|
HC IR MYELOGRAM THORACIC
|
Facility
|
IP
|
$1,033.41
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$454.70 |
| Max. Negotiated Rate |
$930.07 |
| Rate for Payer: Aetna American Axle |
$671.72
|
| Rate for Payer: Aetna Commercial |
$878.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$671.72
|
| Rate for Payer: Cash Price |
$826.73
|
| Rate for Payer: Cofinity Advantage |
$723.39
|
| Rate for Payer: Cofinity Commercial |
$888.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$826.73
|
| Rate for Payer: Healthscope Commercial |
$930.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$723.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$775.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$878.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$775.06
|
| Rate for Payer: PHP Commercial |
$878.40
|
| Rate for Payer: Priority Health SBD |
$651.05
|
| Rate for Payer: UMR Bronson Commercial |
$454.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$775.06
|
|
|
HC IR MYELOGRAM THORACIC
|
Facility
|
OP
|
$1,033.41
|
|
|
Service Code
|
CPT 72255
|
| Hospital Charge Code |
32000054
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$155.96 |
| Max. Negotiated Rate |
$2,526.00 |
| Rate for Payer: Aetna American Axle |
$671.72
|
| Rate for Payer: Aetna Commercial |
$878.40
|
| Rate for Payer: Aetna Medicare |
$812.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$671.72
|
| 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 |
$155.96
|
| Rate for Payer: BCN Commercial |
$155.96
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: Cash Price |
$826.73
|
| Rate for Payer: Cash Price |
$826.73
|
| Rate for Payer: Cofinity Advantage |
$723.39
|
| Rate for Payer: Cofinity Commercial |
$888.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$826.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.10
|
| Rate for Payer: Healthscope Commercial |
$930.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$723.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$775.06
|
| 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 |
$878.40
|
| Rate for Payer: Nomi Health Commercial |
$2,343.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$775.06
|
| Rate for Payer: PACE Medicare |
$742.04
|
| Rate for Payer: PACE SWMI |
$781.10
|
| Rate for Payer: PHP Commercial |
$878.40
|
| 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 |
$651.05
|
| 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) |
$671.72
|
| Rate for Payer: UHC Core |
$538.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$781.10
|
| Rate for Payer: UHC Exchange |
$406.13
|
| Rate for Payer: UHC Medicaid |
$408.52
|
| Rate for Payer: UHCCP Medicaid |
$408.52
|
| Rate for Payer: UMR Bronson Commercial |
$382.36
|
| Rate for Payer: VA VA |
$781.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$775.06
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
OP
|
$1,388.07
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$212.61 |
| Max. Negotiated Rate |
$2,526.00 |
| Rate for Payer: Aetna American Axle |
$902.25
|
| Rate for Payer: Aetna Commercial |
$1,179.86
|
| Rate for Payer: Aetna Medicare |
$812.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$902.25
|
| 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 |
$212.61
|
| Rate for Payer: BCN Commercial |
$212.61
|
| Rate for Payer: BCN Medicare Advantage |
$781.10
|
| Rate for Payer: Cash Price |
$1,110.46
|
| Rate for Payer: Cash Price |
$1,110.46
|
| Rate for Payer: Cofinity Advantage |
$971.65
|
| Rate for Payer: Cofinity Commercial |
$1,193.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,110.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$781.10
|
| Rate for Payer: Healthscope Commercial |
$1,249.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$971.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,041.05
|
| 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 |
$1,179.86
|
| Rate for Payer: Nomi Health Commercial |
$2,343.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,041.05
|
| Rate for Payer: PACE Medicare |
$742.04
|
| Rate for Payer: PACE SWMI |
$781.10
|
| Rate for Payer: PHP Commercial |
$1,179.86
|
| 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 |
$874.48
|
| 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) |
$902.25
|
| Rate for Payer: UHC Core |
$723.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$781.10
|
| Rate for Payer: UHC Exchange |
$545.51
|
| Rate for Payer: UHC Medicaid |
$408.52
|
| Rate for Payer: UHCCP Medicaid |
$408.52
|
| Rate for Payer: UMR Bronson Commercial |
$513.59
|
| Rate for Payer: VA VA |
$781.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,041.05
|
|
|
HC IR MYELOGRAM TWO OR MORE REGIO
|
Facility
|
IP
|
$1,388.07
|
|
|
Service Code
|
CPT 72270
|
| Hospital Charge Code |
