|
HC IOM SUBDERMAL RECORDING ELECTR
|
Facility
|
IP
|
$15.67
|
|
| Hospital Charge Code |
62200009
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$14.10 |
| Rate for Payer: Aetna American Axle |
$10.19
|
| Rate for Payer: Aetna Commercial |
$13.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.19
|
| Rate for Payer: Cash Price |
$12.54
|
| Rate for Payer: Cofinity Advantage |
$10.97
|
| Rate for Payer: Cofinity Commercial |
$13.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.54
|
| Rate for Payer: Healthscope Commercial |
$14.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.75
|
| Rate for Payer: PHP Commercial |
$13.32
|
| Rate for Payer: Priority Health SBD |
$9.87
|
| Rate for Payer: UMR Bronson Commercial |
$6.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.75
|
|
|
HC IONIZED CALCIUM
|
Facility
|
IP
|
$109.66
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
30100130
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.25 |
| Max. Negotiated Rate |
$98.69 |
| Rate for Payer: Aetna American Axle |
$71.28
|
| Rate for Payer: Aetna Commercial |
$93.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.28
|
| Rate for Payer: Cash Price |
$87.73
|
| Rate for Payer: Cofinity Advantage |
$76.76
|
| Rate for Payer: Cofinity Commercial |
$94.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.73
|
| Rate for Payer: Healthscope Commercial |
$98.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.25
|
| Rate for Payer: PHP Commercial |
$93.21
|
| Rate for Payer: Priority Health SBD |
$69.09
|
| Rate for Payer: UMR Bronson Commercial |
$48.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.25
|
|
|
HC IONIZED CALCIUM
|
Facility
|
OP
|
$109.66
|
|
|
Service Code
|
CPT 82330
|
| Hospital Charge Code |
30100130
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.15 |
| Max. Negotiated Rate |
$98.69 |
| Rate for Payer: Aetna American Axle |
$71.28
|
| Rate for Payer: Aetna Commercial |
$93.21
|
| Rate for Payer: Aetna Medicare |
$14.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.10
|
| Rate for Payer: BCBS Complete |
$7.51
|
| Rate for Payer: BCBS MAPPO |
$13.68
|
| Rate for Payer: BCBS Trust/PPO |
$15.81
|
| Rate for Payer: BCN Commercial |
$15.81
|
| Rate for Payer: BCN Medicare Advantage |
$13.68
|
| Rate for Payer: Cash Price |
$87.73
|
| Rate for Payer: Cash Price |
$87.73
|
| Rate for Payer: Cofinity Advantage |
$76.76
|
| Rate for Payer: Cofinity Commercial |
$94.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.68
|
| Rate for Payer: Healthscope Commercial |
$98.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.25
|
| Rate for Payer: Mclaren Medicaid |
$13.68
|
| Rate for Payer: Mclaren Medicare |
$13.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.36
|
| Rate for Payer: Meridian Medicaid |
$14.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.21
|
| Rate for Payer: Nomi Health Commercial |
$20.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.25
|
| Rate for Payer: PACE Medicare |
$13.00
|
| Rate for Payer: PACE SWMI |
$13.68
|
| Rate for Payer: PHP Commercial |
$93.21
|
| Rate for Payer: PHP Medicare Advantage |
$13.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.68
|
| Rate for Payer: Priority Health Medicare |
$13.68
|
| Rate for Payer: Priority Health SBD |
$69.09
|
| Rate for Payer: Priority Health Tiered Network |
$10.94
|
| Rate for Payer: Railroad Medicare Medicare |
$13.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.52
|
| Rate for Payer: UHC Core |
$20.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.68
|
| Rate for Payer: UHC Exchange |
$20.52
|
| Rate for Payer: UHC Medicaid |
$7.15
|
| Rate for Payer: UHCCP Medicaid |
$7.15
|
| Rate for Payer: UMR Bronson Commercial |
$40.57
|
| Rate for Payer: VA VA |
$13.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.25
|
|
|
HC IONTOPHORESIS EACH 15 MIN
|
Facility
|
OP
|
$108.24
|
|
|
Service Code
|
CPT 97033
|
| Hospital Charge Code |
42000016
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$17.54 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$70.36
|
| Rate for Payer: Aetna Commercial |
$92.00
|
| Rate for Payer: Aetna Medicare |
$54.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.36
|
| Rate for Payer: BCBS Complete |
$43.30
|
| Rate for Payer: BCBS Trust/PPO |
$17.54
|
| Rate for Payer: BCN Commercial |
$17.54
|
| Rate for Payer: Cash Price |
$86.59
|
| Rate for Payer: Cash Price |
$86.59
|
| Rate for Payer: Cash Price |
$86.59
|
| Rate for Payer: Cofinity Advantage |
$75.77
|
| Rate for Payer: Cofinity Commercial |
$93.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.59
|
| Rate for Payer: Healthscope Commercial |
$97.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.00
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.18
|
| Rate for Payer: PHP Commercial |
