|
HC IR INSERTION CHEST PORT ABOVE 5 YRS AGE
|
Facility
|
IP
|
$5,103.92
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
36100125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,245.72 |
| Max. Negotiated Rate |
$4,593.53 |
| Rate for Payer: Aetna American Axle |
$3,317.55
|
| Rate for Payer: Aetna Commercial |
$4,338.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,317.55
|
| Rate for Payer: Cash Price |
$4,083.14
|
| Rate for Payer: Cofinity Advantage |
$3,572.74
|
| Rate for Payer: Cofinity Commercial |
$4,389.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,083.14
|
| Rate for Payer: Healthscope Commercial |
$4,593.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,572.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,827.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,338.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,827.94
|
| Rate for Payer: PHP Commercial |
$4,338.33
|
| Rate for Payer: Priority Health SBD |
$3,215.47
|
| Rate for Payer: UMR Bronson Commercial |
$2,245.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,827.94
|
|
|
HC IR INSERTION CHEST PORT LESS THAN 5 YRS AGE
|
Facility
|
IP
|
$4,665.30
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
36100124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,052.73 |
| Max. Negotiated Rate |
$4,198.77 |
| Rate for Payer: Aetna American Axle |
$3,032.45
|
| Rate for Payer: Aetna Commercial |
$3,965.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,032.45
|
| Rate for Payer: Cash Price |
$3,732.24
|
| Rate for Payer: Cofinity Advantage |
$3,265.71
|
| Rate for Payer: Cofinity Commercial |
$4,012.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,732.24
|
| Rate for Payer: Healthscope Commercial |
$4,198.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,265.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,498.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,965.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,498.97
|
| Rate for Payer: PHP Commercial |
$3,965.51
|
| Rate for Payer: Priority Health SBD |
$2,939.14
|
| Rate for Payer: UMR Bronson Commercial |
$2,052.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,498.97
|
|
|
HC IR INSERTION CHEST PORT LESS THAN 5 YRS AGE
|
Facility
|
OP
|
$4,665.30
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
36100124
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$3,032.45
|
| Rate for Payer: Aetna Commercial |
$3,965.51
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,032.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,400.27
|
| Rate for Payer: BCN Commercial |
$2,400.27
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,732.24
|
| Rate for Payer: Cash Price |
$3,732.24
|
| Rate for Payer: Cash Price |
$3,732.24
|
| Rate for Payer: Cofinity Advantage |
$3,265.71
|
| Rate for Payer: Cofinity Commercial |
$4,012.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,732.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$4,198.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,265.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,498.97
|
| 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 |
$3,965.51
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,498.97
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,965.51
|
| 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 |
$2,939.14
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,726.16
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,498.97
|
|
|
HC IR INSERT TUNNEL PERI CATH W PORT
|
Facility
|
IP
|
$4,963.24
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
36100366
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,183.83 |
| Max. Negotiated Rate |
$4,466.92 |
| Rate for Payer: Aetna American Axle |
$3,226.11
|
| Rate for Payer: Aetna Commercial |
$4,218.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,226.11
|
| Rate for Payer: Cash Price |
$3,970.59
|
| Rate for Payer: Cofinity Advantage |
$3,474.27
|
| Rate for Payer: Cofinity Commercial |
$4,268.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,970.59
|
| Rate for Payer: Healthscope Commercial |
$4,466.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,474.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,722.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,218.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,722.43
|
| Rate for Payer: PHP Commercial |
$4,218.75
|
| Rate for Payer: Priority Health SBD |
$3,126.84
|
| Rate for Payer: UMR Bronson Commercial |
$2,183.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,722.43
|
|
|
HC IR INSERT TUNNEL PERI CATH W PORT
|
Facility
|
OP
|
$4,963.24
|
|
|
Service Code
|
CPT 49419
|
| Hospital Charge Code |
36100366
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,836.40 |
| Max. Negotiated Rate |
$17,930.33 |
| Rate for Payer: Aetna American Axle |
$3,226.11
|
| Rate for Payer: Aetna Commercial |
$4,218.75
|
