|
HC INTRACARDIAC ECHOCARDIOGRAPHY
|
Facility
|
IP
|
$5,621.61
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
48100047
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,473.51 |
| Max. Negotiated Rate |
$5,059.45 |
| Rate for Payer: Aetna American Axle |
$3,654.05
|
| Rate for Payer: Aetna Commercial |
$4,778.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,654.05
|
| Rate for Payer: Cash Price |
$4,497.29
|
| Rate for Payer: Cofinity Advantage |
$3,935.13
|
| Rate for Payer: Cofinity Commercial |
$4,834.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,497.29
|
| Rate for Payer: Healthscope Commercial |
$5,059.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,935.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,216.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,778.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,216.21
|
| Rate for Payer: PHP Commercial |
$4,778.37
|
| Rate for Payer: Priority Health SBD |
$3,541.61
|
| Rate for Payer: UMR Bronson Commercial |
$2,473.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,216.21
|
|
|
HC INTRACARDIAC ELECTROCARDIOGRAPHY CATH LVL 55
|
Facility
|
IP
|
$5,500.00
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200379
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,420.00 |
| Max. Negotiated Rate |
$4,950.00 |
| Rate for Payer: Aetna American Axle |
$3,575.00
|
| Rate for Payer: Aetna Commercial |
$4,675.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,575.00
|
| Rate for Payer: Cash Price |
$4,400.00
|
| Rate for Payer: Cofinity Advantage |
$3,850.00
|
| Rate for Payer: Cofinity Commercial |
$4,730.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,400.00
|
| Rate for Payer: Healthscope Commercial |
$4,950.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,850.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,675.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,125.00
|
| Rate for Payer: PHP Commercial |
$4,675.00
|
| Rate for Payer: Priority Health SBD |
$3,465.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,420.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,125.00
|
|
|
HC INTRACARDIAC ELECTROCARDIOGRAPHY CATH LVL 55
|
Facility
|
OP
|
$5,500.00
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200379
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$4,950.00 |
| Rate for Payer: Aetna American Axle |
$3,575.00
|
| Rate for Payer: Aetna Commercial |
$4,675.00
|
| Rate for Payer: Aetna Medicare |
$2,750.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,575.00
|
| Rate for Payer: BCBS Complete |
$2,200.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$4,400.00
|
| Rate for Payer: Cash Price |
$4,400.00
|
| Rate for Payer: Cofinity Advantage |
$3,850.00
|
| Rate for Payer: Cofinity Commercial |
$4,730.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,400.00
|
| Rate for Payer: Healthscope Commercial |
$4,950.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,850.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,125.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,400.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,675.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,125.00
|
| Rate for Payer: PHP Commercial |
$4,675.00
|
| Rate for Payer: Priority Health SBD |
$3,465.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,575.00
|
| Rate for Payer: UHC Core |
$2,865.50
|
| Rate for Payer: UHC Exchange |
$2,161.50
|
| Rate for Payer: UMR Bronson Commercial |
$2,035.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,125.00
|
|
|
HC INTRACAV APPL - I
|
Facility
|
OP
|
$584.73
|
|
|
Service Code
|
CPT 77762
|
| Hospital Charge Code |
33300028
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$216.35 |
| Max. Negotiated Rate |
$1,780.43 |
| Rate for Payer: Aetna American Axle |
$380.07
|
| Rate for Payer: Aetna Commercial |
$497.02
|
| Rate for Payer: Aetna Medicare |
$572.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$688.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$688.20
|
| Rate for Payer: BCBS Complete |
$302.37
|
| Rate for Payer: BCBS MAPPO |
$550.56
|
| Rate for Payer: BCBS Trust/PPO |
$631.27
|
| Rate for Payer: BCN Commercial |
$631.27
|
| Rate for Payer: BCN Medicare Advantage |
$550.56
|
| Rate for Payer: Cash Price |
$467.78
|
| Rate for Payer: Cash Price |
$467.78
|
| Rate for Payer: Cofinity Advantage |
