|
HC INJECTION TRANSFORAMIN LUMB OR SAC SINGLE LEVEL BIL
|
Facility
|
OP
|
$1,208.96
|
|
|
Service Code
|
CPT 64483
|
| Hospital Charge Code |
36100315
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$447.32 |
| Max. Negotiated Rate |
$2,850.01 |
| Rate for Payer: Aetna American Axle |
$785.82
|
| Rate for Payer: Aetna Commercial |
$1,027.62
|
| Rate for Payer: Aetna Medicare |
$916.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$785.82
|
| 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 |
$967.17
|
| Rate for Payer: Cash Price |
$967.17
|
| Rate for Payer: Cash Price |
$967.17
|
| Rate for Payer: Cofinity Advantage |
$846.27
|
| Rate for Payer: Cofinity Commercial |
$1,039.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$967.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,088.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$846.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$906.72
|
| 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 |
$1,027.62
|
| Rate for Payer: Nomi Health Commercial |
$2,643.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$906.72
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$1,027.62
|
| 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 |
$761.64
|
| 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 |
$447.32
|
| Rate for Payer: VA VA |
$881.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$906.72
|
|
|
HC INJECTION TRANSFORAMIN LUMB OR SAC SINGLE LEVEL BIL
|
Facility
|
IP
|
$1,208.96
|
|
|
Service Code
|
CPT 64483
|
| Hospital Charge Code |
36100315
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$531.94 |
| Max. Negotiated Rate |
$1,088.06 |
| Rate for Payer: Aetna American Axle |
$785.82
|
| Rate for Payer: Aetna Commercial |
$1,027.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$785.82
|
| Rate for Payer: Cash Price |
$967.17
|
| Rate for Payer: Cofinity Advantage |
$846.27
|
| Rate for Payer: Cofinity Commercial |
$1,039.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$967.17
|
| Rate for Payer: Healthscope Commercial |
$1,088.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$846.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$906.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,027.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$906.72
|
| Rate for Payer: PHP Commercial |
$1,027.62
|
| Rate for Payer: Priority Health SBD |
$761.64
|
| Rate for Payer: UMR Bronson Commercial |
$531.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$906.72
|
|
|
HC INJECTION TURBINATE THERAPEUTIC
|
Facility
|
OP
|
$1,404.54
|
|
|
Service Code
|
CPT 30200
|
| Hospital Charge Code |
76100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$131.95 |
| Max. Negotiated Rate |
$1,737.88 |
| Rate for Payer: Aetna American Axle |
$912.95
|
| Rate for Payer: Aetna Commercial |
$1,193.86
|
| Rate for Payer: Aetna Medicare |
$558.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$671.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$671.74
|
| Rate for Payer: BCBS Complete |
$295.13
|
| Rate for Payer: BCBS MAPPO |
$537.39
|
| Rate for Payer: BCBS Trust/PPO |
$131.95
|
| Rate for Payer: BCN Commercial |
$131.95
|
| Rate for Payer: BCN Medicare Advantage |
$537.39
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cofinity Advantage |
$983.18
|
| Rate for Payer: Cofinity Commercial |
$1,207.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.39
|
| Rate for Payer: Healthscope Commercial |
$1,264.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$983.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,053.40
|
| Rate for Payer: Mclaren Medicaid |
$537.39
|
| Rate for Payer: Mclaren Medicare |
$537.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.26
|
| Rate for Payer: Meridian Medicaid |
$564.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$618.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,193.86
|
| Rate for Payer: Nomi Health Commercial |
$1,612.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.40
|
| Rate for Payer: PACE Medicare |
$510.52
|
| Rate for Payer: PACE SWMI |
$537.39
|
| Rate for Payer: PHP Commercial |
$1,193.86
|
| Rate for Payer: PHP Medicare Advantage |
$537.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,737.88
|
| Rate for Payer: Priority Health Medicare |
$537.39
|
| Rate for Payer: Priority Health SBD |
$884.86
|
| Rate for Payer: Priority Health Tiered Network |
$1,390.30
|
| Rate for Payer: Railroad Medicare Medicare |
$537.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$912.95
|
| Rate for Payer: UHC Core |
$731.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$537.39
|
| Rate for Payer: UHC Exchange |
$551.98
|
| Rate for Payer: UHC Medicaid |
$281.05
|
| Rate for Payer: UHCCP Medicaid |
$281.05
|
| Rate for Payer: UMR Bronson Commercial |
$519.68
|
| Rate for Payer: VA VA |