$92.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23.00
|
| Rate for Payer: Priority Health SBD |
$68.19
|
| Rate for Payer: Priority Health Tiered Network |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.36
|
| Rate for Payer: UHC Core |
$56.39
|
| Rate for Payer: UHC Exchange |
$42.54
|
| Rate for Payer: UMR Bronson Commercial |
$40.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.18
|
|
|
HC IONTOPHORESIS EACH 15 MIN
|
Facility
|
IP
|
$108.24
|
|
|
Service Code
|
CPT 97033
|
| Hospital Charge Code |
42000016
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$47.63 |
| Max. Negotiated Rate |
$97.42 |
| Rate for Payer: Aetna American Axle |
$70.36
|
| Rate for Payer: Aetna Commercial |
$92.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.36
|
| Rate for Payer: Cash Price |
$86.59
|
| Rate for Payer: Cofinity Advantage |
$75.77
|
| Rate for Payer: Cofinity Commercial |
$93.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.59
|
| Rate for Payer: Healthscope Commercial |
$97.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.18
|
| Rate for Payer: PHP Commercial |
$92.00
|
| Rate for Payer: Priority Health SBD |
$68.19
|
| Rate for Payer: UMR Bronson Commercial |
$47.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.18
|
|
|
HC IP 1:1 HEMODIALYSIS
|
Facility
|
OP
|
$1,430.00
|
|
| Hospital Charge Code |
80100002
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$529.10 |
| Max. Negotiated Rate |
$1,287.00 |
| Rate for Payer: Aetna American Axle |
$929.50
|
| Rate for Payer: Aetna Commercial |
$1,215.50
|
| Rate for Payer: Aetna Medicare |
$715.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$929.50
|
| Rate for Payer: BCBS Complete |
$572.00
|
| Rate for Payer: Cash Price |
$1,144.00
|
| Rate for Payer: Cofinity Advantage |
$1,001.00
|
| Rate for Payer: Cofinity Commercial |
$1,229.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,144.00
|
| Rate for Payer: Healthscope Commercial |
$1,287.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,001.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,072.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,144.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,215.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,072.50
|
| Rate for Payer: PHP Commercial |
$1,215.50
|
| Rate for Payer: Priority Health SBD |
$900.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$929.50
|
| Rate for Payer: UHC Core |
$745.03
|
| Rate for Payer: UHC Exchange |
$561.99
|
| Rate for Payer: UMR Bronson Commercial |
$529.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,072.50
|
|
|
HC IP 1:1 HEMODIALYSIS
|
Facility
|
IP
|
$1,430.00
|
|
| Hospital Charge Code |
80100002
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$629.20 |
| Max. Negotiated Rate |
$1,287.00 |
| Rate for Payer: Aetna American Axle |
$929.50
|
| Rate for Payer: Aetna Commercial |
$1,215.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$929.50
|
| Rate for Payer: Cash Price |
$1,144.00
|
| Rate for Payer: Cofinity Advantage |
$1,001.00
|
| Rate for Payer: Cofinity Commercial |
$1,229.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,144.00
|
| Rate for Payer: Healthscope Commercial |
$1,287.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,001.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,072.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,215.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,072.50
|
| Rate for Payer: PHP Commercial |
$1,215.50
|
| Rate for Payer: Priority Health SBD |
$900.90
|
| Rate for Payer: UMR Bronson Commercial |
$629.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,072.50
|
|
|
HC IP 2:1 HEMODIALYSIS
|
Facility
|
IP
|
$1,205.00
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
80100001
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$530.20 |
| Max. Negotiated Rate |
$1,084.50 |
| Rate for Payer: Aetna American Axle |
$783.25
|
| Rate for Payer: Aetna Commercial |
$1,024.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.25
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Cofinity Advantage |
$843.50
|
| Rate for Payer: Cofinity Commercial |
$1,036.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$964.00
|
| Rate for Payer: Healthscope Commercial |
$1,084.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$843.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,024.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$903.75
|
| Rate for Payer: PHP Commercial |
$1,024.25
|
| Rate for Payer: Priority Health SBD |
$759.15
|
| Rate for Payer: UMR Bronson Commercial |
$530.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.75
|
|
|
HC IP 2:1 HEMODIALYSIS
|
Facility
|
OP
|
$1,205.00
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
80100001
