,690.27 |
| Rate for Payer: Aetna American Axle |
$1,942.97
|
| Rate for Payer: Aetna Commercial |
$2,540.81
|
| Rate for Payer: Aetna Medicare |
$1,494.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,942.97
|
| Rate for Payer: BCBS Complete |
$1,195.68
|
| Rate for Payer: BCBS Trust/PPO |
$891.43
|
| Rate for Payer: BCN Commercial |
$891.43
|
| Rate for Payer: Cash Price |
$2,391.35
|
| Rate for Payer: Cash Price |
$2,391.35
|
| Rate for Payer: Cash Price |
$2,391.35
|
| Rate for Payer: Cofinity Advantage |
$2,092.43
|
| Rate for Payer: Cofinity Commercial |
$2,570.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,391.35
|
| Rate for Payer: Healthscope Commercial |
$2,690.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,092.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,241.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,391.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,540.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,241.89
|
| Rate for Payer: PHP Commercial |
$2,540.81
|
| Rate for Payer: Priority Health SBD |
$1,883.19
|
| Rate for Payer: UMR Bronson Commercial |
$1,106.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,241.89
|
|
|
HC IMPELLA RP FLEX
|
Facility
|
OP
|
$31,250.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$28,125.00 |
| Rate for Payer: Aetna American Axle |
$20,312.50
|
| Rate for Payer: Aetna Commercial |
$26,562.50
|
| Rate for Payer: Aetna Medicare |
$15,625.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20,312.50
|
| Rate for Payer: BCBS Complete |
$12,500.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$25,000.00
|
| Rate for Payer: Cash Price |
$25,000.00
|
| Rate for Payer: Cofinity Advantage |
$21,875.00
|
| Rate for Payer: Cofinity Commercial |
$26,875.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25,000.00
|
| Rate for Payer: Healthscope Commercial |
$28,125.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21,875.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23,437.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,562.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23,437.50
|
| Rate for Payer: PHP Commercial |
$26,562.50
|
| Rate for Payer: Priority Health SBD |
$19,687.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20,312.50
|
| Rate for Payer: UHC Core |
$16,281.25
|
| Rate for Payer: UHC Exchange |
$12,281.25
|
| Rate for Payer: UMR Bronson Commercial |
$11,562.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23,437.50
|
|
|
HC IMPELLA RP FLEX
|
Facility
|
IP
|
$31,250.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800162
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13,750.00 |
| Max. Negotiated Rate |
$28,125.00 |
| Rate for Payer: Aetna American Axle |
$20,312.50
|
| Rate for Payer: Aetna Commercial |
$26,562.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20,312.50
|
| Rate for Payer: Cash Price |
$25,000.00
|
| Rate for Payer: Cofinity Advantage |
$21,875.00
|
| Rate for Payer: Cofinity Commercial |
$26,875.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25,000.00
|
| Rate for Payer: Healthscope Commercial |
$28,125.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21,875.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23,437.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,562.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23,437.50
|
| Rate for Payer: PHP Commercial |
$26,562.50
|
| Rate for Payer: Priority Health SBD |
$19,687.50
|
| Rate for Payer: UMR Bronson Commercial |
$13,750.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23,437.50
|
|
|
HC IMPLANTABLE PRESSURE SENSOR W ANGIO
|
Facility
|
OP
|
$6,326.68
|
|
|
Service Code
|
CPT 33289
|
| Hospital Charge Code |
48100105
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,340.87 |
| Max. Negotiated Rate |
$92,425.85 |
| Rate for Payer: Aetna American Axle |
$4,112.34
|
| Rate for Payer: Aetna Commercial |
$5,377.68
|
| Rate for Payer: Aetna Medicare |
$29,723.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,112.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35,725.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35,725.26
|
| Rate for Payer: BCBS Complete |
$15,696.25
|
| Rate for Payer: BCBS MAPPO |
$28,580.21
|
| Rate for Payer: BCN Medicare Advantage |
$28,580.21
|
| Rate for Payer: Cash Price |
$5,061.34
|
| Rate for Payer: Cash Price |
$5,061.34
|
| Rate for Payer: Cofinity Advantage |
$4,428.68
|
| Rate for Payer: Cofinity Commercial |
$5,440.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,061.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28,580.21
|
| Rate for Payer: Healthscope Commercial |
$5,694.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,428.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,745.01
|
| Rate for Payer: Mclaren Medicaid |
$28,580.21
|
| Rate for Payer: Mclaren Medicare |
$28,580.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30,009.22
|