$409.31
|
| Rate for Payer: Cofinity Commercial |
$502.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.56
|
| Rate for Payer: Healthscope Commercial |
$526.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$409.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.55
|
| Rate for Payer: Mclaren Medicaid |
$550.56
|
| Rate for Payer: Mclaren Medicare |
$550.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.09
|
| Rate for Payer: Meridian Medicaid |
$578.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$633.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$605.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497.02
|
| Rate for Payer: Nomi Health Commercial |
$1,651.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.55
|
| Rate for Payer: PACE Medicare |
$523.03
|
| Rate for Payer: PACE SWMI |
$550.56
|
| Rate for Payer: PHP Commercial |
$497.02
|
| Rate for Payer: PHP Medicare Advantage |
$550.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$287.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,780.43
|
| Rate for Payer: Priority Health Medicare |
$550.56
|
| Rate for Payer: Priority Health SBD |
$368.38
|
| Rate for Payer: Priority Health Tiered Network |
$1,424.34
|
| Rate for Payer: Railroad Medicare Medicare |
$550.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$380.07
|
| Rate for Payer: UHC Core |
$304.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$550.56
|
| Rate for Payer: UHC Exchange |
$229.80
|
| Rate for Payer: UHC Medicaid |
$287.94
|
| Rate for Payer: UHCCP Medicaid |
$287.94
|
| Rate for Payer: UMR Bronson Commercial |
$216.35
|
| Rate for Payer: VA VA |
$550.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.55
|
|
|
HC INTRACAV APPL - I
|
Facility
|
IP
|
$584.73
|
|
|
Service Code
|
CPT 77762
|
| Hospital Charge Code |
33300028
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$257.28 |
| Max. Negotiated Rate |
$526.26 |
| Rate for Payer: Aetna American Axle |
$380.07
|
| Rate for Payer: Aetna Commercial |
$497.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.07
|
| Rate for Payer: Cash Price |
$467.78
|
| Rate for Payer: Cofinity Advantage |
$409.31
|
| Rate for Payer: Cofinity Commercial |
$502.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$467.78
|
| Rate for Payer: Healthscope Commercial |
$526.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$409.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$438.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$438.55
|
| Rate for Payer: PHP Commercial |
$497.02
|
| Rate for Payer: Priority Health SBD |
$368.38
|
| Rate for Payer: UMR Bronson Commercial |
$257.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$438.55
|
|
|
HC INTRACAV APPL - S
|
Facility
|
IP
|
$445.71
|
|
|
Service Code
|
CPT 77761
|
| Hospital Charge Code |
33300027
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$196.11 |
| Max. Negotiated Rate |
$401.14 |
| Rate for Payer: Aetna American Axle |
$289.71
|
| Rate for Payer: Aetna Commercial |
$378.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.71
|
| Rate for Payer: Cash Price |
$356.57
|
| Rate for Payer: Cofinity Advantage |
$312.00
|
| Rate for Payer: Cofinity Commercial |
$383.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.57
|
| Rate for Payer: Healthscope Commercial |
$401.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$378.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.28
|
| Rate for Payer: PHP Commercial |
$378.85
|
| Rate for Payer: Priority Health SBD |
$280.80
|
| Rate for Payer: UMR Bronson Commercial |
$196.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.28
|
|
|
HC INTRACAV APPL - S
|
Facility
|
OP
|
$445.71
|
|
|
Service Code
|
CPT 77761
|
| Hospital Charge Code |
33300027
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$164.91 |
| Max. Negotiated Rate |
$1,780.43 |
| Rate for Payer: Aetna American Axle |
$289.71
|
| Rate for Payer: Aetna Commercial |
$378.85
|
| Rate for Payer: Aetna Medicare |
$572.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$688.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$688.20
|
| Rate for Payer: BCBS Complete |
$302.37
|
| Rate for Payer: BCBS MAPPO |
$550.56
|
| Rate for Payer: BCBS Trust/PPO |
$548.36
|
| Rate for Payer: BCN Commercial |
$548.36
|
| Rate for Payer: BCN Medicare Advantage |
$550.56
|
| Rate for Payer: Cash Price |