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$357.65 |
| Max. Negotiated Rate |
$2,211.50 |
| Rate for Payer: Aetna American Axle |
$783.25
|
| Rate for Payer: Aetna Commercial |
$1,024.25
|
| Rate for Payer: Aetna Medicare |
$711.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$783.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$854.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$854.81
|
| Rate for Payer: BCBS Complete |
$375.57
|
| Rate for Payer: BCBS MAPPO |
$683.85
|
| Rate for Payer: BCN Medicare Advantage |
$683.85
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Cash Price |
$964.00
|
| Rate for Payer: Cofinity Advantage |
$843.50
|
| Rate for Payer: Cofinity Commercial |
$1,036.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$964.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$683.85
|
| Rate for Payer: Healthscope Commercial |
$1,084.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$843.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$903.75
|
| Rate for Payer: Mclaren Medicaid |
$683.85
|
| Rate for Payer: Mclaren Medicare |
$683.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.04
|
| Rate for Payer: Meridian Medicaid |
$718.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$786.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$752.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,024.25
|
| Rate for Payer: Nomi Health Commercial |
$2,051.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$903.75
|
| Rate for Payer: PACE Medicare |
$649.66
|
| Rate for Payer: PACE SWMI |
$683.85
|
| Rate for Payer: PHP Commercial |
$1,024.25
|
| Rate for Payer: PHP Medicare Advantage |
$683.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,211.50
|
| Rate for Payer: Priority Health Medicare |
$683.85
|
| Rate for Payer: Priority Health SBD |
$759.15
|
| Rate for Payer: Priority Health Tiered Network |
$1,769.20
|
| Rate for Payer: Railroad Medicare Medicare |
$683.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$783.25
|
| Rate for Payer: UHC Core |
$627.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$683.85
|
| Rate for Payer: UHC Exchange |
$473.56
|
| Rate for Payer: UHC Medicaid |
$357.65
|
| Rate for Payer: UHCCP Medicaid |
$357.65
|
| Rate for Payer: UMR Bronson Commercial |
$445.85
|
| Rate for Payer: VA VA |
$683.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$903.75
|
|
|
HC IPPB/IPV TREATMENT
|
Facility
|
OP
|
$141.41
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000015
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$705.61 |
| Rate for Payer: Aetna American Axle |
$91.92
|
| Rate for Payer: Aetna Commercial |
$120.20
|
| Rate for Payer: Aetna Medicare |
$226.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.74
|
| Rate for Payer: BCBS Complete |
$119.83
|
| Rate for Payer: BCBS MAPPO |
$218.19
|
| Rate for Payer: BCBS Trust/PPO |
$32.40
|
| Rate for Payer: BCN Commercial |
$32.40
|
| Rate for Payer: BCN Medicare Advantage |
$218.19
|
| Rate for Payer: Cash Price |
$113.13
|
| Rate for Payer: Cash Price |
$113.13
|
| Rate for Payer: Cofinity Advantage |
$98.99
|
| Rate for Payer: Cofinity Commercial |
$121.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.19
|
| Rate for Payer: Healthscope Commercial |
$127.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.06
|
| Rate for Payer: Mclaren Medicaid |
$218.19
|
| Rate for Payer: Mclaren Medicare |
$218.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.10
|
| Rate for Payer: Meridian Medicaid |
$229.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$240.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.20
|
| Rate for Payer: Nomi Health Commercial |
$654.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.06
|
| Rate for Payer: PACE Medicare |
$207.28
|
| Rate for Payer: PACE SWMI |
$218.19
|
| Rate for Payer: PHP Commercial |
$120.20
|
| Rate for Payer: PHP Medicare Advantage |
$218.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$705.61
|
| Rate for Payer: Priority Health Medicare |
$218.19
|
| Rate for Payer: Priority Health SBD |
$89.09
|
| Rate for Payer: Priority Health Tiered Network |
$564.49
|
| Rate for Payer: Railroad Medicare Medicare |
$218.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.92
|
| Rate for Payer: UHC Core |
$73.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$218.19
|
| Rate for Payer: UHC Exchange |
$55.57
|
| Rate for Payer: UHC Medicaid |
$114.11
|
| Rate for Payer: UHCCP Medicaid |
$114.11
|
| Rate for Payer: UMR Bronson Commercial |
$52.32
|
| Rate for Payer: VA VA |
$218.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.06
|
|
|
HC IPPB/IPV TREATMENT
|
Facility
|
IP
|
$141.41
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000015
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$62.22 |
| Max. Negotiated Rate |
$127.27 |
