|
HC INSERT INDWELLING CATH
|
Facility
|
OP
|
$203.24
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
45000004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna American Axle |
$132.11
|
| Rate for Payer: Aetna Commercial |
$172.75
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$306.80
|
| Rate for Payer: BCN Commercial |
$306.80
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$162.59
|
| Rate for Payer: Cash Price |
$162.59
|
| Rate for Payer: Cash Price |
$162.59
|
| Rate for Payer: Cofinity Advantage |
$142.27
|
| Rate for Payer: Cofinity Commercial |
$174.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$182.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$142.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.43
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$172.75
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$152.43
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$172.75
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$128.04
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.11
|
| Rate for Payer: UHC Core |
$105.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$79.87
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$75.20
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.43
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
OP
|
$1,094.92
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$405.12 |
| Max. Negotiated Rate |
$985.43 |
| Rate for Payer: Aetna American Axle |
$711.70
|
| Rate for Payer: Aetna Commercial |
$930.68
|
| Rate for Payer: Aetna Medicare |
$547.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$711.70
|
| Rate for Payer: BCBS Complete |
$437.97
|
| Rate for Payer: Cash Price |
$875.94
|
| Rate for Payer: Cofinity Advantage |
$766.44
|
| Rate for Payer: Cofinity Commercial |
$941.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$875.94
|
| Rate for Payer: Healthscope Commercial |
$985.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$766.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$821.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$875.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$930.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$821.19
|
| Rate for Payer: PHP Commercial |
$930.68
|
| Rate for Payer: Priority Health SBD |
$689.80
|
| Rate for Payer: UMR Bronson Commercial |
$405.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$821.19
|
|
|
HC INSERT INFUSION PUMP
|
Facility
|
IP
|
$1,094.92
|
|
| Hospital Charge Code |
36100438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$481.76 |
| Max. Negotiated Rate |
$985.43 |
| Rate for Payer: Aetna American Axle |
$711.70
|
| Rate for Payer: Aetna Commercial |
$930.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$711.70
|
| Rate for Payer: Cash Price |
$875.94
|
| Rate for Payer: Cofinity Advantage |
$766.44
|
| Rate for Payer: Cofinity Commercial |
$941.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$875.94
|
| Rate for Payer: Healthscope Commercial |
$985.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$766.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$821.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$930.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$821.19
|
| Rate for Payer: PHP Commercial |
$930.68
|
| Rate for Payer: Priority Health SBD |
$689.80
|
| Rate for Payer: UMR Bronson Commercial |
$481.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$821.19
|
|
|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
IP
|
$1,499.55
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$659.80 |
| Max. Negotiated Rate |
$1,349.60 |
| Rate for Payer: Aetna American Axle |
$974.71
|
| Rate for Payer: Aetna Commercial |
$1,274.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.71
|
| Rate for Payer: Cash Price |
$1,199.64
|
| Rate for Payer: Cofinity Advantage |
$1,049.68
|
| Rate for Payer: Cofinity Commercial |
$1,289.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,199.64
|
| Rate for Payer: Healthscope Commercial |
$1,349.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,049.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,124.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,274.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,124.66
|
| Rate for Payer: PHP Commercial |
$1,274.62
|
| Rate for Payer: Priority Health SBD |
$944.72
|
| Rate for Payer: UMR Bronson Commercial |
$659.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,124.66
|
|
|
HC INSERTION CECO TUBE W FLUORO
|
Facility
|
OP
|
$1,499.55
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
36100227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$554.83 |
| Max. Negotiated Rate |
$3,855.91 |
| Rate for Payer: Aetna American Axle |
$974.71
|
| Rate for Payer: Aetna Commercial |
$1,274.62
|
| Rate for Payer: Aetna Medicare |
$1,240.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$974.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,490.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,490.42
|
| Rate for Payer: BCBS Complete |
$654.83
|
| Rate for Payer: BCBS MAPPO |
$1,192.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,310.41
|
| Rate for Payer: BCN Commercial |
$1,310.41
|
| Rate for Payer: BCN Medicare Advantage |
$1,192.34
|
| Rate for Payer: Cash Price |
$1,199.64
|
| Rate for Payer: Cash Price |
$1,199.64
|
| Rate for Payer: Cash Price |
$1,199.64
|
| Rate for Payer: Cofinity Advantage |
$1,049.68
|
| Rate for Payer: Cofinity Commercial |
$1,289.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,199.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,192.34