$356.57
|
| Rate for Payer: Cash Price |
$356.57
|
| Rate for Payer: Cofinity Advantage |
$312.00
|
| Rate for Payer: Cofinity Commercial |
$383.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$550.56
|
| Rate for Payer: Healthscope Commercial |
$401.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.28
|
| Rate for Payer: Mclaren Medicaid |
$550.56
|
| Rate for Payer: Mclaren Medicare |
$550.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$578.09
|
| Rate for Payer: Meridian Medicaid |
$578.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$633.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$605.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$378.85
|
| Rate for Payer: Nomi Health Commercial |
$1,651.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.28
|
| Rate for Payer: PACE Medicare |
$523.03
|
| Rate for Payer: PACE SWMI |
$550.56
|
| Rate for Payer: PHP Commercial |
$378.85
|
| Rate for Payer: PHP Medicare Advantage |
$550.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$287.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,780.43
|
| Rate for Payer: Priority Health Medicare |
$550.56
|
| Rate for Payer: Priority Health SBD |
$280.80
|
| Rate for Payer: Priority Health Tiered Network |
$1,424.34
|
| Rate for Payer: Railroad Medicare Medicare |
$550.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$289.71
|
| Rate for Payer: UHC Core |
$232.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$550.56
|
| Rate for Payer: UHC Exchange |
$175.16
|
| Rate for Payer: UHC Medicaid |
$287.94
|
| Rate for Payer: UHCCP Medicaid |
$287.94
|
| Rate for Payer: UMR Bronson Commercial |
$164.91
|
| Rate for Payer: VA VA |
$550.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.28
|
|
|
HC INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC
|
Facility
|
OP
|
$603.23
|
|
|
Service Code
|
CPT 41005
|
| Hospital Charge Code |
76100557
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$123.43 |
| Max. Negotiated Rate |
$763.21 |
| Rate for Payer: Aetna American Axle |
$392.10
|
| Rate for Payer: Aetna Commercial |
$512.75
|
| Rate for Payer: Aetna Medicare |
$245.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$392.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$295.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$295.00
|
| Rate for Payer: BCBS Complete |
$129.61
|
| Rate for Payer: BCBS MAPPO |
$236.00
|
| Rate for Payer: BCBS Trust/PPO |
$296.18
|
| Rate for Payer: BCN Commercial |
$296.18
|
| Rate for Payer: BCN Medicare Advantage |
$236.00
|
| Rate for Payer: Cash Price |
$482.58
|
| Rate for Payer: Cash Price |
$482.58
|
| Rate for Payer: Cash Price |
$482.58
|
| Rate for Payer: Cofinity Advantage |
$422.26
|
| Rate for Payer: Cofinity Commercial |
$518.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$482.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$542.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$422.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$452.42
|
| Rate for Payer: Mclaren Medicaid |
$236.00
|
| Rate for Payer: Mclaren Medicare |
$236.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.80
|
| Rate for Payer: Meridian Medicaid |
$247.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$512.75
|
| Rate for Payer: Nomi Health Commercial |
$708.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$452.42
|
| Rate for Payer: PACE Medicare |
$224.20
|
| Rate for Payer: PACE SWMI |
$236.00
|
| Rate for Payer: PHP Commercial |
$512.75
|
| Rate for Payer: PHP Medicare Advantage |
$236.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$763.21
|
| Rate for Payer: Priority Health Medicare |
$236.00
|
| Rate for Payer: Priority Health SBD |
$380.03
|
| Rate for Payer: Priority Health Tiered Network |
$610.57
|
| Rate for Payer: Railroad Medicare Medicare |
$236.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.10
|
| Rate for Payer: UHC Core |
$314.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$236.00
|
| Rate for Payer: UHC Exchange |
$237.07
|
| Rate for Payer: UHC Medicaid |
$123.43
|
| Rate for Payer: UHCCP Medicaid |
$123.43
|
| Rate for Payer: UMR Bronson Commercial |
$223.20
|
| Rate for Payer: VA VA |
$236.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$452.42
|
|
|
HC INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC
|
Facility
|
IP
|
$603.23
|
|
