|
HC INJ ANEST/STEROID ILIOING ILIOHYPOGAST NRV
|
Facility
|
OP
|
$994.97
|
|
|
Service Code
|
CPT 64425
|
| Hospital Charge Code |
76100270
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$2,274.56 |
| Rate for Payer: Aetna American Axle |
$646.73
|
| Rate for Payer: Aetna Commercial |
$845.72
|
| Rate for Payer: Aetna Medicare |
$731.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$873.08
|
| Rate for Payer: BCN Commercial |
$873.08
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$795.98
|
| Rate for Payer: Cash Price |
$795.98
|
| Rate for Payer: Cash Price |
$795.98
|
| Rate for Payer: Cofinity Advantage |
$696.48
|
| Rate for Payer: Cofinity Commercial |
$855.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$895.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$696.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.23
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$738.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.72
|
| Rate for Payer: Nomi Health Commercial |
$2,110.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.23
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$845.72
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,274.56
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health SBD |
$626.83
|
| Rate for Payer: Priority Health Tiered Network |
$1,819.65
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$646.73
|
| Rate for Payer: UHC Core |
$518.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Exchange |
$391.02
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UMR Bronson Commercial |
$368.14
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.23
|
|
|
HC INJ ANEST/STEROID ILIOING ILIOHYPOGAST NRV
|
Facility
|
IP
|
$994.97
|
|
|
Service Code
|
CPT 64425
|
| Hospital Charge Code |
76100270
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$437.79 |
| Max. Negotiated Rate |
$895.47 |
| Rate for Payer: Aetna American Axle |
$646.73
|
| Rate for Payer: Aetna Commercial |
$845.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.73
|
| Rate for Payer: Cash Price |
$795.98
|
| Rate for Payer: Cofinity Advantage |
$696.48
|
| Rate for Payer: Cofinity Commercial |
$855.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.98
|
| Rate for Payer: Healthscope Commercial |
$895.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$696.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.23
|
| Rate for Payer: PHP Commercial |
$845.72
|
| Rate for Payer: Priority Health SBD |
$626.83
|
| Rate for Payer: UMR Bronson Commercial |
$437.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.23
|
|
|
HC INJ BEBTELOVIMAB
|
Facility
|
OP
|
$494.70
|
|
|
Service Code
|
HCPCS M0222
|
| Hospital Charge Code |
77100034
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$183.04 |
| Max. Negotiated Rate |
$445.23 |
| Rate for Payer: Aetna American Axle |
$321.56
|
| Rate for Payer: Aetna Commercial |
$420.50
|
| Rate for Payer: Aetna Medicare |
$247.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.56
|
| Rate for Payer: BCBS Complete |
$197.88
|
| Rate for Payer: Cash Price |
$395.76
|
| Rate for Payer: Cofinity Advantage |
$346.29
|
| Rate for Payer: Cofinity Commercial |
$425.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.76
|
| Rate for Payer: Healthscope Commercial |
$445.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$346.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$395.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$371.02
|
| Rate for Payer: PHP Commercial |
$420.50
|
| Rate for Payer: Priority Health SBD |
$311.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.56
|
| Rate for Payer: UHC Core |
$257.74
|
| Rate for Payer: UHC Exchange |
$194.42
|
| Rate for Payer: UMR Bronson Commercial |
$183.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.02
|
|
|
HC INJ BEBTELOVIMAB
|
Facility
|
IP
|
$494.70
|
|
|
Service Code
|
HCPCS M0222
|
| Hospital Charge Code |
77100034
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$217.67 |
| Max. Negotiated Rate |
$445.23 |
| Rate for Payer: Aetna American Axle |
$321.56
|
| Rate for Payer: Aetna Commercial |
$420.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.56
|
| Rate for Payer: Cash Price |
$395.76
|
| Rate for Payer: Cofinity Advantage |
$346.29
|
| Rate for Payer: Cofinity Commercial |
$425.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.76
|
| Rate for Payer: Healthscope Commercial |
$445.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$346.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$371.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$371.02
|
| Rate for Payer: PHP Commercial |
$420.50
|
