|
HC INJ HYDROCORTISONE NA SUCCINATE, UP TO 100MG
|
Facility
|
OP
|
$43.70
|
|
|
Service Code
|
HCPCS J1720
|
| Hospital Charge Code |
63600241
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.17 |
| Max. Negotiated Rate |
$71.51 |
| Rate for Payer: Aetna American Axle |
$28.41
|
| Rate for Payer: Aetna Commercial |
$37.15
|
| Rate for Payer: Aetna Medicare |
$21.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.41
|
| Rate for Payer: BCBS Complete |
$17.48
|
| Rate for Payer: BCBS Trust/PPO |
$71.51
|
| Rate for Payer: BCN Commercial |
$71.51
|
| Rate for Payer: Cash Price |
$34.96
|
| 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: MI Amish Medical Board Commercial |
$34.96
|
| 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: UHC All Payor (Choice/PPO) |
$36.40
|
| Rate for Payer: UHC Core |
$36.40
|
| Rate for Payer: UHC Exchange |
$36.40
|
| Rate for Payer: UMR Bronson Commercial |
$16.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.77
|
|
|
HC INJ KNEE ARTHROGRAM CT/MRI
|
Facility
|
IP
|
$648.00
|
|
|
Service Code
|
CPT 27369
|
| Hospital Charge Code |
36100562
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$285.12 |
| Max. Negotiated Rate |
$583.20 |
| Rate for Payer: Aetna American Axle |
$421.20
|
| Rate for Payer: Aetna Commercial |
$550.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$421.20
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cofinity Advantage |
$453.60
|
| Rate for Payer: Cofinity Commercial |
$557.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.40
|
| Rate for Payer: Healthscope Commercial |
$583.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$453.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$486.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$486.00
|
| Rate for Payer: PHP Commercial |
$550.80
|
| Rate for Payer: Priority Health SBD |
$408.24
|
| Rate for Payer: UMR Bronson Commercial |
$285.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$486.00
|
|
|
HC INJ KNEE ARTHROGRAM CT/MRI
|
Facility
|
OP
|
$648.00
|
|
|
Service Code
|
CPT 27369
|
| Hospital Charge Code |
36100562
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$239.76 |
| Max. Negotiated Rate |
$583.20 |
| Rate for Payer: Aetna American Axle |
$421.20
|
| Rate for Payer: Aetna Commercial |
$550.80
|
| Rate for Payer: Aetna Medicare |
$324.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$421.20
|
| Rate for Payer: BCBS Complete |
$259.20
|
| Rate for Payer: BCBS Trust/PPO |
$383.41
|
| Rate for Payer: BCN Commercial |
$383.41
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cash Price |
$518.40
|
| Rate for Payer: Cofinity Advantage |
$453.60
|
| Rate for Payer: Cofinity Commercial |
$557.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.40
|
| Rate for Payer: Healthscope Commercial |
$583.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$453.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$486.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$518.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$486.00
|
| Rate for Payer: PHP Commercial |
$550.80
|
| Rate for Payer: Priority Health SBD |
$408.24
|
| Rate for Payer: UMR Bronson Commercial |
$239.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$486.00
|
|
|
HC INJ LIDOCAINE HYDROCHLORIDE 1 MG
|
Facility
|
OP
|
$1.02
|
|
|
Service Code
|
HCPCS J2003
|
| Hospital Charge Code |
63600262
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$0.92 |
| Rate for Payer: Aetna American Axle |
$0.66
|
| Rate for Payer: Aetna Commercial |
$0.87
|
| Rate for Payer: Aetna Medicare |
$0.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.66
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: BCBS Trust/PPO |
$0.10
|
| Rate for Payer: BCN Commercial |
$0.10
|
| Rate for Payer: Cash Price |
$0.82
|
| Rate for Payer: Cash Price |
$0.82
|
| Rate for Payer: Cofinity Advantage |
$0.71
|
| Rate for Payer: Cofinity Commercial |
$0.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.82
|
| Rate for Payer: Healthscope Commercial |
$0.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.77
|
| Rate for Payer: PHP Commercial |
$0.87
|
| Rate for Payer: Priority Health SBD |
$0.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UMR Bronson Commercial |
$0.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.77
|
|
|
HC INJ LIDOCAINE HYDROCHLORIDE 1 MG
|
Facility
|
IP
|
$1.02
|
|
|
Service Code
|
HCPCS J2003
|
| Hospital Charge Code |