|
| Rate for Payer: Healthscope Commercial |
$1,349.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,049.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,124.66
|
| Rate for Payer: Mclaren Medicaid |
$1,192.34
|
| Rate for Payer: Mclaren Medicare |
$1,192.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,251.96
|
| Rate for Payer: Meridian Medicaid |
$1,251.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,371.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,311.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,274.62
|
| Rate for Payer: Nomi Health Commercial |
$3,577.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,124.66
|
| Rate for Payer: PACE Medicare |
$1,132.72
|
| Rate for Payer: PACE SWMI |
$1,192.34
|
| Rate for Payer: PHP Commercial |
$1,274.62
|
| Rate for Payer: PHP Medicare Advantage |
$1,192.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$623.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,855.91
|
| Rate for Payer: Priority Health Medicare |
$1,192.34
|
| Rate for Payer: Priority Health SBD |
$944.72
|
| Rate for Payer: Priority Health Tiered Network |
$3,084.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,192.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,192.34
|
| Rate for Payer: UHC Medicaid |
$623.59
|
| Rate for Payer: UHCCP Medicaid |
$623.59
|
| Rate for Payer: UMR Bronson Commercial |
$554.83
|
| Rate for Payer: VA VA |
$1,192.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,124.66
|
|
|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
IP
|
$1,551.78
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$682.78 |
| Max. Negotiated Rate |
$1,396.60 |
| Rate for Payer: Aetna American Axle |
$1,008.66
|
| Rate for Payer: Aetna Commercial |
$1,319.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.66
|
| Rate for Payer: Cash Price |
$1,241.42
|
| Rate for Payer: Cofinity Advantage |
$1,086.25
|
| Rate for Payer: Cofinity Commercial |
$1,334.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,241.42
|
| Rate for Payer: Healthscope Commercial |
$1,396.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,086.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,163.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,319.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,163.84
|
| Rate for Payer: PHP Commercial |
$1,319.01
|
| Rate for Payer: Priority Health SBD |
$977.62
|
| Rate for Payer: UMR Bronson Commercial |
$682.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,163.84
|
|
|
HC INSERTION D OR J TUBE W FLUORO
|
Facility
|
OP
|
$1,551.78
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
36100226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$574.16 |
| Max. Negotiated Rate |
$6,183.25 |
| Rate for Payer: Aetna American Axle |
$1,008.66
|
| Rate for Payer: Aetna Commercial |
$1,319.01
|
| Rate for Payer: Aetna Medicare |
$1,988.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,390.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,390.01
|
| Rate for Payer: BCBS Complete |
$1,050.08
|
| Rate for Payer: BCBS MAPPO |
$1,912.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,144.39
|
| Rate for Payer: BCN Commercial |
$1,144.39
|
| Rate for Payer: BCN Medicare Advantage |
$1,912.01
|
| Rate for Payer: Cash Price |
$1,241.42
|
| Rate for Payer: Cash Price |
$1,241.42
|
| Rate for Payer: Cash Price |
$1,241.42
|
| Rate for Payer: Cofinity Advantage |
$1,086.25
|
| Rate for Payer: Cofinity Commercial |
$1,334.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,241.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,912.01
|
| Rate for Payer: Healthscope Commercial |
$1,396.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,086.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,163.84
|
| Rate for Payer: Mclaren Medicaid |
$1,912.01
|
| Rate for Payer: Mclaren Medicare |
$1,912.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,007.61
|
| Rate for Payer: Meridian Medicaid |
$2,007.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,198.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,103.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,319.01
|
| Rate for Payer: Nomi Health Commercial |
$5,736.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,163.84
|
| Rate for Payer: PACE Medicare |
$1,816.41
|
| Rate for Payer: PACE SWMI |
$1,912.01
|
| Rate for Payer: PHP Commercial |
$1,319.01
|
| Rate for Payer: PHP Medicare Advantage |
$1,912.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$999.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,183.25
|
| Rate for Payer: Priority Health Medicare |
$1,912.01
|
| Rate for Payer: Priority Health SBD |
$977.62
|
| Rate for Payer: Priority Health Tiered Network |
$4,946.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,912.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,912.01
|
| Rate for Payer: UHC Medicaid |
$999.98
|
| Rate for Payer: UHCCP Medicaid |
$999.98
|
| Rate for Payer: UMR Bronson Commercial |
$574.16
|
| Rate for Payer: VA VA |
$1,912.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,163.84
|
|
|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
OP
|
$169.51
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.72 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna American Axle |
$110.18
|
| Rate for Payer: Aetna Commercial |
$144.08
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$157.33
|
| Rate for Payer: BCN Commercial |
$157.33
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$135.61
|
| Rate for Payer: Cash Price |