| Rate for Payer: Priority Health SBD |
$311.66
|
| Rate for Payer: UMR Bronson Commercial |
$217.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$371.02
|
|
|
HC INJ,BETAMETHASONE ACT 3MG AND BETAMETASONE NA PHOS 3 MG
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT J0702
|
| Hospital Charge Code |
63600089
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: UMR Bronson Commercial |
$9.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC INJ,BETAMETHASONE ACT 3MG AND BETAMETASONE NA PHOS 3 MG
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT J0702
|
| Hospital Charge Code |
63600089
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.86 |
| Max. Negotiated Rate |
$22.37 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$10.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: BCBS Trust/PPO |
$22.37
|
| Rate for Payer: BCN Commercial |
$22.37
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.40
|
| Rate for Payer: UHC Core |
$11.40
|
| Rate for Payer: UHC Exchange |
$11.40
|
| Rate for Payer: UMR Bronson Commercial |
$7.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC INJ CATH PLACE CON INF OR BOLUS CERV OR THORACIC W IMAGIG GUID
|
Facility
|
IP
|
$1,125.53
|
|
|
Service Code
|
CPT 62325
|
| Hospital Charge Code |
36100540
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$495.23 |
| Max. Negotiated Rate |
$1,012.98 |
| Rate for Payer: Aetna American Axle |
$731.59
|
| Rate for Payer: Aetna Commercial |
$956.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.59
|
| Rate for Payer: Cash Price |
$900.42
|
| Rate for Payer: Cofinity Advantage |
$787.87
|
| Rate for Payer: Cofinity Commercial |
$967.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.42
|
| Rate for Payer: Healthscope Commercial |
$1,012.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$787.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$844.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$844.15
|
| Rate for Payer: PHP Commercial |
$956.70
|
| Rate for Payer: Priority Health SBD |
$709.08
|
| Rate for Payer: UMR Bronson Commercial |
$495.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$844.15
|
|
|
HC INJ CATH PLACE CON INF OR BOLUS CERV OR THORACIC W IMAGIG GUID
|
Facility
|
OP
|
$1,125.53
|
|
|
Service Code
|
CPT 62325
|
| Hospital Charge Code |
36100540
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$416.45 |
| Max. Negotiated Rate |
$2,850.01 |
| Rate for Payer: Aetna American Axle |
$731.59
|
| Rate for Payer: Aetna Commercial |
$956.70
|
| Rate for Payer: Aetna Medicare |
$916.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$757.95
|
| Rate for Payer: BCN Commercial |
$757.95
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$900.42
|
| Rate for Payer: Cash Price |
$900.42
|
| Rate for Payer: Cash Price |
$900.42
|
| Rate for Payer: Cofinity Advantage |
$787.87
|
| Rate for Payer: Cofinity Commercial |
$967.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,012.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$787.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$844.15
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$925.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.70
|
| Rate for Payer: Nomi Health Commercial |
$2,643.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$844.15
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$956.70
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,850.01
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health SBD |
$709.08
|
| Rate for Payer: Priority Health Tiered Network |
$2,280.01
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: UMR Bronson Commercial |
$416.45
|
| Rate for Payer: VA VA |
$881.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$844.15
|
|
|
HC INJ CATH PLACE CON INF OR BOLUS CERV OR THORACIC WO IMAGING
|
Facility
|
IP
|
$1,125.53
|
|
|
Service Code
|
CPT 62324
|
| Hospital Charge Code |
36100542
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$495.23 |
| Max. Negotiated Rate |
$1,012.98 |
| Rate for Payer: Aetna American Axle |
$731.59
|
| Rate for Payer: Aetna Commercial |
$956.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.59
|
| Rate for Payer: Cash Price |
$900.42
|
| Rate for Payer: Cofinity Advantage |
$787.87
|
| Rate for Payer: Cofinity Commercial |
$967.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.42
|
| Rate for Payer: Healthscope Commercial |
$1,012.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$787.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$844.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$844.15
|
| Rate for Payer: PHP Commercial |
$956.70
|
| Rate for Payer: Priority Health SBD |