| Rate for Payer: Aetna Medicare |
$5,766.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,226.11
|
| 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 |
$2,747.24
|
| Rate for Payer: BCN Commercial |
$2,747.24
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Cash Price |
$3,970.59
|
| Rate for Payer: Cash Price |
$3,970.59
|
| Rate for Payer: Cash Price |
$3,970.59
|
| Rate for Payer: Cofinity Advantage |
$3,474.27
|
| Rate for Payer: Cofinity Commercial |
$4,268.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,970.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Healthscope Commercial |
$4,466.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,474.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,722.43
|
| 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 |
$4,218.75
|
| Rate for Payer: Nomi Health Commercial |
$16,633.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,722.43
|
| Rate for Payer: PACE Medicare |
$5,267.26
|
| Rate for Payer: PACE SWMI |
$5,544.48
|
| Rate for Payer: PHP Commercial |
$4,218.75
|
| 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 |
$3,126.84
|
| Rate for Payer: Priority Health Tiered Network |
$14,344.26
|
| Rate for Payer: Railroad Medicare Medicare |
$5,544.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,544.48
|
| Rate for Payer: UHC Medicaid |
$2,899.76
|
| Rate for Payer: UHCCP Medicaid |
$2,899.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,836.40
|
| Rate for Payer: VA VA |
$5,544.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,722.43
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
OP
|
$2,015.23
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$265.97 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$1,309.90
|
| Rate for Payer: Aetna Commercial |
$1,712.95
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,309.90
|
| 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 |
$265.97
|
| Rate for Payer: BCN Commercial |
$265.97
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$1,612.18
|
| Rate for Payer: Cash Price |
$1,612.18
|
| Rate for Payer: Cofinity Advantage |
$1,410.66
|
| Rate for Payer: Cofinity Commercial |
$1,733.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$1,813.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,410.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,511.42
|
| 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 |
$1,712.95
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,511.42
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$1,712.95
|
| 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 |
$1,269.59
|
| 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) |
$1,309.90
|
| Rate for Payer: UHC Core |
$1,049.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$791.99
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$745.64
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,511.42
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM
|
Facility
|
IP
|
$2,015.23
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$886.70 |
| Max. Negotiated Rate |
$1,813.71 |
| Rate for Payer: Aetna American Axle |
$1,309.90
|
| Rate for Payer: Aetna Commercial |
$1,712.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,309.90
|
| Rate for Payer: Cash Price |
$1,612.18
|
| Rate for Payer: Cofinity Advantage |
$1,410.66
|
| Rate for Payer: Cofinity Commercial |
$1,733.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,612.18
|
| Rate for Payer: Healthscope Commercial |
$1,813.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,410.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,511.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,712.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,511.42
|
| Rate for Payer: PHP Commercial |
$1,712.95
|
| Rate for Payer: Priority Health SBD |
$1,269.59
|
| Rate for Payer: UMR Bronson Commercial |
$886.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,511.42
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
OP
|
$2,639.16
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$265.97 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$1,715.45
|
| Rate for Payer: Aetna Commercial |
$2,243.29
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,715.45
|
| 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 |
$265.97
|
| Rate for Payer: BCN Commercial |
$265.97
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,111.33
|
| Rate for Payer: Cash Price |
$2,111.33
|
| Rate for Payer: Cofinity Advantage |
$1,847.41
|
| Rate for Payer: Cofinity Commercial |
$2,269.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,111.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,375.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,847.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,979.37
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,243.29
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,979.37