$537.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,053.40
|
|
|
HC INJECTION TURBINATE THERAPEUTIC
|
Facility
|
IP
|
$1,404.54
|
|
|
Service Code
|
CPT 30200
|
| Hospital Charge Code |
76100450
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$618.00 |
| Max. Negotiated Rate |
$1,264.09 |
| Rate for Payer: Aetna American Axle |
$912.95
|
| Rate for Payer: Aetna Commercial |
$1,193.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.95
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cofinity Advantage |
$983.18
|
| Rate for Payer: Cofinity Commercial |
$1,207.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.63
|
| Rate for Payer: Healthscope Commercial |
$1,264.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$983.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,053.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,193.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.40
|
| Rate for Payer: PHP Commercial |
$1,193.86
|
| Rate for Payer: Priority Health SBD |
$884.86
|
| Rate for Payer: UMR Bronson Commercial |
$618.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,053.40
|
|
|
HC INJECTION VENOGRAM
|
Facility
|
OP
|
$595.32
|
|
|
Service Code
|
CPT 36005
|
| Hospital Charge Code |
36100095
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$220.27 |
| Max. Negotiated Rate |
$2,299.14 |
| Rate for Payer: Aetna American Axle |
$386.96
|
| Rate for Payer: Aetna Commercial |
$506.02
|
| Rate for Payer: Aetna Medicare |
$297.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.96
|
| Rate for Payer: BCBS Complete |
$238.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,299.14
|
| Rate for Payer: BCN Commercial |
$2,299.14
|
| Rate for Payer: Cash Price |
$476.26
|
| Rate for Payer: Cash Price |
$476.26
|
| Rate for Payer: Cash Price |
$476.26
|
| Rate for Payer: Cofinity Advantage |
$416.72
|
| Rate for Payer: Cofinity Commercial |
$511.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.26
|
| Rate for Payer: Healthscope Commercial |
$535.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$416.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$476.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.49
|
| Rate for Payer: PHP Commercial |
$506.02
|
| Rate for Payer: Priority Health SBD |
$375.05
|
| Rate for Payer: UMR Bronson Commercial |
$220.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.49
|
|
|
HC INJECTION VENOGRAM
|
Facility
|
IP
|
$595.32
|
|
|
Service Code
|
CPT 36005
|
| Hospital Charge Code |
36100095
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$261.94 |
| Max. Negotiated Rate |
$535.79 |
| Rate for Payer: Aetna American Axle |
$386.96
|
| Rate for Payer: Aetna Commercial |
$506.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.96
|
| Rate for Payer: Cash Price |
$476.26
|
| Rate for Payer: Cofinity Advantage |
$416.72
|
| Rate for Payer: Cofinity Commercial |
$511.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.26
|
| Rate for Payer: Healthscope Commercial |
$535.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$416.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.49
|
| Rate for Payer: PHP Commercial |
$506.02
|
| Rate for Payer: Priority Health SBD |
$375.05
|
| Rate for Payer: UMR Bronson Commercial |
$261.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.49
|
|
|
HC INJECTION WRIST ARTHROGRAM
|
Facility
|
OP
|
$1,175.24
|
|
|
Service Code
|
CPT 25246
|
| Hospital Charge Code |
36100039
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$353.34 |
| Max. Negotiated Rate |
$1,057.72 |
| Rate for Payer: Aetna American Axle |
$763.91
|
| Rate for Payer: Aetna Commercial |
$998.95
|
| Rate for Payer: Aetna Medicare |
$587.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$763.91
|
| Rate for Payer: BCBS Complete |
$470.10
|
| Rate for Payer: BCBS Trust/PPO |
$353.34
|
| Rate for Payer: BCN Commercial |
$353.34
|
| Rate for Payer: Cash Price |
$940.19
|
| Rate for Payer: Cash Price |
$940.19
|
| Rate for Payer: Cash Price |
$940.19
|
| Rate for Payer: Cofinity Advantage |
$822.67
|
| Rate for Payer: Cofinity Commercial |
$1,010.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.19
|
| Rate for Payer: Healthscope Commercial |
$1,057.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$822.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$881.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$940.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$998.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$881.43
|
| Rate for Payer: PHP Commercial |
$998.95
|
| Rate for Payer: Priority Health SBD |
$740.40
|
| Rate for Payer: UMR Bronson Commercial |
$434.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$881.43
|
|
|
HC INJECTION WRIST ARTHROGRAM
|
Facility
|
IP
|
$1,175.24
|
|
|
Service Code
|
CPT 25246
|
| Hospital Charge Code |
36100039
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$517.11 |