| Rate for Payer: Meridian Medicaid |
$30,009.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32,867.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$31,438.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,377.68
|
| Rate for Payer: Nomi Health Commercial |
$85,740.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,745.01
|
| Rate for Payer: PACE Medicare |
$27,151.20
|
| Rate for Payer: PACE SWMI |
$28,580.21
|
| Rate for Payer: PHP Commercial |
$5,377.68
|
| Rate for Payer: PHP Medicare Advantage |
$28,580.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$14,947.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$92,425.85
|
| Rate for Payer: Priority Health Medicare |
$28,580.21
|
| Rate for Payer: Priority Health SBD |
$3,985.81
|
| Rate for Payer: Priority Health Tiered Network |
$73,940.68
|
| Rate for Payer: Railroad Medicare Medicare |
$28,580.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28,580.21
|
| Rate for Payer: UHC Medicaid |
$14,947.45
|
| Rate for Payer: UHCCP Medicaid |
$14,947.45
|
| Rate for Payer: UMR Bronson Commercial |
$2,340.87
|
| Rate for Payer: VA VA |
$28,580.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,745.01
|
|
|
HC IMPLANTABLE PRESSURE SENSOR W ANGIO
|
Facility
|
IP
|
$6,326.68
|
|
|
Service Code
|
CPT 33289
|
| Hospital Charge Code |
48100105
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,783.74 |
| Max. Negotiated Rate |
$5,694.01 |
| Rate for Payer: Aetna American Axle |
$4,112.34
|
| Rate for Payer: Aetna Commercial |
$5,377.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,112.34
|
| Rate for Payer: Cash Price |
$5,061.34
|
| Rate for Payer: Cofinity Advantage |
$4,428.68
|
| Rate for Payer: Cofinity Commercial |
$5,440.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,061.34
|
| Rate for Payer: Healthscope Commercial |
$5,694.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,428.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,745.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,377.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,745.01
|
| Rate for Payer: PHP Commercial |
$5,377.68
|
| Rate for Payer: Priority Health SBD |
$3,985.81
|
| Rate for Payer: UMR Bronson Commercial |
$2,783.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,745.01
|
|
|
HC IMPLANTABLE PRESSURE SENSOR WO LEAD
|
Facility
|
IP
|
$73,582.69
|
|
|
Service Code
|
HCPCS C2624
|
| Hospital Charge Code |
27800103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$32,376.38 |
| Max. Negotiated Rate |
$66,224.42 |
| Rate for Payer: Aetna American Axle |
$47,828.75
|
| Rate for Payer: Aetna Commercial |
$62,545.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47,828.75
|
| Rate for Payer: Cash Price |
$58,866.15
|
| Rate for Payer: Cofinity Advantage |
$51,507.88
|
| Rate for Payer: Cofinity Commercial |
$63,281.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58,866.15
|
| Rate for Payer: Healthscope Commercial |
$66,224.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51,507.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55,187.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62,545.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55,187.02
|
| Rate for Payer: PHP Commercial |
$62,545.29
|
| Rate for Payer: Priority Health SBD |
$46,357.09
|
| Rate for Payer: UMR Bronson Commercial |
$32,376.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55,187.02
|
|
|
HC IMPLANTABLE PRESSURE SENSOR WO LEAD
|
Facility
|
OP
|
$73,582.69
|
|
|
Service Code
|
HCPCS C2624
|
| Hospital Charge Code |
27800103
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$66,224.42 |
| Rate for Payer: Aetna American Axle |
$47,828.75
|
| Rate for Payer: Aetna Commercial |
$62,545.29
|
| Rate for Payer: Aetna Medicare |
$36,791.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47,828.75
|
| Rate for Payer: BCBS Complete |
$29,433.08
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$58,866.15
|
| Rate for Payer: Cash Price |
$58,866.15
|
| Rate for Payer: Cofinity Advantage |
$51,507.88
|
| Rate for Payer: Cofinity Commercial |
$63,281.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58,866.15
|
| Rate for Payer: Healthscope Commercial |
$66,224.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51,507.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55,187.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58,866.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62,545.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55,187.02
|
| Rate for Payer: PHP Commercial |
$62,545.29
|
| Rate for Payer: Priority Health SBD |
$46,357.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47,828.75
|
| Rate for Payer: UHC Core |
$38,336.58
|
| Rate for Payer: UHC Exchange |
$28,918.00
|
| Rate for Payer: UMR Bronson Commercial |
$27,225.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55,187.02
|
|
|
HC IMPLANT HORMONE SUBCUTANEOUS
|
Facility
|
OP
|
$554.20
|
|
