|
HC SCLEROTHERAPY OF FLUID COLLECTION
|
Facility
|
OP
|
$2,125.40
|
|
|
Service Code
|
CPT 49185
|
| Hospital Charge Code |
36100501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$114.28 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$1,381.51
|
| Rate for Payer: Aetna Commercial |
$1,806.59
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,381.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,409.17
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,700.32
|
| Rate for Payer: Cash Price |
$1,700.32
|
| Rate for Payer: Cofinity Commercial |
$1,827.84
|
| Rate for Payer: Cofinity Commercial |
$1,487.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,700.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,912.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,487.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,594.05
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,806.59
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,806.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$1,339.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.71
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$114.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$786.40
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,594.05
|
|
|
HC SCREENING PAP SMEAR, OBTAIN PREP TO LAB
|
Facility
|
OP
|
$77.05
|
|
|
Service Code
|
CPT Q0091
|
| Hospital Charge Code |
31100043
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$9.90 |
| Max. Negotiated Rate |
$83.33 |
| Rate for Payer: Aetna American Axle |
$50.08
|
| Rate for Payer: Aetna Commercial |
$65.49
|
| Rate for Payer: Aetna Medicare |
$27.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.09
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$26.47
|
| Rate for Payer: BCBS Trust/PPO |
$49.25
|
| Rate for Payer: BCCCP Commercial |
$15.88
|
| Rate for Payer: BCN Medicare Advantage |
$26.47
|
| Rate for Payer: Cash Price |
$61.64
|
| Rate for Payer: Cash Price |
$61.64
|
| Rate for Payer: Cofinity Commercial |
$66.26
|
| Rate for Payer: Cofinity Commercial |
$53.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.47
|
| Rate for Payer: Healthscope Commercial |
$69.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.79
|
| Rate for Payer: Mclaren Medicaid |
$14.48
|
| Rate for Payer: Mclaren Medicare |
$26.47
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.49
|
| Rate for Payer: PACE Medicare |
$25.15
|
| Rate for Payer: PACE SWMI |
$26.47
|
| Rate for Payer: PHP Commercial |
$65.49
|
| Rate for Payer: PHP Medicare Advantage |
$26.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.33
|
| Rate for Payer: Priority Health Medicare |
$26.47
|
| Rate for Payer: Priority Health Narrow Network |
$66.66
|
| Rate for Payer: Priority Health SBD |
$48.54
|
| Rate for Payer: Railroad Medicare Medicare |
$26.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.45
|
| Rate for Payer: UHC Core |
$9.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.47
|
| Rate for Payer: UHC Exchange |
$17.68
|
| Rate for Payer: UHC Medicare Advantage |
$27.26
|
| Rate for Payer: UMR Bronson Commercial |
$28.51
|
| Rate for Payer: VA VA |
$26.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.79
|
|
|
HC SCREENING PAP SMEAR, OBTAIN PREP TO LAB
|
Facility
|
IP
|
$77.05
|
|
|
Service Code
|
CPT Q0091
|
| Hospital Charge Code |
31100043
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$33.90 |
| Max. Negotiated Rate |
$69.34 |
| Rate for Payer: Aetna American Axle |
$50.08
|
| Rate for Payer: Aetna Commercial |
$65.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.08
|
| Rate for Payer: Cash Price |
$61.64
|
| Rate for Payer: Cofinity Commercial |
$53.94
|
| Rate for Payer: Cofinity Commercial |
$66.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.64
|
| Rate for Payer: Healthscope Commercial |
$69.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.49
|
| Rate for Payer: PHP Commercial |
$65.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.94
|
| Rate for Payer: Priority Health SBD |
$48.54
|
| Rate for Payer: UMR Bronson Commercial |
$33.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.79
|
|
|
HC SCREENING TOMOSYNTHESIS
|
Facility
|
IP
|
$101.19
|
|
|
Service Code
|
CPT 77063
|
| Hospital Charge Code |
32000301
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$44.52 |
| Max. Negotiated Rate |
$91.07 |
| Rate for Payer: Aetna American Axle |
$65.77
|
| Rate for Payer: Aetna Commercial |
