|
HC RETICULOCYTE COUNT
|
Facility
|
OP
|
$40.70
|
|
|
Service Code
|
CPT 85046
|
| Hospital Charge Code |
30500010
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.05 |
| Max. Negotiated Rate |
$36.63 |
| Rate for Payer: Aetna American Axle |
$26.46
|
| Rate for Payer: Aetna Commercial |
$34.60
|
| Rate for Payer: Aetna Medicare |
$5.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.96
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCBS MAPPO |
$5.57
|
| Rate for Payer: BCBS Trust/PPO |
$5.01
|
| Rate for Payer: BCN Medicare Advantage |
$5.57
|
| Rate for Payer: Cash Price |
$32.56
|
| Rate for Payer: Cash Price |
$32.56
|
| Rate for Payer: Cofinity Commercial |
$35.00
|
| Rate for Payer: Cofinity Commercial |
$28.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.57
|
| Rate for Payer: Healthscope Commercial |
$36.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.52
|
| Rate for Payer: Mclaren Medicaid |
$3.05
|
| Rate for Payer: Mclaren Medicare |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$3.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.60
|
| Rate for Payer: PACE Medicare |
$5.29
|
| Rate for Payer: PACE SWMI |
$5.57
|
| Rate for Payer: PHP Commercial |
$34.60
|
| Rate for Payer: PHP Medicare Advantage |
$5.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.65
|
| Rate for Payer: Priority Health Medicare |
$5.57
|
| Rate for Payer: Priority Health Narrow Network |
$4.52
|
| Rate for Payer: Priority Health SBD |
$25.64
|
| Rate for Payer: Railroad Medicare Medicare |
$5.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.68
|
| Rate for Payer: UHC Core |
$9.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.57
|
| Rate for Payer: UHC Exchange |
$5.57
|
| Rate for Payer: UHC Medicare Advantage |
$5.74
|
| Rate for Payer: UMR Bronson Commercial |
$15.06
|
| Rate for Payer: VA VA |
$5.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.52
|
|
|
HC REVAS ADD.VESSEL/DES
|
Facility
|
OP
|
$18,972.73
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
48100090
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$17,075.46 |
| Rate for Payer: Aetna American Axle |
$12,332.27
|
| Rate for Payer: Aetna Commercial |
$16,126.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,332.27
|
| Rate for Payer: BCBS Complete |
$7,589.09
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: Cash Price |
$15,178.18
|
| Rate for Payer: Cash Price |
$15,178.18
|
| Rate for Payer: Cofinity Commercial |
$13,280.91
|
| Rate for Payer: Cofinity Commercial |
$16,316.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,178.18
|
| Rate for Payer: Healthscope Commercial |
$17,075.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,280.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,229.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,126.82
|
| Rate for Payer: PHP Commercial |
$16,126.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,280.91
|
| Rate for Payer: Priority Health SBD |
$11,952.82
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UMR Bronson Commercial |
$7,019.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,229.55
|
|
|
HC REVAS ADD.VESSEL/DES
|
Facility
|
IP
|
$18,972.73
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
48100090
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,348.00 |
| Max. Negotiated Rate |
$17,075.46 |
| Rate for Payer: Aetna American Axle |
$12,332.27
|
| Rate for Payer: Aetna Commercial |
$16,126.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,332.27
|
| Rate for Payer: Cash Price |
$15,178.18
|
| Rate for Payer: Cofinity Commercial |
$13,280.91
|
| Rate for Payer: Cofinity Commercial |
$16,316.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,178.18
|
| Rate for Payer: Healthscope Commercial |
$17,075.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,280.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,229.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,126.82
|
| Rate for Payer: PHP Commercial |
$16,126.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,280.91
|
| Rate for Payer: Priority Health SBD |
$11,952.82
|
| Rate for Payer: UMR Bronson Commercial |
$8,348.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,229.55
|
|
|
HC REVAS ADD.VESSEL/STENT
|
Facility
|
OP
|
$18,972.73
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
48100089
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$871.81 |
| Max. Negotiated Rate |
$17,075.46 |
| Rate for Payer: Aetna American Axle |
$12,332.27
|
| Rate for Payer: Aetna Commercial |
$16,126.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,332.27
|
| Rate for Payer: BCBS Complete |
$7,589.09
|
| Rate for Payer: BCBS Trust/PPO |