|
Service Code
|
CPT 11980
|
| Hospital Charge Code |
76100178
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$205.05 |
| Max. Negotiated Rate |
$1,439.47 |
| Rate for Payer: Aetna American Axle |
$360.23
|
| Rate for Payer: Aetna Commercial |
$471.07
|
| Rate for Payer: Aetna Medicare |
$462.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$360.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$556.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$556.40
|
| Rate for Payer: BCBS Complete |
$244.46
|
| Rate for Payer: BCBS MAPPO |
$445.12
|
| Rate for Payer: BCBS Trust/PPO |
$511.61
|
| Rate for Payer: BCN Commercial |
$511.61
|
| Rate for Payer: BCN Medicare Advantage |
$445.12
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cofinity Advantage |
$387.94
|
| Rate for Payer: Cofinity Commercial |
$476.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.12
|
| Rate for Payer: Healthscope Commercial |
$498.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$387.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$415.65
|
| Rate for Payer: Mclaren Medicaid |
$445.12
|
| Rate for Payer: Mclaren Medicare |
$445.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.38
|
| Rate for Payer: Meridian Medicaid |
$467.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$511.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$489.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$471.07
|
| Rate for Payer: Nomi Health Commercial |
$1,335.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.65
|
| Rate for Payer: PACE Medicare |
$422.86
|
| Rate for Payer: PACE SWMI |
$445.12
|
| Rate for Payer: PHP Commercial |
$471.07
|
| Rate for Payer: PHP Medicare Advantage |
$445.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,439.47
|
| Rate for Payer: Priority Health Medicare |
$445.12
|
| Rate for Payer: Priority Health SBD |
$349.15
|
| Rate for Payer: Priority Health Tiered Network |
$1,151.58
|
| Rate for Payer: Railroad Medicare Medicare |
$445.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.23
|
| Rate for Payer: UHC Core |
$288.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$445.12
|
| Rate for Payer: UHC Exchange |
$217.80
|
| Rate for Payer: UHC Medicaid |
$232.80
|
| Rate for Payer: UHCCP Medicaid |
$232.80
|
| Rate for Payer: UMR Bronson Commercial |
$205.05
|
| Rate for Payer: VA VA |
$445.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$415.65
|
|
|
HC IMPLANT HORMONE SUBCUTANEOUS
|
Facility
|
IP
|
$554.20
|
|
|
Service Code
|
CPT 11980
|
| Hospital Charge Code |
76100178
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$243.85 |
| Max. Negotiated Rate |
$498.78 |
| Rate for Payer: Aetna American Axle |
$360.23
|
| Rate for Payer: Aetna Commercial |
$471.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$360.23
|
| Rate for Payer: Cash Price |
$443.36
|
| Rate for Payer: Cofinity Advantage |
$387.94
|
| Rate for Payer: Cofinity Commercial |
$476.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$443.36
|
| Rate for Payer: Healthscope Commercial |
$498.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$387.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$415.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$471.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$415.65
|
| Rate for Payer: PHP Commercial |
$471.07
|
| Rate for Payer: Priority Health SBD |
$349.15
|
| Rate for Payer: UMR Bronson Commercial |
$243.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$415.65
|
|
|
HC IMRT PLAN
|
Facility
|
IP
|
$7,268.21
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
33300006
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$3,198.01 |
| Max. Negotiated Rate |
$6,541.39 |
| Rate for Payer: Aetna American Axle |
$4,724.34
|
| Rate for Payer: Aetna Commercial |
$6,177.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,724.34
|
| Rate for Payer: Cash Price |
$5,814.57
|
| Rate for Payer: Cofinity Advantage |
$5,087.75
|
| Rate for Payer: Cofinity Commercial |
$6,250.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,814.57
|
| Rate for Payer: Healthscope Commercial |
$6,541.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,087.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,451.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,177.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,451.16
|
| Rate for Payer: PHP Commercial |
$6,177.98
|
| Rate for Payer: Priority Health SBD |
$4,578.97
|
| Rate for Payer: UMR Bronson Commercial |
$3,198.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,451.16
|
|
|
HC IMRT PLAN
|
Facility
|
OP
|
$7,268.21
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
33300006
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$721.30 |
| Max. Negotiated Rate |
$6,541.39 |
| Rate for Payer: Aetna American Axle |
$4,724.34
|
| Rate for Payer: Aetna Commercial |
$6,177.98
|
| Rate for Payer: Aetna Medicare |