63600262
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$0.92 |
| Rate for Payer: Aetna American Axle |
$0.66
|
| Rate for Payer: Aetna Commercial |
$0.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.66
|
| Rate for Payer: Cash Price |
$0.82
|
| Rate for Payer: Cofinity Advantage |
$0.71
|
| Rate for Payer: Cofinity Commercial |
$0.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.82
|
| Rate for Payer: Healthscope Commercial |
$0.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.77
|
| Rate for Payer: PHP Commercial |
$0.87
|
| Rate for Payer: Priority Health SBD |
$0.64
|
| Rate for Payer: UMR Bronson Commercial |
$0.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.77
|
|
|
HC INJ LUMB W MYELO 2+REG SAME MD
|
Facility
|
OP
|
$2,201.80
|
|
|
Service Code
|
CPT 62305
|
| Hospital Charge Code |
36100463
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$408.52 |
| Max. Negotiated Rate |
$2,526.00 |
| Rate for Payer: Aetna American Axle |
$1,431.17
|
| Rate for Payer: Aetna Commercial |
$1,871.53
|
| Rate for Payer: Aetna Medicare |
$812.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,431.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$976.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$976.38
|
| Rate for Payer: BCBS Complete |
$428.98
|
| Rate for Payer: BCBS MAPPO |
$781.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,196.63
|
| Rate for Payer: BCN Commercial |
$1,196.63
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: Cash Price |
$1,761.44
|
| Rate for Payer: Cash Price |
$1,761.44
|
| Rate for Payer: Cash Price |
$1,761.44
|
| Rate for Payer: Cofinity Advantage |
$1,541.26
|
| Rate for Payer: Cofinity Commercial |
$1,893.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,761.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.10
|
| Rate for Payer: Healthscope Commercial |
$1,981.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,541.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,651.35
|
| Rate for Payer: Mclaren Medicaid |
$781.10
|
| Rate for Payer: Mclaren Medicare |
$781.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$820.15
|
| Rate for Payer: Meridian Medicaid |
$820.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$898.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$859.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,871.53
|
| Rate for Payer: Nomi Health Commercial |
$2,343.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,651.35
|
| Rate for Payer: PACE Medicare |
$742.04
|
| Rate for Payer: PACE SWMI |
$781.10
|
| Rate for Payer: PHP Commercial |
$1,871.53
|
| Rate for Payer: PHP Medicare Advantage |
$781.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,526.00
|
| Rate for Payer: Priority Health Medicare |
$781.10
|
| Rate for Payer: Priority Health SBD |
$1,387.13
|
| Rate for Payer: Priority Health Tiered Network |
$2,020.80
|
| Rate for Payer: Railroad Medicare Medicare |
$781.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$781.10
|
| Rate for Payer: UHC Medicaid |
$408.52
|
| Rate for Payer: UHCCP Medicaid |
$408.52
|
| Rate for Payer: UMR Bronson Commercial |
$814.67
|
| Rate for Payer: VA VA |
$781.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,651.35
|
|
|
HC INJ LUMB W MYELO 2+REG SAME MD
|
Facility
|
IP
|
$2,201.80
|
|
|
Service Code
|
CPT 62305
|
| Hospital Charge Code |
36100463
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$968.79 |
| Max. Negotiated Rate |
$1,981.62 |
| Rate for Payer: Aetna American Axle |
$1,431.17
|
| Rate for Payer: Aetna Commercial |
$1,871.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,431.17
|
| Rate for Payer: Cash Price |
$1,761.44
|
| Rate for Payer: Cofinity Advantage |
$1,541.26
|
| Rate for Payer: Cofinity Commercial |
$1,893.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,761.44
|
| Rate for Payer: Healthscope Commercial |
$1,981.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,541.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,651.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,871.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,651.35
|
| Rate for Payer: PHP Commercial |
$1,871.53
|
| Rate for Payer: Priority Health SBD |
$1,387.13
|
| Rate for Payer: UMR Bronson Commercial |
$968.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,651.35
|
|
|
HC INJ LUMB W MYELO CERV SAME MD
|
Facility
|
OP
|
$2,248.62
|
|
|
Service Code
|
CPT 62302
|