$709.08
|
| Rate for Payer: UMR Bronson Commercial |
$495.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$844.15
|
|
|
HC INJ CATH PLACE CON INF OR BOLUS CERV OR THORACIC WO IMAGING
|
Facility
|
OP
|
$1,125.53
|
|
|
Service Code
|
CPT 62324
|
| Hospital Charge Code |
36100542
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$416.45 |
| Max. Negotiated Rate |
$2,850.01 |
| Rate for Payer: Aetna American Axle |
$731.59
|
| Rate for Payer: Aetna Commercial |
$956.70
|
| Rate for Payer: Aetna Medicare |
$916.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$757.95
|
| Rate for Payer: BCN Commercial |
$757.95
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$900.42
|
| Rate for Payer: Cash Price |
$900.42
|
| Rate for Payer: Cash Price |
$900.42
|
| Rate for Payer: Cofinity Advantage |
$787.87
|
| Rate for Payer: Cofinity Commercial |
$967.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,012.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$787.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$844.15
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$925.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.70
|
| Rate for Payer: Nomi Health Commercial |
$2,643.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$844.15
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$956.70
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,850.01
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health SBD |
$709.08
|
| Rate for Payer: Priority Health Tiered Network |
$2,280.01
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: UMR Bronson Commercial |
$416.45
|
| Rate for Payer: VA VA |
$881.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$844.15
|
|
|
HC INJ CATH PLACE CON INF OR BOLUS LUMBAR OR SACRAL W IMAGING GUID
|
Facility
|
IP
|
$1,125.53
|
|
|
Service Code
|
CPT 62327
|
| Hospital Charge Code |
36100541
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$495.23 |
| Max. Negotiated Rate |
$1,012.98 |
| Rate for Payer: Aetna American Axle |
$731.59
|
| Rate for Payer: Aetna Commercial |
$956.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.59
|
| Rate for Payer: Cash Price |
$900.42
|
| Rate for Payer: Cofinity Advantage |
$787.87
|
| Rate for Payer: Cofinity Commercial |
$967.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.42
|
| Rate for Payer: Healthscope Commercial |
$1,012.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$787.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$844.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$844.15
|
| Rate for Payer: PHP Commercial |
$956.70
|
| Rate for Payer: Priority Health SBD |
$709.08
|
| Rate for Payer: UMR Bronson Commercial |
$495.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$844.15
|
|
|
HC INJ CATH PLACE CON INF OR BOLUS LUMBAR OR SACRAL W IMAGING GUID
|
Facility
|
OP
|
$1,125.53
|
|
|
Service Code
|
CPT 62327
|
| Hospital Charge Code |
36100541
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$416.45 |
| Max. Negotiated Rate |
$2,850.01 |
| Rate for Payer: Aetna American Axle |
$731.59
|
| Rate for Payer: Aetna Commercial |
$956.70
|
| Rate for Payer: Aetna Medicare |
$916.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$731.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$757.95
|
| Rate for Payer: BCN Commercial |
$757.95
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$900.42
|
| Rate for Payer: Cash Price |
$900.42
|
| Rate for Payer: Cash Price |
$900.42
|
| Rate for Payer: Cofinity Advantage |
$787.87
|
| Rate for Payer: Cofinity Commercial |
$967.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$900.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,012.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$787.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$844.15
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$925.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$956.70
|
| Rate for Payer: Nomi Health Commercial |
$2,643.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$844.15
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$956.70
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,850.01
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health SBD |
$709.08
|
| Rate for Payer: Priority Health Tiered Network |
$2,280.01
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: UMR Bronson Commercial |
$416.45
|
| Rate for Payer: VA VA |
$881.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$844.15
|
|
|
HC INJ COLLAGENASE, CLOSTRIDIUM HISTOLYTICUM, 0.01MG
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
HCPCS J0775
|
| Hospital Charge Code |
63600164