$86.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.77
|
| Rate for Payer: Cash Price |
$80.95
|
| Rate for Payer: Cofinity Commercial |
$70.83
|
| Rate for Payer: Cofinity Commercial |
$87.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.95
|
| Rate for Payer: Healthscope Commercial |
$91.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.01
|
| Rate for Payer: PHP Commercial |
$86.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.83
|
| Rate for Payer: Priority Health SBD |
$63.75
|
| Rate for Payer: UMR Bronson Commercial |
$44.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.89
|
|
|
HC SCREENING TOMOSYNTHESIS
|
Facility
|
OP
|
$101.19
|
|
|
Service Code
|
CPT 77063
|
| Hospital Charge Code |
32000301
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$20.38 |
| Max. Negotiated Rate |
$332.00 |
| Rate for Payer: Aetna American Axle |
$65.77
|
| Rate for Payer: Aetna Commercial |
$86.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.77
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCBS Trust/PPO |
$45.61
|
| Rate for Payer: BCCCP Commercial |
$54.20
|
| Rate for Payer: Cash Price |
$80.95
|
| Rate for Payer: Cash Price |
$80.95
|
| Rate for Payer: Cash Price |
$80.95
|
| Rate for Payer: Cofinity Commercial |
$87.02
|
| Rate for Payer: Cofinity Commercial |
$70.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.95
|
| Rate for Payer: Healthscope Commercial |
$91.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.01
|
| Rate for Payer: PHP Commercial |
$86.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.48
|
| Rate for Payer: Priority Health Narrow Network |
$20.38
|
| Rate for Payer: Priority Health SBD |
$63.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.19
|
| Rate for Payer: UHC Core |
$332.00
|
| Rate for Payer: UHC Exchange |
$51.08
|
| Rate for Payer: UMR Bronson Commercial |
$37.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.89
|
|
|
HC SDL MSLT/MWT
|
Facility
|
IP
|
$2,521.75
|
|
|
Service Code
|
CPT 95805
|
| Hospital Charge Code |
92000005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,109.57 |
| Max. Negotiated Rate |
$2,269.58 |
| Rate for Payer: Aetna American Axle |
$1,639.14
|
| Rate for Payer: Aetna Commercial |
$2,143.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,639.14
|
| Rate for Payer: Cash Price |
$2,017.40
|
| Rate for Payer: Cofinity Commercial |
$1,765.22
|
| Rate for Payer: Cofinity Commercial |
$2,168.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,017.40
|
| Rate for Payer: Healthscope Commercial |
$2,269.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,765.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,891.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,143.49
|
| Rate for Payer: PHP Commercial |
$2,143.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,765.22
|
| Rate for Payer: Priority Health SBD |
$1,588.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,109.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,891.31
|
|
|
HC SDL MSLT/MWT
|
Facility
|
OP
|
$2,521.75
|
|
|
Service Code
|
CPT 95805
|
| Hospital Charge Code |
92000005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$260.60 |
| Max. Negotiated Rate |
$2,269.58 |
| Rate for Payer: Aetna American Axle |
$1,639.14
|
| Rate for Payer: Aetna Commercial |
$2,143.49
|
| Rate for Payer: Aetna Medicare |
$495.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,639.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$595.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$595.52
|
| Rate for Payer: BCBS Complete |
$273.66
|
| Rate for Payer: BCBS MAPPO |
$476.42
|
| Rate for Payer: BCBS Trust/PPO |
$1,813.01
|
| Rate for Payer: BCN Medicare Advantage |
$476.42
|
| Rate for Payer: Cash Price |
$2,017.40
|
| Rate for Payer: Cash Price |
$2,017.40
|
| Rate for Payer: Cash Price |
$2,017.40
|
| Rate for Payer: Cofinity Commercial |
$2,168.70
|
| Rate for Payer: Cofinity Commercial |
$1,765.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,017.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$476.42
|
| Rate for Payer: Healthscope Commercial |
$2,269.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,765.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,891.31
|
| Rate for Payer: Mclaren Medicaid |
$260.60
|
| Rate for Payer: Mclaren Medicare |
$476.42
|
| Rate for Payer: Meridian Medicaid |