32000056
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$610.75 |
| Max. Negotiated Rate |
$1,249.26 |
| Rate for Payer: Aetna American Axle |
$902.25
|
| Rate for Payer: Aetna Commercial |
$1,179.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$902.25
|
| Rate for Payer: Cash Price |
$1,110.46
|
| Rate for Payer: Cofinity Advantage |
$971.65
|
| Rate for Payer: Cofinity Commercial |
$1,193.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,110.46
|
| Rate for Payer: Healthscope Commercial |
$1,249.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$971.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,041.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,179.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,041.05
|
| Rate for Payer: PHP Commercial |
$1,179.86
|
| Rate for Payer: Priority Health SBD |
$874.48
|
| Rate for Payer: UMR Bronson Commercial |
$610.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,041.05
|
|
|
HC IRON BINDING CAPACITY
|
Facility
|
IP
|
$46.85
|
|
|
Service Code
|
CPT 83550
|
| Hospital Charge Code |
30100268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.61 |
| Max. Negotiated Rate |
$42.16 |
| Rate for Payer: Aetna American Axle |
$30.45
|
| Rate for Payer: Aetna Commercial |
$39.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.45
|
| Rate for Payer: Cash Price |
$37.48
|
| Rate for Payer: Cofinity Advantage |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$40.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.48
|
| Rate for Payer: Healthscope Commercial |
$42.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.14
|
| Rate for Payer: PHP Commercial |
$39.82
|
| Rate for Payer: Priority Health SBD |
$29.52
|
| Rate for Payer: UMR Bronson Commercial |
$20.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.14
|
|
|
HC IRON BINDING CAPACITY
|
Facility
|
OP
|
$46.85
|
|
|
Service Code
|
CPT 83550
|
| Hospital Charge Code |
30100268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$42.16 |
| Rate for Payer: Aetna American Axle |
$30.45
|
| Rate for Payer: Aetna Commercial |
$39.82
|
| Rate for Payer: Aetna Medicare |
$9.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.93
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: BCBS MAPPO |
$8.74
|
| Rate for Payer: BCBS Trust/PPO |
$10.11
|
| Rate for Payer: BCN Commercial |
$10.11
|
| Rate for Payer: BCN Medicare Advantage |
$8.74
|
| Rate for Payer: Cash Price |
$37.48
|
| Rate for Payer: Cash Price |
$37.48
|
| Rate for Payer: Cofinity Advantage |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$40.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.74
|
| Rate for Payer: Healthscope Commercial |
$42.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.14
|
| Rate for Payer: Mclaren Medicaid |
$8.74
|
| Rate for Payer: Mclaren Medicare |
$8.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.18
|
| Rate for Payer: Meridian Medicaid |
$9.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.82
|
| Rate for Payer: Nomi Health Commercial |
$13.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.14
|
| Rate for Payer: PACE Medicare |
$8.30
|
| Rate for Payer: PACE SWMI |
$8.74
|
| Rate for Payer: PHP Commercial |
$39.82
|
| Rate for Payer: PHP Medicare Advantage |
$8.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.74
|
| Rate for Payer: Priority Health Medicare |
$8.74
|
| Rate for Payer: Priority Health SBD |
$29.52
|
| Rate for Payer: Priority Health Tiered Network |
$6.99
|
| Rate for Payer: Railroad Medicare Medicare |
$8.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.11
|
| Rate for Payer: UHC Core |
$13.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.74
|
| Rate for Payer: UHC Exchange |
$13.11
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: UMR Bronson Commercial |
$17.33
|
| Rate for Payer: VA VA |
$8.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.14
|
|
|
HC IRON LEVEL
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
30100267
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC IRON LEVEL
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
30100267
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$3.55
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$7.48
|
| Rate for Payer: BCN Commercial |
$7.48
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$6.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$6.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$9.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.47
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: Priority Health Tiered Network |
$5.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.71
|
| Rate for Payer: UHC Core |
$9.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.47
|
| Rate for Payer: UHC Exchange |
$9.71
|
| Rate for Payer: UHC Medicaid |
