|
HC INJECTION SI JOINT BIL ANESTHESIA/STEROID
|
Facility
|
IP
|
$1,068.81
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100043
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$470.28 |
| Max. Negotiated Rate |
$961.93 |
| Rate for Payer: Aetna American Axle |
$694.73
|
| Rate for Payer: Aetna Commercial |
$908.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$694.73
|
| Rate for Payer: Cash Price |
$855.05
|
| Rate for Payer: Cofinity Advantage |
$748.17
|
| Rate for Payer: Cofinity Commercial |
$919.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.05
|
| Rate for Payer: Healthscope Commercial |
$961.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$748.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$801.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$801.61
|
| Rate for Payer: PHP Commercial |
$908.49
|
| Rate for Payer: Priority Health SBD |
$673.35
|
| Rate for Payer: UMR Bronson Commercial |
$470.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$801.61
|
|
|
HC INJECTION SINGLE TENDON ORIGIN/INSERTION
|
Facility
|
OP
|
$284.95
|
|
|
Service Code
|
CPT 20551
|
| Hospital Charge Code |
36100519
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.43 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna American Axle |
$185.22
|
| Rate for Payer: Aetna Commercial |
$242.21
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.22
|
| 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 |
$227.96
|
| Rate for Payer: Cash Price |
$227.96
|
| Rate for Payer: Cash Price |
$227.96
|
| Rate for Payer: Cofinity Advantage |
$199.47
|
| Rate for Payer: Cofinity Commercial |
$245.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$256.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.71
|
| 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 |
$242.21
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.71
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$242.21
|
| 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 |
$179.52
|
| 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) |
$185.22
|
| Rate for Payer: UHC Core |
$148.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$111.99
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$105.43
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.71
|
|
|
HC INJECTION SINGLE TENDON ORIGIN/INSERTION
|
Facility
|
IP
|
$284.95
|
|
|
Service Code
|
CPT 20551
|
| Hospital Charge Code |
36100519
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.38 |
| Max. Negotiated Rate |
$256.45 |
| Rate for Payer: Aetna American Axle |
$185.22
|
| Rate for Payer: Aetna Commercial |
$242.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.22
|
| Rate for Payer: Cash Price |
$227.96
|
| Rate for Payer: Cofinity Advantage |
$199.47
|
| Rate for Payer: Cofinity Commercial |
$245.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.96
|
| Rate for Payer: Healthscope Commercial |
$256.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.71
|
| Rate for Payer: PHP Commercial |
$242.21
|
| Rate for Payer: Priority Health SBD |
$179.52
|
| Rate for Payer: UMR Bronson Commercial |
$125.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.71
|
|
|
HC INJECTION SPLENOPOTOGRAM SPLENOPORTOG
|
Facility
|
OP
|
$446.38
|
|
|
Service Code
|
CPT 38200
|
| Hospital Charge Code |
36100183
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$165.16 |
| Max. Negotiated Rate |
$598.35 |
| Rate for Payer: Aetna American Axle |
$290.15
|
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna Medicare |
$223.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.15
|
| Rate for Payer: BCBS Complete |
$178.55
|
| Rate for Payer: BCBS Trust/PPO |
$598.35
|
| Rate for Payer: BCN Commercial |
$598.35
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Advantage |
$312.47
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$357.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: Priority Health SBD |
$281.22
|
| Rate for Payer: UMR Bronson Commercial |
$165.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC INJECTION SPLENOPOTOGRAM SPLENOPORTOG
|
Facility
|
IP
|
$446.38
|
|
|
Service Code
|
CPT 38200
|
| Hospital Charge Code |
36100183
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$196.41 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna American Axle |
$290.15
|
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.15
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Advantage |
$312.47
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: Priority Health SBD |
$281.22
|
| Rate for Payer: UMR Bronson Commercial |
$196.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC INJECTIONS SCLEROSANT FOR SPIDER VEINS /TRNK
|
Facility
|
IP
|
$1,106.99
|
|
|
Service Code
|
CPT 36468
|
| Hospital Charge Code |
76100400
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$487.08 |
| Max. Negotiated Rate |
$996.29 |
| Rate for Payer: Aetna American Axle |
$719.54
|
| Rate for Payer: Aetna Commercial |
$940.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$719.54
|
| Rate for Payer: Cash Price |
$885.59
|
| Rate for Payer: Cofinity Advantage |
$774.89
|