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$2,243.29
|
| 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 |
$1,662.67
|
| 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) |
$1,715.45
|
| Rate for Payer: UHC Core |
$1,375.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$1,037.19
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$976.49
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,979.37
|
|
|
HC IR INTERNAL MAMM ARTERIOGRAM BILAT
|
Facility
|
IP
|
$2,639.16
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
32000199
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,161.23 |
| Max. Negotiated Rate |
$2,375.24 |
| Rate for Payer: Aetna American Axle |
$1,715.45
|
| Rate for Payer: Aetna Commercial |
$2,243.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,715.45
|
| Rate for Payer: Cash Price |
$2,111.33
|
| Rate for Payer: Cofinity Advantage |
$1,847.41
|
| Rate for Payer: Cofinity Commercial |
$2,269.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,111.33
|
| Rate for Payer: Healthscope Commercial |
$2,375.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,847.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,979.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,243.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,979.37
|
| Rate for Payer: PHP Commercial |
$2,243.29
|
| Rate for Payer: Priority Health SBD |
$1,662.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,161.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,979.37
|
|
|
HC IR IV LITHROTRP IVT W IN SAME ART
|
Facility
|
IP
|
$12,417.99
|
|
|
Service Code
|
CPT 37262
|
| Hospital Charge Code |
36100654
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,463.92 |
| Max. Negotiated Rate |
$11,176.19 |
| Rate for Payer: Aetna American Axle |
$8,071.69
|
| Rate for Payer: Aetna Commercial |
$10,555.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,071.69
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cofinity Advantage |
$8,692.59
|
| Rate for Payer: Cofinity Commercial |
$10,679.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,934.39
|
| Rate for Payer: Healthscope Commercial |
$11,176.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,692.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,313.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,555.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,313.49
|
| Rate for Payer: PHP Commercial |
$10,555.29
|
| Rate for Payer: Priority Health SBD |
$7,823.33
|
| Rate for Payer: UMR Bronson Commercial |
$5,463.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,313.49
|
|
|
HC IR IV LITHROTRP IVT W IN SAME ART
|
Facility
|
OP
|
$12,417.99
|
|
|
Service Code
|
CPT 37262
|
| Hospital Charge Code |
36100654
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,594.66 |
| Max. Negotiated Rate |
$11,176.19 |
| Rate for Payer: Aetna American Axle |
$8,071.69
|
| Rate for Payer: Aetna Commercial |
$10,555.29
|
| Rate for Payer: Aetna Medicare |
$6,208.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,071.69
|
| Rate for Payer: BCBS Complete |
$4,967.20
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cofinity Advantage |
$8,692.59
|
| Rate for Payer: Cofinity Commercial |
$10,679.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,934.39
|
| Rate for Payer: Healthscope Commercial |
$11,176.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,692.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,313.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,934.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,555.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,313.49
|
| Rate for Payer: PHP Commercial |
$10,555.29
|
| Rate for Payer: Priority Health SBD |
$7,823.33
|
| Rate for Payer: UMR Bronson Commercial |
$4,594.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,313.49
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$1,462.47
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$643.49 |
| Max. Negotiated Rate |
$1,316.22 |
| Rate for Payer: Aetna American Axle |
$950.61
|
| Rate for Payer: Aetna Commercial |
$1,243.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$950.61
|
| Rate for Payer: Cash Price |
$1,169.98
|
| Rate for Payer: Cofinity Advantage |
$1,023.73
|
| Rate for Payer: Cofinity Commercial |
$1,257.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,169.98
|
| Rate for Payer: Healthscope Commercial |
$1,316.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,023.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,096.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,243.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,096.85
|
| Rate for Payer: PHP Commercial |
$1,243.10
|
| Rate for Payer: Priority Health SBD |
$921.36
|
| Rate for Payer: UMR Bronson Commercial |
$643.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,096.85
|
|
|
HC IR LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$1,462.47