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna American Axle |
$43.96
|
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Advantage |
$47.34
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.72
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: UMR Bronson Commercial |
$29.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC INJ COLLAGENASE, CLOSTRIDIUM HISTOLYTICUM, 0.01MG
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
HCPCS J0775
|
| Hospital Charge Code |
63600164
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$25.02 |
| Max. Negotiated Rate |
$245.60 |
| Rate for Payer: Aetna American Axle |
$43.96
|
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$81.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$97.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$97.94
|
| Rate for Payer: BCBS Complete |
$43.03
|
| Rate for Payer: BCBS MAPPO |
$78.35
|
| Rate for Payer: BCBS Trust/PPO |
$245.60
|
| Rate for Payer: BCN Commercial |
$245.60
|
| Rate for Payer: BCN Medicare Advantage |
$78.35
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Advantage |
$47.34
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.35
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$78.35
|
| Rate for Payer: Mclaren Medicare |
$78.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.27
|
| Rate for Payer: Meridian Medicaid |
$82.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$235.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.72
|
| Rate for Payer: PACE Medicare |
$74.43
|
| Rate for Payer: PACE SWMI |
$78.35
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$78.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$239.39
|
| Rate for Payer: Priority Health Medicare |
$78.35
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: Priority Health Tiered Network |
$191.51
|
| Rate for Payer: Railroad Medicare Medicare |
$78.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.33
|
| Rate for Payer: UHC Core |
$83.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$78.35
|
| Rate for Payer: UHC Exchange |
$83.33
|
| Rate for Payer: UHC Medicaid |
$40.98
|
| Rate for Payer: UHCCP Medicaid |
$40.98
|
| Rate for Payer: UMR Bronson Commercial |
$25.02
|
| Rate for Payer: VA VA |
$78.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC INJ CORPORA CAVERN, PHARM AGENT
|
Facility
|
IP
|
$368.24
|
|
|
Service Code
|
CPT 54235
|
| Hospital Charge Code |
76100218
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$162.03 |
| Max. Negotiated Rate |
$331.42 |
| Rate for Payer: Aetna American Axle |
$239.36
|
| Rate for Payer: Aetna Commercial |
$313.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.36
|
| Rate for Payer: Cash Price |
$294.59
|
| Rate for Payer: Cofinity Advantage |
$257.77
|
| Rate for Payer: Cofinity Commercial |
$316.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.59
|
| Rate for Payer: Healthscope Commercial |
$331.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$257.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.18
|
| Rate for Payer: PHP Commercial |
$313.00
|
| Rate for Payer: Priority Health SBD |
$231.99
|
| Rate for Payer: UMR Bronson Commercial |
$162.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.18
|
|
|
HC INJ CORPORA CAVERN, PHARM AGENT
|
Facility
|
OP
|
$368.24
|
|
|
Service Code
|
CPT 54235
|
| Hospital Charge Code |
76100218
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$130.20 |
| Max. Negotiated Rate |
$805.08 |
| Rate for Payer: Aetna American Axle |
$239.36
|
| Rate for Payer: Aetna Commercial |
$313.00
|
| Rate for Payer: Aetna Medicare |
$258.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.19
|
| Rate for Payer: BCBS Complete |
$136.72
|
| Rate for Payer: BCBS MAPPO |
$248.95
|
| Rate for Payer: BCBS Trust/PPO |
$196.19
|
| Rate for Payer: BCN Commercial |
$196.19
|
| Rate for Payer: BCN Medicare Advantage |
$248.95
|
| Rate for Payer: Cash Price |
$294.59
|
| Rate for Payer: Cash Price |
$294.59
|
| Rate for Payer: Cash Price |
$294.59
|
| Rate for Payer: Cofinity Advantage |
$257.77
|
| Rate for Payer: Cofinity Commercial |
$316.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.95
|
| Rate for Payer: Healthscope Commercial |
$331.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$257.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.18
|
| Rate for Payer: Mclaren Medicaid |
$248.95
|
| Rate for Payer: Mclaren Medicare |
$248.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.40
|
| Rate for Payer: Meridian Medicaid |
$261.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.00
|
| Rate for Payer: Nomi Health Commercial |
$746.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.18