$871.81
|
| Rate for Payer: Cash Price |
$15,178.18
|
| Rate for Payer: Cash Price |
$15,178.18
|
| Rate for Payer: Cofinity Commercial |
$13,280.91
|
| Rate for Payer: Cofinity Commercial |
$16,316.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,178.18
|
| Rate for Payer: Healthscope Commercial |
$17,075.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,280.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,229.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,126.82
|
| Rate for Payer: PHP Commercial |
$16,126.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,280.91
|
| Rate for Payer: Priority Health SBD |
$11,952.82
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UMR Bronson Commercial |
$7,019.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,229.55
|
|
|
HC REVAS ADD.VESSEL/STENT
|
Facility
|
IP
|
$18,972.73
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
48100089
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,348.00 |
| Max. Negotiated Rate |
$17,075.46 |
| Rate for Payer: Aetna American Axle |
$12,332.27
|
| Rate for Payer: Aetna Commercial |
$16,126.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,332.27
|
| Rate for Payer: Cash Price |
$15,178.18
|
| Rate for Payer: Cofinity Commercial |
$13,280.91
|
| Rate for Payer: Cofinity Commercial |
$16,316.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,178.18
|
| Rate for Payer: Healthscope Commercial |
$17,075.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,280.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,229.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16,126.82
|
| Rate for Payer: PHP Commercial |
$16,126.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,280.91
|
| Rate for Payer: Priority Health SBD |
$11,952.82
|
| Rate for Payer: UMR Bronson Commercial |
$8,348.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,229.55
|
|
|
HC REVAS CABG ADD.BRANCH
|
Facility
|
OP
|
$18,727.35
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
48100082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$775.45 |
| Max. Negotiated Rate |
$16,854.62 |
| Rate for Payer: Aetna American Axle |
$12,172.78
|
| Rate for Payer: Aetna Commercial |
$15,918.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,172.78
|
| Rate for Payer: BCBS Complete |
$7,490.94
|
| Rate for Payer: BCBS Trust/PPO |
$775.45
|
| Rate for Payer: Cash Price |
$14,981.88
|
| Rate for Payer: Cash Price |
$14,981.88
|
| Rate for Payer: Cofinity Commercial |
$16,105.52
|
| Rate for Payer: Cofinity Commercial |
$13,109.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,981.88
|
| Rate for Payer: Healthscope Commercial |
$16,854.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,109.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,045.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,918.25
|
| Rate for Payer: PHP Commercial |
$15,918.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,109.14
|
| Rate for Payer: Priority Health SBD |
$11,798.23
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UMR Bronson Commercial |
$6,929.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,045.51
|
|
|
HC REVAS CABG ADD.BRANCH
|
Facility
|
IP
|
$18,727.35
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
48100082
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,240.03 |
| Max. Negotiated Rate |
$16,854.62 |
| Rate for Payer: Aetna American Axle |
$12,172.78
|
| Rate for Payer: Aetna Commercial |
$15,918.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,172.78
|
| Rate for Payer: Cash Price |
$14,981.88
|
| Rate for Payer: Cofinity Commercial |
$13,109.14
|
| Rate for Payer: Cofinity Commercial |
$16,105.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,981.88
|
| Rate for Payer: Healthscope Commercial |
$16,854.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,109.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,045.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,918.25
|
| Rate for Payer: PHP Commercial |
$15,918.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,109.14
|
| Rate for Payer: Priority Health SBD |
$11,798.23
|
| Rate for Payer: UMR Bronson Commercial |
$8,240.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,045.51
|
|
|
HC REVAS CABG VES/BRANCH
|
Facility
|
OP
|
$28,586.86
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
48100081
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$562.87 |
| Max. Negotiated Rate |
$30,783.77 |
| Rate for Payer: Aetna American Axle |
$18,581.46
|
| Rate for Payer: Aetna Commercial |
$24,298.83
|
| Rate for Payer: Aetna Medicare |