$135.61
|
| Rate for Payer: Cash Price |
$135.61
|
| Rate for Payer: Cofinity Advantage |
$118.66
|
| Rate for Payer: Cofinity Commercial |
$145.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$152.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.13
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.08
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.13
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$144.08
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$106.79
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.18
|
| Rate for Payer: UHC Core |
$88.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$66.62
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$62.72
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.13
|
|
|
HC INSERTION DRUG IMPLANT DEVICE
|
Facility
|
IP
|
$169.51
|
|
|
Service Code
|
CPT 11981
|
| Hospital Charge Code |
76100179
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$74.58 |
| Max. Negotiated Rate |
$152.56 |
| Rate for Payer: Aetna American Axle |
$110.18
|
| Rate for Payer: Aetna Commercial |
$144.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.18
|
| Rate for Payer: Cash Price |
$135.61
|
| Rate for Payer: Cofinity Advantage |
$118.66
|
| Rate for Payer: Cofinity Commercial |
$145.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.61
|
| Rate for Payer: Healthscope Commercial |
$152.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.13
|
| Rate for Payer: PHP Commercial |
$144.08
|
| Rate for Payer: Priority Health SBD |
$106.79
|
| Rate for Payer: UMR Bronson Commercial |
$74.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.13
|
|
|
HC INSERTION GASTRO TUBE W FLUORO
|
Facility
|
OP
|
$1,474.53
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$545.58 |
| Max. Negotiated Rate |
$6,183.25 |
| Rate for Payer: Aetna American Axle |
$958.44
|
| Rate for Payer: Aetna Commercial |
$1,253.35
|
| Rate for Payer: Aetna Medicare |
$1,988.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$958.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,390.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,390.01
|
| Rate for Payer: BCBS Complete |
$1,050.08
|
| Rate for Payer: BCBS MAPPO |
$1,912.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,359.85
|
| Rate for Payer: BCN Commercial |
$2,359.85
|
| Rate for Payer: BCN Medicare Advantage |
$1,912.01
|
| Rate for Payer: Cash Price |
$1,179.62
|
| Rate for Payer: Cash Price |
$1,179.62
|
| Rate for Payer: Cash Price |
$1,179.62
|
| Rate for Payer: Cofinity Advantage |
$1,032.17
|
| Rate for Payer: Cofinity Commercial |
$1,268.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,179.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,912.01
|
| Rate for Payer: Healthscope Commercial |
$1,327.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,032.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,105.90
|
| Rate for Payer: Mclaren Medicaid |
$1,912.01
|
| Rate for Payer: Mclaren Medicare |
$1,912.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,007.61
|
| Rate for Payer: Meridian Medicaid |
$2,007.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,198.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,103.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,253.35
|
| Rate for Payer: Nomi Health Commercial |
$5,736.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,105.90
|
| Rate for Payer: PACE Medicare |
$1,816.41
|
| Rate for Payer: PACE SWMI |
$1,912.01
|
| Rate for Payer: PHP Commercial |
$1,253.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,912.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$999.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,183.25
|
| Rate for Payer: Priority Health Medicare |
$1,912.01
|
| Rate for Payer: Priority Health SBD |
$928.95
|
| Rate for Payer: Priority Health Tiered Network |
$4,946.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,912.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,912.01
|
| Rate for Payer: UHC Medicaid |
$999.98
|
| Rate for Payer: UHCCP Medicaid |
$999.98
|
| Rate for Payer: UMR Bronson Commercial |
$545.58
|
| Rate for Payer: VA VA |
$1,912.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,105.90
|
|
|
HC INSERTION GASTRO TUBE W FLUORO
|
Facility
|
IP
|
$1,474.53
|
|
|
Service Code
|
CPT 49440
|
| Hospital Charge Code |
36100225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$648.79 |
| Max. Negotiated Rate |
$1,327.08 |
| Rate for Payer: Aetna American Axle |
$958.44
|
| Rate for Payer: Aetna Commercial |
$1,253.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$958.44
|
| Rate for Payer: Cash Price |
$1,179.62
|
| Rate for Payer: Cofinity Advantage |
$1,032.17
|
| Rate for Payer: Cofinity Commercial |
$1,268.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,179.62
|
| Rate for Payer: Healthscope Commercial |
$1,327.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,032.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,105.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,253.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,105.90
|
| Rate for Payer: PHP Commercial |
$1,253.35
|
| Rate for Payer: Priority Health SBD |
$928.95
|
| Rate for Payer: UMR Bronson Commercial |
$648.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,105.90
|
|
|
HC INSERTION IUD
|
Facility
|
IP
|
$387.53
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$170.51 |
| Max. Negotiated Rate |
$348.78 |
| Rate for Payer: Aetna American Axle |
$251.89
|
| Rate for Payer: Aetna Commercial |
$329.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.89