| Rate for Payer: Cofinity Commercial |
$952.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$885.59
|
| Rate for Payer: Healthscope Commercial |
$996.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$774.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$830.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$940.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$830.24
|
| Rate for Payer: PHP Commercial |
$940.94
|
| Rate for Payer: Priority Health SBD |
$697.40
|
| Rate for Payer: UMR Bronson Commercial |
$487.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$830.24
|
|
|
HC INJECTIONS SCLEROSANT FOR SPIDER VEINS /TRNK
|
Facility
|
OP
|
$1,106.99
|
|
|
Service Code
|
CPT 36468
|
| Hospital Charge Code |
76100400
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$172.78 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna American Axle |
$719.54
|
| Rate for Payer: Aetna Commercial |
$940.94
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$719.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$172.78
|
| Rate for Payer: BCN Commercial |
$172.78
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$885.59
|
| Rate for Payer: Cash Price |
$885.59
|
| Rate for Payer: Cash Price |
$885.59
|
| Rate for Payer: Cofinity Advantage |
$774.89
|
| Rate for Payer: Cofinity Commercial |
$952.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$885.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$996.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$774.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$830.24
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$940.94
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$830.24
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$940.94
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$697.40
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$719.54
|
| Rate for Payer: UHC Core |
$576.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$435.05
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: UMR Bronson Commercial |
$409.59
|
| Rate for Payer: VA VA |
$405.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$830.24
|
|
|
HC INJECTION, TESTOSTERONE CYPIONATE, 1 MG
|
Facility
|
IP
|
$0.16
|
|
|
Service Code
|
CPT J1071
|
| Hospital Charge Code |
63600109
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: Aetna American Axle |
$0.10
|
| Rate for Payer: Aetna Commercial |
$0.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.10
|
| Rate for Payer: Cash Price |
$0.13
|
| Rate for Payer: Cofinity Advantage |
$0.11
|
| Rate for Payer: Cofinity Commercial |
$0.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.13
|
| Rate for Payer: Healthscope Commercial |
$0.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.12
|
| Rate for Payer: PHP Commercial |
$0.14
|
| Rate for Payer: Priority Health SBD |
$0.10
|
| Rate for Payer: UMR Bronson Commercial |
$0.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.12
|
|
|
HC INJECTION, TESTOSTERONE CYPIONATE, 1 MG
|
Facility
|
OP
|
$0.16
|
|
|
Service Code
|
CPT J1071
|
| Hospital Charge Code |
63600109
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: Aetna American Axle |
$0.10
|
| Rate for Payer: Aetna Commercial |
$0.14
|
| Rate for Payer: Aetna Medicare |
$0.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.10
|
| Rate for Payer: BCBS Complete |
$0.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.06
|
| Rate for Payer: BCN Commercial |
$0.06
|
| Rate for Payer: Cash Price |
$0.13
|
| Rate for Payer: Cash Price |
$0.13
|
| Rate for Payer: Cofinity Advantage |
$0.11
|
| Rate for Payer: Cofinity Commercial |
$0.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.13
|
| Rate for Payer: Healthscope Commercial |
$0.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.12
|
| Rate for Payer: PHP Commercial |
$0.14
|
| Rate for Payer: Priority Health SBD |
$0.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.05
|
| Rate for Payer: UHC Core |
$0.05
|
| Rate for Payer: UHC Exchange |
$0.05
|
| Rate for Payer: UMR Bronson Commercial |
$0.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.12
|
|
|
HC INJECTION THERAPEUTIC SINUS TRACT
|
Facility
|
IP
|
$942.13
|
|
|
Service Code
|
CPT 20500
|
| Hospital Charge Code |
36100020
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$414.54 |
| Max. Negotiated Rate |
$847.92 |
| Rate for Payer: Aetna American Axle |
$612.38
|
| Rate for Payer: Aetna Commercial |
$800.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.38
|
| Rate for Payer: Cash Price |
$753.70
|
| Rate for Payer: Cofinity Advantage |
$659.49
|
| Rate for Payer: Cofinity Commercial |
$810.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$753.70
|
| Rate for Payer: Healthscope Commercial |
$847.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$659.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$706.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$800.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$706.60
|
| Rate for Payer: PHP Commercial |
$800.81
|
| Rate for Payer: Priority Health SBD |
$593.54
|
| Rate for Payer: UMR Bronson Commercial |