|
|
|
Service Code
|
CPT 62328
|
| Hospital Charge Code |
36100578
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$2,274.56 |
| Rate for Payer: Aetna American Axle |
$950.61
|
| Rate for Payer: Aetna Commercial |
$1,243.10
|
| Rate for Payer: Aetna Medicare |
$731.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$950.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$865.33
|
| Rate for Payer: BCN Commercial |
$865.33
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$1,169.98
|
| Rate for Payer: Cash Price |
$1,169.98
|
| Rate for Payer: Cash Price |
$1,169.98
|
| Rate for Payer: Cofinity Advantage |
$1,023.73
|
| Rate for Payer: Cofinity Commercial |
$1,257.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,169.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$1,316.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,023.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,096.85
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$738.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,243.10
|
| Rate for Payer: Nomi Health Commercial |
$2,110.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,096.85
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$1,243.10
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,274.56
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health SBD |
$921.36
|
| Rate for Payer: Priority Health Tiered Network |
$1,819.65
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UMR Bronson Commercial |
$541.11
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,096.85
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
IP
|
$1,115.76
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$490.93 |
| Max. Negotiated Rate |
$1,004.18 |
| Rate for Payer: Aetna American Axle |
$725.24
|
| Rate for Payer: Aetna Commercial |
$948.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$725.24
|
| Rate for Payer: Cash Price |
$892.61
|
| Rate for Payer: Cofinity Advantage |
$781.03
|
| Rate for Payer: Cofinity Commercial |
$959.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$892.61
|
| Rate for Payer: Healthscope Commercial |
$1,004.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$781.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$836.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$948.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$836.82
|
| Rate for Payer: PHP Commercial |
$948.40
|
| Rate for Payer: Priority Health SBD |
$702.93
|
| Rate for Payer: UMR Bronson Commercial |
$490.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$836.82
|
|
|
HC IR LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
OP
|
$1,115.76
|
|
|
Service Code
|
CPT 62329
|
| Hospital Charge Code |
36100579
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$367.85 |
| Max. Negotiated Rate |
$2,274.56 |
| Rate for Payer: Aetna American Axle |
$725.24
|
| Rate for Payer: Aetna Commercial |
$948.40
|
| Rate for Payer: Aetna Medicare |
$731.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$725.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$879.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$879.17
|
| Rate for Payer: BCBS Complete |
$386.27
|
| Rate for Payer: BCBS MAPPO |
$703.34
|
| Rate for Payer: BCBS Trust/PPO |
$660.18
|
| Rate for Payer: BCN Commercial |
$660.18
|
| Rate for Payer: BCN Medicare Advantage |
$703.34
|
| Rate for Payer: Cash Price |
$892.61
|
| Rate for Payer: Cash Price |
$892.61
|
| Rate for Payer: Cash Price |
$892.61
|
| Rate for Payer: Cofinity Advantage |
$781.03
|
| Rate for Payer: Cofinity Commercial |
$959.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$892.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$703.34
|
| Rate for Payer: Healthscope Commercial |
$1,004.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$781.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$836.82
|
| Rate for Payer: Mclaren Medicaid |
$703.34
|
| Rate for Payer: Mclaren Medicare |
$703.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$738.51
|
| Rate for Payer: Meridian Medicaid |
$738.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$808.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$773.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$948.40
|
| Rate for Payer: Nomi Health Commercial |
$2,110.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$836.82
|
| Rate for Payer: PACE Medicare |
$668.17
|
| Rate for Payer: PACE SWMI |
$703.34
|
| Rate for Payer: PHP Commercial |
$948.40
|
| Rate for Payer: PHP Medicare Advantage |
$703.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,274.56
|
| Rate for Payer: Priority Health Medicare |
$703.34
|
| Rate for Payer: Priority Health SBD |
$702.93
|
| Rate for Payer: Priority Health Tiered Network |
$1,819.65
|
| Rate for Payer: Railroad Medicare Medicare |
$703.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$703.34
|
| Rate for Payer: UHC Medicaid |