| Max. Negotiated Rate |
$1,057.72 |
| Rate for Payer: Aetna American Axle |
$763.91
|
| Rate for Payer: Aetna Commercial |
$998.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$763.91
|
| Rate for Payer: Cash Price |
$940.19
|
| Rate for Payer: Cofinity Advantage |
$822.67
|
| Rate for Payer: Cofinity Commercial |
$1,010.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.19
|
| Rate for Payer: Healthscope Commercial |
$1,057.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$822.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$881.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$998.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$881.43
|
| Rate for Payer: PHP Commercial |
$998.95
|
| Rate for Payer: Priority Health SBD |
$740.40
|
| Rate for Payer: UMR Bronson Commercial |
$517.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$881.43
|
|
|
HC INJECT/IRRIGATE CORPORA CAVERNOSA
|
Facility
|
IP
|
$380.84
|
|
| Hospital Charge Code |
45000094
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$167.57 |
| Max. Negotiated Rate |
$342.76 |
| Rate for Payer: Aetna American Axle |
$247.55
|
| Rate for Payer: Aetna Commercial |
$323.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.55
|
| Rate for Payer: Cash Price |
$304.67
|
| Rate for Payer: Cofinity Advantage |
$266.59
|
| Rate for Payer: Cofinity Commercial |
$327.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.67
|
| Rate for Payer: Healthscope Commercial |
$342.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$266.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$323.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$285.63
|
| Rate for Payer: PHP Commercial |
$323.71
|
| Rate for Payer: Priority Health SBD |
$239.93
|
| Rate for Payer: UMR Bronson Commercial |
$167.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.63
|
|
|
HC INJECT/IRRIGATE CORPORA CAVERNOSA
|
Facility
|
OP
|
$380.84
|
|
| Hospital Charge Code |
45000094
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$342.76 |
| Rate for Payer: Aetna American Axle |
$247.55
|
| Rate for Payer: Aetna Commercial |
$323.71
|
| Rate for Payer: Aetna Medicare |
$190.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.55
|
| Rate for Payer: BCBS Complete |
$152.34
|
| Rate for Payer: Cash Price |
$304.67
|
| Rate for Payer: Cash Price |
$304.67
|
| Rate for Payer: Cofinity Advantage |
$266.59
|
| Rate for Payer: Cofinity Commercial |
$327.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.67
|
| Rate for Payer: Healthscope Commercial |
$342.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$266.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$304.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$323.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$285.63
|
| Rate for Payer: PHP Commercial |
$323.71
|
| Rate for Payer: Priority Health SBD |
$239.93
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: UMR Bronson Commercial |
$140.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.63
|
|
|
HC INJECT PORTAL VEIN
|
Facility
|
OP
|
$2,836.51
|
|
|
Service Code
|
CPT 36481
|
| Hospital Charge Code |
36100543
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,049.51 |
| Max. Negotiated Rate |
$8,488.28 |
| Rate for Payer: Aetna American Axle |
$1,843.73
|
| Rate for Payer: Aetna Commercial |
$2,411.03
|
| Rate for Payer: Aetna Medicare |
$1,418.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,843.73
|
| Rate for Payer: BCBS Complete |
$1,134.60
|
| Rate for Payer: BCBS Trust/PPO |
$8,488.28
|
| Rate for Payer: BCN Commercial |
$8,488.28
|
| Rate for Payer: Cash Price |
$2,269.21
|
| Rate for Payer: Cash Price |
$2,269.21
|
| Rate for Payer: Cash Price |
$2,269.21
|
| Rate for Payer: Cofinity Advantage |
$1,985.56
|
| Rate for Payer: Cofinity Commercial |
$2,439.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,269.21
|
| Rate for Payer: Healthscope Commercial |
$2,552.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,985.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,127.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,269.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,411.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,127.38
|
| Rate for Payer: PHP Commercial |
$2,411.03
|
| Rate for Payer: Priority Health SBD |
$1,787.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,049.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,127.38
|
|
|
HC INJECT PORTAL VEIN
|
Facility
|
IP
|
$2,836.51
|
|
|
Service Code
|
CPT 36481
|
| Hospital Charge Code |
36100543
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,248.06 |
| Max. Negotiated Rate |
$2,552.86 |
| Rate for Payer: Aetna American Axle |
$1,843.73
|
| Rate for Payer: Aetna Commercial |
$2,411.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,843.73
|
| Rate for Payer: Cash Price |