|
Service Code
|
CPT 41005
|
| Hospital Charge Code |
76100557
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$265.42 |
| Max. Negotiated Rate |
$542.91 |
| Rate for Payer: Aetna American Axle |
$392.10
|
| Rate for Payer: Aetna Commercial |
$512.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$392.10
|
| Rate for Payer: Cash Price |
$482.58
|
| Rate for Payer: Cofinity Advantage |
$422.26
|
| Rate for Payer: Cofinity Commercial |
$518.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$482.58
|
| Rate for Payer: Healthscope Commercial |
$542.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$422.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$452.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$512.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$452.42
|
| Rate for Payer: PHP Commercial |
$512.75
|
| Rate for Payer: Priority Health SBD |
$380.03
|
| Rate for Payer: UMR Bronson Commercial |
$265.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$452.42
|
|
|
HC INTRAOSSEOUS NEEDLE PLACEMENT
|
Facility
|
IP
|
$494.59
|
|
|
Service Code
|
CPT 36680
|
| Hospital Charge Code |
45000080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$217.62 |
| Max. Negotiated Rate |
$445.13 |
| Rate for Payer: Aetna American Axle |
$321.48
|
| Rate for Payer: Aetna Commercial |
$420.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.48
|
| Rate for Payer: Cash Price |
$395.67
|
| Rate for Payer: Cofinity Advantage |
$346.21
|
| Rate for Payer: Cofinity Commercial |
$425.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.67
|
| Rate for Payer: Healthscope Commercial |
$445.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$346.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.94
|
| Rate for Payer: PHP Commercial |
$420.40
|
| Rate for Payer: Priority Health SBD |
$311.59
|
| Rate for Payer: UMR Bronson Commercial |
$217.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.94
|
|
|
HC INTRAOSSEOUS NEEDLE PLACEMENT
|
Facility
|
OP
|
$494.59
|
|
|
Service Code
|
CPT 36680
|
| Hospital Charge Code |
45000080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$1,439.47 |
| Rate for Payer: Aetna American Axle |
$321.48
|
| Rate for Payer: Aetna Commercial |
$420.40
|
| Rate for Payer: Aetna Medicare |
$462.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$556.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$556.40
|
| Rate for Payer: BCBS Complete |
$244.46
|
| Rate for Payer: BCBS MAPPO |
$445.12
|
| Rate for Payer: BCBS Trust/PPO |
$297.46
|
| Rate for Payer: BCN Commercial |
$297.46
|
| Rate for Payer: BCN Medicare Advantage |
$445.12
|
| Rate for Payer: Cash Price |
$395.67
|
| Rate for Payer: Cash Price |
$395.67
|
| Rate for Payer: Cash Price |
$395.67
|
| Rate for Payer: Cofinity Advantage |
$346.21
|
| Rate for Payer: Cofinity Commercial |
$425.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.12
|
| Rate for Payer: Healthscope Commercial |
$445.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$346.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.94
|
| Rate for Payer: Mclaren Medicaid |
$445.12
|
| Rate for Payer: Mclaren Medicare |
$445.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.38
|
| Rate for Payer: Meridian Medicaid |
$467.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$511.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$489.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.40
|
| Rate for Payer: Nomi Health Commercial |
$1,335.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.94
|
| Rate for Payer: PACE Medicare |
$422.86
|
| Rate for Payer: PACE SWMI |
$445.12
|
| Rate for Payer: PHP Commercial |
$420.40
|
| Rate for Payer: PHP Medicare Advantage |
$445.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,439.47
|
| Rate for Payer: Priority Health Medicare |
$445.12
|
| Rate for Payer: Priority Health SBD |
$311.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,151.58
|
| Rate for Payer: Railroad Medicare Medicare |
$445.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$445.12
|
| Rate for Payer: UHC Medicaid |
$232.80
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: UMR Bronson Commercial |
$183.00
|
| Rate for Payer: VA VA |
$445.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.94
|
|
|
HC INTRASPINAL CATHETER
|
Facility
|
OP
|
$298.59
|
|
|
Service Code
|
HCPCS C1755
|