$10,169.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,581.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,223.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,223.36
|
| Rate for Payer: BCBS Complete |
$5,616.88
|
| Rate for Payer: BCBS MAPPO |
$9,778.69
|
| Rate for Payer: BCBS Trust/PPO |
$628.35
|
| Rate for Payer: BCN Medicare Advantage |
$9,778.69
|
| Rate for Payer: Cash Price |
$22,869.49
|
| Rate for Payer: Cash Price |
$22,869.49
|
| Rate for Payer: Cofinity Commercial |
$20,010.80
|
| Rate for Payer: Cofinity Commercial |
$24,584.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,869.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,778.69
|
| Rate for Payer: Healthscope Commercial |
$25,728.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,010.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,440.14
|
| Rate for Payer: Mclaren Medicaid |
$5,348.94
|
| Rate for Payer: Mclaren Medicare |
$9,778.69
|
| Rate for Payer: Meridian Medicaid |
$5,616.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,267.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,245.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,298.83
|
| Rate for Payer: PACE Medicare |
$9,289.76
|
| Rate for Payer: PACE SWMI |
$9,778.69
|
| Rate for Payer: PHP Commercial |
$24,298.83
|
| Rate for Payer: PHP Medicare Advantage |
$9,778.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,348.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,010.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30,783.77
|
| Rate for Payer: Priority Health Medicare |
$9,778.69
|
| Rate for Payer: Priority Health Narrow Network |
$24,627.02
|
| Rate for Payer: Priority Health SBD |
$18,009.72
|
| Rate for Payer: Railroad Medicare Medicare |
$9,778.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$619.16
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,778.69
|
| Rate for Payer: UHC Exchange |
$562.87
|
| Rate for Payer: UHC Medicare Advantage |
$10,072.05
|
| Rate for Payer: UMR Bronson Commercial |
$10,577.14
|
| Rate for Payer: VA VA |
$9,778.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,440.14
|
|
|
HC REVAS CABG VES/BRANCH
|
Facility
|
IP
|
$28,586.86
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
48100081
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,578.22 |
| Max. Negotiated Rate |
$25,728.17 |
| Rate for Payer: Aetna American Axle |
$18,581.46
|
| Rate for Payer: Aetna Commercial |
$24,298.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,581.46
|
| Rate for Payer: Cash Price |
$22,869.49
|
| Rate for Payer: Cofinity Commercial |
$20,010.80
|
| Rate for Payer: Cofinity Commercial |
$24,584.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,869.49
|
| Rate for Payer: Healthscope Commercial |
$25,728.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,010.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,440.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,298.83
|
| Rate for Payer: PHP Commercial |
$24,298.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,010.80
|
| Rate for Payer: Priority Health SBD |
$18,009.72
|
| Rate for Payer: UMR Bronson Commercial |
$12,578.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,440.14
|
|
|
HC REVASC STENT TIB PERONL UNI INITIAL
|
Facility
|
OP
|
$11,594.76
|
|
|
Service Code
|
CPT 37230
|
| Hospital Charge Code |
36100174
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$660.12 |
| Max. Negotiated Rate |
$49,067.27 |
| Rate for Payer: Aetna American Axle |
$7,536.59
|
| Rate for Payer: Aetna Commercial |
$9,855.55
|
| Rate for Payer: Aetna Medicare |
$16,210.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,536.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,483.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,483.22
|
| Rate for Payer: BCBS Complete |
$8,952.93
|
| Rate for Payer: BCBS MAPPO |
$15,586.58
|
| Rate for Payer: BCBS Trust/PPO |
$12,530.83
|
| Rate for Payer: BCN Medicare Advantage |
$15,586.58
|
| Rate for Payer: Cash Price |
$9,275.81
|
| Rate for Payer: Cash Price |
$9,275.81
|
| Rate for Payer: Cofinity Commercial |
$8,116.33
|
| Rate for Payer: Cofinity Commercial |
$9,971.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,275.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,586.58
|
| Rate for Payer: Healthscope Commercial |
$10,435.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,116.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,696.07
|
| Rate for Payer: Mclaren Medicaid |
$8,525.86
|
| Rate for Payer: Mclaren Medicare |
$15,586.58
|
| Rate for Payer: Meridian Medicaid |
$8,952.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,365.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,924.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,855.55