$2,269.21
|
| Rate for Payer: Cofinity Advantage |
$1,985.56
|
| Rate for Payer: Cofinity Commercial |
$2,439.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,269.21
|
| Rate for Payer: Healthscope Commercial |
$2,552.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,985.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,127.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,411.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,127.38
|
| Rate for Payer: PHP Commercial |
$2,411.03
|
| Rate for Payer: Priority Health SBD |
$1,787.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,248.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,127.38
|
|
|
HC INJECT PROC PENILE PLAQUE
|
Facility
|
OP
|
$368.37
|
|
|
Service Code
|
CPT 54200
|
| Hospital Charge Code |
76100199
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$130.20 |
| Max. Negotiated Rate |
$805.08 |
| Rate for Payer: Aetna American Axle |
$239.44
|
| Rate for Payer: Aetna Commercial |
$313.11
|
| Rate for Payer: Aetna Medicare |
$258.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.44
|
| 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 |
$291.15
|
| Rate for Payer: BCN Commercial |
$291.15
|
| Rate for Payer: BCN Medicare Advantage |
$248.95
|
| Rate for Payer: Cash Price |
$294.70
|
| Rate for Payer: Cash Price |
$294.70
|
| Rate for Payer: Cash Price |
$294.70
|
| Rate for Payer: Cofinity Advantage |
$257.86
|
| Rate for Payer: Cofinity Commercial |
$316.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.95
|
| Rate for Payer: Healthscope Commercial |
$331.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$257.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.28
|
| 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 |
$313.11
|
| Rate for Payer: Nomi Health Commercial |
$746.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.28
|
| Rate for Payer: PACE Medicare |
$236.50
|
| Rate for Payer: PACE SWMI |
$248.95
|
| Rate for Payer: PHP Commercial |
$313.11
|
| 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 |
$232.07
|
| 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) |
$239.44
|
| Rate for Payer: UHC Core |
$191.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$248.95
|
| Rate for Payer: UHC Exchange |
$144.77
|
| Rate for Payer: UHC Medicaid |
$130.20
|
| Rate for Payer: UHCCP Medicaid |
$130.20
|
| Rate for Payer: UMR Bronson Commercial |
$136.30
|
| Rate for Payer: VA VA |
$248.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.28
|
|
|
HC INJECT PROC PENILE PLAQUE
|
Facility
|
IP
|
$368.37
|
|
|
Service Code
|
CPT 54200
|
| Hospital Charge Code |
76100199
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$162.08 |
| Max. Negotiated Rate |
$331.53 |
| Rate for Payer: Aetna American Axle |
$239.44
|
| Rate for Payer: Aetna Commercial |
$313.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.44
|
| Rate for Payer: Cash Price |
$294.70
|
| Rate for Payer: Cofinity Advantage |
$257.86
|
| Rate for Payer: Cofinity Commercial |
$316.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.70
|
| Rate for Payer: Healthscope Commercial |
$331.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$257.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$313.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$276.28
|
| Rate for Payer: PHP Commercial |
$313.11
|
| Rate for Payer: Priority Health SBD |
$232.07
|
| Rate for Payer: UMR Bronson Commercial |
$162.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.28
|
|
|
HC INJECT SING OR MULTI TRIGGER PTS 1 OR 2 MUSCLES
|
Facility
|
IP
|
$381.62
|
|
|
Service Code
|
CPT 20552
|
| Hospital Charge Code |
36100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$167.91 |
| Max. Negotiated Rate |
$343.46 |
| Rate for Payer: Aetna American Axle |
$248.05
|
| Rate for Payer: Aetna Commercial |
$324.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.05
|
| Rate for Payer: Cash Price |
$305.30
|
| Rate for Payer: Cofinity Advantage |
$267.13
|
| Rate for Payer: Cofinity Commercial |
$328.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$305.30
|
| Rate for Payer: Healthscope Commercial |
$343.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$267.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$324.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$286.21
|
| Rate for Payer: PHP Commercial |
$324.38
|
| Rate for Payer: Priority Health SBD |
$240.42
|
| Rate for Payer: UMR Bronson Commercial |
$167.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.21
|
|
|
HC INJECT SING OR MULTI TRIGGER PTS 1 OR 2 MUSCLES
|
Facility
|
OP
|
$381.62
|
|
|
Service Code
|
CPT 20552
|
| Hospital Charge Code |
36100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$141.20 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna American Axle |
$248.05
|
| Rate for Payer: Aetna Commercial |
$324.38