$3.38
|
| Rate for Payer: UHCCP Medicaid |
$3.38
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC IR PERCUTANEOUS TUBE CHANGE
|
Facility
|
OP
|
$587.78
|
|
|
Service Code
|
CPT 75984
|
| Hospital Charge Code |
32000228
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$140.37 |
| Max. Negotiated Rate |
$529.00 |
| Rate for Payer: Aetna American Axle |
$382.06
|
| Rate for Payer: Aetna Commercial |
$499.61
|
| Rate for Payer: Aetna Medicare |
$293.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.06
|
| Rate for Payer: BCBS Complete |
$235.11
|
| Rate for Payer: BCBS Trust/PPO |
$140.37
|
| Rate for Payer: BCN Commercial |
$140.37
|
| Rate for Payer: Cash Price |
$470.22
|
| Rate for Payer: Cash Price |
$470.22
|
| Rate for Payer: Cofinity Advantage |
$411.45
|
| Rate for Payer: Cofinity Commercial |
$505.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.22
|
| Rate for Payer: Healthscope Commercial |
$529.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$411.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$440.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$470.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$499.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$440.83
|
| Rate for Payer: PHP Commercial |
$499.61
|
| Rate for Payer: Priority Health SBD |
$370.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$382.06
|
| Rate for Payer: UHC Core |
$306.23
|
| Rate for Payer: UHC Exchange |
$231.00
|
| Rate for Payer: UMR Bronson Commercial |
$217.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$440.83
|
|
|
HC IR PERCUTANEOUS TUBE CHANGE
|
Facility
|
IP
|
$587.78
|
|
|
Service Code
|
CPT 75984
|
| Hospital Charge Code |
32000228
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$258.62 |
| Max. Negotiated Rate |
$529.00 |
| Rate for Payer: Aetna American Axle |
$382.06
|
| Rate for Payer: Aetna Commercial |
$499.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.06
|
| Rate for Payer: Cash Price |
$470.22
|
| Rate for Payer: Cofinity Advantage |
$411.45
|
| Rate for Payer: Cofinity Commercial |
$505.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.22
|
| Rate for Payer: Healthscope Commercial |
$529.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$411.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$440.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$499.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$440.83
|
| Rate for Payer: PHP Commercial |
$499.61
|
| Rate for Payer: Priority Health SBD |
$370.30
|
| Rate for Payer: UMR Bronson Commercial |
$258.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$440.83
|
|
|
HC IR PLACEMENT CAROTID STENT
|
Facility
|
IP
|
$11,870.12
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
36100163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,222.85 |
| Max. Negotiated Rate |
$10,683.11 |
| Rate for Payer: Aetna American Axle |
$7,715.58
|
| Rate for Payer: Aetna Commercial |
$10,089.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,715.58
|
| Rate for Payer: Cash Price |
$9,496.10
|
| Rate for Payer: Cofinity Advantage |
$8,309.08
|
| Rate for Payer: Cofinity Commercial |
$10,208.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,496.10
|
| Rate for Payer: Healthscope Commercial |
$10,683.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,309.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,902.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,089.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,902.59
|
| Rate for Payer: PHP Commercial |
$10,089.60
|
| Rate for Payer: Priority Health SBD |
$7,478.18
|
| Rate for Payer: UMR Bronson Commercial |
$5,222.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,902.59
|
|
|
HC IR PLACEMENT CAROTID STENT
|
Facility
|
OP
|
$11,870.12
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
36100163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,391.94 |
| Max. Negotiated Rate |
$10,683.11 |
| Rate for Payer: Aetna American Axle |
$7,715.58
|
| Rate for Payer: Aetna Commercial |
$10,089.60
|
| Rate for Payer: Aetna Medicare |
$5,935.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,715.58
|
| Rate for Payer: BCBS Complete |
$4,748.05
|
| Rate for Payer: BCBS Trust/PPO |
$4,440.31
|
| Rate for Payer: BCN Commercial |
$4,440.31
|
| Rate for Payer: Cash Price |
$9,496.10
|
| Rate for Payer: Cash Price |
$9,496.10
|
| Rate for Payer: Cash Price |
$9,496.10
|
| Rate for Payer: Cofinity Advantage |
$8,309.08
|
| Rate for Payer: Cofinity Commercial |
$10,208.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,496.10
|
| Rate for Payer: Healthscope Commercial |
$10,683.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,309.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,902.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,496.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,089.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,902.59