$1,434.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,724.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,723.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,723.94
|
| Rate for Payer: BCBS Complete |
$757.43
|
| Rate for Payer: BCBS MAPPO |
$1,379.15
|
| Rate for Payer: BCBS Trust/PPO |
$3,662.45
|
| Rate for Payer: BCN Commercial |
$3,662.45
|
| Rate for Payer: BCN Medicare Advantage |
$1,379.15
|
| Rate for Payer: Cash Price |
$5,814.57
|
| Rate for Payer: Cash Price |
$5,814.57
|
| Rate for Payer: Cofinity Advantage |
$5,087.75
|
| Rate for Payer: Cofinity Commercial |
$6,250.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,814.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,379.15
|
| Rate for Payer: Healthscope Commercial |
$6,541.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,087.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,451.16
|
| Rate for Payer: Mclaren Medicaid |
$1,379.15
|
| Rate for Payer: Mclaren Medicare |
$1,379.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,448.11
|
| Rate for Payer: Meridian Medicaid |
$1,448.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,586.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,517.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,177.98
|
| Rate for Payer: Nomi Health Commercial |
$4,137.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,451.16
|
| Rate for Payer: PACE Medicare |
$1,310.19
|
| Rate for Payer: PACE SWMI |
$1,379.15
|
| Rate for Payer: PHP Commercial |
$6,177.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,379.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,460.05
|
| Rate for Payer: Priority Health Medicare |
$1,379.15
|
| Rate for Payer: Priority Health SBD |
$4,578.97
|
| Rate for Payer: Priority Health Tiered Network |
$3,568.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,379.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,724.34
|
| Rate for Payer: UHC Core |
$3,786.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,379.15
|
| Rate for Payer: UHC Exchange |
$2,856.41
|
| Rate for Payer: UHC Medicaid |
$721.30
|
| Rate for Payer: UHCCP Medicaid |
$721.30
|
| Rate for Payer: UMR Bronson Commercial |
$2,689.24
|
| Rate for Payer: VA VA |
$1,379.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,451.16
|
|
|
HC IN 111 AUTOLOG WBC PER STUDY
|
Facility
|
IP
|
$4,131.00
|
|
|
Service Code
|
HCPCS A9570
|
| Hospital Charge Code |
34300013
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,817.64 |
| Max. Negotiated Rate |
$3,717.90 |
| Rate for Payer: Aetna American Axle |
$2,685.15
|
| Rate for Payer: Aetna Commercial |
$3,511.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,685.15
|
| Rate for Payer: Cash Price |
$3,304.80
|
| Rate for Payer: Cofinity Advantage |
$2,891.70
|
| Rate for Payer: Cofinity Commercial |
$3,552.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,304.80
|
| Rate for Payer: Healthscope Commercial |
$3,717.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,891.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,098.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,511.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,098.25
|
| Rate for Payer: PHP Commercial |
$3,511.35
|
| Rate for Payer: Priority Health SBD |
$2,602.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,817.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,098.25
|
|
|
HC IN 111 AUTOLOG WBC PER STUDY
|
Facility
|
OP
|
$4,131.00
|
|
|
Service Code
|
HCPCS A9570
|
| Hospital Charge Code |
34300013
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$576.97 |
| Max. Negotiated Rate |
$3,717.90 |
| Rate for Payer: Aetna American Axle |
$2,685.15
|
| Rate for Payer: Aetna Commercial |
$3,511.35
|
| Rate for Payer: Aetna Medicare |
$1,147.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,685.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,378.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,378.99
|
| Rate for Payer: BCBS Complete |
$605.87
|
| Rate for Payer: BCBS MAPPO |
$1,103.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,589.68
|
| Rate for Payer: BCN Commercial |
$1,589.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,103.19
|
| Rate for Payer: Cash Price |
$3,304.80
|
| Rate for Payer: Cash Price |
$3,304.80
|
| Rate for Payer: Cofinity Advantage |
$2,891.70
|
| Rate for Payer: Cofinity Commercial |
$3,552.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,304.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,103.19
|
| Rate for Payer: Healthscope Commercial |
$3,717.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,891.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,098.25
|
| Rate for Payer: Mclaren Medicaid |
$1,103.19
|
| Rate for Payer: Mclaren Medicare |
$1,103.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,158.35
|
| Rate for Payer: Meridian Medicaid |
$1,158.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,268.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,213.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,511.35