$414.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$706.60
|
|
|
HC INJECTION THERAPEUTIC SINUS TRACT
|
Facility
|
OP
|
$942.13
|
|
|
Service Code
|
CPT 20500
|
| Hospital Charge Code |
36100020
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$87.78 |
| Max. Negotiated Rate |
$4,999.64 |
| Rate for Payer: Aetna American Axle |
$612.38
|
| Rate for Payer: Aetna Commercial |
$800.81
|
| Rate for Payer: Aetna Medicare |
$1,607.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$612.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,932.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,932.50
|
| Rate for Payer: BCBS Complete |
$849.06
|
| Rate for Payer: BCBS MAPPO |
$1,546.00
|
| Rate for Payer: BCBS Trust/PPO |
$87.78
|
| Rate for Payer: BCN Commercial |
$87.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,546.00
|
| Rate for Payer: Cash Price |
$753.70
|
| Rate for Payer: Cash Price |
$753.70
|
| Rate for Payer: Cash Price |
$753.70
|
| Rate for Payer: Cofinity Advantage |
$659.49
|
| Rate for Payer: Cofinity Commercial |
$810.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$753.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,546.00
|
| Rate for Payer: Healthscope Commercial |
$847.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$659.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$706.60
|
| Rate for Payer: Mclaren Medicaid |
$1,546.00
|
| Rate for Payer: Mclaren Medicare |
$1,546.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,623.30
|
| Rate for Payer: Meridian Medicaid |
$1,623.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,777.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,700.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$800.81
|
| Rate for Payer: Nomi Health Commercial |
$4,638.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$706.60
|
| Rate for Payer: PACE Medicare |
$1,468.70
|
| Rate for Payer: PACE SWMI |
$1,546.00
|
| Rate for Payer: PHP Commercial |
$800.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,546.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$808.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,999.64
|
| Rate for Payer: Priority Health Medicare |
$1,546.00
|
| Rate for Payer: Priority Health SBD |
$593.54
|
| Rate for Payer: Priority Health Tiered Network |
$3,999.71
|
| Rate for Payer: Railroad Medicare Medicare |
$1,546.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,546.00
|
| Rate for Payer: UHC Medicaid |
$808.56
|
| Rate for Payer: UHCCP Medicaid |
$808.56
|
| Rate for Payer: UMR Bronson Commercial |
$348.59
|
| Rate for Payer: VA VA |
$1,546.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$706.60
|
|
|
HC INJECTION TRANSFORAMINAL CERVICAL OR THORACIC
|
Facility
|
OP
|
$1,758.91
|
|
|
Service Code
|
CPT 64479
|
| Hospital Charge Code |
36100286
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.91 |
| Max. Negotiated Rate |
$2,850.01 |
| Rate for Payer: Aetna American Axle |
$1,143.29
|
| Rate for Payer: Aetna Commercial |
$1,495.07
|
| Rate for Payer: Aetna Medicare |
$916.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,143.29
|
| 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 |
$1,107.17
|
| Rate for Payer: BCN Commercial |
$1,107.17
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$1,407.13
|
| Rate for Payer: Cash Price |
$1,407.13
|
| Rate for Payer: Cash Price |
$1,407.13
|
| Rate for Payer: Cofinity Advantage |
$1,231.24
|
| Rate for Payer: Cofinity Commercial |
$1,512.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,407.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,583.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,231.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,319.18
|
| 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 |
$1,495.07
|
| Rate for Payer: Nomi Health Commercial |
$2,643.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,319.18
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$1,495.07
|
| 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 |
$1,108.11
|
| 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 |
$650.80
|
| Rate for Payer: VA VA |
$881.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,319.18
|
|
|
HC INJECTION TRANSFORAMINAL CERVICAL OR THORACIC
|
Facility
|
IP
|
$1,758.91
|
|
|
Service Code
|
CPT 64479
|
| Hospital Charge Code |
36100286
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$773.92 |
| Max. Negotiated Rate |
$1,583.02 |
| Rate for Payer: Aetna American Axle |
$1,143.29
|
| Rate for Payer: Aetna Commercial |
$1,495.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,143.29
|
| Rate for Payer: Cash Price |
$1,407.13
|
| Rate for Payer: Cofinity Advantage |
$1,231.24
|
| Rate for Payer: Cofinity Commercial |
$1,512.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,407.13
|
| Rate for Payer: Healthscope Commercial |
$1,583.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,231.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,319.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,495.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,319.18
|
| Rate for Payer: PHP Commercial |
$1,495.07
|