|
| Rate for Payer: PHP Commercial |
$10,089.60
|
| Rate for Payer: Priority Health SBD |
$7,478.18
|
| Rate for Payer: UMR Bronson Commercial |
$4,391.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,902.59
|
|
|
HC IR PLACEMENT STENT INTRACRANIAL W ANGIOPLASTY
|
Facility
|
OP
|
$3,526.75
|
|
|
Service Code
|
CPT 61635
|
| Hospital Charge Code |
36100274
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,304.90 |
| Max. Negotiated Rate |
$6,378.84 |
| 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: BCBS Trust/PPO |
$6,378.84
|
| Rate for Payer: BCN Commercial |
$6,378.84
|
| Rate for Payer: Cash Price |
$2,821.40
|
| Rate for Payer: Cash Price |
$2,821.40
|
| 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 PLACEMENT STENT INTRACRANIAL W ANGIOPLASTY
|
Facility
|
IP
|
$3,526.75
|
|
|
Service Code
|
CPT 61635
|
| Hospital Charge Code |
36100274
|
|
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 PLACEMENT TIPS WITH FLUORO
|
Facility
|
IP
|
$5,510.00
|
|
|
Service Code
|
CPT 37182
|
| Hospital Charge Code |
36100147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,424.40 |
| Max. Negotiated Rate |
$4,959.00 |
| Rate for Payer: Aetna American Axle |
$3,581.50
|
| Rate for Payer: Aetna Commercial |
$4,683.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,581.50
|
| Rate for Payer: Cash Price |
$4,408.00
|
| Rate for Payer: Cofinity Advantage |
$3,857.00
|
| Rate for Payer: Cofinity Commercial |
$4,738.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,408.00
|
| Rate for Payer: Healthscope Commercial |
$4,959.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,857.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,132.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,683.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,132.50
|
| Rate for Payer: PHP Commercial |
$4,683.50
|
| Rate for Payer: Priority Health SBD |
$3,471.30
|
| Rate for Payer: UMR Bronson Commercial |
$2,424.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,132.50
|
|
|
HC IR PLACEMENT TIPS WITH FLUORO
|
Facility
|
OP
|
$5,510.00
|
|
|
Service Code
|
CPT 37182
|
| Hospital Charge Code |
36100147
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,038.70 |
| Max. Negotiated Rate |
$59,069.70 |
| Rate for Payer: Aetna American Axle |
$3,581.50
|
| Rate for Payer: Aetna Commercial |
$4,683.50
|
| Rate for Payer: Aetna Medicare |
$18,996.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,581.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,677.09
|
| Rate for Payer: BCN Commercial |
$3,677.09
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$4,408.00
|
| Rate for Payer: Cash Price |
$4,408.00
|
| Rate for Payer: Cash Price |
$4,408.00
|
| Rate for Payer: Cofinity Advantage |
$3,857.00
|
| Rate for Payer: Cofinity Commercial |
$4,738.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,408.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$4,959.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,857.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,132.50
|
| Rate for Payer: Mclaren Medicaid |
$18,265.72
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$19,179.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,683.50
|
| Rate for Payer: Nomi Health Commercial |
$54,797.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,132.50
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$4,683.50
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59,069.70
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health SBD |
$3,471.30
|
| Rate for Payer: Priority Health Tiered Network |
$47,255.76
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: UMR Bronson Commercial |
$2,038.70
|
| Rate for Payer: VA VA |
$18,265.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,132.50
|
|
|
HC IR PLACE STENT VERTEBRAL ART EA AD
|
Facility
|
IP
|
$10,487.46
|
|
|
Service Code
|
CPT 0076T
|
| Hospital Charge Code |
36100368
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,614.48 |
| Max. Negotiated Rate |
$9,438.71 |
| Rate for Payer: Aetna American Axle |
$6,816.85
|
| Rate for Payer: Aetna Commercial |
$8,914.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,816.85
|
| Rate for Payer: Cash Price |
$8,389.97
|
| Rate for Payer: Cofinity Advantage |
$7,341.22
|
| Rate for Payer: Cofinity Commercial |
$9,019.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,389.97
|
| Rate for Payer: Healthscope Commercial |
$9,438.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,341.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,865.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,914.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,865.60
|