$273.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$500.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$547.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,143.49
|
| Rate for Payer: PACE Medicare |
$452.60
|
| Rate for Payer: PACE SWMI |
$476.42
|
| Rate for Payer: PHP Commercial |
$2,143.49
|
| Rate for Payer: PHP Medicare Advantage |
$476.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,765.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,499.80
|
| Rate for Payer: Priority Health Medicare |
$476.42
|
| Rate for Payer: Priority Health Narrow Network |
$1,199.84
|
| Rate for Payer: Priority Health SBD |
$1,588.70
|
| Rate for Payer: Railroad Medicare Medicare |
$476.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$466.80
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$476.42
|
| Rate for Payer: UHC Exchange |
$424.36
|
| Rate for Payer: UHC Medicare Advantage |
$490.71
|
| Rate for Payer: UMR Bronson Commercial |
$933.05
|
| Rate for Payer: VA VA |
$476.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,891.31
|
|
|
HC SDL POLYSOMNOGRAPHY
|
Facility
|
IP
|
$3,490.58
|
|
|
Service Code
|
CPT 95810
|
| Hospital Charge Code |
74000001
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,535.86 |
| Max. Negotiated Rate |
$3,141.52 |
| Rate for Payer: Aetna American Axle |
$2,268.88
|
| Rate for Payer: Aetna Commercial |
$2,966.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,268.88
|
| Rate for Payer: Cash Price |
$2,792.46
|
| Rate for Payer: Cofinity Commercial |
$3,001.90
|
| Rate for Payer: Cofinity Commercial |
$2,443.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,792.46
|
| Rate for Payer: Healthscope Commercial |
$3,141.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,443.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,617.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,966.99
|
| Rate for Payer: PHP Commercial |
$2,966.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,443.41
|
| Rate for Payer: Priority Health SBD |
$2,199.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,535.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,617.94
|
|
|
HC SDL POLYSOMNOGRAPHY
|
Facility
|
OP
|
$3,490.58
|
|
|
Service Code
|
CPT 95810
|
| Hospital Charge Code |
74000001
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$508.36 |
| Max. Negotiated Rate |
$3,141.52 |
| Rate for Payer: Aetna American Axle |
$2,268.88
|
| Rate for Payer: Aetna Commercial |
$2,966.99
|
| Rate for Payer: Aetna Medicare |
$966.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,268.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,161.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,161.70
|
| Rate for Payer: BCBS Complete |
$533.82
|
| Rate for Payer: BCBS MAPPO |
$929.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,976.51
|
| Rate for Payer: BCN Medicare Advantage |
$929.36
|
| Rate for Payer: Cash Price |
$2,792.46
|
| Rate for Payer: Cash Price |
$2,792.46
|
| Rate for Payer: Cash Price |
$2,792.46
|
| Rate for Payer: Cofinity Commercial |
$3,001.90
|
| Rate for Payer: Cofinity Commercial |
$2,443.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,792.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$929.36
|
| Rate for Payer: Healthscope Commercial |
$3,141.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,443.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,617.94
|
| Rate for Payer: Mclaren Medicaid |
$508.36
|
| Rate for Payer: Mclaren Medicare |
$929.36
|
| Rate for Payer: Meridian Medicaid |
$533.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$975.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,068.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,966.99
|
| Rate for Payer: PACE Medicare |
$882.89
|
| Rate for Payer: PACE SWMI |
$929.36
|
| Rate for Payer: PHP Commercial |
$2,966.99
|
| Rate for Payer: PHP Medicare Advantage |
$929.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,443.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,925.66
|
| Rate for Payer: Priority Health Medicare |
$929.36
|
| Rate for Payer: Priority Health Narrow Network |
$2,340.53
|
| Rate for Payer: Priority Health SBD |
$2,199.07
|
| Rate for Payer: Railroad Medicare Medicare |
$929.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$674.27
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$929.36
|
| Rate for Payer: UHC Exchange |
$612.97
|
| Rate for Payer: UHC Medicare Advantage |
$957.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,291.51