|
| Rate for Payer: PACE Medicare |
$14,807.25
|
| Rate for Payer: PACE SWMI |
$15,586.58
|
| Rate for Payer: PHP Commercial |
$9,855.55
|
| Rate for Payer: PHP Medicare Advantage |
$15,586.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,525.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,116.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49,067.27
|
| Rate for Payer: Priority Health Medicare |
$15,586.58
|
| Rate for Payer: Priority Health Narrow Network |
$39,253.82
|
| Rate for Payer: Priority Health SBD |
$7,304.70
|
| Rate for Payer: Railroad Medicare Medicare |
$15,586.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$726.13
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,586.58
|
| Rate for Payer: UHC Exchange |
$660.12
|
| Rate for Payer: UHC Medicare Advantage |
$16,054.18
|
| Rate for Payer: UMR Bronson Commercial |
$4,290.06
|
| Rate for Payer: VA VA |
$15,586.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,696.07
|
|
|
HC REVASC STENT TIB PERONL UNI INITIAL
|
Facility
|
IP
|
$11,594.76
|
|
|
Service Code
|
CPT 37230
|
| Hospital Charge Code |
36100174
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,101.69 |
| Max. Negotiated Rate |
$10,435.28 |
| Rate for Payer: Aetna American Axle |
$7,536.59
|
| Rate for Payer: Aetna Commercial |
$9,855.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,536.59
|
| Rate for Payer: Cash Price |
$9,275.81
|
| Rate for Payer: Cofinity Commercial |
$8,116.33
|
| Rate for Payer: Cofinity Commercial |
$9,971.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,275.81
|
| Rate for Payer: Healthscope Commercial |
$10,435.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,116.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,696.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,855.55
|
| Rate for Payer: PHP Commercial |
$9,855.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,116.33
|
| Rate for Payer: Priority Health SBD |
$7,304.70
|
| Rate for Payer: UMR Bronson Commercial |
$5,101.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,696.07
|
|
|
HC REVASCULARIZATION STENT FEM POP UNI
|
Facility
|
IP
|
$12,754.23
|
|
|
Service Code
|
CPT 37226
|
| Hospital Charge Code |
36100170
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,611.86 |
| Max. Negotiated Rate |
$11,478.81 |
| Rate for Payer: Aetna American Axle |
$8,290.25
|
| Rate for Payer: Aetna Commercial |
$10,841.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,290.25
|
| Rate for Payer: Cash Price |
$10,203.38
|
| Rate for Payer: Cofinity Commercial |
$10,968.64
|
| Rate for Payer: Cofinity Commercial |
$8,927.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,203.38
|
| Rate for Payer: Healthscope Commercial |
$11,478.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,927.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,565.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,841.10
|
| Rate for Payer: PHP Commercial |
$10,841.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,927.96
|
| Rate for Payer: Priority Health SBD |
$8,035.16
|
| Rate for Payer: UMR Bronson Commercial |
$5,611.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,565.67
|
|
|
HC REVASCULARIZATION STENT FEM POP UNI
|
Facility
|
OP
|
$12,754.23
|
|
|
Service Code
|
CPT 37226
|
| Hospital Charge Code |
36100170
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$494.11 |
| Max. Negotiated Rate |
$30,783.77 |
| Rate for Payer: Aetna American Axle |
$8,290.25
|
| Rate for Payer: Aetna Commercial |
$10,841.10
|
| Rate for Payer: Aetna Medicare |
$10,169.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,290.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,223.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,223.36
|
| Rate for Payer: BCBS Complete |
$5,616.88
|
| Rate for Payer: BCBS MAPPO |
$9,778.69
|
| Rate for Payer: BCBS Trust/PPO |
$9,198.86
|
| Rate for Payer: BCN Medicare Advantage |
$9,778.69
|
| Rate for Payer: Cash Price |
$10,203.38
|
| Rate for Payer: Cash Price |
$10,203.38
|
| Rate for Payer: Cofinity Commercial |
$8,927.96
|
| Rate for Payer: Cofinity Commercial |
$10,968.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,203.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,778.69
|
| Rate for Payer: Healthscope Commercial |
$11,478.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,927.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,565.67
|
| Rate for Payer: Mclaren Medicaid |
$5,348.94
|
| Rate for Payer: Mclaren Medicare |
$9,778.69
|
| Rate for Payer: Meridian Medicaid |
$5,616.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,267.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,245.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,841.10