| Rate for Payer: Priority Health SBD |
$1,108.11
|
| Rate for Payer: UMR Bronson Commercial |
$773.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,319.18
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC BIL
|
Facility
|
OP
|
$2,638.36
|
|
|
Service Code
|
CPT 64479
|
| Hospital Charge Code |
36100623
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.91 |
| Max. Negotiated Rate |
$2,850.01 |
| Rate for Payer: Aetna American Axle |
$1,714.93
|
| Rate for Payer: Aetna Commercial |
$2,242.61
|
| Rate for Payer: Aetna Medicare |
$916.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,714.93
|
| 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 |
$1,107.17
|
| Rate for Payer: BCN Commercial |
$1,107.17
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$2,110.69
|
| Rate for Payer: Cash Price |
$2,110.69
|
| Rate for Payer: Cash Price |
$2,110.69
|
| Rate for Payer: Cofinity Advantage |
$1,846.85
|
| Rate for Payer: Cofinity Commercial |
$2,268.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,110.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$2,374.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,846.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,978.77
|
| 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 |
$2,242.61
|
| Rate for Payer: Nomi Health Commercial |
$2,643.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,978.77
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$2,242.61
|
| 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 |
$1,662.17
|
| 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 |
$976.19
|
| Rate for Payer: VA VA |
$881.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,978.77
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC BIL
|
Facility
|
IP
|
$2,638.36
|
|
|
Service Code
|
CPT 64479
|
| Hospital Charge Code |
36100623
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,160.88 |
| Max. Negotiated Rate |
$2,374.52 |
| Rate for Payer: Aetna American Axle |
$1,714.93
|
| Rate for Payer: Aetna Commercial |
$2,242.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,714.93
|
| Rate for Payer: Cash Price |
$2,110.69
|
| Rate for Payer: Cofinity Advantage |
$1,846.85
|
| Rate for Payer: Cofinity Commercial |
$2,268.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,110.69
|
| Rate for Payer: Healthscope Commercial |
$2,374.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,846.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,978.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,242.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,978.77
|
| Rate for Payer: PHP Commercial |
$2,242.61
|
| Rate for Payer: Priority Health SBD |
$1,662.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,160.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,978.77
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC EA ADD
|
Facility
|
OP
|
$929.72
|
|
|
Service Code
|
CPT 64480
|
| Hospital Charge Code |
36100287
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$344.00 |
| Max. Negotiated Rate |
$836.75 |
| Rate for Payer: Aetna American Axle |
$604.32
|
| Rate for Payer: Aetna Commercial |
$790.26
|
| Rate for Payer: Aetna Medicare |
$464.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$604.32
|
| Rate for Payer: BCBS Complete |
$371.89
|
| Rate for Payer: BCBS Trust/PPO |
$486.91
|
| Rate for Payer: BCN Commercial |
$486.91
|
| Rate for Payer: Cash Price |
$743.78
|
| Rate for Payer: Cash Price |
$743.78
|
| Rate for Payer: Cash Price |
$743.78
|
| Rate for Payer: Cofinity Advantage |
$650.80
|
| Rate for Payer: Cofinity Commercial |
$799.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$743.78
|
| Rate for Payer: Healthscope Commercial |
$836.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$650.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$697.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$743.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$790.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$697.29
|
| Rate for Payer: PHP Commercial |
$790.26
|
| Rate for Payer: Priority Health SBD |
$585.72
|
| Rate for Payer: UMR Bronson Commercial |
$344.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$697.29
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC EA ADD
|
Facility
|
IP
|
$929.72
|
|
|
Service Code
|
CPT 64480
|
| Hospital Charge Code |
36100287
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$409.08 |
| Max. Negotiated Rate |
$836.75 |
| Rate for Payer: Aetna American Axle |
$604.32
|
| Rate for Payer: Aetna Commercial |
$790.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$604.32
|
| Rate for Payer: Cash Price |
$743.78
|
| Rate for Payer: Cofinity Advantage |
$650.80
|
| Rate for Payer: Cofinity Commercial |
$799.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$743.78
|
| Rate for Payer: Healthscope Commercial |
$836.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$650.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$697.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$790.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$697.29
|
| Rate for Payer: PHP Commercial |