|
| Rate for Payer: VA VA |
$929.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,617.94
|
|
|
HC SDL PSG WITH CPAP/BIPAP
|
Facility
|
OP
|
$3,859.04
|
|
|
Service Code
|
CPT 95811
|
| Hospital Charge Code |
74000002
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$508.36 |
| Max. Negotiated Rate |
$3,473.14 |
| Rate for Payer: Aetna American Axle |
$2,508.38
|
| Rate for Payer: Aetna Commercial |
$3,280.18
|
| Rate for Payer: Aetna Medicare |
$966.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,508.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,161.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,161.70
|
| Rate for Payer: BCBS Complete |
$533.82
|
| Rate for Payer: BCBS MAPPO |
$929.36
|
| Rate for Payer: BCBS Trust/PPO |
$2,072.10
|
| Rate for Payer: BCN Medicare Advantage |
$929.36
|
| Rate for Payer: Cash Price |
$3,087.23
|
| Rate for Payer: Cash Price |
$3,087.23
|
| Rate for Payer: Cash Price |
$3,087.23
|
| Rate for Payer: Cofinity Commercial |
$2,701.33
|
| Rate for Payer: Cofinity Commercial |
$3,318.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,087.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$929.36
|
| Rate for Payer: Healthscope Commercial |
$3,473.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,701.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,894.28
|
| Rate for Payer: Mclaren Medicaid |
$508.36
|
| Rate for Payer: Mclaren Medicare |
$929.36
|
| Rate for Payer: Meridian Medicaid |
$533.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$975.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,068.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,280.18
|
| Rate for Payer: PACE Medicare |
$882.89
|
| Rate for Payer: PACE SWMI |
$929.36
|
| Rate for Payer: PHP Commercial |
$3,280.18
|
| Rate for Payer: PHP Medicare Advantage |
$929.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$508.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,701.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,925.66
|
| Rate for Payer: Priority Health Medicare |
$929.36
|
| Rate for Payer: Priority Health Narrow Network |
$2,340.53
|
| Rate for Payer: Priority Health SBD |
$2,431.20
|
| Rate for Payer: Railroad Medicare Medicare |
$929.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$704.88
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$929.36
|
| Rate for Payer: UHC Exchange |
$640.80
|
| Rate for Payer: UHC Medicare Advantage |
$957.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,427.84
|
| Rate for Payer: VA VA |
$929.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,894.28
|
|
|
HC SDL PSG WITH CPAP/BIPAP
|
Facility
|
IP
|
$3,859.04
|
|
|
Service Code
|
CPT 95811
|
| Hospital Charge Code |
74000002
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,697.98 |
| Max. Negotiated Rate |
$3,473.14 |
| Rate for Payer: Aetna American Axle |
$2,508.38
|
| Rate for Payer: Aetna Commercial |
$3,280.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,508.38
|
| Rate for Payer: Cash Price |
$3,087.23
|
| Rate for Payer: Cofinity Commercial |
$2,701.33
|
| Rate for Payer: Cofinity Commercial |
$3,318.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,087.23
|
| Rate for Payer: Healthscope Commercial |
$3,473.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,701.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,894.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,280.18
|
| Rate for Payer: PHP Commercial |
$3,280.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,701.33
|
| Rate for Payer: Priority Health SBD |
$2,431.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,697.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,894.28
|
|
|
HC SEDATION IV / IM OR INHALANT
|
Facility
|
IP
|
$720.47
|
|
| Hospital Charge Code |
37000005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$317.01 |
| Max. Negotiated Rate |
$648.42 |
| Rate for Payer: Aetna American Axle |
$468.31
|
| Rate for Payer: Aetna Commercial |
$612.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$468.31
|
| Rate for Payer: Cash Price |
$576.38
|
| Rate for Payer: Cofinity Commercial |
$504.33
|
| Rate for Payer: Cofinity Commercial |
$619.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.38
|
| Rate for Payer: Healthscope Commercial |
$648.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$504.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$612.40
|
| Rate for Payer: PHP Commercial |