|
| Rate for Payer: PACE Medicare |
$236.50
|
| Rate for Payer: PACE SWMI |
$248.95
|
| Rate for Payer: PHP Commercial |
$313.00
|
| Rate for Payer: PHP Medicare Advantage |
$248.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$805.08
|
| Rate for Payer: Priority Health Medicare |
$248.95
|
| Rate for Payer: Priority Health SBD |
$231.99
|
| Rate for Payer: Priority Health Tiered Network |
$644.06
|
| Rate for Payer: Railroad Medicare Medicare |
$248.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.36
|
| Rate for Payer: UHC Core |
$191.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$248.95
|
| Rate for Payer: UHC Exchange |
$144.72
|
| Rate for Payer: UHC Medicaid |
$130.20
|
| Rate for Payer: UHCCP Medicaid |
$130.20
|
| Rate for Payer: UMR Bronson Commercial |
$136.25
|
| Rate for Payer: VA VA |
$248.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.18
|
|
|
HC INJ DAXIBOTULINUMTOXINA-LANM, 1 UNIT
|
Facility
|
OP
|
$11.22
|
|
|
Service Code
|
HCPCS J0589
|
| Hospital Charge Code |
63600257
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.62 |
| Max. Negotiated Rate |
$10.10 |
| Rate for Payer: Aetna American Axle |
$7.29
|
| Rate for Payer: Aetna Commercial |
$9.54
|
| Rate for Payer: Aetna Medicare |
$3.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.86
|
| Rate for Payer: BCBS Complete |
$1.70
|
| Rate for Payer: BCBS MAPPO |
$3.09
|
| Rate for Payer: BCBS Trust/PPO |
$10.09
|
| Rate for Payer: BCN Commercial |
$10.09
|
| Rate for Payer: BCN Medicare Advantage |
$3.09
|
| Rate for Payer: Cash Price |
$8.98
|
| Rate for Payer: Cash Price |
$8.98
|
| Rate for Payer: Cofinity Advantage |
$7.85
|
| Rate for Payer: Cofinity Commercial |
$9.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.09
|
| Rate for Payer: Healthscope Commercial |
$10.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.41
|
| Rate for Payer: Mclaren Medicaid |
$3.09
|
| Rate for Payer: Mclaren Medicare |
$3.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.24
|
| Rate for Payer: Meridian Medicaid |
$3.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.54
|
| Rate for Payer: Nomi Health Commercial |
$9.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.41
|
| Rate for Payer: PACE Medicare |
$2.94
|
| Rate for Payer: PACE SWMI |
$3.09
|
| Rate for Payer: PHP Commercial |
$9.54
|
| Rate for Payer: PHP Medicare Advantage |
$3.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.92
|
| Rate for Payer: Priority Health Medicare |
$3.09
|
| Rate for Payer: Priority Health SBD |
$7.07
|
| Rate for Payer: Priority Health Tiered Network |
$7.94
|
| Rate for Payer: Railroad Medicare Medicare |
$3.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.13
|
| Rate for Payer: UHC Core |
$5.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.09
|
| Rate for Payer: UHC Exchange |
$5.13
|
| Rate for Payer: UHC Medicaid |
$1.62
|
| Rate for Payer: UHCCP Medicaid |
$1.62
|
| Rate for Payer: UMR Bronson Commercial |
$4.15
|
| Rate for Payer: VA VA |
$3.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.41
|
|
|
HC INJ DAXIBOTULINUMTOXINA-LANM, 1 UNIT
|
Facility
|
IP
|
$11.22
|
|
|
Service Code
|
HCPCS J0589
|
| Hospital Charge Code |
63600257
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$10.10 |
| Rate for Payer: Aetna American Axle |
$7.29
|
| Rate for Payer: Aetna Commercial |
$9.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.29
|
| Rate for Payer: Cash Price |
$8.98
|
| Rate for Payer: Cofinity Advantage |
$7.85
|
| Rate for Payer: Cofinity Commercial |
$9.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.98
|
| Rate for Payer: Healthscope Commercial |
$10.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.41
|
| Rate for Payer: PHP Commercial |
$9.54
|
| Rate for Payer: Priority Health SBD |
$7.07
|
| Rate for Payer: UMR Bronson Commercial |
$4.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.41
|
|
|
HC INJ, DENOSUMAB-BMWO, 1 MG
|
Facility
|
IP
|
$24.17
|
|
|
Service Code
|
HCPCS Q5157
|
| Hospital Charge Code |
63600286
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.63 |
| Max. Negotiated Rate |
$21.75 |
| Rate for Payer: Aetna American Axle |
$15.71
|
| Rate for Payer: Aetna Commercial |
$20.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.71
|
| Rate for Payer: Cash Price |
$19.34
|
| Rate for Payer: Cofinity Advantage |
$16.92
|
| Rate for Payer: Cofinity Commercial |
$20.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.34
|
| Rate for Payer: Healthscope Commercial |
$21.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.13
|
| Rate for Payer: PHP Commercial |
$20.54
|
| Rate for Payer: Priority Health SBD |