|
| Rate for Payer: Cash Price |
$310.02
|
| Rate for Payer: Cofinity Advantage |
$271.27
|
| Rate for Payer: Cofinity Commercial |
$333.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.02
|
| Rate for Payer: Healthscope Commercial |
$348.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$271.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.65
|
| Rate for Payer: PHP Commercial |
$329.40
|
| Rate for Payer: Priority Health SBD |
$244.14
|
| Rate for Payer: UMR Bronson Commercial |
$170.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.65
|
|
|
HC INSERTION IUD
|
Facility
|
OP
|
$387.53
|
|
|
Service Code
|
CPT 58300
|
| Hospital Charge Code |
76100142
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$117.08 |
| Max. Negotiated Rate |
$915.84 |
| Rate for Payer: Aetna American Axle |
$251.89
|
| Rate for Payer: Aetna Commercial |
$329.40
|
| Rate for Payer: Aetna Medicare |
$193.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.89
|
| Rate for Payer: BCBS Complete |
$155.01
|
| Rate for Payer: BCBS Trust/PPO |
$915.84
|
| Rate for Payer: BCN Commercial |
$915.84
|
| Rate for Payer: Cash Price |
$310.02
|
| Rate for Payer: Cash Price |
$310.02
|
| Rate for Payer: Cash Price |
$310.02
|
| Rate for Payer: Cofinity Advantage |
$271.27
|
| Rate for Payer: Cofinity Commercial |
$333.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.02
|
| Rate for Payer: Healthscope Commercial |
$348.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$271.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$310.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.65
|
| Rate for Payer: PHP Commercial |
$329.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$146.35
|
| Rate for Payer: Priority Health SBD |
$244.14
|
| Rate for Payer: Priority Health Tiered Network |
$117.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.89
|
| Rate for Payer: UHC Core |
$201.90
|
| Rate for Payer: UHC Exchange |
$152.30
|
| Rate for Payer: UMR Bronson Commercial |
$143.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.65
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
IP
|
$2,596.45
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,142.44 |
| Max. Negotiated Rate |
$2,336.80 |
| Rate for Payer: Aetna American Axle |
$1,687.69
|
| Rate for Payer: Aetna Commercial |
$2,206.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,687.69
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cofinity Advantage |
$1,817.52
|
| Rate for Payer: Cofinity Commercial |
$2,232.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,077.16
|
| Rate for Payer: Healthscope Commercial |
$2,336.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,817.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,947.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.34
|
| Rate for Payer: PHP Commercial |
$2,206.98
|
| Rate for Payer: Priority Health SBD |
$1,635.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,142.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,947.34
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE ABOVE 5 YRS AGE
|
Facility
|
OP
|
$2,596.45
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100120
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$960.69 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$1,687.69
|
| Rate for Payer: Aetna Commercial |
$2,206.98
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,687.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$4,036.50
|
| Rate for Payer: BCN Commercial |
$4,036.50
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cofinity Advantage |
$1,817.52
|
| Rate for Payer: Cofinity Commercial |
$2,232.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,077.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,336.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,817.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,947.34
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.98
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.34
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$2,206.98
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$1,635.76
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,687.69
|
| Rate for Payer: UHC Core |
$1,352.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$1,020.40
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$960.69
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,947.34
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
OP
|
$2,596.45
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$811.58 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$1,687.69
|
| Rate for Payer: Aetna Commercial |
$2,206.98
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,687.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$811.58
|
| Rate for Payer: BCN Commercial |
$811.58
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cofinity Advantage |
$1,817.52
|
| Rate for Payer: Cofinity Commercial |
$2,232.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,077.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,336.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,817.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,947.34
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.98
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.34
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$2,206.98
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$1,635.76
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$960.69
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,947.34
|
|
|