$367.85
|
| Rate for Payer: UHCCP Medicaid |
$367.85
|
| Rate for Payer: UMR Bronson Commercial |
$412.83
|
| Rate for Payer: VA VA |
$703.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$836.82
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
IP
|
$3,088.75
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,359.05 |
| Max. Negotiated Rate |
$2,779.88 |
| Rate for Payer: Aetna American Axle |
$2,007.69
|
| Rate for Payer: Aetna Commercial |
$2,625.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,007.69
|
| Rate for Payer: Cash Price |
$2,471.00
|
| Rate for Payer: Cofinity Advantage |
$2,162.12
|
| Rate for Payer: Cofinity Commercial |
$2,656.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,471.00
|
| Rate for Payer: Healthscope Commercial |
$2,779.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,162.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,316.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,625.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,316.56
|
| Rate for Payer: PHP Commercial |
$2,625.44
|
| Rate for Payer: Priority Health SBD |
$1,945.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,359.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,316.56
|
|
|
HC IR LYMPHANGIOGRAM BILATERAL
|
Facility
|
OP
|
$3,088.75
|
|
|
Service Code
|
CPT 75807
|
| Hospital Charge Code |
32000201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,142.84 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$2,007.69
|
| Rate for Payer: Aetna Commercial |
$2,625.44
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,007.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$4,851.24
|
| Rate for Payer: BCN Commercial |
$4,851.24
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,471.00
|
| Rate for Payer: Cash Price |
$2,471.00
|
| Rate for Payer: Cofinity Advantage |
$2,162.12
|
| Rate for Payer: Cofinity Commercial |
$2,656.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,471.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,779.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,162.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,316.56
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,625.44
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,316.56
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$2,625.44
|
| 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 |
$1,945.91
|
| 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) |
$2,007.69
|
| Rate for Payer: UHC Core |
$1,609.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$1,213.88
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,142.84
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,316.56
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
IP
|
$1,325.59
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$583.26 |
| Max. Negotiated Rate |
$1,193.03 |
| Rate for Payer: Aetna American Axle |
$861.63
|
| Rate for Payer: Aetna Commercial |
$1,126.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$861.63
|
| Rate for Payer: Cash Price |
$1,060.47
|
| Rate for Payer: Cofinity Advantage |
$927.91
|
| Rate for Payer: Cofinity Commercial |
$1,140.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,060.47
|
| Rate for Payer: Healthscope Commercial |
$1,193.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$927.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$994.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,126.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$994.19
|
| Rate for Payer: PHP Commercial |
$1,126.75
|
| Rate for Payer: Priority Health SBD |
$835.12
|
| Rate for Payer: UMR Bronson Commercial |
$583.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$994.19
|
|
|
HC IR LYMPHANGIOGRAM UNILATERAL
|
Facility
|
OP
|
$1,325.59
|
|
|
Service Code
|
CPT 75805
|
| Hospital Charge Code |
32000324
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$490.47 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$861.63
|
| Rate for Payer: Aetna Commercial |
$1,126.75
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$861.63
|
| 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 |
$1,060.47
|
| Rate for Payer: Cash Price |
$1,060.47
|
| Rate for Payer: Cofinity Advantage |
$927.91
|
| Rate for Payer: Cofinity Commercial |
$1,140.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,060.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$1,193.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$927.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$994.19
|
| 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 |
$1,126.75
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$994.19
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$1,126.75
|
| 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 |
$835.12
|
| 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) |
$861.63
|
| Rate for Payer: UHC Core |
$690.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$520.96