$15.23
|
| Rate for Payer: UMR Bronson Commercial |
$10.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.13
|
|
|
HC INJ, DENOSUMAB-BMWO, 1 MG
|
Facility
|
OP
|
$24.17
|
|
|
Service Code
|
HCPCS Q5157
|
| Hospital Charge Code |
63600286
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.94 |
| Max. Negotiated Rate |
$88.72 |
| Rate for Payer: Aetna American Axle |
$15.71
|
| Rate for Payer: Aetna Commercial |
$20.54
|
| Rate for Payer: Aetna Medicare |
$27.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.76
|
| Rate for Payer: BCBS Complete |
$14.39
|
| Rate for Payer: BCBS MAPPO |
$26.21
|
| Rate for Payer: BCBS Trust/PPO |
$86.88
|
| Rate for Payer: BCN Commercial |
$86.88
|
| Rate for Payer: BCN Medicare Advantage |
$26.21
|
| Rate for Payer: Cash Price |
$19.34
|
| Rate for Payer: Cash Price |
$19.34
|
| Rate for Payer: Cofinity Advantage |
$16.92
|
| Rate for Payer: Cofinity Commercial |
$20.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.21
|
| Rate for Payer: Healthscope Commercial |
$21.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.13
|
| Rate for Payer: Mclaren Medicaid |
$26.21
|
| Rate for Payer: Mclaren Medicare |
$26.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.52
|
| Rate for Payer: Meridian Medicaid |
$27.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.54
|
| Rate for Payer: Nomi Health Commercial |
$78.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.13
|
| Rate for Payer: PACE Medicare |
$24.90
|
| Rate for Payer: PACE SWMI |
$26.21
|
| Rate for Payer: PHP Commercial |
$20.54
|
| Rate for Payer: PHP Medicare Advantage |
$26.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$88.72
|
| Rate for Payer: Priority Health Medicare |
$26.21
|
| Rate for Payer: Priority Health SBD |
$15.23
|
| Rate for Payer: Priority Health Tiered Network |
$70.98
|
| Rate for Payer: Railroad Medicare Medicare |
$26.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.41
|
| Rate for Payer: UHC Core |
$46.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.21
|
| Rate for Payer: UHC Exchange |
$46.41
|
| Rate for Payer: UHC Medicaid |
$13.71
|
| Rate for Payer: UHCCP Medicaid |
$13.71
|
| Rate for Payer: UMR Bronson Commercial |
$8.94
|
| Rate for Payer: VA VA |
$26.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.13
|
|
|
HC INJ DIAG OR THER CERV OR THORACIC WITH IMAGING GUIDANCE
|
Facility
|
OP
|
$893.87
|
|
|
Service Code
|
CPT 62321
|
| Hospital Charge Code |
36100538
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$330.73 |
| Max. Negotiated Rate |
$2,274.56 |
| Rate for Payer: Aetna American Axle |
$581.02
|
| Rate for Payer: Aetna Commercial |
$759.79
|
| Rate for Payer: Aetna Medicare |
$731.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$770.29
|
| Rate for Payer: BCN Commercial |
$770.29
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$715.10
|
| Rate for Payer: Cash Price |
$715.10
|
| Rate for Payer: Cash Price |
$715.10
|
| Rate for Payer: Cofinity Advantage |
$625.71
|
| Rate for Payer: Cofinity Commercial |
$768.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$715.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$804.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$625.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$670.40
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$738.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$759.79
|
| Rate for Payer: Nomi Health Commercial |
$2,110.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$670.40
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$759.79
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,274.56
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health SBD |
$563.14
|
| Rate for Payer: Priority Health Tiered Network |
$1,819.65
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UMR Bronson Commercial |
$330.73
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$670.40
|
|
|
HC INJ DIAG OR THER CERV OR THORACIC WITH IMAGING GUIDANCE
|
Facility
|
IP
|
$893.87
|
|
|
Service Code
|
CPT 62321
|
| Hospital Charge Code |
36100538
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$393.30 |
| Max. Negotiated Rate |
$804.48 |
| Rate for Payer: Aetna American Axle |
$581.02
|
| Rate for Payer: Aetna Commercial |
$759.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.02
|
| Rate for Payer: Cash Price |
$715.10
|
| Rate for Payer: Cofinity Advantage |
$625.71
|
| Rate for Payer: Cofinity Commercial |
$768.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$715.10
|
| Rate for Payer: Healthscope Commercial |