| Hospital Charge Code |
36100460
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$408.52 |
| Max. Negotiated Rate |
$2,526.00 |
| Rate for Payer: Aetna American Axle |
$1,461.60
|
| Rate for Payer: Aetna Commercial |
$1,911.33
|
| Rate for Payer: Aetna Medicare |
$812.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,461.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$976.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$976.38
|
| Rate for Payer: BCBS Complete |
$428.98
|
| Rate for Payer: BCBS MAPPO |
$781.10
|
| Rate for Payer: BCBS Trust/PPO |
$951.32
|
| Rate for Payer: BCN Commercial |
$951.32
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cofinity Advantage |
$1,574.03
|
| Rate for Payer: Cofinity Commercial |
$1,933.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,798.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.10
|
| Rate for Payer: Healthscope Commercial |
$2,023.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,574.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,686.46
|
| Rate for Payer: Mclaren Medicaid |
$781.10
|
| Rate for Payer: Mclaren Medicare |
$781.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$820.15
|
| Rate for Payer: Meridian Medicaid |
$820.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$898.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$859.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,911.33
|
| Rate for Payer: Nomi Health Commercial |
$2,343.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,686.46
|
| Rate for Payer: PACE Medicare |
$742.04
|
| Rate for Payer: PACE SWMI |
$781.10
|
| Rate for Payer: PHP Commercial |
$1,911.33
|
| Rate for Payer: PHP Medicare Advantage |
$781.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,526.00
|
| Rate for Payer: Priority Health Medicare |
$781.10
|
| Rate for Payer: Priority Health SBD |
$1,416.63
|
| Rate for Payer: Priority Health Tiered Network |
$2,020.80
|
| Rate for Payer: Railroad Medicare Medicare |
$781.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$781.10
|
| Rate for Payer: UHC Medicaid |
$408.52
|
| Rate for Payer: UHCCP Medicaid |
$408.52
|
| Rate for Payer: UMR Bronson Commercial |
$831.99
|
| Rate for Payer: VA VA |
$781.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,686.46
|
|
|
HC INJ LUMB W MYELO CERV SAME MD
|
Facility
|
IP
|
$2,248.62
|
|
|
Service Code
|
CPT 62302
|
| Hospital Charge Code |
36100460
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$989.39 |
| Max. Negotiated Rate |
$2,023.76 |
| Rate for Payer: Aetna American Axle |
$1,461.60
|
| Rate for Payer: Aetna Commercial |
$1,911.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,461.60
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cofinity Advantage |
$1,574.03
|
| Rate for Payer: Cofinity Commercial |
$1,933.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,798.90
|
| Rate for Payer: Healthscope Commercial |
$2,023.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,574.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,686.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,911.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,686.46
|
| Rate for Payer: PHP Commercial |
$1,911.33
|
| Rate for Payer: Priority Health SBD |
$1,416.63
|
| Rate for Payer: UMR Bronson Commercial |
$989.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,686.46
|
|
|
HC INJ LUMB W MYELO LS SAME MD
|
Facility
|
OP
|
$2,248.62
|
|
|
Service Code
|
CPT 62304
|
| Hospital Charge Code |
36100462
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$408.52 |
| Max. Negotiated Rate |
$2,526.00 |
| Rate for Payer: Aetna American Axle |
$1,461.60
|
| Rate for Payer: Aetna Commercial |
$1,911.33
|
| Rate for Payer: Aetna Medicare |
$812.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,461.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$976.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$976.38
|
| Rate for Payer: BCBS Complete |
$428.98
|
| Rate for Payer: BCBS MAPPO |
$781.10
|
| Rate for Payer: BCBS Trust/PPO |
$973.40
|
| Rate for Payer: BCN Commercial |
$973.40
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cofinity Advantage |
$1,574.03
|
| Rate for Payer: Cofinity Commercial |
$1,933.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,798.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.10
|
| Rate for Payer: Healthscope Commercial |