$612.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.33
|
| Rate for Payer: Priority Health SBD |
$453.90
|
| Rate for Payer: UMR Bronson Commercial |
$317.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.35
|
|
|
HC SEDATION IV / IM OR INHALANT
|
Facility
|
OP
|
$720.47
|
|
| Hospital Charge Code |
37000005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$266.57 |
| Max. Negotiated Rate |
$648.42 |
| Rate for Payer: Aetna American Axle |
$468.31
|
| Rate for Payer: Aetna Commercial |
$612.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$468.31
|
| Rate for Payer: BCBS Complete |
$288.19
|
| Rate for Payer: Cash Price |
$576.38
|
| Rate for Payer: Cofinity Commercial |
$504.33
|
| Rate for Payer: Cofinity Commercial |
$619.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.38
|
| Rate for Payer: Healthscope Commercial |
$648.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$504.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$612.40
|
| Rate for Payer: PHP Commercial |
$612.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.33
|
| Rate for Payer: Priority Health SBD |
$453.90
|
| Rate for Payer: UMR Bronson Commercial |
$266.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.35
|
|
|
HC SED RATE WESTERGREN
|
Facility
|
IP
|
$15.30
|
|
|
Service Code
|
CPT 85652
|
| Hospital Charge Code |
30500060
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna American Axle |
$9.94
|
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.94
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: UMR Bronson Commercial |
$6.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC SED RATE WESTERGREN
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
CPT 85652
|
| Hospital Charge Code |
30500060
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.48 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna American Axle |
$9.94
|
| Rate for Payer: Aetna Commercial |
$13.00
|
| Rate for Payer: Aetna Medicare |
$2.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.38
|
| Rate for Payer: BCBS Complete |
$1.55
|
| Rate for Payer: BCBS MAPPO |
$2.70
|
| Rate for Payer: BCBS Trust/PPO |
$2.43
|
| Rate for Payer: BCN Medicare Advantage |
$2.70
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.70
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Mclaren Medicaid |
$1.48
|
| Rate for Payer: Mclaren Medicare |
$2.70
|
| Rate for Payer: Meridian Medicaid |
$1.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.00
|
| Rate for Payer: PACE Medicare |
$2.56
|
| Rate for Payer: PACE SWMI |
$2.70
|
| Rate for Payer: PHP Commercial |
$13.00
|
| Rate for Payer: PHP Medicare Advantage |
$2.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.70
|
| Rate for Payer: Priority Health Medicare |
$2.70
|
| Rate for Payer: Priority Health Narrow Network |
$2.96
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$2.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.24
|
| Rate for Payer: UHC Core |
$4.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.70
|
| Rate for Payer: UHC Exchange |
$2.70
|
| Rate for Payer: UHC Medicare Advantage |
$2.78
|
| Rate for Payer: UMR Bronson Commercial |
$5.66
|
| Rate for Payer: VA VA |
$2.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
HC SELECTIVE EACH INTRACRANIAL UNI
|
Facility
|
OP
|
$4,869.66
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
36100386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$241.65 |
| Max. Negotiated Rate |
$4,895.23 |
| Rate for Payer: Aetna American Axle |
$3,165.28
|
| Rate for Payer: Aetna Commercial |
$4,139.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,165.28
|
| Rate for Payer: BCBS Complete |
$1,947.86
|
| Rate for Payer: BCBS Trust/PPO |
$4,895.23
|
| Rate for Payer: Cash Price |
$3,895.73
|
| Rate for Payer: Cash Price |
$3,895.73
|
| Rate for Payer: Cofinity Commercial |
$4,187.91
|
| Rate for Payer: Cofinity Commercial |
$3,408.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,895.73
|
| Rate for Payer: Healthscope Commercial |
$4,382.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,408.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,652.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,139.21
|
| Rate for Payer: PHP Commercial |
$4,139.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,408.76
|
| Rate for Payer: Priority Health SBD |
$3,067.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$265.82