$790.26
|
| Rate for Payer: Priority Health SBD |
$585.72
|
| Rate for Payer: UMR Bronson Commercial |
$409.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$697.29
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC EACH ADDL BIL
|
Facility
|
OP
|
$1,394.58
|
|
|
Service Code
|
CPT 64480
|
| Hospital Charge Code |
36100624
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$486.91 |
| Max. Negotiated Rate |
$1,255.12 |
| Rate for Payer: Aetna American Axle |
$906.48
|
| Rate for Payer: Aetna Commercial |
$1,185.39
|
| Rate for Payer: Aetna Medicare |
$697.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$906.48
|
| Rate for Payer: BCBS Complete |
$557.83
|
| Rate for Payer: BCBS Trust/PPO |
$486.91
|
| Rate for Payer: BCN Commercial |
$486.91
|
| Rate for Payer: Cash Price |
$1,115.66
|
| Rate for Payer: Cash Price |
$1,115.66
|
| Rate for Payer: Cash Price |
$1,115.66
|
| Rate for Payer: Cofinity Advantage |
$976.21
|
| Rate for Payer: Cofinity Commercial |
$1,199.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,115.66
|
| Rate for Payer: Healthscope Commercial |
$1,255.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$976.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,045.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,115.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,185.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,045.93
|
| Rate for Payer: PHP Commercial |
$1,185.39
|
| Rate for Payer: Priority Health SBD |
$878.59
|
| Rate for Payer: UMR Bronson Commercial |
$515.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,045.93
|
|
|
HC INJECTION TRANSFORAMIN CERVICAL OR THORACIC EACH ADDL BIL
|
Facility
|
IP
|
$1,394.58
|
|
|
Service Code
|
CPT 64480
|
| Hospital Charge Code |
36100624
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$613.62 |
| Max. Negotiated Rate |
$1,255.12 |
| Rate for Payer: Aetna American Axle |
$906.48
|
| Rate for Payer: Aetna Commercial |
$1,185.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$906.48
|
| Rate for Payer: Cash Price |
$1,115.66
|
| Rate for Payer: Cofinity Advantage |
$976.21
|
| Rate for Payer: Cofinity Commercial |
$1,199.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,115.66
|
| Rate for Payer: Healthscope Commercial |
$1,255.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$976.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,045.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,185.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,045.93
|
| Rate for Payer: PHP Commercial |
$1,185.39
|
| Rate for Payer: Priority Health SBD |
$878.59
|
| Rate for Payer: UMR Bronson Commercial |
$613.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,045.93
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR EA ADD LEVEL
|
Facility
|
IP
|
$991.57
|
|
|
Service Code
|
CPT 64484
|
| Hospital Charge Code |
36100289
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$436.29 |
| Max. Negotiated Rate |
$892.41 |
| Rate for Payer: Aetna American Axle |
$644.52
|
| Rate for Payer: Aetna Commercial |
$842.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.52
|
| Rate for Payer: Cash Price |
$793.26
|
| Rate for Payer: Cofinity Advantage |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$852.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.26
|
| Rate for Payer: Healthscope Commercial |
$892.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$694.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$842.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$743.68
|
| Rate for Payer: PHP Commercial |
$842.83
|
| Rate for Payer: Priority Health SBD |
$624.69
|
| Rate for Payer: UMR Bronson Commercial |
$436.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.68
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR EA ADD LEVEL
|
Facility
|
OP
|
$991.57
|
|
|
Service Code
|
CPT 64484
|
| Hospital Charge Code |
36100289
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$366.88 |
| Max. Negotiated Rate |
$892.41 |
| Rate for Payer: Aetna American Axle |
$644.52
|
| Rate for Payer: Aetna Commercial |
$842.83
|
| Rate for Payer: Aetna Medicare |
$495.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.52
|
| Rate for Payer: BCBS Complete |
$396.63
|
| Rate for Payer: BCBS Trust/PPO |
$378.56
|
| Rate for Payer: BCN Commercial |
$378.56
|
| Rate for Payer: Cash Price |
$793.26
|
| Rate for Payer: Cash Price |
$793.26
|
| Rate for Payer: Cash Price |
$793.26
|
| Rate for Payer: Cofinity Advantage |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$852.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.26
|
| Rate for Payer: Healthscope Commercial |
$892.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$694.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$793.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$842.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$743.68
|
| Rate for Payer: PHP Commercial |
$842.83
|
| Rate for Payer: Priority Health SBD |
$624.69
|
| Rate for Payer: UMR Bronson Commercial |
$366.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.68