|
| Rate for Payer: Nomi Health Commercial |
$3,309.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,098.25
|
| Rate for Payer: PACE Medicare |
$1,048.03
|
| Rate for Payer: PACE SWMI |
$1,103.19
|
| Rate for Payer: PHP Commercial |
$3,511.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,103.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$576.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,479.42
|
| Rate for Payer: Priority Health Medicare |
$1,103.19
|
| Rate for Payer: Priority Health SBD |
$2,602.53
|
| Rate for Payer: Priority Health Tiered Network |
$2,783.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,103.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,820.26
|
| Rate for Payer: UHC Core |
$1,820.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,103.19
|
| Rate for Payer: UHC Exchange |
$1,820.26
|
| Rate for Payer: UHC Medicaid |
$576.97
|
| Rate for Payer: UHCCP Medicaid |
$576.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,528.47
|
| Rate for Payer: VA VA |
$1,103.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,098.25
|
|
|
HC IN 111 OCTEO PER STUDY UP TO 6 MCI
|
Facility
|
OP
|
$5,519.76
|
|
|
Service Code
|
HCPCS A9572
|
| Hospital Charge Code |
34300014
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,046.49 |
| Max. Negotiated Rate |
$6,310.89 |
| Rate for Payer: Aetna American Axle |
$3,587.84
|
| Rate for Payer: Aetna Commercial |
$4,691.80
|
| Rate for Payer: Aetna Medicare |
$2,080.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,587.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,501.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,501.18
|
| Rate for Payer: BCBS Complete |
$1,098.92
|
| Rate for Payer: BCBS MAPPO |
$2,000.94
|
| Rate for Payer: BCBS Trust/PPO |
$2,950.99
|
| Rate for Payer: BCN Commercial |
$2,950.99
|
| Rate for Payer: BCN Medicare Advantage |
$2,000.94
|
| Rate for Payer: Cash Price |
$4,415.81
|
| Rate for Payer: Cash Price |
$4,415.81
|
| Rate for Payer: Cofinity Advantage |
$3,863.83
|
| Rate for Payer: Cofinity Commercial |
$4,746.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,415.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,000.94
|
| Rate for Payer: Healthscope Commercial |
$4,967.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,863.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,139.82
|
| Rate for Payer: Mclaren Medicaid |
$2,000.94
|
| Rate for Payer: Mclaren Medicare |
$2,000.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,100.99
|
| Rate for Payer: Meridian Medicaid |
$2,100.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,301.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,201.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,691.80
|
| Rate for Payer: Nomi Health Commercial |
$6,002.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,139.82
|
| Rate for Payer: PACE Medicare |
$1,900.89
|
| Rate for Payer: PACE SWMI |
$2,000.94
|
| Rate for Payer: PHP Commercial |
$4,691.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,000.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,046.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,310.89
|
| Rate for Payer: Priority Health Medicare |
$2,000.94
|
| Rate for Payer: Priority Health SBD |
$3,477.45
|
| Rate for Payer: Priority Health Tiered Network |
$5,048.71
|
| Rate for Payer: Railroad Medicare Medicare |
$2,000.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,301.55
|
| Rate for Payer: UHC Core |
$3,301.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,000.94
|
| Rate for Payer: UHC Exchange |
$3,301.55
|
| Rate for Payer: UHC Medicaid |
$1,046.49
|
| Rate for Payer: UHCCP Medicaid |
$1,046.49
|
| Rate for Payer: UMR Bronson Commercial |
$2,042.31
|
| Rate for Payer: VA VA |
$2,000.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,139.82
|
|
|
HC IN 111 OCTEO PER STUDY UP TO 6 MCI
|
Facility
|
IP
|
$5,519.76
|
|
|
Service Code
|
HCPCS A9572
|
| Hospital Charge Code |
34300014
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$2,428.69 |
| Max. Negotiated Rate |
$4,967.78 |
| Rate for Payer: Aetna American Axle |
$3,587.84
|
| Rate for Payer: Aetna Commercial |
$4,691.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,587.84
|
| Rate for Payer: Cash Price |
$4,415.81
|
| Rate for Payer: Cofinity Advantage |
$3,863.83
|
| Rate for Payer: Cofinity Commercial |
$4,746.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,415.81
|
| Rate for Payer: Healthscope Commercial |
$4,967.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,863.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,139.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,691.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,139.82
|
| Rate for Payer: PHP Commercial |
$4,691.80
|
| Rate for Payer: Priority Health SBD |
$3,477.45
|