|
| Rate for Payer: PACE Medicare |
$9,289.76
|
| Rate for Payer: PACE SWMI |
$9,778.69
|
| Rate for Payer: PHP Commercial |
$10,841.10
|
| Rate for Payer: PHP Medicare Advantage |
$9,778.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,348.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,927.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30,783.77
|
| Rate for Payer: Priority Health Medicare |
$9,778.69
|
| Rate for Payer: Priority Health Narrow Network |
$24,627.02
|
| Rate for Payer: Priority Health SBD |
$8,035.16
|
| Rate for Payer: Railroad Medicare Medicare |
$9,778.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$543.52
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,778.69
|
| Rate for Payer: UHC Exchange |
$494.11
|
| Rate for Payer: UHC Medicare Advantage |
$10,072.05
|
| Rate for Payer: UMR Bronson Commercial |
$4,719.07
|
| Rate for Payer: VA VA |
$9,778.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,565.67
|
|
|
HC REVAS DES/CABG ADD.
|
Facility
|
IP
|
$18,727.35
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
48100084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,240.03 |
| Max. Negotiated Rate |
$16,854.62 |
| Rate for Payer: Aetna American Axle |
$12,172.78
|
| Rate for Payer: Aetna Commercial |
$15,918.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,172.78
|
| Rate for Payer: Cash Price |
$14,981.88
|
| Rate for Payer: Cofinity Commercial |
$16,105.52
|
| Rate for Payer: Cofinity Commercial |
$13,109.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,981.88
|
| Rate for Payer: Healthscope Commercial |
$16,854.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,109.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,045.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,918.25
|
| Rate for Payer: PHP Commercial |
$15,918.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,109.14
|
| Rate for Payer: Priority Health SBD |
$11,798.23
|
| Rate for Payer: UMR Bronson Commercial |
$8,240.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,045.51
|
|
|
HC REVAS DES/CABG ADD.
|
Facility
|
OP
|
$18,727.35
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
48100084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$16,854.62 |
| Rate for Payer: Aetna American Axle |
$12,172.78
|
| Rate for Payer: Aetna Commercial |
$15,918.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,172.78
|
| Rate for Payer: BCBS Complete |
$7,490.94
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: Cash Price |
$14,981.88
|
| Rate for Payer: Cash Price |
$14,981.88
|
| Rate for Payer: Cofinity Commercial |
$16,105.52
|
| Rate for Payer: Cofinity Commercial |
$13,109.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,981.88
|
| Rate for Payer: Healthscope Commercial |
$16,854.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,109.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,045.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15,918.25
|
| Rate for Payer: PHP Commercial |
$15,918.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,109.14
|
| Rate for Payer: Priority Health SBD |
$11,798.23
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UMR Bronson Commercial |
$6,929.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,045.51
|
|
|
HC REVAS DES/CABG INITIAL
|
Facility
|
OP
|
$28,586.86
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
48100083
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,348.94 |
| Max. Negotiated Rate |
$30,783.77 |
| Rate for Payer: Aetna American Axle |
$18,581.46
|
| Rate for Payer: Aetna Commercial |
$24,298.83
|
| Rate for Payer: Aetna Medicare |
$10,169.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,581.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,223.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,223.36
|
| Rate for Payer: BCBS Complete |
$5,616.88
|
| Rate for Payer: BCBS MAPPO |
$9,778.69
|
| Rate for Payer: BCBS Trust/PPO |
$9,738.02
|
| Rate for Payer: BCN Medicare Advantage |
$9,778.69
|
| Rate for Payer: Cash Price |
$22,869.49
|
| Rate for Payer: Cash Price |
$22,869.49
|
| Rate for Payer: Cofinity Commercial |
$24,584.70
|
| Rate for Payer: Cofinity Commercial |
$20,010.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,869.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,778.69
|
| Rate for Payer: Healthscope Commercial |
$25,728.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,010.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,440.14
|
| Rate for Payer: Mclaren Medicaid |
$5,348.94
|
| Rate for Payer: Mclaren Medicare |
$9,778.69
|