$2,023.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,574.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,686.46
|
| Rate for Payer: Mclaren Medicaid |
$781.10
|
| Rate for Payer: Mclaren Medicare |
$781.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$820.15
|
| Rate for Payer: Meridian Medicaid |
$820.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$898.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$859.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,911.33
|
| Rate for Payer: Nomi Health Commercial |
$2,343.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,686.46
|
| Rate for Payer: PACE Medicare |
$742.04
|
| Rate for Payer: PACE SWMI |
$781.10
|
| Rate for Payer: PHP Commercial |
$1,911.33
|
| Rate for Payer: PHP Medicare Advantage |
$781.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,526.00
|
| Rate for Payer: Priority Health Medicare |
$781.10
|
| Rate for Payer: Priority Health SBD |
$1,416.63
|
| Rate for Payer: Priority Health Tiered Network |
$2,020.80
|
| Rate for Payer: Railroad Medicare Medicare |
$781.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$781.10
|
| Rate for Payer: UHC Medicaid |
$408.52
|
| Rate for Payer: UHCCP Medicaid |
$408.52
|
| Rate for Payer: UMR Bronson Commercial |
$831.99
|
| Rate for Payer: VA VA |
$781.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,686.46
|
|
|
HC INJ LUMB W MYELO LS SAME MD
|
Facility
|
IP
|
$2,248.62
|
|
|
Service Code
|
CPT 62304
|
| Hospital Charge Code |
36100462
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$989.39 |
| Max. Negotiated Rate |
$2,023.76 |
| Rate for Payer: Aetna American Axle |
$1,461.60
|
| Rate for Payer: Aetna Commercial |
$1,911.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,461.60
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cofinity Advantage |
$1,574.03
|
| Rate for Payer: Cofinity Commercial |
$1,933.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,798.90
|
| Rate for Payer: Healthscope Commercial |
$2,023.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,574.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,686.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,911.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,686.46
|
| Rate for Payer: PHP Commercial |
$1,911.33
|
| Rate for Payer: Priority Health SBD |
$1,416.63
|
| Rate for Payer: UMR Bronson Commercial |
$989.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,686.46
|
|
|
HC INJ LUMB W MYELO THOR SAME MD
|
Facility
|
OP
|
$2,248.62
|
|
|
Service Code
|
CPT 62303
|
| Hospital Charge Code |
36100461
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$408.52 |
| Max. Negotiated Rate |
$2,526.00 |
| Rate for Payer: Aetna American Axle |
$1,461.60
|
| Rate for Payer: Aetna Commercial |
$1,911.33
|
| Rate for Payer: Aetna Medicare |
$812.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,461.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$976.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$976.38
|
| Rate for Payer: BCBS Complete |
$428.98
|
| Rate for Payer: BCBS MAPPO |
$781.10
|
| Rate for Payer: BCBS Trust/PPO |
$507.39
|
| Rate for Payer: BCN Commercial |
$507.39
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cofinity Advantage |
$1,574.03
|
| Rate for Payer: Cofinity Commercial |
$1,933.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,798.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.10
|
| Rate for Payer: Healthscope Commercial |
$2,023.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,574.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,686.46
|
| Rate for Payer: Mclaren Medicaid |
$781.10
|
| Rate for Payer: Mclaren Medicare |
$781.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$820.15
|
| Rate for Payer: Meridian Medicaid |
$820.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$898.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$859.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,911.33
|
| Rate for Payer: Nomi Health Commercial |
$2,343.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,686.46
|
| Rate for Payer: PACE Medicare |
$742.04
|
| Rate for Payer: PACE SWMI |
$781.10
|
| Rate for Payer: PHP Commercial |
$1,911.33
|
| Rate for Payer: PHP Medicare Advantage |
$781.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,526.00
|
| Rate for Payer: Priority Health Medicare |
$781.10
|
| Rate for Payer: Priority Health SBD |
$1,416.63
|
| Rate for Payer: Priority Health Tiered Network |
$2,020.80