| Rate for Payer: Aetna American Axle |
$91.92
|
| Rate for Payer: Aetna Commercial |
$120.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.92
|
| Rate for Payer: Cash Price |
$113.13
|
| Rate for Payer: Cofinity Advantage |
$98.99
|
| Rate for Payer: Cofinity Commercial |
$121.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.13
|
| Rate for Payer: Healthscope Commercial |
$127.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$120.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.06
|
| Rate for Payer: PHP Commercial |
$120.20
|
| Rate for Payer: Priority Health SBD |
$89.09
|
| Rate for Payer: UMR Bronson Commercial |
$62.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.06
|
|
|
HC IPRATROPIUM BROMIDE, INHALATION SOLUTION, UNIT DOSE/MILLIGRAM
|
Facility
|
IP
|
$4.24
|
|
|
Service Code
|
CPT J7644
|
| Hospital Charge Code |
63600112
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$3.82 |
| Rate for Payer: Aetna American Axle |
$2.76
|
| Rate for Payer: Aetna Commercial |
$3.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.76
|
| Rate for Payer: Cash Price |
$3.39
|
| Rate for Payer: Cofinity Advantage |
$2.97
|
| Rate for Payer: Cofinity Commercial |
$3.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.39
|
| Rate for Payer: Healthscope Commercial |
$3.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.18
|
| Rate for Payer: PHP Commercial |
$3.60
|
| Rate for Payer: Priority Health SBD |
$2.67
|
| Rate for Payer: UMR Bronson Commercial |
$1.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.18
|
|
|
HC IPRATROPIUM BROMIDE, INHALATION SOLUTION, UNIT DOSE/MILLIGRAM
|
Facility
|
OP
|
$4.24
|
|
|
Service Code
|
CPT J7644
|
| Hospital Charge Code |
63600112
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.32 |
| Max. Negotiated Rate |
$3.82 |
| Rate for Payer: Aetna American Axle |
$2.76
|
| Rate for Payer: Aetna Commercial |
$3.60
|
| Rate for Payer: Aetna Medicare |
$2.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.76
|
| Rate for Payer: BCBS Complete |
$1.70
|
| Rate for Payer: BCBS Trust/PPO |
$1.27
|
| Rate for Payer: BCN Commercial |
$1.27
|
| Rate for Payer: Cash Price |
$3.39
|
| Rate for Payer: Cash Price |
$3.39
|
| Rate for Payer: Cofinity Advantage |
$2.97
|
| Rate for Payer: Cofinity Commercial |
$3.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.39
|
| Rate for Payer: Healthscope Commercial |
$3.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.18
|
| Rate for Payer: PHP Commercial |
$3.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.40
|
| Rate for Payer: Priority Health SBD |
$2.67
|
| Rate for Payer: Priority Health Tiered Network |
$0.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.66
|
| Rate for Payer: UHC Core |
$0.66
|
| Rate for Payer: UHC Exchange |
$0.66
|
| Rate for Payer: UMR Bronson Commercial |
$1.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.18
|
|
|
HC IR ABSCESS DRAIN CATH PLACE
|
Facility
|
IP
|
$895.68
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
35000021
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$394.10 |
| Max. Negotiated Rate |
$806.11 |
| Rate for Payer: Aetna American Axle |
$582.19
|
| Rate for Payer: Aetna Commercial |
$761.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$582.19
|
| Rate for Payer: Cash Price |
$716.54
|
| Rate for Payer: Cofinity Advantage |
$626.98
|
| Rate for Payer: Cofinity Commercial |
$770.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$716.54
|
| Rate for Payer: Healthscope Commercial |
$806.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$626.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$671.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$761.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$671.76
|
| Rate for Payer: PHP Commercial |
$761.33
|
| Rate for Payer: Priority Health SBD |
$564.28
|
| Rate for Payer: UMR Bronson Commercial |
$394.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$671.76
|
|
|
HC IR ABSCESS DRAIN CATH PLACE
|
Facility
|
OP
|
$895.68
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
35000021
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$137.92 |
| Max. Negotiated Rate |
$806.11 |
| Rate for Payer: Aetna American Axle |
$582.19
|
| Rate for Payer: Aetna Commercial |
$761.33
|
| Rate for Payer: Aetna Medicare |
$447.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$582.19
|
| Rate for Payer: BCBS Complete |
$358.27
|
| Rate for Payer: BCBS Trust/PPO |
$137.92
|
| Rate for Payer: BCN Commercial |
$137.92
|
| Rate for Payer: Cash Price |
$716.54
|
| Rate for Payer: Cash Price |
$716.54
|
| Rate for Payer: Cofinity Advantage |
$626.98
|
| Rate for Payer: Cofinity Commercial |
$770.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$716.54
|
| Rate for Payer: Healthscope Commercial |