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$241.65
|
| Rate for Payer: UMR Bronson Commercial |
$1,801.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,652.24
|
|
|
HC SELECTIVE EACH INTRACRANIAL UNI
|
Facility
|
IP
|
$4,869.66
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
36100386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,142.65 |
| Max. Negotiated Rate |
$4,382.69 |
| Rate for Payer: Aetna American Axle |
$3,165.28
|
| Rate for Payer: Aetna Commercial |
$4,139.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,165.28
|
| Rate for Payer: Cash Price |
$3,895.73
|
| Rate for Payer: Cofinity Commercial |
$3,408.76
|
| Rate for Payer: Cofinity Commercial |
$4,187.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,895.73
|
| Rate for Payer: Healthscope Commercial |
$4,382.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,408.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,652.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,139.21
|
| Rate for Payer: PHP Commercial |
$4,139.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,408.76
|
| Rate for Payer: Priority Health SBD |
$3,067.89
|
| Rate for Payer: UMR Bronson Commercial |
$2,142.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,652.24
|
|
|
HC SELECTIVE EXTERNAL CAROTID UNI
|
Facility
|
OP
|
$5,633.63
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
36100382
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$117.22 |
| Max. Negotiated Rate |
$5,070.27 |
| Rate for Payer: Aetna American Axle |
$3,661.86
|
| Rate for Payer: Aetna Commercial |
$4,788.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,661.86
|
| Rate for Payer: BCBS Complete |
$2,253.45
|
| Rate for Payer: BCBS Trust/PPO |
$972.55
|
| Rate for Payer: Cash Price |
$4,506.90
|
| Rate for Payer: Cash Price |
$4,506.90
|
| Rate for Payer: Cofinity Commercial |
$3,943.54
|
| Rate for Payer: Cofinity Commercial |
$4,844.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,506.90
|
| Rate for Payer: Healthscope Commercial |
$5,070.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,943.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,225.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,788.59
|
| Rate for Payer: PHP Commercial |
$4,788.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,943.54
|
| Rate for Payer: Priority Health SBD |
$3,549.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.94
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$117.22
|
| Rate for Payer: UMR Bronson Commercial |
$2,084.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,225.22
|
|
|
HC SELECTIVE EXTERNAL CAROTID UNI
|
Facility
|
IP
|
$5,633.63
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
36100382
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,478.80 |
| Max. Negotiated Rate |
$5,070.27 |
| Rate for Payer: Aetna American Axle |
$3,661.86
|
| Rate for Payer: Aetna Commercial |
$4,788.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,661.86
|
| Rate for Payer: Cash Price |
$4,506.90
|
| Rate for Payer: Cofinity Commercial |
$3,943.54
|
| Rate for Payer: Cofinity Commercial |
$4,844.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,506.90
|
| Rate for Payer: Healthscope Commercial |
$5,070.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,943.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,225.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,788.59
|
| Rate for Payer: PHP Commercial |
$4,788.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,943.54
|
| Rate for Payer: Priority Health SBD |
$3,549.19
|
| Rate for Payer: UMR Bronson Commercial |
$2,478.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,225.22
|
|
|
HC SELECTIVE EXTRACRANIAL ARTERY UNI
|
Facility
|
OP
|
$9,359.88
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
36100377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$275.71 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$6,083.92
|
| Rate for Payer: Aetna Commercial |
$7,955.90
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,083.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,357.09
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$7,487.90
|
| Rate for Payer: Cash Price |
$7,487.90
|
| Rate for Payer: Cofinity Commercial |
$6,551.92
|
| Rate for Payer: Cofinity Commercial |
$8,049.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,487.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$8,423.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,551.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,019.91