|
| Rate for Payer: Railroad Medicare Medicare |
$781.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$781.10
|
| Rate for Payer: UHC Medicaid |
$408.52
|
| Rate for Payer: UHCCP Medicaid |
$408.52
|
| Rate for Payer: UMR Bronson Commercial |
$831.99
|
| Rate for Payer: VA VA |
$781.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,686.46
|
|
|
HC INJ LUMB W MYELO THOR SAME MD
|
Facility
|
IP
|
$2,248.62
|
|
|
Service Code
|
CPT 62303
|
| Hospital Charge Code |
36100461
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$989.39 |
| Max. Negotiated Rate |
$2,023.76 |
| Rate for Payer: Aetna American Axle |
$1,461.60
|
| Rate for Payer: Aetna Commercial |
$1,911.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,461.60
|
| Rate for Payer: Cash Price |
$1,798.90
|
| Rate for Payer: Cofinity Advantage |
$1,574.03
|
| Rate for Payer: Cofinity Commercial |
$1,933.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,798.90
|
| Rate for Payer: Healthscope Commercial |
$2,023.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,574.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,686.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,911.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,686.46
|
| Rate for Payer: PHP Commercial |
$1,911.33
|
| Rate for Payer: Priority Health SBD |
$1,416.63
|
| Rate for Payer: UMR Bronson Commercial |
$989.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,686.46
|
|
|
HC INJ LYMPHANGIOGRAPHY
|
Facility
|
OP
|
$1,331.27
|
|
|
Service Code
|
CPT 38790
|
| Hospital Charge Code |
36100445
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$366.32 |
| Max. Negotiated Rate |
$1,198.14 |
| Rate for Payer: Aetna American Axle |
$865.33
|
| Rate for Payer: Aetna Commercial |
$1,131.58
|
| Rate for Payer: Aetna Medicare |
$665.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$865.33
|
| Rate for Payer: BCBS Complete |
$532.51
|
| Rate for Payer: BCBS Trust/PPO |
$366.32
|
| Rate for Payer: BCN Commercial |
$366.32
|
| Rate for Payer: Cash Price |
$1,065.02
|
| Rate for Payer: Cash Price |
$1,065.02
|
| Rate for Payer: Cash Price |
$1,065.02
|
| Rate for Payer: Cofinity Advantage |
$931.89
|
| Rate for Payer: Cofinity Commercial |
$1,144.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,065.02
|
| Rate for Payer: Healthscope Commercial |
$1,198.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$931.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$998.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,065.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,131.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$998.45
|
| Rate for Payer: PHP Commercial |
$1,131.58
|
| Rate for Payer: Priority Health SBD |
$838.70
|
| Rate for Payer: UMR Bronson Commercial |
$492.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$998.45
|
|
|
HC INJ LYMPHANGIOGRAPHY
|
Facility
|
IP
|
$1,331.27
|
|
|
Service Code
|
CPT 38790
|
| Hospital Charge Code |
36100445
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$585.76 |
| Max. Negotiated Rate |
$1,198.14 |
| Rate for Payer: Aetna American Axle |
$865.33
|
| Rate for Payer: Aetna Commercial |
$1,131.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$865.33
|
| Rate for Payer: Cash Price |
$1,065.02
|
| Rate for Payer: Cofinity Advantage |
$931.89
|
| Rate for Payer: Cofinity Commercial |
$1,144.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,065.02
|
| Rate for Payer: Healthscope Commercial |
$1,198.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$931.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$998.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,131.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$998.45
|
| Rate for Payer: PHP Commercial |
$1,131.58
|
| Rate for Payer: Priority Health SBD |
$838.70
|
| Rate for Payer: UMR Bronson Commercial |
$585.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$998.45
|
|
|
HC INJ, METHYLPREDNISOLONE ACETATE, 1 MG
|
Facility
|
OP
|
$0.53
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
63600239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.48 |
| Rate for Payer: Aetna American Axle |
$0.34
|
| Rate for Payer: Aetna Commercial |
$0.45
|
| Rate for Payer: Aetna Medicare |
$0.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.34
|
| Rate for Payer: BCBS Complete |
$0.21
|
| Rate for Payer: BCBS Trust/PPO |
$0.38
|
| Rate for Payer: BCN Commercial |
$0.38
|