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$490.47
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$994.19
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
IP
|
$594.95
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$261.78 |
| Max. Negotiated Rate |
$535.46 |
| Rate for Payer: Aetna American Axle |
$386.72
|
| Rate for Payer: Aetna Commercial |
$505.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.72
|
| Rate for Payer: Cash Price |
$475.96
|
| Rate for Payer: Cofinity Advantage |
$416.46
|
| Rate for Payer: Cofinity Commercial |
$511.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.96
|
| Rate for Payer: Healthscope Commercial |
$535.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$416.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.21
|
| Rate for Payer: PHP Commercial |
$505.71
|
| Rate for Payer: Priority Health SBD |
$374.82
|
| Rate for Payer: UMR Bronson Commercial |
$261.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.21
|
|
|
HC IR LYMPHATIC SYSTEM UNLISTED P
|
Facility
|
OP
|
$594.95
|
|
|
Service Code
|
CPT 38999
|
| Hospital Charge Code |
36100188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$220.13 |
| Max. Negotiated Rate |
$1,421.59 |
| Rate for Payer: Aetna American Axle |
$386.72
|
| Rate for Payer: Aetna Commercial |
$505.71
|
| Rate for Payer: Aetna Medicare |
$457.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$549.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$549.49
|
| Rate for Payer: BCBS Complete |
$241.42
|
| Rate for Payer: BCBS MAPPO |
$439.59
|
| Rate for Payer: BCBS Trust/PPO |
$400.05
|
| Rate for Payer: BCN Commercial |
$400.05
|
| Rate for Payer: BCN Medicare Advantage |
$439.59
|
| Rate for Payer: Cash Price |
$475.96
|
| Rate for Payer: Cash Price |
$475.96
|
| Rate for Payer: Cash Price |
$475.96
|
| Rate for Payer: Cofinity Advantage |
$416.46
|
| Rate for Payer: Cofinity Commercial |
$511.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$475.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.59
|
| Rate for Payer: Healthscope Commercial |
$535.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$416.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.21
|
| Rate for Payer: Mclaren Medicaid |
$439.59
|
| Rate for Payer: Mclaren Medicare |
$439.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.57
|
| Rate for Payer: Meridian Medicaid |
$461.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$505.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$483.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.71
|
| Rate for Payer: Nomi Health Commercial |
$1,318.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.21
|
| Rate for Payer: PACE Medicare |
$417.61
|
| Rate for Payer: PACE SWMI |
$439.59
|
| Rate for Payer: PHP Commercial |
$505.71
|
| Rate for Payer: PHP Medicare Advantage |
$439.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,421.59
|
| Rate for Payer: Priority Health Medicare |
$439.59
|
| Rate for Payer: Priority Health SBD |
$374.82
|
| Rate for Payer: Priority Health Tiered Network |
$1,137.27
|
| Rate for Payer: Railroad Medicare Medicare |
$439.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$439.59
|
| Rate for Payer: UHC Medicaid |
$229.91
|
| Rate for Payer: UHCCP Medicaid |
$229.91
|
| Rate for Payer: UMR Bronson Commercial |
$220.13
|
| Rate for Payer: VA VA |
$439.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.21
|
|
|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
OP
|
$3,747.95
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$190.44 |
| Max. Negotiated Rate |
$17,930.33 |
| Rate for Payer: Aetna American Axle |
$2,436.17
|
| Rate for Payer: Aetna Commercial |
$3,185.76
|
| Rate for Payer: Aetna Medicare |
$5,766.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,436.17
|
| 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 |
$190.44
|
| Rate for Payer: BCN Commercial |
$190.44
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Cash Price |
$2,998.36
|
| Rate for Payer: Cash Price |
$2,998.36
|
| Rate for Payer: Cofinity Advantage |
$2,623.57
|
| Rate for Payer: Cofinity Commercial |
$3,223.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,998.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Healthscope Commercial |
$3,373.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,623.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,810.96
|
| 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 |
$3,185.76
|
| Rate for Payer: Nomi Health Commercial |
$16,633.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,810.96
|
| Rate for Payer: PACE Medicare |
$5,267.26
|
| Rate for Payer: PACE SWMI |
$5,544.48
|
| Rate for Payer: PHP Commercial |
$3,185.76
|
| 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 |
$2,361.21
|
| 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) |
$2,436.17
|
| Rate for Payer: UHC Core |