| Rate for Payer: Meridian Medicaid |
$5,616.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10,267.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,245.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,298.83
|
| Rate for Payer: PACE Medicare |
$9,289.76
|
| Rate for Payer: PACE SWMI |
$9,778.69
|
| Rate for Payer: PHP Commercial |
$24,298.83
|
| Rate for Payer: PHP Medicare Advantage |
$9,778.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,348.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,010.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30,783.77
|
| Rate for Payer: Priority Health Medicare |
$9,778.69
|
| Rate for Payer: Priority Health Narrow Network |
$24,627.02
|
| Rate for Payer: Priority Health SBD |
$18,009.72
|
| Rate for Payer: Railroad Medicare Medicare |
$9,778.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27,416.51
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$9,778.69
|
| Rate for Payer: UHC Exchange |
$18,688.05
|
| Rate for Payer: UHC Medicare Advantage |
$10,072.05
|
| Rate for Payer: UMR Bronson Commercial |
$10,577.14
|
| Rate for Payer: VA VA |
$9,778.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,440.14
|
|
|
HC REVAS DES/CABG INITIAL
|
Facility
|
IP
|
$28,586.86
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
48100083
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,578.22 |
| Max. Negotiated Rate |
$25,728.17 |
| Rate for Payer: Aetna American Axle |
$18,581.46
|
| Rate for Payer: Aetna Commercial |
$24,298.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,581.46
|
| Rate for Payer: Cash Price |
$22,869.49
|
| Rate for Payer: Cofinity Commercial |
$20,010.80
|
| Rate for Payer: Cofinity Commercial |
$24,584.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,869.49
|
| Rate for Payer: Healthscope Commercial |
$25,728.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,010.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,440.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,298.83
|
| Rate for Payer: PHP Commercial |
$24,298.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,010.80
|
| Rate for Payer: Priority Health SBD |
$18,009.72
|
| Rate for Payer: UMR Bronson Commercial |
$12,578.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,440.14
|
|
|
HC REVAS MI/DES
|
Facility
|
OP
|
$29,091.52
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,879.00 |
| Max. Negotiated Rate |
$26,182.37 |
| Rate for Payer: Aetna American Axle |
$18,909.49
|
| Rate for Payer: Aetna Commercial |
$24,727.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,909.49
|
| Rate for Payer: BCBS Complete |
$11,636.61
|
| Rate for Payer: BCBS Trust/PPO |
$14,760.30
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cofinity Commercial |
$20,364.06
|
| Rate for Payer: Cofinity Commercial |
$25,018.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,273.22
|
| Rate for Payer: Healthscope Commercial |
$26,182.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,364.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,818.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,727.79
|
| Rate for Payer: PHP Commercial |
$24,727.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,364.06
|
| Rate for Payer: Priority Health SBD |
$18,327.66
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UMR Bronson Commercial |
$10,763.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,818.64
|
|
|
HC REVAS MI/DES
|
Facility
|
IP
|
$29,091.52
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,800.27 |
| Max. Negotiated Rate |
$26,182.37 |
| Rate for Payer: Aetna American Axle |
$18,909.49
|
| Rate for Payer: Aetna Commercial |
$24,727.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,909.49
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cofinity Commercial |
$20,364.06
|
| Rate for Payer: Cofinity Commercial |
$25,018.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,273.22
|
| Rate for Payer: Healthscope Commercial |
$26,182.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,364.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,818.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,727.79
|
| Rate for Payer: PHP Commercial |
$24,727.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,364.06
|
| Rate for Payer: Priority Health SBD |
$18,327.66
|
| Rate for Payer: UMR Bronson Commercial |
$12,800.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,818.64
|
|
|
HC REVAS MI/STENT
|
Facility
|
IP
|
$29,091.52
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
48100085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,800.27 |
| Max. Negotiated Rate |
$26,182.37 |
| Rate for Payer: Aetna American Axle |