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,955.90
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$7,955.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,551.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$5,896.72
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$303.28
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$275.71
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$3,463.16
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,019.91
|
|
|
HC SELECTIVE EXTRACRANIAL ARTERY UNI
|
Facility
|
IP
|
$9,359.88
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
36100377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,118.35 |
| Max. Negotiated Rate |
$8,423.89 |
| Rate for Payer: Aetna American Axle |
$6,083.92
|
| Rate for Payer: Aetna Commercial |
$7,955.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,083.92
|
| Rate for Payer: Cash Price |
$7,487.90
|
| Rate for Payer: Cofinity Commercial |
$6,551.92
|
| Rate for Payer: Cofinity Commercial |
$8,049.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,487.90
|
| Rate for Payer: Healthscope Commercial |
$8,423.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,551.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,019.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,955.90
|
| Rate for Payer: PHP Commercial |
$7,955.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,551.92
|
| Rate for Payer: Priority Health SBD |
$5,896.72
|
| Rate for Payer: UMR Bronson Commercial |
$4,118.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,019.91
|
|
|
HC SELECTIVE EXTRA/INTRACRANIAL ARTERY UNI
|
Facility
|
IP
|
$10,751.21
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
36100378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,730.53 |
| Max. Negotiated Rate |
$9,676.09 |
| Rate for Payer: Aetna American Axle |
$6,988.29
|
| Rate for Payer: Aetna Commercial |
$9,138.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,988.29
|
| Rate for Payer: Cash Price |
$8,600.97
|
| Rate for Payer: Cofinity Commercial |
$7,525.85
|
| Rate for Payer: Cofinity Commercial |
$9,246.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,600.97
|
| Rate for Payer: Healthscope Commercial |
$9,676.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,525.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,063.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,138.53
|
| Rate for Payer: PHP Commercial |
$9,138.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,525.85
|
| Rate for Payer: Priority Health SBD |
$6,773.26
|
| Rate for Payer: UMR Bronson Commercial |
$4,730.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,063.41
|
|
|
HC SELECTIVE EXTRA/INTRACRANIAL ARTERY UNI
|
Facility
|
OP
|
$10,751.21
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
36100378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$318.60 |
| Max. Negotiated Rate |
$15,377.24 |
| Rate for Payer: Aetna American Axle |
$6,988.29
|
| Rate for Payer: Aetna Commercial |
$9,138.53
|
| Rate for Payer: Aetna Medicare |
$5,080.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,988.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,105.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,105.86
|
| Rate for Payer: BCBS Complete |
$2,805.77
|
| Rate for Payer: BCBS MAPPO |
$4,884.69
|
| Rate for Payer: BCBS Trust/PPO |
$5,304.40
|
| Rate for Payer: BCN Medicare Advantage |
$4,884.69
|
| Rate for Payer: Cash Price |
$8,600.97
|
| Rate for Payer: Cash Price |
$8,600.97
|
| Rate for Payer: Cofinity Commercial |
$7,525.85
|
| Rate for Payer: Cofinity Commercial |
$9,246.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,600.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,884.69
|
| Rate for Payer: Healthscope Commercial |
$9,676.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,525.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,063.41
|
| Rate for Payer: Mclaren Medicaid |
$2,671.93
|
| Rate for Payer: Mclaren Medicare |
$4,884.69
|
| Rate for Payer: Meridian Medicaid |
$2,805.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,128.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,617.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,138.53
|
| Rate for Payer: PACE Medicare |
$4,640.46
|
| Rate for Payer: PACE SWMI |
$4,884.69
|
| Rate for Payer: PHP Commercial |
$9,138.53