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.05
|
| 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 |
$305.30
|
| Rate for Payer: Cash Price |
$305.30
|
| Rate for Payer: Cash Price |
$305.30
|
| Rate for Payer: Cofinity Advantage |
$267.13
|
| Rate for Payer: Cofinity Commercial |
$328.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$305.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$343.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$267.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.21
|
| 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 |
$324.38
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$286.21
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$324.38
|
| 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 |
$240.42
|
| 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) |
$248.05
|
| Rate for Payer: UHC Core |
$198.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$149.98
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$141.20
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.21
|
|
|
HC INJECT SING OR MULTI TRIGGER PTS 3 OR MORE MUSCLES
|
Facility
|
OP
|
$497.42
|
|
|
Service Code
|
CPT 20553
|
| Hospital Charge Code |
36100400
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.96 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna American Axle |
$323.32
|
| Rate for Payer: Aetna Commercial |
$422.81
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$323.32
|
| 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 |
$397.94
|
| Rate for Payer: Cash Price |
$397.94
|
| Rate for Payer: Cash Price |
$397.94
|
| Rate for Payer: Cofinity Advantage |
$348.19
|
| Rate for Payer: Cofinity Commercial |
$427.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$397.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$447.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$348.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$373.06
|
| 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 |
$422.81
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$373.06
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$422.81
|
| 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 |
$313.37
|
| 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) |
$323.32
|
| Rate for Payer: UHC Core |
$259.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$195.49
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$184.05
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$373.06
|
|
|
HC INJECT SING OR MULTI TRIGGER PTS 3 OR MORE MUSCLES
|
Facility
|
IP
|
$497.42
|
|
|
Service Code
|
CPT 20553
|
| Hospital Charge Code |
36100400
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$218.86 |
| Max. Negotiated Rate |
$447.68 |
| Rate for Payer: Aetna American Axle |
$323.32
|
| Rate for Payer: Aetna Commercial |
$422.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$323.32
|
| Rate for Payer: Cash Price |
$397.94
|
| Rate for Payer: Cofinity Advantage |
$348.19
|
| Rate for Payer: Cofinity Commercial |
$427.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$397.94
|
| Rate for Payer: Healthscope Commercial |
$447.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$348.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$373.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$422.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$373.06
|
| Rate for Payer: PHP Commercial |
$422.81
|
| Rate for Payer: Priority Health SBD |
$313.37
|
| Rate for Payer: UMR Bronson Commercial |
$218.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$373.06
|
|
|
HC INJ ENOXAPARIN SODIUM PER 10 MG
|
Facility
|
IP
|
$15.92
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
63600151
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna American Axle |
$10.35
|
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: UMR Bronson Commercial |
$7.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC INJ ENOXAPARIN SODIUM PER 10 MG
|
Facility
|
OP
|
$15.92
|
|
|
Service Code
|
HCPCS J1650
|
| Hospital Charge Code |
63600151
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna American Axle |
$10.35
|
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: BCBS Complete |
$6.37
|
| Rate for Payer: BCBS Trust/PPO |
$1.72
|
| Rate for Payer: BCN Commercial |
$1.72
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.87
|
| Rate for Payer: UHC Core |
$0.87
|
| Rate for Payer: UHC Exchange |
$0.87
|
| Rate for Payer: UMR Bronson Commercial |
$5.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC INJ ENZYME PALMAR FASCIAL CORD
|
Facility
|
OP
|
$346.44
|
|
|
Service Code
|
CPT 20527
|
| Hospital Charge Code |
76100305
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna American Axle |
$225.19
|
| Rate for Payer: Aetna Commercial |
$294.47
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.19
|