| Rate for Payer: Cash Price |
$0.42
|
| Rate for Payer: Cash Price |
$0.42
|
| Rate for Payer: Cofinity Advantage |
$0.37
|
| Rate for Payer: Cofinity Commercial |
$0.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.42
|
| Rate for Payer: Healthscope Commercial |
$0.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.40
|
| Rate for Payer: PHP Commercial |
$0.45
|
| Rate for Payer: Priority Health SBD |
$0.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.20
|
| Rate for Payer: UHC Core |
$0.20
|
| Rate for Payer: UHC Exchange |
$0.20
|
| Rate for Payer: UMR Bronson Commercial |
$0.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.40
|
|
|
HC INJ, METHYLPREDNISOLONE ACETATE, 1 MG
|
Facility
|
IP
|
$0.53
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
63600239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$0.48 |
| Rate for Payer: Aetna American Axle |
$0.34
|
| Rate for Payer: Aetna Commercial |
$0.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.34
|
| Rate for Payer: Cash Price |
$0.42
|
| Rate for Payer: Cofinity Advantage |
$0.37
|
| Rate for Payer: Cofinity Commercial |
$0.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.42
|
| Rate for Payer: Healthscope Commercial |
$0.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.40
|
| Rate for Payer: PHP Commercial |
$0.45
|
| Rate for Payer: Priority Health SBD |
$0.33
|
| Rate for Payer: UMR Bronson Commercial |
$0.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.40
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, 5 MG
|
Facility
|
OP
|
$2.65
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
63600240
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$2.38 |
| Rate for Payer: Aetna American Axle |
$1.72
|
| Rate for Payer: Aetna Commercial |
$2.25
|
| Rate for Payer: Aetna Medicare |
$1.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.72
|
| Rate for Payer: BCBS Complete |
$1.06
|
| Rate for Payer: BCBS Trust/PPO |
$0.83
|
| Rate for Payer: BCN Commercial |
$0.83
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cofinity Advantage |
$1.85
|
| Rate for Payer: Cofinity Commercial |
$2.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.12
|
| Rate for Payer: Healthscope Commercial |
$2.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.99
|
| Rate for Payer: PHP Commercial |
$2.25
|
| Rate for Payer: Priority Health SBD |
$1.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.43
|
| Rate for Payer: UHC Core |
$0.43
|
| Rate for Payer: UHC Exchange |
$0.43
|
| Rate for Payer: UMR Bronson Commercial |
$0.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.99
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, 5 MG
|
Facility
|
IP
|
$2.65
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
63600240
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.17 |
| Max. Negotiated Rate |
$2.38 |
| Rate for Payer: Aetna American Axle |
$1.72
|
| Rate for Payer: Aetna Commercial |
$2.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.72
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cofinity Advantage |
$1.85
|
| Rate for Payer: Cofinity Commercial |
$2.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.12
|
| Rate for Payer: Healthscope Commercial |
$2.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.99
|
| Rate for Payer: PHP Commercial |
$2.25
|
| Rate for Payer: Priority Health SBD |
$1.67
|
| Rate for Payer: UMR Bronson Commercial |
$1.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.99
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, UP TO 125MG
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
63600102
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, UP TO 125MG
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
63600102
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.82 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$13.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: BCBS Complete |
$10.61
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.27
|
| Rate for Payer: UHC Core |
$13.27
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, UP TO 40MG
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT J2920
|
| Hospital Charge Code |
63600101
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: UMR Bronson Commercial |
$9.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC INJ, METHYLPREDNISOLONE NA SUCCINATE, UP TO 40MG
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT J2920
|