$18,909.49
|
| Rate for Payer: Aetna Commercial |
$24,727.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,909.49
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cofinity Commercial |
$20,364.06
|
| Rate for Payer: Cofinity Commercial |
$25,018.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,273.22
|
| Rate for Payer: Healthscope Commercial |
$26,182.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,364.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,818.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,727.79
|
| Rate for Payer: PHP Commercial |
$24,727.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,364.06
|
| Rate for Payer: Priority Health SBD |
$18,327.66
|
| Rate for Payer: UMR Bronson Commercial |
$12,800.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,818.64
|
|
|
HC REVAS MI/STENT
|
Facility
|
OP
|
$29,091.52
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
48100085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$631.96 |
| Max. Negotiated Rate |
$26,182.37 |
| Rate for Payer: Aetna American Axle |
$18,909.49
|
| Rate for Payer: Aetna Commercial |
$24,727.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,909.49
|
| Rate for Payer: BCBS Complete |
$11,636.61
|
| Rate for Payer: BCBS Trust/PPO |
$708.78
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cofinity Commercial |
$20,364.06
|
| Rate for Payer: Cofinity Commercial |
$25,018.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,273.22
|
| Rate for Payer: Healthscope Commercial |
$26,182.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,364.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,818.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,727.79
|
| Rate for Payer: PHP Commercial |
$24,727.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,364.06
|
| Rate for Payer: Priority Health SBD |
$18,327.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$695.16
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Exchange |
$631.96
|
| Rate for Payer: UMR Bronson Commercial |
$10,763.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,818.64
|
|
|
HC REVISE/REPLACE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
OP
|
$15,710.04
|
|
|
Service Code
|
CPT 63663
|
| Hospital Charge Code |
36100612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$444.01 |
| Max. Negotiated Rate |
$19,137.49 |
| Rate for Payer: Aetna American Axle |
$10,211.53
|
| Rate for Payer: Aetna Commercial |
$13,353.53
|
| Rate for Payer: Aetna Medicare |
$6,322.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,211.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,598.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,598.96
|
| Rate for Payer: BCBS Complete |
$3,491.88
|
| Rate for Payer: BCBS MAPPO |
$6,079.17
|
| Rate for Payer: BCBS Trust/PPO |
$6,252.75
|
| Rate for Payer: BCN Medicare Advantage |
$6,079.17
|
| Rate for Payer: Cash Price |
$12,568.03
|
| Rate for Payer: Cash Price |
$12,568.03
|
| Rate for Payer: Cofinity Commercial |
$13,510.63
|
| Rate for Payer: Cofinity Commercial |
$10,997.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,568.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,079.17
|
| Rate for Payer: Healthscope Commercial |
$14,139.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,997.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,782.53
|
| Rate for Payer: Mclaren Medicaid |
$3,325.31
|
| Rate for Payer: Mclaren Medicare |
$6,079.17
|
| Rate for Payer: Meridian Medicaid |
$3,491.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,383.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,991.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13,353.53
|
| Rate for Payer: PACE Medicare |
$5,775.21
|
| Rate for Payer: PACE SWMI |
$6,079.17
|
| Rate for Payer: PHP Commercial |
$13,353.53
|
| Rate for Payer: PHP Medicare Advantage |
$6,079.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,325.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,997.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19,137.49
|
| Rate for Payer: Priority Health Medicare |
$6,079.17
|
| Rate for Payer: Priority Health Narrow Network |
$15,309.99
|
| Rate for Payer: Priority Health SBD |
$9,897.33
|
| Rate for Payer: Railroad Medicare Medicare |
$6,079.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$488.41
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,079.17
|
| Rate for Payer: UHC Exchange |
$444.01
|
| Rate for Payer: UHC Medicare Advantage |
$6,261.55
|
| Rate for Payer: UMR Bronson Commercial |
$5,812.71
|
| Rate for Payer: VA VA |
$6,079.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,782.53
|
|
|