| Hospital Charge Code |
27200248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.48 |
| Max. Negotiated Rate |
$268.73 |
| Rate for Payer: Aetna American Axle |
$194.08
|
| Rate for Payer: Aetna Commercial |
$253.80
|
| Rate for Payer: Aetna Medicare |
$149.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.08
|
| Rate for Payer: BCBS Complete |
$119.44
|
| Rate for Payer: Cash Price |
$238.87
|
| Rate for Payer: Cofinity Advantage |
$209.01
|
| Rate for Payer: Cofinity Commercial |
$256.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.87
|
| Rate for Payer: Healthscope Commercial |
$268.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$209.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$238.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.94
|
| Rate for Payer: PHP Commercial |
$253.80
|
| Rate for Payer: Priority Health SBD |
$188.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$194.08
|
| Rate for Payer: UHC Core |
$155.57
|
| Rate for Payer: UHC Exchange |
$117.35
|
| Rate for Payer: UMR Bronson Commercial |
$110.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.94
|
|
|
HC INTRASPINAL CATHETER
|
Facility
|
IP
|
$298.59
|
|
|
Service Code
|
HCPCS C1755
|
| Hospital Charge Code |
27200248
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.38 |
| Max. Negotiated Rate |
$268.73 |
| Rate for Payer: Aetna American Axle |
$194.08
|
| Rate for Payer: Aetna Commercial |
$253.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.08
|
| Rate for Payer: Cash Price |
$238.87
|
| Rate for Payer: Cofinity Advantage |
$209.01
|
| Rate for Payer: Cofinity Commercial |
$256.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$238.87
|
| Rate for Payer: Healthscope Commercial |
$268.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$209.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$253.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.94
|
| Rate for Payer: PHP Commercial |
$253.80
|
| Rate for Payer: Priority Health SBD |
$188.11
|
| Rate for Payer: UMR Bronson Commercial |
$131.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.94
|
|
|
HC INTRAUTERINE COPPER CONTRACEPTIVE
|
Facility
|
IP
|
$1,800.75
|
|
|
Service Code
|
HCPCS J7300
|
| Hospital Charge Code |
63600119
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$792.33 |
| Max. Negotiated Rate |
$1,620.67 |
| Rate for Payer: Aetna American Axle |
$1,170.49
|
| Rate for Payer: Aetna Commercial |
$1,530.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,170.49
|
| Rate for Payer: Cash Price |
$1,440.60
|
| Rate for Payer: Cofinity Advantage |
$1,260.53
|
| Rate for Payer: Cofinity Commercial |
$1,548.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,440.60
|
| Rate for Payer: Healthscope Commercial |
$1,620.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,260.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,350.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,530.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,350.56
|
| Rate for Payer: PHP Commercial |
$1,530.64
|
| Rate for Payer: Priority Health SBD |
$1,134.47
|
| Rate for Payer: UMR Bronson Commercial |
$792.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,350.56
|
|
|
HC INTRAUTERINE COPPER CONTRACEPTIVE
|
Facility
|
OP
|
$1,800.75
|
|
|
Service Code
|
HCPCS J7300
|
| Hospital Charge Code |
63600119
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$666.28 |
| Max. Negotiated Rate |
$3,806.87 |
| Rate for Payer: Aetna American Axle |
$1,170.49
|
| Rate for Payer: Aetna Commercial |
$1,530.64
|
| Rate for Payer: Aetna Medicare |
$900.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,170.49
|
| Rate for Payer: BCBS Complete |
$720.30
|
| Rate for Payer: BCBS Trust/PPO |
$3,806.87
|
| Rate for Payer: BCN Commercial |
$3,806.87
|
| Rate for Payer: Cash Price |
$1,440.60
|
| Rate for Payer: Cash Price |
$1,440.60
|
| Rate for Payer: Cofinity Advantage |
$1,260.53
|
| Rate for Payer: Cofinity Commercial |
$1,548.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,440.60
|
| Rate for Payer: Healthscope Commercial |
$1,620.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,260.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,350.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,440.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,530.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,350.56