| 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 |
$70.00
|
| Rate for Payer: BCN Commercial |
$70.00
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$277.15
|
| Rate for Payer: Cash Price |
$277.15
|
| Rate for Payer: Cash Price |
$277.15
|
| Rate for Payer: Cofinity Advantage |
$242.51
|
| Rate for Payer: Cofinity Commercial |
$297.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$311.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$242.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.83
|
| 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 |
$294.47
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.83
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$294.47
|
| 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 |
$218.26
|
| 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) |
$225.19
|
| Rate for Payer: UHC Core |
$180.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$136.15
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$128.18
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.83
|
|
|
HC INJ ENZYME PALMAR FASCIAL CORD
|
Facility
|
IP
|
$346.44
|
|
|
Service Code
|
CPT 20527
|
| Hospital Charge Code |
76100305
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$152.43 |
| Max. Negotiated Rate |
$311.80 |
| Rate for Payer: Aetna American Axle |
$225.19
|
| Rate for Payer: Aetna Commercial |
$294.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.19
|
| Rate for Payer: Cash Price |
$277.15
|
| Rate for Payer: Cofinity Advantage |
$242.51
|
| Rate for Payer: Cofinity Commercial |
$297.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.15
|
| Rate for Payer: Healthscope Commercial |
$311.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$242.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.83
|
| Rate for Payer: PHP Commercial |
$294.47
|
| Rate for Payer: Priority Health SBD |
$218.26
|
| Rate for Payer: UMR Bronson Commercial |
$152.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.83
|
|
|
HC INJ HEPARIN SODIUM PER 1000U
|
Facility
|
OP
|
$1.06
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
63600140
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.30 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna American Axle |
$0.69
|
| Rate for Payer: Aetna Commercial |
$0.90
|
| Rate for Payer: Aetna Medicare |
$0.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.69
|
| Rate for Payer: BCBS Complete |
$0.42
|
| Rate for Payer: BCBS Trust/PPO |
$0.57
|
| Rate for Payer: BCN Commercial |
$0.57
|
| Rate for Payer: Cash Price |
$0.85
|
| Rate for Payer: Cash Price |
$0.85
|
| Rate for Payer: Cofinity Advantage |
$0.74
|
| Rate for Payer: Cofinity Commercial |
$0.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.85
|
| Rate for Payer: Healthscope Commercial |
$0.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.80
|
| Rate for Payer: PHP Commercial |
$0.90
|
| Rate for Payer: Priority Health SBD |
$0.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.30
|
| Rate for Payer: UHC Core |
$0.30
|
| Rate for Payer: UHC Exchange |
$0.30
|
| Rate for Payer: UMR Bronson Commercial |
$0.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.80
|
|
|
HC INJ HEPARIN SODIUM PER 1000U
|
Facility
|
IP
|
$1.06
|
|
|
Service Code
|
HCPCS J1644
|
| Hospital Charge Code |
63600140
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.47 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna American Axle |
$0.69
|
| Rate for Payer: Aetna Commercial |
$0.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.69
|
| Rate for Payer: Cash Price |
$0.85
|
| Rate for Payer: Cofinity Advantage |
$0.74
|
| Rate for Payer: Cofinity Commercial |
$0.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.85
|
| Rate for Payer: Healthscope Commercial |
$0.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.80
|
| Rate for Payer: PHP Commercial |
$0.90
|
| Rate for Payer: Priority Health SBD |
$0.67
|
| Rate for Payer: UMR Bronson Commercial |
$0.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.80
|
|
|
HC INJ HYDROCORTISONE NA SUCCINATE, UP TO 100MG
|
Facility
|
IP
|
$43.70
|
|
|
Service Code
|
HCPCS J1720
|
| Hospital Charge Code |
63600241
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.23 |
| Max. Negotiated Rate |
$39.33 |
| Rate for Payer: Aetna American Axle |
$28.41
|
| Rate for Payer: Aetna Commercial |
$37.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.41
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Advantage |
$30.59
|
| Rate for Payer: Cofinity Commercial |
$37.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Healthscope Commercial |
$39.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.77
|
| Rate for Payer: PHP Commercial |
$37.15
|
| Rate for Payer: Priority Health SBD |
$27.53
|
| Rate for Payer: UMR Bronson Commercial |
$19.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.77
|
|