| Rate for Payer: PHP Commercial |
$8,914.34
|
| Rate for Payer: Priority Health SBD |
$6,607.10
|
| Rate for Payer: UMR Bronson Commercial |
$4,614.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,865.60
|
|
|
HC IR PLACE STENT VERTEBRAL ART EA AD
|
Facility
|
OP
|
$10,487.46
|
|
|
Service Code
|
CPT 0076T
|
| Hospital Charge Code |
36100368
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,880.36 |
| Max. Negotiated Rate |
$9,438.71 |
| Rate for Payer: Aetna American Axle |
$6,816.85
|
| Rate for Payer: Aetna Commercial |
$8,914.34
|
| Rate for Payer: Aetna Medicare |
$5,243.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,816.85
|
| Rate for Payer: BCBS Complete |
$4,194.98
|
| Rate for Payer: Cash Price |
$8,389.97
|
| Rate for Payer: Cofinity Advantage |
$7,341.22
|
| Rate for Payer: Cofinity Commercial |
$9,019.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,389.97
|
| Rate for Payer: Healthscope Commercial |
$9,438.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,341.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,865.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,389.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,914.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,865.60
|
| Rate for Payer: PHP Commercial |
$8,914.34
|
| Rate for Payer: Priority Health SBD |
$6,607.10
|
| Rate for Payer: UMR Bronson Commercial |
$3,880.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,865.60
|
|
|
HC IR PLACE STENT VERTEBRAL ART INIT
|
Facility
|
OP
|
$10,487.46
|
|
|
Service Code
|
CPT 0075T
|
| Hospital Charge Code |
36100367
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,880.36 |
| Max. Negotiated Rate |
$9,438.71 |
| Rate for Payer: Aetna American Axle |
$6,816.85
|
| Rate for Payer: Aetna Commercial |
$8,914.34
|
| Rate for Payer: Aetna Medicare |
$5,243.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,816.85
|
| Rate for Payer: BCBS Complete |
$4,194.98
|
| Rate for Payer: Cash Price |
$8,389.97
|
| Rate for Payer: Cofinity Advantage |
$7,341.22
|
| Rate for Payer: Cofinity Commercial |
$9,019.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,389.97
|
| Rate for Payer: Healthscope Commercial |
$9,438.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,341.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,865.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,389.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,914.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,865.60
|
| Rate for Payer: PHP Commercial |
$8,914.34
|
| Rate for Payer: Priority Health SBD |
$6,607.10
|
| Rate for Payer: UMR Bronson Commercial |
$3,880.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,865.60
|
|
|
HC IR PLACE STENT VERTEBRAL ART INIT
|
Facility
|
IP
|
$10,487.46
|
|
|
Service Code
|
CPT 0075T
|
| Hospital Charge Code |
36100367
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,614.48 |
| Max. Negotiated Rate |
$9,438.71 |
| Rate for Payer: Aetna American Axle |
$6,816.85
|
| Rate for Payer: Aetna Commercial |
$8,914.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,816.85
|
| Rate for Payer: Cash Price |
$8,389.97
|
| Rate for Payer: Cofinity Advantage |
$7,341.22
|
| Rate for Payer: Cofinity Commercial |
$9,019.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,389.97
|
| Rate for Payer: Healthscope Commercial |
$9,438.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,341.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,865.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,914.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,865.60
|
| Rate for Payer: PHP Commercial |
$8,914.34
|
| Rate for Payer: Priority Health SBD |
$6,607.10
|
| Rate for Payer: UMR Bronson Commercial |
$4,614.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,865.60
|
|
|
HC IR PULMONARY
|
Facility
|
OP
|
$2,050.65
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
32000195
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$172.39 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$1,332.92
|
| Rate for Payer: Aetna Commercial |
$1,743.05
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,332.92
|
| 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 |
$172.39
|
| Rate for Payer: BCN Commercial |
$172.39
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$1,640.52
|
| Rate for Payer: Cash Price |
$1,640.52
|
| Rate for Payer: Cofinity Advantage |
$1,435.45
|
| Rate for Payer: Cofinity Commercial |
$1,763.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,640.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$1,845.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,435.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,537.99
|
| 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 |
$1,743.05
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,537.99