|
| Rate for Payer: PHP Commercial |
$1,530.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,207.34
|
| Rate for Payer: Priority Health SBD |
$1,134.47
|
| Rate for Payer: Priority Health Tiered Network |
$965.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,349.60
|
| Rate for Payer: UHC Core |
$2,349.60
|
| Rate for Payer: UHC Exchange |
$2,349.60
|
| Rate for Payer: UMR Bronson Commercial |
$666.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,350.56
|
|
|
HC INTRAVENTRICULAR PACING
|
Facility
|
IP
|
$3,842.58
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
48100034
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,690.74 |
| Max. Negotiated Rate |
$3,458.32 |
| Rate for Payer: Aetna American Axle |
$2,497.68
|
| Rate for Payer: Aetna Commercial |
$3,266.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,497.68
|
| Rate for Payer: Cash Price |
$3,074.06
|
| Rate for Payer: Cofinity Advantage |
$2,689.81
|
| Rate for Payer: Cofinity Commercial |
$3,304.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,074.06
|
| Rate for Payer: Healthscope Commercial |
$3,458.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,689.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,881.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,266.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,881.93
|
| Rate for Payer: PHP Commercial |
$3,266.19
|
| Rate for Payer: Priority Health SBD |
$2,420.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,690.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,881.93
|
|
|
HC INTRAVENTRICULAR PACING
|
Facility
|
OP
|
$3,842.58
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
48100034
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,421.75 |
| Max. Negotiated Rate |
$25,132.71 |
| Rate for Payer: Aetna American Axle |
$2,497.68
|
| Rate for Payer: Aetna Commercial |
$3,266.19
|
| Rate for Payer: Aetna Medicare |
$8,082.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,497.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,714.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,714.52
|
| Rate for Payer: BCBS Complete |
$4,268.17
|
| Rate for Payer: BCBS MAPPO |
$7,771.62
|
| Rate for Payer: BCBS Trust/PPO |
$20,072.80
|
| Rate for Payer: BCN Commercial |
$20,072.80
|
| Rate for Payer: BCN Medicare Advantage |
$7,771.62
|
| Rate for Payer: Cash Price |
$3,074.06
|
| Rate for Payer: Cash Price |
$3,074.06
|
| Rate for Payer: Cofinity Advantage |
$2,689.81
|
| Rate for Payer: Cofinity Commercial |
$3,304.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,074.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,771.62
|
| Rate for Payer: Healthscope Commercial |
$3,458.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,689.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,881.93
|
| Rate for Payer: Mclaren Medicaid |
$7,771.62
|
| Rate for Payer: Mclaren Medicare |
$7,771.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,160.20
|
| Rate for Payer: Meridian Medicaid |
$8,160.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,937.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,548.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,266.19
|
| Rate for Payer: Nomi Health Commercial |
$23,314.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,881.93
|
| Rate for Payer: PACE Medicare |
$7,383.04
|
| Rate for Payer: PACE SWMI |
$7,771.62
|
| Rate for Payer: PHP Commercial |
$3,266.19
|
| Rate for Payer: PHP Medicare Advantage |
$7,771.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,064.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,132.71
|
| Rate for Payer: Priority Health Medicare |
$7,771.62
|
| Rate for Payer: Priority Health SBD |
$2,420.83
|
| Rate for Payer: Priority Health Tiered Network |
$20,106.17
|
| Rate for Payer: Railroad Medicare Medicare |
$7,771.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,771.62
|
| Rate for Payer: UHC Medicaid |
$4,064.56
|
| Rate for Payer: UHCCP Medicaid |
$4,064.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,421.75
|
| Rate for Payer: VA VA |
$7,771.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,881.93
|
|
|
HC INTRINSIC FACTOR ANTIBODIES
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 86340
|
| Hospital Charge Code |
30200200