| Rate for Payer: UMR Bronson Commercial |
$2,428.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,139.82
|
|
|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
IP
|
$5,627.68
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,476.18 |
| Max. Negotiated Rate |
$5,064.91 |
| Rate for Payer: Aetna American Axle |
$3,657.99
|
| Rate for Payer: Aetna Commercial |
$4,783.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,657.99
|
| Rate for Payer: Cash Price |
$4,502.14
|
| Rate for Payer: Cofinity Advantage |
$3,939.38
|
| Rate for Payer: Cofinity Commercial |
$4,839.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,502.14
|
| Rate for Payer: Healthscope Commercial |
$5,064.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,939.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,220.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,783.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,220.76
|
| Rate for Payer: PHP Commercial |
$4,783.53
|
| Rate for Payer: Priority Health SBD |
$3,545.44
|
| Rate for Payer: UMR Bronson Commercial |
$2,476.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,220.76
|
|
|
HC INCIS & DRAIN EPIDIDYMIS TESTIS &/OR SCROTUM
|
Facility
|
OP
|
$5,627.68
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
76100349
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna American Axle |
$3,657.99
|
| Rate for Payer: Aetna Commercial |
$4,783.53
|
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,657.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,801.50
|
| Rate for Payer: BCN Commercial |
$1,801.50
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$4,502.14
|
| Rate for Payer: Cash Price |
$4,502.14
|
| Rate for Payer: Cash Price |
$4,502.14
|
| Rate for Payer: Cofinity Advantage |
$3,939.38
|
| Rate for Payer: Cofinity Commercial |
$4,839.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,502.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$5,064.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,939.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,220.76
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$2,187.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,783.53
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,220.76
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$4,783.53
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,735.82
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health SBD |
$3,545.44
|
| Rate for Payer: Priority Health Tiered Network |
$5,388.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,657.99
|
| Rate for Payer: UHC Core |
$2,932.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Exchange |
$2,211.68
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: UMR Bronson Commercial |
$2,082.24
|
| Rate for Payer: VA VA |
$2,082.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,220.76
|
|
|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$113.55
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$49.96 |
| Max. Negotiated Rate |
$102.19 |
| Rate for Payer: Aetna American Axle |
$73.81
|
| Rate for Payer: Aetna Commercial |
$96.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.81
|
| Rate for Payer: Cash Price |
$90.84
|
| Rate for Payer: Cofinity Advantage |
$79.48
|
| Rate for Payer: Cofinity Commercial |
$97.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.84
|
| Rate for Payer: Healthscope Commercial |
$102.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.16
|
| Rate for Payer: PHP Commercial |
$96.52
|
| Rate for Payer: Priority Health SBD |
$71.54
|
| Rate for Payer: UMR Bronson Commercial |
$49.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.16
|
|
|
HC INCISIONAL BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$113.55
|
|
|
Service Code
|
CPT 11107
|
| Hospital Charge Code |
76100153
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$42.01 |
| Max. Negotiated Rate |
$311.11 |
| Rate for Payer: Aetna American Axle |
$73.81
|
| Rate for Payer: Aetna Commercial |
$96.52
|
| Rate for Payer: Aetna Medicare |
$56.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.81
|
| Rate for Payer: BCBS Complete |
$45.42
|
| Rate for Payer: BCBS Trust/PPO |
$311.11
|
| Rate for Payer: BCN Commercial |
$311.11
|
| Rate for Payer: Cash Price |
$90.84
|
| Rate for Payer: Cash Price |
$90.84
|
| Rate for Payer: Cash Price |
$90.84
|
| Rate for Payer: Cofinity Advantage |
$79.48
|
| Rate for Payer: Cofinity Commercial |
$97.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.84
|
| Rate for Payer: Healthscope Commercial |
$102.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.16
|
| Rate for Payer: PHP Commercial |
$96.52
|
| Rate for Payer: Priority Health SBD |
$71.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.81
|
| Rate for Payer: UHC Core |
$59.16
|
| Rate for Payer: UHC Exchange |
$44.63
|
| Rate for Payer: UMR Bronson Commercial |
$42.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.16
|
|