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$1,743.05
|
| 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 |
$1,291.91
|
| 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) |
$1,332.92
|
| Rate for Payer: UHC Core |
$1,068.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$805.91
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$758.74
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,537.99
|
|
|
HC IR PULMONARY
|
Facility
|
IP
|
$2,050.65
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
32000195
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$902.29 |
| Max. Negotiated Rate |
$1,845.59 |
| Rate for Payer: Aetna American Axle |
$1,332.92
|
| Rate for Payer: Aetna Commercial |
$1,743.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,332.92
|
| Rate for Payer: Cash Price |
$1,640.52
|
| Rate for Payer: Cofinity Advantage |
$1,435.45
|
| Rate for Payer: Cofinity Commercial |
$1,763.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,640.52
|
| Rate for Payer: Healthscope Commercial |
$1,845.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,435.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,537.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,743.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,537.99
|
| Rate for Payer: PHP Commercial |
$1,743.05
|
| Rate for Payer: Priority Health SBD |
$1,291.91
|
| Rate for Payer: UMR Bronson Commercial |
$902.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,537.99
|
|
|
HC IR PULMONARY BILATERAL
|
Facility
|
OP
|
$3,569.52
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
32000196
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$175.68 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$2,320.19
|
| Rate for Payer: Aetna Commercial |
$3,034.09
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.19
|
| 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 |
$175.68
|
| Rate for Payer: BCN Commercial |
$175.68
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,855.62
|
| Rate for Payer: Cash Price |
$2,855.62
|
| Rate for Payer: Cofinity Advantage |
$2,498.66
|
| Rate for Payer: Cofinity Commercial |
$3,069.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,855.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,212.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,498.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.14
|
| 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 |
$3,034.09
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,677.14
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,034.09
|
| 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 |
$2,248.80
|
| 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) |
$2,320.19
|
| Rate for Payer: UHC Core |
$1,859.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$1,402.82
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,320.72
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.14
|
|
|
HC IR PULMONARY BILATERAL
|
Facility
|
IP
|
$3,569.52
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
32000196
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,570.59 |
| Max. Negotiated Rate |
$3,212.57 |
| Rate for Payer: Aetna American Axle |
$2,320.19
|
| Rate for Payer: Aetna Commercial |
$3,034.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.19
|
| Rate for Payer: Cash Price |
$2,855.62
|
| Rate for Payer: Cofinity Advantage |
$2,498.66
|
| Rate for Payer: Cofinity Commercial |
$3,069.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,855.62
|
| Rate for Payer: Healthscope Commercial |
$3,212.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,498.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,677.14
|
| Rate for Payer: PHP Commercial |
$3,034.09
|
| Rate for Payer: Priority Health SBD |
$2,248.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,570.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.14
|
|
|
HC IRRADIATION BLOOD PROD-EA UNIT
|
Facility
|
IP
|
$126.20
|
|
|
Service Code
|
CPT 86945
|
| Hospital Charge Code |
39000026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$55.53 |
| Max. Negotiated Rate |
$113.58 |
| Rate for Payer: Aetna American Axle |
$82.03
|
| Rate for Payer: Aetna Commercial |
$107.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.03
|
| Rate for Payer: Cash Price |
$100.96
|
| Rate for Payer: Cofinity Advantage |
$88.34
|
| Rate for Payer: Cofinity Commercial |
$108.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.96
|
| Rate for Payer: Healthscope Commercial |
$113.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.65
|
| Rate for Payer: PHP Commercial |
$107.27
|
| Rate for Payer: Priority Health SBD |
$79.51
|
| Rate for Payer: UMR Bronson Commercial |
$55.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.65
|
|