$806.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$626.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$671.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$716.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$761.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$671.76
|
| Rate for Payer: PHP Commercial |
$761.33
|
| Rate for Payer: Priority Health SBD |
$564.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$582.19
|
| Rate for Payer: UHC Core |
$466.65
|
| Rate for Payer: UHC Exchange |
$352.00
|
| Rate for Payer: UMR Bronson Commercial |
$331.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$671.76
|
|
|
HC IR ABSCESS DRAIN TUBE CHECK
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000236
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$87.02 |
| Max. Negotiated Rate |
$1,760.71 |
| Rate for Payer: Aetna American Axle |
$257.71
|
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna Medicare |
$566.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$680.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$680.56
|
| Rate for Payer: BCBS Complete |
$299.01
|
| Rate for Payer: BCBS MAPPO |
$544.45
|
| Rate for Payer: BCBS Trust/PPO |
$87.02
|
| Rate for Payer: BCN Commercial |
$87.02
|
| Rate for Payer: BCN Medicare Advantage |
$544.45
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Advantage |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$544.45
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Mclaren Medicaid |
$544.45
|
| Rate for Payer: Mclaren Medicare |
$544.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$571.67
|
| Rate for Payer: Meridian Medicaid |
$571.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$626.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$598.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$1,633.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PACE Medicare |
$517.23
|
| Rate for Payer: PACE SWMI |
$544.45
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: PHP Medicare Advantage |
$544.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$284.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,760.71
|
| Rate for Payer: Priority Health Medicare |
$544.45
|
| Rate for Payer: Priority Health SBD |
$249.78
|
| Rate for Payer: Priority Health Tiered Network |
$1,408.57
|
| Rate for Payer: Railroad Medicare Medicare |
$544.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.71
|
| Rate for Payer: UHC Core |
$206.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$544.45
|
| Rate for Payer: UHC Exchange |
$155.82
|
| Rate for Payer: UHC Medicaid |
$284.75
|
| Rate for Payer: UHCCP Medicaid |
$284.75
|
| Rate for Payer: UMR Bronson Commercial |
$146.70
|
| Rate for Payer: VA VA |
$544.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC IR ABSCESS DRAIN TUBE CHECK
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000236
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$174.45 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna American Axle |
$257.71
|
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.71
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Advantage |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: Priority Health SBD |
$249.78
|
| Rate for Payer: UMR Bronson Commercial |
$174.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC IR ANGIO FU EMBO THROMBOLYSIS
|
Facility
|
OP
|
$1,751.20
|
|
|
Service Code
|
CPT 75898
|
| Hospital Charge Code |
32000212
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$647.94 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$1,138.28
|
| Rate for Payer: Aetna Commercial |
$1,488.52
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,138.28
|
| 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 |
$4,851.24
|
| Rate for Payer: BCN Commercial |
$4,851.24
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$1,400.96
|
| Rate for Payer: Cash Price |
$1,400.96
|
| Rate for Payer: Cofinity Advantage |
$1,225.84
|
| Rate for Payer: Cofinity Commercial |
$1,506.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,400.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$1,576.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,225.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,313.40
|
| 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 |
$1,488.52
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,313.40
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$1,488.52
|
| 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 |
$1,103.26
|
| 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) |
$1,138.28
|
| Rate for Payer: UHC Core |
$912.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$688.22
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$647.94
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,313.40