HC INSERTION NON TUNNELED CENTRAL LINE LESS 5 YRS AGE
|
Facility
|
IP
|
$2,596.45
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
36100119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,142.44 |
| Max. Negotiated Rate |
$2,336.80 |
| Rate for Payer: Aetna American Axle |
$1,687.69
|
| Rate for Payer: Aetna Commercial |
$2,206.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,687.69
|
| Rate for Payer: Cash Price |
$2,077.16
|
| Rate for Payer: Cofinity Advantage |
$1,817.52
|
| Rate for Payer: Cofinity Commercial |
$2,232.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,077.16
|
| Rate for Payer: Healthscope Commercial |
$2,336.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,817.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,947.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,206.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,947.34
|
| Rate for Payer: PHP Commercial |
$2,206.98
|
| Rate for Payer: Priority Health SBD |
$1,635.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,142.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,947.34
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
IP
|
$3,021.82
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,329.60 |
| Max. Negotiated Rate |
$2,719.64 |
| Rate for Payer: Aetna American Axle |
$1,964.18
|
| Rate for Payer: Aetna Commercial |
$2,568.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,964.18
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cofinity Advantage |
$2,115.27
|
| Rate for Payer: Cofinity Commercial |
$2,598.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.46
|
| Rate for Payer: Healthscope Commercial |
$2,719.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,115.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,266.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.36
|
| Rate for Payer: PHP Commercial |
$2,568.55
|
| Rate for Payer: Priority Health SBD |
$1,903.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,329.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,266.36
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT ABOVE 5 YRS AGE
|
Facility
|
OP
|
$3,021.82
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
36100130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,118.07 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$1,964.18
|
| Rate for Payer: Aetna Commercial |
$2,568.55
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,964.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,566.24
|
| Rate for Payer: BCN Commercial |
$3,566.24
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cofinity Advantage |
$2,115.27
|
| Rate for Payer: Cofinity Commercial |
$2,598.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,719.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,115.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,266.36
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.55
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.36
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$2,568.55
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$1,903.75
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,118.07
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,266.36
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$3,021.82
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
36100129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,329.60 |
| Max. Negotiated Rate |
$2,719.64 |
| Rate for Payer: Aetna American Axle |
$1,964.18
|
| Rate for Payer: Aetna Commercial |
$2,568.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,964.18
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cofinity Advantage |
$2,115.27
|
| Rate for Payer: Cofinity Commercial |
$2,598.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.46
|
| Rate for Payer: Healthscope Commercial |
$2,719.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,115.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,266.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.36
|
| Rate for Payer: PHP Commercial |
$2,568.55
|
| Rate for Payer: Priority Health SBD |
$1,903.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,329.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,266.36
|
|
|
HC INSERTION PERIPHERALLY CVAD W PORT LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$3,021.82
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
36100129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,118.07 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$1,964.18
|
| Rate for Payer: Aetna Commercial |
$2,568.55
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,964.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,400.27
|
| Rate for Payer: BCN Commercial |
$2,400.27
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cash Price |
$2,417.46
|
| Rate for Payer: Cofinity Advantage |
$2,115.27
|
| Rate for Payer: Cofinity Commercial |
$2,598.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,417.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,719.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,115.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,266.36
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,568.55
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,266.36
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$2,568.55
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$1,903.75
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,118.07
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,266.36
|
|
|
HC INSERTION PICC 5 YRS OR ABOVE WO IMAGING
|
Facility
|
OP
|
$1,806.05