$1,952.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,544.48
|
| Rate for Payer: UHC Exchange |
$1,472.94
|
| Rate for Payer: UHC Medicaid |
$2,899.76
|
| Rate for Payer: UHCCP Medicaid |
$2,899.76
|
| Rate for Payer: UMR Bronson Commercial |
$1,386.74
|
| Rate for Payer: VA VA |
$5,544.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,810.96
|
|
|
HC IR MESENTERIC VISCERAL ANGIOGR
|
Facility
|
IP
|
$3,747.95
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
32000193
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,649.10 |
| Max. Negotiated Rate |
$3,373.16 |
| Rate for Payer: Aetna American Axle |
$2,436.17
|
| Rate for Payer: Aetna Commercial |
$3,185.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,436.17
|
| Rate for Payer: Cash Price |
$2,998.36
|
| Rate for Payer: Cofinity Advantage |
$2,623.57
|
| Rate for Payer: Cofinity Commercial |
$3,223.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,998.36
|
| Rate for Payer: Healthscope Commercial |
$3,373.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,623.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,810.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,185.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,810.96
|
| Rate for Payer: PHP Commercial |
$3,185.76
|
| Rate for Payer: Priority Health SBD |
$2,361.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,649.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,810.96
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
OP
|
$937.08
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$168.28 |
| Max. Negotiated Rate |
$2,526.00 |
| Rate for Payer: Aetna American Axle |
$609.10
|
| Rate for Payer: Aetna Commercial |
$796.52
|
| Rate for Payer: Aetna Medicare |
$812.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$976.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$976.38
|
| Rate for Payer: BCBS Complete |
$428.98
|
| Rate for Payer: BCBS MAPPO |
$781.10
|
| Rate for Payer: BCBS Trust/PPO |
$168.28
|
| Rate for Payer: BCN Commercial |
$168.28
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: Cash Price |
$749.66
|
| Rate for Payer: Cash Price |
$749.66
|
| Rate for Payer: Cofinity Advantage |
$655.96
|
| Rate for Payer: Cofinity Commercial |
$805.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.10
|
| Rate for Payer: Healthscope Commercial |
$843.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$655.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$702.81
|
| Rate for Payer: Mclaren Medicaid |
$781.10
|
| Rate for Payer: Mclaren Medicare |
$781.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$820.15
|
| Rate for Payer: Meridian Medicaid |
$820.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$898.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$859.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.52
|
| Rate for Payer: Nomi Health Commercial |
$2,343.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.81
|
| Rate for Payer: PACE Medicare |
$742.04
|
| Rate for Payer: PACE SWMI |
$781.10
|
| Rate for Payer: PHP Commercial |
$796.52
|
| Rate for Payer: PHP Medicare Advantage |
$781.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,526.00
|
| Rate for Payer: Priority Health Medicare |
$781.10
|
| Rate for Payer: Priority Health SBD |
$590.36
|
| Rate for Payer: Priority Health Tiered Network |
$2,020.80
|
| Rate for Payer: Railroad Medicare Medicare |
$781.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$609.10
|
| Rate for Payer: UHC Core |
$488.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$781.10
|
| Rate for Payer: UHC Exchange |
$368.27
|
| Rate for Payer: UHC Medicaid |
$408.52
|
| Rate for Payer: UHCCP Medicaid |
$408.52
|
| Rate for Payer: UMR Bronson Commercial |
$346.72
|
| Rate for Payer: VA VA |
$781.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$702.81
|
|
|
HC IR MYELOGRAM LUMBAR
|
Facility
|
IP
|
$937.08
|
|
|
Service Code
|
CPT 72265
|
| Hospital Charge Code |
32000055
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$412.32 |
| Max. Negotiated Rate |
$843.37 |
| Rate for Payer: Aetna American Axle |
$609.10
|
| Rate for Payer: Aetna Commercial |
$796.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$609.10
|
| Rate for Payer: Cash Price |
$749.66
|
| Rate for Payer: Cofinity Advantage |
$655.96
|
| Rate for Payer: Cofinity Commercial |
$805.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$749.66
|
| Rate for Payer: Healthscope Commercial |
$843.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$655.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$702.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$796.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$702.81
|
| Rate for Payer: PHP Commercial |
$796.52
|
| Rate for Payer: Priority Health SBD |
$590.36
|
| Rate for Payer: UMR Bronson Commercial |
$412.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$702.81
|
|