|
|
|
HC IR ANGIO FU EMBO THROMBOLYSIS
|
Facility
|
IP
|
$1,751.20
|
|
|
Service Code
|
CPT 75898
|
| Hospital Charge Code |
32000212
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$770.53 |
| Max. Negotiated Rate |
$1,576.08 |
| Rate for Payer: Aetna American Axle |
$1,138.28
|
| Rate for Payer: Aetna Commercial |
$1,488.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,138.28
|
| Rate for Payer: Cash Price |
$1,400.96
|
| Rate for Payer: Cofinity Advantage |
$1,225.84
|
| Rate for Payer: Cofinity Commercial |
$1,506.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,400.96
|
| Rate for Payer: Healthscope Commercial |
$1,576.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,225.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,313.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,488.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,313.40
|
| Rate for Payer: PHP Commercial |
$1,488.52
|
| Rate for Payer: Priority Health SBD |
$1,103.26
|
| Rate for Payer: UMR Bronson Commercial |
$770.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,313.40
|
|
|
HC IR ANGIOGRAM PELVIC
|
Facility
|
OP
|
$3,331.45
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
32000194
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$229.85 |
| Max. Negotiated Rate |
$17,930.33 |
| Rate for Payer: Aetna American Axle |
$2,165.44
|
| Rate for Payer: Aetna Commercial |
$2,831.73
|
| Rate for Payer: Aetna Medicare |
$5,766.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,165.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,930.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,930.60
|
| Rate for Payer: BCBS Complete |
$3,045.03
|
| Rate for Payer: BCBS MAPPO |
$5,544.48
|
| Rate for Payer: BCBS Trust/PPO |
$229.85
|
| Rate for Payer: BCN Commercial |
$229.85
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Cash Price |
$2,665.16
|
| Rate for Payer: Cash Price |
$2,665.16
|
| Rate for Payer: Cofinity Advantage |
$2,332.01
|
| Rate for Payer: Cofinity Commercial |
$2,865.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,665.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Healthscope Commercial |
$2,998.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,332.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,498.59
|
| Rate for Payer: Mclaren Medicaid |
$5,544.48
|
| Rate for Payer: Mclaren Medicare |
$5,544.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,821.70
|
| Rate for Payer: Meridian Medicaid |
$5,821.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,376.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,098.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,831.73
|
| Rate for Payer: Nomi Health Commercial |
$16,633.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,498.59
|
| Rate for Payer: PACE Medicare |
$5,267.26
|
| Rate for Payer: PACE SWMI |
$5,544.48
|
| Rate for Payer: PHP Commercial |
$2,831.73
|
| Rate for Payer: PHP Medicare Advantage |
$5,544.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,899.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17,930.33
|
| Rate for Payer: Priority Health Medicare |
$5,544.48
|
| Rate for Payer: Priority Health SBD |
$2,098.81
|
| Rate for Payer: Priority Health Tiered Network |
$14,344.26
|
| Rate for Payer: Railroad Medicare Medicare |
$5,544.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,165.44
|
| Rate for Payer: UHC Core |
$1,735.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,544.48
|
| Rate for Payer: UHC Exchange |
$1,309.26
|
| Rate for Payer: UHC Medicaid |
$2,899.76
|
| Rate for Payer: UHCCP Medicaid |
$2,899.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,232.64
|
| Rate for Payer: VA VA |
$5,544.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,498.59
|
|
|
HC IR ANGIOGRAM PELVIC
|
Facility
|
IP
|
$3,331.45
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
32000194
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,465.84 |
| Max. Negotiated Rate |
$2,998.30 |
| Rate for Payer: Aetna American Axle |
$2,165.44
|
| Rate for Payer: Aetna Commercial |
$2,831.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,165.44
|
| Rate for Payer: Cash Price |
$2,665.16
|
| Rate for Payer: Cofinity Advantage |
$2,332.01
|
| Rate for Payer: Cofinity Commercial |
$2,865.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,665.16
|
| Rate for Payer: Healthscope Commercial |
$2,998.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,332.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,498.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,831.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,498.59
|
| Rate for Payer: PHP Commercial |
$2,831.73
|
| Rate for Payer: Priority Health SBD |
$2,098.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,465.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,498.59