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
36100128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$668.24 |
| Max. Negotiated Rate |
$5,072.36 |
| Rate for Payer: Aetna American Axle |
$1,173.93
|
| Rate for Payer: Aetna Commercial |
$1,535.14
|
| Rate for Payer: Aetna Medicare |
$1,631.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,173.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,346.42
|
| Rate for Payer: BCN Commercial |
$1,346.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$1,444.84
|
| Rate for Payer: Cash Price |
$1,444.84
|
| Rate for Payer: Cash Price |
$1,444.84
|
| Rate for Payer: Cofinity Advantage |
$1,264.23
|
| Rate for Payer: Cofinity Commercial |
$1,553.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$1,625.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,264.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,354.54
|
| Rate for Payer: Mclaren Medicaid |
$1,568.49
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$1,646.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,535.14
|
| Rate for Payer: Nomi Health Commercial |
$4,705.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,354.54
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$1,535.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,072.36
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health SBD |
$1,137.81
|
| Rate for Payer: Priority Health Tiered Network |
$4,057.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: UMR Bronson Commercial |
$668.24
|
| Rate for Payer: VA VA |
$1,568.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,354.54
|
|
|
HC INSERTION PICC 5 YRS OR ABOVE WO IMAGING
|
Facility
|
IP
|
$1,806.05
|
|
|
Service Code
|
CPT 36569
|
| Hospital Charge Code |
36100128
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$794.66 |
| Max. Negotiated Rate |
$1,625.44 |
| Rate for Payer: Aetna American Axle |
$1,173.93
|
| Rate for Payer: Aetna Commercial |
$1,535.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,173.93
|
| Rate for Payer: Cash Price |
$1,444.84
|
| Rate for Payer: Cofinity Advantage |
$1,264.23
|
| Rate for Payer: Cofinity Commercial |
$1,553.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,444.84
|
| Rate for Payer: Healthscope Commercial |
$1,625.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,264.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,354.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,535.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,354.54
|
| Rate for Payer: PHP Commercial |
$1,535.14
|
| Rate for Payer: Priority Health SBD |
$1,137.81
|
| Rate for Payer: UMR Bronson Commercial |
$794.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,354.54
|
|
|
HC INSERTION PICC LESS THAN 5 YRS WO IMAGING
|
Facility
|
OP
|
$1,675.08
|
|
|
Service Code
|
CPT 36568
|
| Hospital Charge Code |
36100127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$619.78 |
| Max. Negotiated Rate |
$5,072.36 |
| Rate for Payer: Aetna American Axle |
$1,088.80
|
| Rate for Payer: Aetna Commercial |
$1,423.82
|
| Rate for Payer: Aetna Medicare |
$1,631.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,088.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$811.58
|
| Rate for Payer: BCN Commercial |
$811.58
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$1,340.06
|
| Rate for Payer: Cash Price |
$1,340.06
|
| Rate for Payer: Cash Price |
$1,340.06
|
| Rate for Payer: Cofinity Advantage |
$1,172.56
|
| Rate for Payer: Cofinity Commercial |
$1,440.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,340.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$1,507.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,172.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,256.31
|
| Rate for Payer: Mclaren Medicaid |
$1,568.49
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$1,646.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,423.82
|
| Rate for Payer: Nomi Health Commercial |
$4,705.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,256.31
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$1,423.82
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,072.36
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health SBD |
$1,055.30
|
| Rate for Payer: Priority Health Tiered Network |
$4,057.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: UMR Bronson Commercial |
$619.78
|
| Rate for Payer: VA VA |
$1,568.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,256.31
|
|
|
HC INSERTION PICC LESS THAN 5 YRS WO IMAGING
|
Facility
|
IP
|
$1,675.08
|
|
|
Service Code
|
CPT 36568
|
| Hospital Charge Code |
36100127
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$737.04 |
| Max. Negotiated Rate |
$1,507.57 |
| Rate for Payer: Aetna American Axle |
$1,088.80
|
| Rate for Payer: Aetna Commercial |
$1,423.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,088.80
|
| Rate for Payer: Cash Price |
$1,340.06
|
| Rate for Payer: Cofinity Advantage |
$1,172.56
|
| Rate for Payer: Cofinity Commercial |
$1,440.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,340.06
|
| Rate for Payer: Healthscope Commercial |
$1,507.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,172.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,256.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,423.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,256.31
|
| Rate for Payer: PHP Commercial |
$1,423.82
|
| Rate for Payer: Priority Health SBD |
$1,055.30
|
| Rate for Payer: UMR Bronson Commercial |
$737.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,256.31
|
|