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.89 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna American Axle |
$32.46
|
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna Medicare |
$15.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.85
|
| Rate for Payer: BCBS Complete |
$8.28
|
| Rate for Payer: BCBS MAPPO |
$15.08
|
| Rate for Payer: BCBS Trust/PPO |
$17.43
|
| Rate for Payer: BCN Commercial |
$17.43
|
| Rate for Payer: BCN Medicare Advantage |
$15.08
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Advantage |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.45
|
| Rate for Payer: Mclaren Medicaid |
$15.08
|
| Rate for Payer: Mclaren Medicare |
$15.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.83
|
| Rate for Payer: Meridian Medicaid |
$15.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$22.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PACE Medicare |
$14.33
|
| Rate for Payer: PACE SWMI |
$15.08
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: PHP Medicare Advantage |
$15.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.08
|
| Rate for Payer: Priority Health Medicare |
$15.08
|
| Rate for Payer: Priority Health SBD |
$31.46
|
| Rate for Payer: Priority Health Tiered Network |
$12.06
|
| Rate for Payer: Railroad Medicare Medicare |
$15.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.62
|
| Rate for Payer: UHC Core |
$22.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.08
|
| Rate for Payer: UHC Exchange |
$22.62
|
| Rate for Payer: UHC Medicaid |
$7.89
|
| Rate for Payer: UHCCP Medicaid |
$7.89
|
| Rate for Payer: UMR Bronson Commercial |
$18.48
|
| Rate for Payer: VA VA |
$15.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.45
|
|
|
HC INTRINSIC FACTOR ANTIBODIES
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 86340
|
| Hospital Charge Code |
30200200
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.97 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna American Axle |
$32.46
|
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Advantage |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: Priority Health SBD |
$31.46
|
| Rate for Payer: UMR Bronson Commercial |
$21.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.45
|
|
|
HC INTRO AORTA TRANSLUMBAR
|
Facility
|
OP
|
$3,820.35
|
|
|
Service Code
|
CPT 36160
|
| Hospital Charge Code |
36100621
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,413.53 |
| Max. Negotiated Rate |
$3,438.32 |
| Rate for Payer: Aetna American Axle |
$2,483.23
|
| Rate for Payer: Aetna Commercial |
$3,247.30
|
| Rate for Payer: Aetna Medicare |
$1,910.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,483.23
|
| Rate for Payer: BCBS Complete |
$1,528.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,126.27
|
| Rate for Payer: BCN Commercial |
$2,126.27
|
| Rate for Payer: Cash Price |
$3,056.28
|
| Rate for Payer: Cash Price |
$3,056.28
|
| Rate for Payer: Cash Price |
$3,056.28
|
| Rate for Payer: Cofinity Advantage |
$2,674.24
|
| Rate for Payer: Cofinity Commercial |
$3,285.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,056.28
|
| Rate for Payer: Healthscope Commercial |
$3,438.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,674.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,865.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,056.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,247.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,865.26
|
| Rate for Payer: PHP Commercial |
$3,247.30
|
| Rate for Payer: Priority Health SBD |
$2,406.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,413.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,865.26
|
|
|
HC INTRO AORTA TRANSLUMBAR
|
Facility
|
IP
|
$3,820.35
|
|
|
Service Code
|
CPT 36160
|
| Hospital Charge Code |
36100621
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,680.95 |
| Max. Negotiated Rate |
$3,438.32 |
| Rate for Payer: Aetna American Axle |
$2,483.23
|
| Rate for Payer: Aetna Commercial |
$3,247.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,483.23
|
| Rate for Payer: Cash Price |
$3,056.28
|
| Rate for Payer: Cofinity Advantage |
$2,674.24
|
| Rate for Payer: Cofinity Commercial |
$3,285.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,056.28
|
| Rate for Payer: Healthscope Commercial |