HC REVISE/REPLACE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
IP
|
$15,710.04
|
|
|
Service Code
|
CPT 63663
|
| Hospital Charge Code |
36100612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,912.42 |
| Max. Negotiated Rate |
$14,139.04 |
| Rate for Payer: Aetna American Axle |
$10,211.53
|
| Rate for Payer: Aetna Commercial |
$13,353.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,211.53
|
| Rate for Payer: Cash Price |
$12,568.03
|
| Rate for Payer: Cofinity Commercial |
$10,997.03
|
| Rate for Payer: Cofinity Commercial |
$13,510.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,568.03
|
| Rate for Payer: Healthscope Commercial |
$14,139.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,997.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,782.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13,353.53
|
| Rate for Payer: PHP Commercial |
$13,353.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,997.03
|
| Rate for Payer: Priority Health SBD |
$9,897.33
|
| Rate for Payer: UMR Bronson Commercial |
$6,912.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,782.53
|
|
|
HC RF ABLATION KIDNEY TUMOR
|
Facility
|
OP
|
$7,263.14
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
36100247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$328.75 |
| Max. Negotiated Rate |
$16,145.72 |
| Rate for Payer: Aetna American Axle |
$4,721.04
|
| Rate for Payer: Aetna Commercial |
$6,173.67
|
| Rate for Payer: Aetna Medicare |
$5,333.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,721.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,411.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,411.01
|
| Rate for Payer: BCBS Complete |
$2,945.99
|
| Rate for Payer: BCBS MAPPO |
$5,128.81
|
| Rate for Payer: BCBS Trust/PPO |
$3,910.93
|
| Rate for Payer: BCN Medicare Advantage |
$5,128.81
|
| Rate for Payer: Cash Price |
$5,810.51
|
| Rate for Payer: Cash Price |
$5,810.51
|
| Rate for Payer: Cofinity Commercial |
$5,084.20
|
| Rate for Payer: Cofinity Commercial |
$6,246.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,810.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,128.81
|
| Rate for Payer: Healthscope Commercial |
$6,536.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,084.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,447.36
|
| Rate for Payer: Mclaren Medicaid |
$2,805.46
|
| Rate for Payer: Mclaren Medicare |
$5,128.81
|
| Rate for Payer: Meridian Medicaid |
$2,945.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,385.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,898.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,173.67
|
| Rate for Payer: PACE Medicare |
$4,872.37
|
| Rate for Payer: PACE SWMI |
$5,128.81
|
| Rate for Payer: PHP Commercial |
$6,173.67
|
| Rate for Payer: PHP Medicare Advantage |
$5,128.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,805.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,084.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,145.72
|
| Rate for Payer: Priority Health Medicare |
$5,128.81
|
| Rate for Payer: Priority Health Narrow Network |
$12,916.58
|
| Rate for Payer: Priority Health SBD |
$4,575.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5,128.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$361.62
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,128.81
|
| Rate for Payer: UHC Exchange |
$328.75
|
| Rate for Payer: UHC Medicare Advantage |
$5,282.67
|
| Rate for Payer: UMR Bronson Commercial |
$2,687.36
|
| Rate for Payer: VA VA |
$5,128.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,447.36
|
|
|
HC RF ABLATION KIDNEY TUMOR
|
Facility
|
IP
|
$7,263.14
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
36100247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,195.78 |
| Max. Negotiated Rate |
$6,536.83 |
| Rate for Payer: Aetna American Axle |
$4,721.04
|
| Rate for Payer: Aetna Commercial |
$6,173.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,721.04
|
| Rate for Payer: Cash Price |
$5,810.51
|
| Rate for Payer: Cofinity Commercial |
$5,084.20
|
| Rate for Payer: Cofinity Commercial |
$6,246.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,810.51
|
| Rate for Payer: Healthscope Commercial |
$6,536.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,084.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,447.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,173.67
|
| Rate for Payer: PHP Commercial |
$6,173.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,084.20
|
| Rate for Payer: Priority Health SBD |
$4,575.78
|
| Rate for Payer: UMR Bronson Commercial |
$3,195.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,447.36
|
|