$804.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$625.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$670.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$759.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$670.40
|
| Rate for Payer: PHP Commercial |
$759.79
|
| Rate for Payer: Priority Health SBD |
$563.14
|
| Rate for Payer: UMR Bronson Commercial |
$393.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$670.40
|
|
|
HC INJ DIAG OR THER LUMBAR OR SACRAL WITH IMAGING GUIDANCE
|
Facility
|
OP
|
$966.17
|
|
|
Service Code
|
CPT 62323
|
| Hospital Charge Code |
36100539
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$357.48 |
| Max. Negotiated Rate |
$2,274.56 |
| Rate for Payer: Aetna American Axle |
$628.01
|
| Rate for Payer: Aetna Commercial |
$821.24
|
| Rate for Payer: Aetna Medicare |
$731.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$628.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$713.94
|
| Rate for Payer: BCN Commercial |
$713.94
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$772.94
|
| Rate for Payer: Cash Price |
$772.94
|
| Rate for Payer: Cash Price |
$772.94
|
| Rate for Payer: Cofinity Advantage |
$676.32
|
| Rate for Payer: Cofinity Commercial |
$830.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$772.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$869.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$676.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$724.63
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$738.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$821.24
|
| Rate for Payer: Nomi Health Commercial |
$2,110.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$724.63
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$821.24
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,274.56
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health SBD |
$608.69
|
| Rate for Payer: Priority Health Tiered Network |
$1,819.65
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UMR Bronson Commercial |
$357.48
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$724.63
|
|
|
HC INJ DIAG OR THER LUMBAR OR SACRAL WITH IMAGING GUIDANCE
|
Facility
|
IP
|
$966.17
|
|
|
Service Code
|
CPT 62323
|
| Hospital Charge Code |
36100539
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$425.11 |
| Max. Negotiated Rate |
$869.55 |
| Rate for Payer: Aetna American Axle |
$628.01
|
| Rate for Payer: Aetna Commercial |
$821.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$628.01
|
| Rate for Payer: Cash Price |
$772.94
|
| Rate for Payer: Cofinity Advantage |
$676.32
|
| Rate for Payer: Cofinity Commercial |
$830.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$772.94
|
| Rate for Payer: Healthscope Commercial |
$869.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$676.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$724.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$821.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$724.63
|
| Rate for Payer: PHP Commercial |
$821.24
|
| Rate for Payer: Priority Health SBD |
$608.69
|
| Rate for Payer: UMR Bronson Commercial |
$425.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$724.63
|
|
|
HC INJECT CARPAL TUNNEL
|
Facility
|
OP
|
$393.93
|
|
|
Service Code
|
CPT 20526
|
| Hospital Charge Code |
76100182
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$145.75 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna American Axle |
$256.05
|
| Rate for Payer: Aetna Commercial |
$334.84
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$368.41
|
| Rate for Payer: BCN Commercial |
$368.41
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$315.14
|
| Rate for Payer: Cash Price |
$315.14
|
| Rate for Payer: Cash Price |
$315.14
|
| Rate for Payer: Cofinity Advantage |
$275.75
|
| Rate for Payer: Cofinity Commercial |
$338.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$354.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$275.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.45
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$321.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$334.84
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$295.45
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$334.84
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$989.08
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health SBD |
$248.18
|
| Rate for Payer: Priority Health Tiered Network |
$791.26
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.05
|
| Rate for Payer: UHC Core |
$205.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$154.81
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$145.75
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.45
|
|