$3,438.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,674.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,865.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,247.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,865.26
|
| Rate for Payer: PHP Commercial |
$3,247.30
|
| Rate for Payer: Priority Health SBD |
$2,406.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,680.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,865.26
|
|
|
HC INTRODUCER
|
Facility
|
IP
|
$305.57
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200049
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$134.45 |
| Max. Negotiated Rate |
$275.01 |
| Rate for Payer: Aetna American Axle |
$198.62
|
| Rate for Payer: Aetna Commercial |
$259.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.62
|
| Rate for Payer: Cash Price |
$244.46
|
| Rate for Payer: Cofinity Advantage |
$213.90
|
| Rate for Payer: Cofinity Commercial |
$262.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.46
|
| Rate for Payer: Healthscope Commercial |
$275.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.18
|
| Rate for Payer: PHP Commercial |
$259.73
|
| Rate for Payer: Priority Health SBD |
$192.51
|
| Rate for Payer: UMR Bronson Commercial |
$134.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.18
|
|
|
HC INTRODUCER
|
Facility
|
OP
|
$305.57
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200049
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$113.06 |
| Max. Negotiated Rate |
$275.01 |
| Rate for Payer: Aetna American Axle |
$198.62
|
| Rate for Payer: Aetna Commercial |
$259.73
|
| Rate for Payer: Aetna Medicare |
$152.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.62
|
| Rate for Payer: BCBS Complete |
$122.23
|
| Rate for Payer: Cash Price |
$244.46
|
| Rate for Payer: Cofinity Advantage |
$213.90
|
| Rate for Payer: Cofinity Commercial |
$262.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.46
|
| Rate for Payer: Healthscope Commercial |
$275.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$244.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$229.18
|
| Rate for Payer: PHP Commercial |
$259.73
|
| Rate for Payer: Priority Health SBD |
$192.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.62
|
| Rate for Payer: UHC Core |
$159.20
|
| Rate for Payer: UHC Exchange |
$120.09
|
| Rate for Payer: UMR Bronson Commercial |
$113.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.18
|
|
|
HC INTRODUCER LONG
|
Facility
|
IP
|
$260.03
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200050
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$114.41 |
| Max. Negotiated Rate |
$234.03 |
| Rate for Payer: Aetna American Axle |
$169.02
|
| Rate for Payer: Aetna Commercial |
$221.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.02
|
| Rate for Payer: Cash Price |
$208.02
|
| Rate for Payer: Cofinity Advantage |
$182.02
|
| Rate for Payer: Cofinity Commercial |
$223.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.02
|
| Rate for Payer: Healthscope Commercial |
$234.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.02
|
| Rate for Payer: PHP Commercial |
$221.03
|
| Rate for Payer: Priority Health SBD |
$163.82
|
| Rate for Payer: UMR Bronson Commercial |
$114.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.02
|
|
|
HC INTRODUCER LONG
|
Facility
|
OP
|
$260.03
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200050
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$96.21 |
| Max. Negotiated Rate |
$234.03 |
| Rate for Payer: Aetna American Axle |
$169.02
|
| Rate for Payer: Aetna Commercial |
$221.03
|
| Rate for Payer: Aetna Medicare |
$130.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.02
|
| Rate for Payer: BCBS Complete |
$104.01
|
| Rate for Payer: Cash Price |
$208.02
|
| Rate for Payer: Cofinity Advantage |
$182.02
|
| Rate for Payer: Cofinity Commercial |
$223.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.02
|
| Rate for Payer: Healthscope Commercial |
$234.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$208.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.02
|
| Rate for Payer: PHP Commercial |
$221.03
|
| Rate for Payer: Priority Health SBD |
$163.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.02
|
| Rate for Payer: UHC Core |
$135.48
|
| Rate for Payer: UHC Exchange |
$102.19
|
| Rate for Payer: UMR Bronson Commercial |
$96.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.02
|
|