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR EA ADD LEVEL BIL
|
Facility
|
IP
|
$1,487.35
|
|
|
Service Code
|
CPT 64484
|
| Hospital Charge Code |
36100625
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$654.43 |
| Max. Negotiated Rate |
$1,338.62 |
| Rate for Payer: Aetna American Axle |
$966.78
|
| Rate for Payer: Aetna Commercial |
$1,264.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$966.78
|
| Rate for Payer: Cash Price |
$1,189.88
|
| Rate for Payer: Cofinity Advantage |
$1,041.14
|
| Rate for Payer: Cofinity Commercial |
$1,279.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,189.88
|
| Rate for Payer: Healthscope Commercial |
$1,338.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,041.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,115.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,264.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,115.51
|
| Rate for Payer: PHP Commercial |
$1,264.25
|
| Rate for Payer: Priority Health SBD |
$937.03
|
| Rate for Payer: UMR Bronson Commercial |
$654.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,115.51
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR EA ADD LEVEL BIL
|
Facility
|
OP
|
$1,487.35
|
|
|
Service Code
|
CPT 64484
|
| Hospital Charge Code |
36100625
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$378.56 |
| Max. Negotiated Rate |
$1,338.62 |
| Rate for Payer: Aetna American Axle |
$966.78
|
| Rate for Payer: Aetna Commercial |
$1,264.25
|
| Rate for Payer: Aetna Medicare |
$743.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$966.78
|
| Rate for Payer: BCBS Complete |
$594.94
|
| Rate for Payer: BCBS Trust/PPO |
$378.56
|
| Rate for Payer: BCN Commercial |
$378.56
|
| Rate for Payer: Cash Price |
$1,189.88
|
| Rate for Payer: Cash Price |
$1,189.88
|
| Rate for Payer: Cash Price |
$1,189.88
|
| Rate for Payer: Cofinity Advantage |
$1,041.14
|
| Rate for Payer: Cofinity Commercial |
$1,279.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,189.88
|
| Rate for Payer: Healthscope Commercial |
$1,338.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,041.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,115.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,189.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,264.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,115.51
|
| Rate for Payer: PHP Commercial |
$1,264.25
|
| Rate for Payer: Priority Health SBD |
$937.03
|
| Rate for Payer: UMR Bronson Commercial |
$550.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,115.51
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR SINGLE LEVEL
|
Facility
|
IP
|
$1,567.72
|
|
|
Service Code
|
CPT 64483
|
| Hospital Charge Code |
36100288
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$689.80 |
| Max. Negotiated Rate |
$1,410.95 |
| Rate for Payer: Aetna American Axle |
$1,019.02
|
| Rate for Payer: Aetna Commercial |
$1,332.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,019.02
|
| Rate for Payer: Cash Price |
$1,254.18
|
| Rate for Payer: Cofinity Advantage |
$1,097.40
|
| Rate for Payer: Cofinity Commercial |
$1,348.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,254.18
|
| Rate for Payer: Healthscope Commercial |
$1,410.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,097.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,175.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,175.79
|
| Rate for Payer: PHP Commercial |
$1,332.56
|
| Rate for Payer: Priority Health SBD |
$987.66
|
| Rate for Payer: UMR Bronson Commercial |
$689.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,175.79
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SACR SINGLE LEVEL
|
Facility
|
OP
|
$1,567.72
|
|
|
Service Code
|
CPT 64483
|
| Hospital Charge Code |
36100288
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.91 |
| Max. Negotiated Rate |
$2,850.01 |
| Rate for Payer: Aetna American Axle |
$1,019.02
|
| Rate for Payer: Aetna Commercial |
$1,332.56
|
| Rate for Payer: Aetna Medicare |
$916.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,019.02
|
| 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 |
$1,007.79
|
| Rate for Payer: BCN Commercial |
$1,007.79
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$1,254.18
|
| Rate for Payer: Cash Price |
$1,254.18
|
| Rate for Payer: Cash Price |
$1,254.18
|
| Rate for Payer: Cofinity Advantage |
$1,097.40
|
| Rate for Payer: Cofinity Commercial |
$1,348.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,254.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,410.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,097.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,175.79
|
| 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 |
$1,332.56
|
| Rate for Payer: Nomi Health Commercial |
$2,643.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,175.79
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$1,332.56
|
| 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 |
$987.66
|
| 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 |
$580.06
|
| Rate for Payer: VA VA |
$881.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,175.79
|
|