|
| Rate for Payer: PHP Medicare Advantage |
$4,884.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,671.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,525.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,377.24
|
| Rate for Payer: Priority Health Medicare |
$4,884.69
|
| Rate for Payer: Priority Health Narrow Network |
$12,301.79
|
| Rate for Payer: Priority Health SBD |
$6,773.26
|
| Rate for Payer: Railroad Medicare Medicare |
$4,884.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.46
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,884.69
|
| Rate for Payer: UHC Exchange |
$318.60
|
| Rate for Payer: UHC Medicare Advantage |
$5,031.23
|
| Rate for Payer: UMR Bronson Commercial |
$3,977.95
|
| Rate for Payer: VA VA |
$4,884.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,063.41
|
|
|
HC SELECTIVE INTRACRANIAL ART UNI
|
Facility
|
OP
|
$12,648.49
|
|
|
Service Code
|
CPT 36224
|
| Hospital Charge Code |
36100385
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$357.89 |
| Max. Negotiated Rate |
$15,377.24 |
| Rate for Payer: Aetna American Axle |
$8,221.52
|
| Rate for Payer: Aetna Commercial |
$10,751.22
|
| Rate for Payer: Aetna Medicare |
$5,080.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,221.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,105.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,105.86
|
| Rate for Payer: BCBS Complete |
$2,805.77
|
| Rate for Payer: BCBS MAPPO |
$4,884.69
|
| Rate for Payer: BCBS Trust/PPO |
$6,602.60
|
| Rate for Payer: BCN Medicare Advantage |
$4,884.69
|
| Rate for Payer: Cash Price |
$10,118.79
|
| Rate for Payer: Cash Price |
$10,118.79
|
| Rate for Payer: Cofinity Commercial |
$8,853.94
|
| Rate for Payer: Cofinity Commercial |
$10,877.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,118.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,884.69
|
| Rate for Payer: Healthscope Commercial |
$11,383.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,853.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,486.37
|
| Rate for Payer: Mclaren Medicaid |
$2,671.93
|
| Rate for Payer: Mclaren Medicare |
$4,884.69
|
| Rate for Payer: Meridian Medicaid |
$2,805.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5,128.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,617.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,751.22
|
| Rate for Payer: PACE Medicare |
$4,640.46
|
| Rate for Payer: PACE SWMI |
$4,884.69
|
| Rate for Payer: PHP Commercial |
$10,751.22
|
| Rate for Payer: PHP Medicare Advantage |
$4,884.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,671.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,853.94
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,377.24
|
| Rate for Payer: Priority Health Medicare |
$4,884.69
|
| Rate for Payer: Priority Health Narrow Network |
$12,301.79
|
| Rate for Payer: Priority Health SBD |
$7,968.55
|
| Rate for Payer: Railroad Medicare Medicare |
$4,884.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$393.68
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,884.69
|
| Rate for Payer: UHC Exchange |
$357.89
|
| Rate for Payer: UHC Medicare Advantage |
$5,031.23
|
| Rate for Payer: UMR Bronson Commercial |
$4,679.94
|
| Rate for Payer: VA VA |
$4,884.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,486.37
|
|
|
HC SELECTIVE INTRACRANIAL ART UNI
|
Facility
|
IP
|
$12,648.49
|
|
|
Service Code
|
CPT 36224
|
| Hospital Charge Code |
36100385
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,565.34 |
| Max. Negotiated Rate |
$11,383.64 |
| Rate for Payer: Aetna American Axle |
$8,221.52
|
| Rate for Payer: Aetna Commercial |
$10,751.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,221.52
|
| Rate for Payer: Cash Price |
$10,118.79
|
| Rate for Payer: Cofinity Commercial |
$10,877.70
|
| Rate for Payer: Cofinity Commercial |
$8,853.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,118.79
|
| Rate for Payer: Healthscope Commercial |
$11,383.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,853.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,486.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,751.22
|
| Rate for Payer: PHP Commercial |
$10,751.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,853.94
|
| Rate for Payer: Priority Health SBD |
$7,968.55
|
| Rate for Payer: UMR Bronson Commercial |
$5,565.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,486.37
|
|