| Hospital Charge Code |
63600101
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.86 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$10.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.62
|
| Rate for Payer: UHC Core |
$10.62
|
| Rate for Payer: UHC Exchange |
$10.62
|
| Rate for Payer: UMR Bronson Commercial |
$7.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC INJ NERV BLOCK GREAT OCCIPTL
|
Facility
|
OP
|
$269.67
|
|
|
Service Code
|
CPT 64405
|
| Hospital Charge Code |
36100545
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$99.78 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna American Axle |
$175.29
|
| Rate for Payer: Aetna American Axle |
$262.93
|
| Rate for Payer: Aetna Commercial |
$229.22
|
| Rate for Payer: Aetna Commercial |
$343.82
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$368.41
|
| Rate for Payer: BCBS Trust/PPO |
$368.41
|
| Rate for Payer: BCN Commercial |
$368.41
|
| Rate for Payer: BCN Commercial |
$368.41
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$323.60
|
| Rate for Payer: Cash Price |
$215.74
|
| Rate for Payer: Cash Price |
$323.60
|
| Rate for Payer: Cash Price |
$215.74
|
| Rate for Payer: Cash Price |
$215.74
|
| Rate for Payer: Cash Price |
$323.60
|
| Rate for Payer: Cofinity Advantage |
$188.77
|
| Rate for Payer: Cofinity Advantage |
$283.15
|
| Rate for Payer: Cofinity Commercial |
$347.87
|
| Rate for Payer: Cofinity Commercial |
$231.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$364.05
|
| Rate for Payer: Healthscope Commercial |
$242.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$283.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$188.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.38
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$321.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$343.82
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$202.25
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$343.82
|
| Rate for Payer: PHP Commercial |
$229.22
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| 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 Cigna Priority Health/HMO/PPO/Narrow Network |
$989.08
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health SBD |
$254.84
|
| Rate for Payer: Priority Health SBD |
$169.89
|
| Rate for Payer: Priority Health Tiered Network |
$791.26
|
| Rate for Payer: Priority Health Tiered Network |
$791.26
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$262.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.29
|
| Rate for Payer: UHC Core |
$210.74
|
| Rate for Payer: UHC Core |
$140.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$158.97
|
| Rate for Payer: UHC Exchange |
$105.98
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$99.78
|
| Rate for Payer: UMR Bronson Commercial |
$149.66
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.25
|
|
|
HC INJ NERV BLOCK GREAT OCCIPTL
|
Facility
|
IP
|
$269.67
|
|
|
Service Code
|
CPT 64405
|
| Hospital Charge Code |
36100545
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.65 |
| Max. Negotiated Rate |
$242.70 |
| Rate for Payer: Aetna American Axle |
$175.29
|
| Rate for Payer: Aetna American Axle |
$262.93
|
| Rate for Payer: Aetna Commercial |
$229.22
|
| Rate for Payer: Aetna Commercial |
$343.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$262.93
|
| Rate for Payer: Cash Price |
$215.74
|
| Rate for Payer: Cash Price |
$323.60
|
| Rate for Payer: Cofinity Advantage |
$283.15
|
| Rate for Payer: Cofinity Advantage |
$188.77
|
| Rate for Payer: Cofinity Commercial |
$347.87
|
| Rate for Payer: Cofinity Commercial |
$231.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.60
|
| Rate for Payer: Healthscope Commercial |
$242.70
|
| Rate for Payer: Healthscope Commercial |
$364.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$283.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$188.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$343.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$202.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.38
|
| Rate for Payer: PHP Commercial |
$229.22
|
| Rate for Payer: PHP Commercial |
$343.82
|
| Rate for Payer: Priority Health SBD |
$254.84
|
| Rate for Payer: Priority Health SBD |
$169.89
|
| Rate for Payer: UMR Bronson Commercial |
$118.65
|
| Rate for Payer: UMR Bronson Commercial |
$177.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.38
|
|