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL
|
Facility
|
IP
|
$3,526.75
|
|
|
Service Code
|
CPT 61630
|
| Hospital Charge Code |
36100273
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,551.77 |
| Max. Negotiated Rate |
$3,174.07 |
| Rate for Payer: Aetna American Axle |
$2,292.39
|
| Rate for Payer: Aetna Commercial |
$2,997.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,292.39
|
| Rate for Payer: Cash Price |
$2,821.40
|
| Rate for Payer: Cofinity Advantage |
$2,468.72
|
| Rate for Payer: Cofinity Commercial |
$3,033.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,821.40
|
| Rate for Payer: Healthscope Commercial |
$3,174.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,468.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,645.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,997.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,645.06
|
| Rate for Payer: PHP Commercial |
$2,997.74
|
| Rate for Payer: Priority Health SBD |
$2,221.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,551.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,645.06
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL
|
Facility
|
OP
|
$3,526.75
|
|
|
Service Code
|
CPT 61630
|
| Hospital Charge Code |
36100273
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,304.90 |
| Max. Negotiated Rate |
$3,174.07 |
| Rate for Payer: Aetna American Axle |
$2,292.39
|
| Rate for Payer: Aetna Commercial |
$2,997.74
|
| Rate for Payer: Aetna Medicare |
$1,763.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,292.39
|
| Rate for Payer: BCBS Complete |
$1,410.70
|
| Rate for Payer: Cash Price |
$2,821.40
|
| Rate for Payer: Cofinity Advantage |
$2,468.72
|
| Rate for Payer: Cofinity Commercial |
$3,033.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,821.40
|
| Rate for Payer: Healthscope Commercial |
$3,174.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,468.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,645.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,821.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,997.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,645.06
|
| Rate for Payer: PHP Commercial |
$2,997.74
|
| Rate for Payer: Priority Health SBD |
$2,221.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,304.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,645.06
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL VASOSPASM INIT
|
Facility
|
OP
|
$10,051.22
|
|
|
Service Code
|
CPT 61640
|
| Hospital Charge Code |
36100275
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,718.95 |
| Max. Negotiated Rate |
$9,046.10 |
| Rate for Payer: Aetna American Axle |
$6,533.29
|
| Rate for Payer: Aetna Commercial |
$8,543.54
|
| Rate for Payer: Aetna Medicare |
$5,025.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,533.29
|
| Rate for Payer: BCBS Complete |
$4,020.49
|
| Rate for Payer: Cash Price |
$8,040.98
|
| Rate for Payer: Cofinity Advantage |
$7,035.85
|
| Rate for Payer: Cofinity Commercial |
$8,644.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,040.98
|
| Rate for Payer: Healthscope Commercial |
$9,046.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,035.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,538.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,040.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,543.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,538.41
|
| Rate for Payer: PHP Commercial |
$8,543.54
|
| Rate for Payer: Priority Health SBD |
$6,332.27
|
| Rate for Payer: UMR Bronson Commercial |
$3,718.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,538.41
|
|
|
HC IR ANGIOPLASTY INTRACRANIAL VASOSPASM INIT
|
Facility
|
IP
|
$10,051.22
|
|
|
Service Code
|
CPT 61640
|
| Hospital Charge Code |
36100275
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,422.54 |
| Max. Negotiated Rate |
$9,046.10 |
| Rate for Payer: Aetna American Axle |
$6,533.29
|
| Rate for Payer: Aetna Commercial |
$8,543.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,533.29
|
| Rate for Payer: Cash Price |
$8,040.98
|
| Rate for Payer: Cofinity Advantage |
$7,035.85
|
| Rate for Payer: Cofinity Commercial |
$8,644.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,040.98
|
| Rate for Payer: Healthscope Commercial |
$9,046.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,035.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,538.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,543.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,538.41
|
| Rate for Payer: PHP Commercial |
$8,543.54
|
| Rate for Payer: Priority Health SBD |
$6,332.27
|
| Rate for Payer: UMR Bronson Commercial |
$4,422.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,538.41
|
|
